Essentials 1 Forearm fractures are among the most common fractures seen in the emergency department (ED). 2 When the need for or potential success of reduction is being assessed, the external appearance of the limb is a key feature. 3…
Essentials 1 Fractures of the proximal humerus occur primarily in the elderly, whereas distal humeral fractures occur more often in children. 2 Falls producing fractures in elderly patients are often precipitated by an underlying medical problem that should be sought…
Essentials 1 Elbow dislocations are the third most common large joint dislocations. 2 Surgical intervention is rarely required for simple elbow dislocations. 3 Surgical intervention may be required when fractures of the radius, ulna and humerus are associated with elbow…
Essentials 1 Most clavicular fractures heal despite displacement; therefore reduction is not necessary. 2 Injuries to the shoulder region may also involve injury to local neurovascular structures. 3 Acromioclavicular joint injuries and fractures of the scapula are usually treated conservatively.…
Essentials 1 Early prediction of massive transfusion and activation of massive transfusion guidelines can ease some of challenges of resuscitation. 2 Systems should be instituted for effective prenotification of patients at risk of massive transfusion and a team-based approach to…
Essentials 1 Effective triage and advances in the treatment of severely burned patients, including judicious fluid resuscitation, control of sepsis, early excision and use of skin substitutes, have made previously lethal burns survivable. 2 Signs of impending or developed laryngeal…
Essentials 1 Good cosmesis can be achieved in the emergency department with conservative treatment, thorough debridement and accurate apposition of everted skin edges. 2 Choose a suture that is monofilament, causes little tissue reactivity and retains tensile strength until the…
Essentials 1 Trauma in pregnancy is the most common cause of non-obstetric maternal death, with most deaths due to head injury and haemorrhagic shock. 2 Fetal death occurs more often than maternal death and is dependent on the severity of…
Essentials 1 The initial trauma series x-rays should include a chest x-ray (CXR) and pelvic x-ray (PXR). Computed tomography (CT) of the cervical spine is essential to rule out a major fracture 2 CT of the brain will rule out…
Essentials 1 Optimal trauma resuscitation and fracture management will reduce limb and life-threatening complications. 2 Skin under pressure over a fracture is an orthopaedic emergency. 3 Fracture management consists of reduction, immobilization and rehabilitation. 4 Specific limb trauma assessment is…