Musculoskeletal Trauma Flashcards

Which mechanism of injury is MOST likely to produce a posterior hip dislocation?

Answer: A dashboard impact with the knee in a flexed position

A dashboard injury where the knee strikes the dashboard while the hip is flexed transmits force posteriorly, forcing the femoral head out of the acetabulum posteriorly.

What is the primary reason to check neurovascular status distal to a fracture BEFORE and AFTER splinting?

Answer: To detect vascular or nerve compromise caused by or worsened by the splint

Neurovascular checks before and after splinting detect compromise present at injury and identify new compromise inadvertently caused by the splint.

A patient has a mid-shaft humerus fracture after a fall. Which nerve is MOST commonly injured with this fracture and what deficit would you expect?

Answer: Radial nerve; wrist drop and inability to extend the fingers

The radial nerve courses in the spiral groove of the humerus and is frequently injured with mid-shaft humeral fractures, resulting in wrist drop.

A patient in hemorrhagic shock has a suspected pelvic fracture and open femur fracture. Which sequence of interventions is MOST appropriate?

Answer: Pelvic binder first, control femur hemorrhage, then traction splint during transport

In a multiply injured patient, hemorrhage control takes priority; the pelvic binder stabilizes the largest source of internal hemorrhage, then visible external femur bleeding is controlled before traction splinting.

Which of the following BEST describes an open fracture classification concern in the prehospital setting?

Answer: Identify any wound communicating with the fracture and treat as contaminated

Prehospital providers should identify any wound near a fracture as potentially communicating with the fracture, treat it as contaminated, and cover it with a moist sterile dressing.

A patient with bilateral femur fractures cannot receive bilateral traction splints due to equipment limitations. What is the BEST alternative immobilization strategy?

Answer: Apply one traction splint to the more deformed limb and splint the other in place

If only one traction splint is available, it should be applied to the more severely injured limb, and the other leg immobilized with a rigid or padded splint.

Which of the following clinical signs would MOST suggest fat embolism syndrome following a long bone fracture?

Answer: Petechiae on the upper chest and axillae, altered mental status, and hypoxia

Fat embolism syndrome classically presents with the triad of petechiae (particularly on the upper chest/axillae), neurological deterioration, and hypoxia 24–72 hours after long bone fracture.