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Trauma

Trauma . Spring 2010 FINAL. Some Trauma Stats. Most common cause of death for those 1-44 years of age Medical costs for trauma 200 billion annually Mostly results from MVA, unintentional accidents, gunshot wounds, stabbing, fights, domestic violence. Trimodal Distribution.

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Trauma

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  1. Trauma Spring 2010 FINAL

  2. Some Trauma Stats • Most common cause of death for those • 1-44 years of age • Medical costs for trauma • 200 billion annually • Mostly results from MVA, unintentional accidents, gunshot wounds, stabbing, fights, domestic violence

  3. Trimodal Distribution ImmediateEarly Late

  4. Immediate Deaths Lacerations of the brain and spinal cord Lacerations of the heart or great vessels

  5. Early Deaths • Within first 4 hours • Intracranial hemorrhage • Lacerations of liver or spleen • Significant blood loss Liver laceration with extravasation

  6. Early Deaths • Within first 4 hours • Intracranial hemorrhage • Lacerations of liver or spleen • Significant blood loss Liver laceration with extravasation

  7. Late Deaths • Weeks after injury • Infection and multiple organ failure

  8. Level 1 Usually in large metro areas and serve as both primary and tertiary care institutions Must be avail 24 hrs Must treat 1200 admissions or 240 major trauma patients per year Level II Can transport to level I when necessary Serve smaller cites and towns Must be avail 24 hrs Level III Remote and rural areas On call on nights and weekends Level I, II & III Trauma Centers

  9. Skeletal Trauma

  10. Fracture Classifications

  11. FRACTURE TYPES

  12. Closed reduction

  13. Open Reduction

  14. OPEN FRACTURES

  15. Open Fracture • Bone has penetrated skin • May lead to infection • Precautions must be taken to prevent infection from setting into the bone

  16. Closed Fracture • Skin is not penetrated • Fractures can be classified by the mechanics of the stress that caused the break • Torsion • Transverse linear • Spiral

  17. Closed Fracture- Clavicle

  18. Forearm Closed fracture

  19. Impacted Fracture- Wrist • When the fractured bone is jammed into the cancellous tissue of another fragment

  20. Impacted Fracture- Hip

  21. Fibular Impacted Fracture

  22. Comminuted Fracture • Do not represent the full thickness of the bone. • Usually extensively shattered • Particularly apt to be open fractures

  23. Comminuted Fracture

  24. Comminuted Fracture

  25. Non-Comminuted Fracture

  26. Non-Comminuted Fracture • Complete fracture in which the bone is separated into to fragments • Can be classified according to the direction of its fracture line • Spiral or oblique • Transverse

  27. Avulsion Fracture • Fragment of the bone is pulled away from the shaft • Occur around the joints because of ligaments, tendons, muscles, associated with sprain or dislocation

  28. Avulsion Fracture

  29. Avulsion Fracture

  30. Incomplete Fracture • Part of bony structure gives way with little no displacement • Common example is a greenstick fracture • Torus fracture

  31. Greenstick :Incomplete Fracture • Cortex breaks on one side without separation or breaking of the opposite cortex • Found almost exclusively in children under the age of 10

  32. Incomplete Fracture

  33. Greenstick Fracture

  34. Greenstick Fracture

  35. Greenstick Fracture

  36. Torus: Incomplete Fracture • AKA Buckle Fracture • It is a greenstick fracture • Cortex bulges outward producing a slight irregularity

  37. Torus Fracture

  38. Growth Plate Fracture • Involve the end of the long bone • Not visible unless displacement occurs • Classified according to severity • Salter-Harris System • I-IV • Based on degree of epiphysis involvement

  39. Growth Plate Fracture

  40. Growth Plate Fracture

  41. Stress Fracture • Results from an abnormal degree of repetition • Generally found where muscles attachments are • EX: runners at tib/fib • Not always seen on plain x-ray

  42. Stress Fracture

  43. Stress Fracture

  44. Occult Fracture • Gives clinical symptoms without radiologic evidence • 10 days later may show repairing itself or displacement

  45. Occult Fracture

  46. Occult Fracture

  47. Colles Fracture • Fracture through distal inch of the radius • Distal fragment angled backward on the shaft • Impaction along dorsal aspect • Avulsion fx of the styloid process

  48. Colles Fracture

  49. Boxer’s Fracture

  50. Monteggia’s Fracture Fx of the proximal 1/3 of the ulnar shaft

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