ATLS Musculoskeletal Trauma 2

Question 1

A patient presents with a deformed, swollen thigh after a motorcycle collision. Distal pulses are weak. What is the most important initial step?

Accepted Answer

Apply traction splinting and reassess neurovascular status

Answer

Femoral shaft fractures should be managed with traction splinting to reduce pain, control hemorrhage, and restore alignment.

Question 2

Which fracture is most commonly associated with life-threatening hemorrhage?

Accepted Answer

Pelvic ring disruption

Answer

Pelvic ring disruptions can cause massive hemorrhage from the presacral venous plexus and internal iliac artery branches.

Question 3

A patient with a tibial fracture develops severe pain disproportionate to injury, pain with passive toe extension, and a tense compartment. What is the diagnosis and treatment?

Accepted Answer

Acute compartment syndrome; emergent fasciotomy

Answer

Classic compartment syndrome presentation requires emergent fasciotomy within 6 hours.

Question 4

What is the appropriate initial antibiotic for a Grade III open tibial fracture?

Accepted Answer

IV cefazolin plus an aminoglycoside

Answer

Grade III open fractures require cefazolin (gram-positive) plus aminoglycoside (gram-negative) coverage.

Question 5

24 hours after femoral fixation, a patient develops sudden dyspnea, petechial rash on chest, and confusion. Most likely diagnosis?

Accepted Answer

Fat embolism syndrome

Answer

The triad of respiratory distress, petechial rash, and neurological changes 24-72 hours after long bone fracture is classic for fat embolism syndrome.

ATLS - Advanced Trauma Life Support Practice Test

ATLS - Advanced Trauma Life Support Practice Test

ATLS Musculoskeletal Trauma 2