Examination: -examination of leg wound -site -size -clean /dirty -bone exposure -examination of limb -shortening/angulation -examination of external fixator & complications -EF configuration -pin tract -rock the EF - pain? loosening? -movement of ankle and knee joint - stiffness? -neurovascular bundle
Common Qs: 1. How to grade open fracture: -Gustillo-Anderson classification -wound size,duration of injury, degree of soft tissue injury
2.How to manage open fracture? -wound debridement- wash copiusly and remove foreign & unhealthy tissue. -IV antibiotics -external fixation -leave wound open -avoid internal fixation
3.How to differentiate between healty and necrotic muscles? -5C -Healthy muscles: color (red), character (turgid, not friable),contractility, circulation (bleeds)
4. Complications of open fracture. -infection -osteomyelitis -non union
5.What is the common indications of EF? -open fracture -bone lengthening -pelvic # (open book # - to control bleeding) -comminuted, intraarticular # d/e radius -joint fusion (knee) -infected non union
6.Advantages? -can be done under LA -fast procedure -allow better wound inspection/care -low infection risk
7.Complications of EF? -pin tract infection-- OM -joint stiffness -non union -neurovascular injury