2 - Local Complications of Fractures - D3

2 - Local Complications of Fractures - D3 - Local...

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Unformatted text preview: Local Complications of Fractures :Presented by Ahmed Khaled Alshammari www.icareunit.com Early complications Early visceral injury.1 vascular injury.2 compartment syndrome.3 nerve injury.4 infections.5 hemarthrosis.6 There is no accepted time for a complication to be considered ‘early’, but the term is usually applied to complications that occur during the .acute phase of treatment www.icareunit.com www.icareunit.com www.icareunit.com www.icareunit.com :Clinical features www.icareunit.com .Fractures commonly associated with vascular injury Injury Injury Vessel 1st rib fracture subclavian Shoulder dislocation Axillary Humeral supracondylar Humeral fracture fracture Brachial Elbow dislocation Brachial Pelvic fracture Presacral and internal iliac Presacral Femoral supracondylar Femoral fracture fracture Femoral Knee dislocation Popliteal Proximal tibial fracture Popliteal or its branches www.icareunit.com www.icareunit.com www.icareunit.com Closed Injuries The nerve is rarely severely affected (just neuropraxia or axontmesis) and spontaneous recovery is usually the role. If not; the nerve should be explored because it sometimes trapped between the fragment and occasionally it is found to be divided and more likely to be completely injured. And should be explored during wound debridement or in 2nd operation. www.icareunit.com Open Injuries www.icareunit.com Injury Injury nerve 1. Shoulder dislocation Axillary 2. Humeral shaft fracture Radial 3. Lower end of radius Median 4. Humeral supracondylar (esp. children) (esp. Radial or Radial median(ant.interosseous) median(ant.interosseous) 5. Medial condyle Ulnar 6. Elbow dislocation 7. Hip dislocation Ulnar Sciatic 8. Knee dislocation 9. Fracture of fibular neck Peroneal Peroneal www.icareunit.com www.icareunit.com www.icareunit.com www.icareunit.com ischemia Reduction of blood flow edema Arterial damage Increase pressure Direct injury www.icareunit.com www.icareunit.com Don’t wait for the obvious sings of ischemia to appear. If you suspect An impending compartment syndrome, start treatment straightaway www.icareunit.com www.icareunit.com www.icareunit.com www.icareunit.com www.icareunit.com Thank You www.icareunit.com ...
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