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Extremity trauma
From WikEM
Contents
Background
- Can result in soft tissue, neurovascular, muscular, and ligamentous damage
Clinical Features
Limb salvage is based of several features (See calculator below):
- Age
- Severity of skeletal and soft tissue injury
- Severity of limb ischemia
- Duration of limb ischemia
- Severity of shock
Differential Diagnosis
Extremity trauma
- Peripheral nerve injury
- Vascular injury
- Tendon injury
- Laceration
- Fracture
- Open joint injury
- Crush syndrome
- Compartment syndrome
- Rhabdomyolysis
- Contusion
- Myositis ossificans
Evaluation
Workup
- ATLS
- X-rays
- Trauma labs with close attention to K, Creat, and CK
- Consider CTA or conventional angiography if evidence for vascular compromise
Management
- ATLS protocols if unstable
- Consider use of tourniquet
- Can be an excellent adjunct to control bleeding
- Tetanus
- Antibiotics
- Cefazolin 2g IV
- Consider adding Gentamycin or Tobramycin
- Additional treatments depending on specific findings
Disposition
- May require admission with trauma team with consultation from ortho and/or vascular surgery
