Introduction
Millions of cases annually.
Multiple MOI :
Falls, Automobile collisions, Crashes,
Violence, etc
Multi-system trauma
Structures
Skin
Bones
Joints where bones interact
Muscles
Tendons - connect muscle to bone
Ligaments - connect bone to bone
Neurovascular
The Skeleton
Types of Muscles
The Neurovascular
Function
Protects organs
Allows for efficient movement
Stores salts and other materials needed
for metabolism
Produces RBCis
Scaffolding / Support
Pathophysiology of the
Musculoskeletal System
Scene Size-up
Initial Assessment
Focused history and physical exam
Rapid Trauma Assessment
Scene Size-up
Initial Assessment
Focused history and physical exam
Rapid Trauma Assessment
Scene Size-up
Initial Assessment
Focused history and physical exam
Rapid Trauma Assessment
Scene Size-up
Initial Assessment
Focused history and physical exam
Rapid Trauma Assessment
Scene Size-up
Initial Assessment
Focused history and physical exam
Rapid Trauma Assessment
General Principles
Protecting Open Wounds
Positioning the limb
Immobilizing the injury
Checking Neurovascular Function
Immobilizing a joint
Preoperative
Debridement + necrotomy
Bone Fixation
COMPARTMENT
SYNDROME
Compartment Syndrome
Occurs when pressure w/i soft tissues in a
fixed body compartment increases to level
that exceeds venous pressure,
compromising venous blood flow, and
limiting capillary perfusion.
Leads to muscle ischemia and necrosis.
TRUE ORTHOPEDIC EMERGENCY
Compartment Syndrome
Contributing Factors
External:
Conditions that reduced size of muscle
compartment (casts/splints); occlusive
dressing; eschar of burns
Internal:
Conditions that increase compartment
volume: bleeding, swelling, fluid
extravasation into tissue
CS-Recognition
Suspect with long bone fx, crush injuries, Fxs
associated w/ significant vascular injuries or
pronounced swelling.
Presents as pain out of proportion to physical
findings, +/- hypoesthesia, pulselessness (late).
Compartment Syndrome
Intra-compartment pressures must be measured once
the issue of compartment syndrome is raised.
Summary
Musculoskeletal system extends into all
parts of the body
Musculoskeletal trauma usually not life
threatening
Proper recognition and treatment is very
important to avoid permanent disability
Thank You