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LOWER LIMB FRACTURE Complications

Specialists Without Borders Seminar in Surgery Rwanda, September 2010. LOWER LIMB FRACTURE Complications. Professor Jegan Krishnan Flinders University Adelaide, South Australia. www.specialistswithoutborders.org. Learning Objectives. Identifying the common lower limb

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LOWER LIMB FRACTURE Complications

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  1. Specialists Without Borders Seminar in Surgery Rwanda, September 2010 LOWER LIMB FRACTUREComplications Professor Jegan Krishnan Flinders University Adelaide, South Australia

  2. www.specialistswithoutborders.org Learning Objectives • Identifying the common lower limb fracture complications • Early assessment and management • Prevention of complications

  3. www.specialistswithoutborders.org Infection • Infection at fracture prevented by early and maticulouss debridement • Early appropriate antibiotics • Fracture stabilisation • Soft tissue coverage

  4. www.specialistswithoutborders.org Compartment Syndrome • Most common fracture complication missed • Early assessment • Clinical features • Compartment Pressure Measurements • Early Fasciotomy

  5. www.specialistswithoutborders.org Vascular Injury • Early recognition • Early Investigation • Vascular Surgery Consultation • Reanastomosis

  6. www.specialistswithoutborders.org Vascular Injury

  7. www.specialistswithoutborders.org Neurological Injury • Early assessment both pre-reduction and post reduction • Majority of injuries are neuropraxia • When to explore is a tricky decision

  8. www.specialistswithoutborders.org Neuropraxia • Early recognition • Determine level of injury • Observe recovery rate • Nerve conduction test and EMG • Explore if recovery rate not progressing as expected

  9. www.specialistswithoutborders.org Non Union • Definition • Types – Hypertrophic – Atrophic • Management – Stabilisation – Bone Grafting

  10. www.specialistswithoutborders.org Malunion • Definition • Management

  11. www.specialistswithoutborders.org SUMMARY • Best management is prevention • Early suspicion • Early recognition • Early correction • Late corrective options are available

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