You are posted as an intern in causality. Which among the following patients with fracture will be your 1st priority to call Orthopedic postgraduate and inform?
Correct Answer: Patient's finger is blackening
Description: (A) Patient's finger is blackeningOf all the given choices in the question, the patient's blackening of finger is to be given top most priority, as it may be due to Vascular injury, that is complicating as impending danger of gangrenous digit after fracture.Hence, it should be given as first priority to informed to the Orthopedic senior postgraduate to tackle the problem.[?]GANGRENE:Indirect Traumatic Gangrene: Interference with blood vessels from pressure by a fractured bones/strangulationThrombosis of an arteryLigation of an arteryPoor technique for digital anesthesiaErgot - Claviceps purpurea.Fingers, nose & ears.Seen in migraine suffers. Arterial injuries associated with fractures or dislocationsClavicle fractureSubclavian arteryShoulder Fracture/dislocationAxillary arterySupracondylar humerus fractureBrachial arteryElbow dislocationBrachial arteryPelvic fractureGluteal arteries Iliac arteriesFemoral shaft fractureFemoral arteryDistal femur fracturePopliteal arteryKnee dislocationPopliteal arteryTibial shaft fractureTibial arteries Post-traumatic:60% of all gas gangreneAutomobile collisions.Other complications of trauma: Crush injuries; Compound fractures; Gunshot wounds; Thermal; Electrical burns; FrostbiteFarm or industrial injuries contaminated with soilRare causes- IM or SC injections with insulin, epinephrine, quinine, or cocaineManagement of arterial injury:Urgent surgical exposure as early as circumstances allow, preferably within six hours of injury."Look & See" is wiser than "wait and see".Every effort should be made to repair arterial damage.After major arterial ligation the incidence of limb gangrene is very high.Fractures should be fixed after vascular surgery.
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Orthopaedics
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