Extremity Trauma: Nonaxial Skeleton Fractures, Sprains, Dislocations

Abstract

Orthopedic extremity injuries may require emergent orthopedic consultation, but are typically managed by the acute care provider. Initial management for all fractures should focus on providing immediate analgesia and ensuring adequate blood flow distal to the fracture. This review summarizes the assessment and stabilization, diagnosis, treatment and disposition, and outcomes for fractures, dislocations, and sprains. Figures include illustrations of fracture types, carpal bones and their articlulation in the wrist, bones of the hand, the anatomy of the hip demonstrating the areas where hip fractures occur, the Weber classification, the Bohler angle, and fractures of the proximal fifth metatarsal; a bedside sonogram of a fracture of the distal radius; and 10 radiographs showing various fractures and dislocations. Tables list the Gustilo classification of open fractures; common terms used to accurately describe fractures; components of the Ottawa Knee Rules and the Ottawa Ankle/Foot Rules; Schatzker classification system of tibial plateau fractures; common fractures of the hand and foot, respectively, with their associated treatment, splint, and recommended follow-up; normal anatomic alignments that should be assessed on radiographic evaluation of a possible Lisfranc injury; common splints and the associated fractures they are used to treat; AC joint injuries graded according to the severity of injury to the joint structures; and the four stages of worsening lunate instablity. This review contains 18 highly rendered figures, 11 tables, and 98 references.