| Femoral Shaft Fracture 🦴 |
- Severe thigh pain + swelling
- Inability to bear weight
- Deformity/shortening of leg
- ⚠️ Risk of hypovolemic shock (blood loss up to 1–2 L)
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- X-ray femur (AP & lateral)
- CT if comminuted/complex
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- Initial resus (IV fluids, traction splint)
- Definitive: intramedullary nailing (gold standard)
- ORIF or external fixation if open fracture
- Rehab: early physio, weight-bearing as guided
|
| Intertrochanteric Fracture 🦯 |
- Hip pain, inability to bear weight
- Leg shortened + externally rotated
- Common in elderly post-fall
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- Hip X-ray (AP & lateral)
- CT for surgical planning if needed
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- Dynamic hip screw (stable) or intramedullary nail (unstable)
- Mobilise early to reduce DVT/pneumonia risk
- Physio + osteoporosis management
|
| Tibial Shaft Fracture 🦵 |
- Pain, swelling, deformity of shin
- Unable to bear weight
- ⚠️ Risk of compartment syndrome
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- X-ray tibia/fibula (AP & lateral)
- CT for intra-articular extension
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- Undisplaced: cast or functional brace
- Displaced: intramedullary nail or ORIF
- Monitor closely for compartment syndrome 🚨
- Rehab: progressive loading
|
| Patellar Fracture 🦿 |
- Knee pain + swelling
- Inability to extend knee / do straight-leg raise
- Palpable step in patella
|
- Knee X-ray (AP, lateral, skyline/sunrise view)
- MRI if concern for extensor mechanism injury
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- Stable, non-displaced: knee immobiliser or cylinder cast
- Displaced: ORIF (tension band wiring)
- Rehab: restore quadriceps strength
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| Ankle Fracture 👣 |
- Pain, swelling, bruising
- Unable to bear weight
- Gross deformity if severe
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- Ankle X-ray (AP, lateral, mortise views)
- CT for pilon fractures or surgical planning
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- Stable: cast or boot
- Unstable/displaced: ORIF with plates + screws
- Rehab: gradual weight-bearing, physiotherapy
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| Femoral Neck Fracture 🦯 |
- Hip pain, inability to bear weight
- Leg shortened, externally rotated
- Fragility fracture in elderly (osteoporosis)
|
- Hip X-ray (AP & lateral)
- MRI if occult fracture suspected
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- Non-displaced: internal fixation (screws)
- Displaced: hemiarthroplasty (elderly) or THR (active)
- Mobilise early; DVT prophylaxis
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| Calcaneal Fracture 🦶 |
- Severe heel pain + swelling
- Bruising to ankle/sole (Mondor’s sign)
- Inability to bear weight
|
- Foot X-ray (AP, lateral, axial)
- CT ➝ essential for surgical planning (complex intra-articular)
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- Stable: cast + non-weight bearing
- Displaced/intra-articular: ORIF
- Slow rehab — risk of chronic pain & stiffness
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