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ORTHOPAEDIC EMERGENCIES
IC3
Musculoskeletal Teaching week
Gavin OReilly
6/1/15
SEPTIC ARTHRITIS
SEPTIC ARTHRITIS
Inflammation and redness in joint
Systemically unwell may have SIRS
In children symptoms can be more subtle
Off food
Irritable
Wont use affected limb
Imaging
XR can should widened joint space
US if effusion is to be tapped
MRI if any collections / osteomyelitis present
DIAGNOSIS
TREATMENT
Treatment is wash out of joint and IV antibiotics
Samples of pus should be sent for culture and sensitivity
OPEN FRACTURES
An open fracture occurs when the skin overlying a
fracture is broken allowing communication between the
fracture and the external environment
High risk of infection
Soft tissue
Osteomyelitis
Septic arthritis
Tetanus
JOINT DISLOCATIONS
Dislocation is where a bone is put out of joint
Usually traumatic
Any dislocated joint should be reduced as soon as
possible once it is safe to do so
COMPARTMENT SYNDROME
A pain syndrome resulting from increased pressure in a
closed fascial compartments leading to microvascular
complications
Can technically occur in any closed compartment (eg
abdominal compartment syndrome)
Most commonly seen in leg
Characterized by pain disproportionate to injury
No relief from adequate analgesia
COMPARTMENT SYNDROME
MANAGEMENT
If there is concern over compartment syndrome
decompressive fasciotomy needs to be performed
All compartments should be opened
E.g. for leg all four