Makindo Medical Notes

Related Subjects: |Fractured Neck of Femur |Fractured Shaft Femur |Supracondylar Femur Fractures |Femoral fractures and Injuries

🦴 Femoral Fractures & Injuries

⚠️ In young patients, femoral injuries imply major trauma. Always X-ray hip & knee to exclude associated injuries. Consider pelvic & spinal trauma.

📌 Exam Pearls:
– NOF in <65 yrs = 🚨 emergency.
– Always check 👣 neurovascular status.
– SUFE often mimics knee pain.
– THR dislocation = theatre job, not ED unless GA + senior present.
– Native hip dislocation must be reduced <6 hrs to avoid AVN.

🦵 Knee Fractures & Injuries

🔎 Lipo-haemarthrosis on lateral XR = intra-articular injury.
💉 Aspirate for analgesia if tense haemarthrosis.
⚠️ Always check hips & abdomen if knee exam normal.

📌 Exam Pearls:
– Patella fracture vs bipartite → Skyline XR.
– Always test extensor mechanism.
– PLCI often missed → Dial test.
– Knee dislocation = vascular emergency.
– Bucket handle tear = true mechanical lock.

🦴 Tibia & Fibula Fractures

📌 Exam Pearls:
– Always document NV exam.
– Mid-shaft tibia → watch for compartment syndrome.
– Toddler’s # often occult → repeat imaging.
– Osgood–Schlatter self-limiting.
– Fibula # may mean ankle instability.

🦶 Ankle & Foot Injuries

📌 Re-XR displaced # after POP. 💡 NICE: unstable ankle # → fixation within 24–36 hrs. Discuss early with T&O.

🩹 Soft Tissue Ankle Injuries

📌 Exam Pearls:
– Always re-XR displaced # after POP.
– NV status must be documented.
– Maisonneuve # = medial + fibular head tenderness.
– Achilles rupture → calf squeeze is diagnostic.
– NICE: unstable ankle # → fixation within 24–36h.