7. BLOOD
VESSELS
INJURY
BLOODVESSELS :VASCULAR
INJURY
Injury to the artery is classically associated with
several specific fractures involving such sites as :
Clavicle bone sub clavicle artery.
Supracondylar region of the elbow brachial
artery.
Femoral shaft femoral artery .
Around the kneeThe popliteal artery .
9. ADULT
RESPIRATORY
DISTRESS
SYNDROME
(ARDS)
known as :Shock lung or wet lung.
Follow: slight fluid overload.
Edema and electrolyte retention secondary to the
trauma also contribute to it.
Treatment is by oxygen and ventilation.
10. FAT EMBOLI
SYNDROME
(FES)
Mechanical blockage of blood vessels by
circulating fat particles .
Occurs following ( Long bone fracture, pelvic
fracture, total hip arthroplasty. )
FAT EMBOLI SYNDROME (FES)
11. FAT EMBOLI
SYNDROME
(FES)
Signs and symptoms can appear 12-72 hours
post injury
Change in mental status
Respiratory distress
Petechial of skin & mucosa.
Diagnostics: ( No specific labs test )
Fat globules may be detected in blood, urine or
sputum
PO2 drops to < 50 mm HG
Chest X Ray with diffuse “snowstorm” effect
12. DEEPVEIN
THROMBOSIS
&
PULMONARY
EMBOLISM
Formation of fibrin leads to development of a
thrombus (fibrin clot)
Embolus can enter pulmonary circulation and
perfusion distal to the embolus can be partially
or completely occluded.
(DVT) & (PE)
14. CRUSH
SYNDROME
Also known as traumatic rhabdomyolysis.
It is compression of extremities or other parts of
the body that causes muscle swelling and/or
neurological disturbances in the affected areas
of the body.
It is characterized by major shock and renal
failure after a crushing injury to skeletal muscle.
CRUSH SYNDROME
15. COMPARTMENT
SYNDROME
A condition in which the circulation and function
of tissues within a closed space compromised by
an increased pressure within that space.
RISK FACTORS
COMPARTMENT SYNDROME
Internal FactorsExternal Force
• Bleeding
• Swelling/edema
• Tight cast
• Tight dressing
• Prolonged compression
• Crush injuries
18. Problems in
Bone
Healing
Delayed
union
• Less than 6
months
Non union
• More than
6 months
Malunion
• Healing
with
deformity
Cross Union
• happens in very
specific area
Avascular necrosis
• Bone death due to
interruption of
blood supply
Problems in Bone Healing
- local :could be at the site of injury or surrounding
systematic : involve all the body
#systemic: no deled complications at all. more dangerous than the local
The worst things in local complication ampulate the limb
- the worst things in systemic complication death
we will have bleeding wither becuz of bleeding from bone itself or fracture it self some times had sharp bone end cutting the blood vessels
Systemic immediate complication occur as result of Hypovolemic shock occur as result of (Hemorrhage) occur as result bleeding from bone itsel
(Adult respiratory distress syndrome)
Disseminated Intravascular
Septicaemia in open fracture
Compartment syndrome most dangerous early and local complication
Relatively uncommon event when associated with fractures. When it occurs, it is always an emergent situation
Neuropraxia.
Mild injury of the axon so , anatomically intact and physiologically nonfunctional Death of the axon does not occur.
The condition is generally caused by pressure or contusion and usually improves by itself in a few weeks.
Axonotmesis.
Sever injury in the axon Is an anatomic disruption of the axon in its sheath.
Improvement follows regeneration, the axon growing at a slow rate of 1 mm
The patient may restore function even if it got lost but partial not complete
Neurotmesis.
Severe injeryIs an anatomic disruption of the nerve itself.
Minimal chance for recovery
what happened ?
patient comes with haemorrhage and you replace the fluid but the fluids actually make the condition worse becuz the patient is already has of oedema .
the lung is hypo perfusion so u need oxygen
Pathology fracture will rupture the blood vassal that around the bone lead to move the fat from bone to blood vessale then to lung
Petechial of skin & mucosa (appear above nipple line and blanch)
Early recognition of FES is paramount to prevent morbidity and mortality.
Minimizing movement of long bone fractures during care reduces the risk
For patients in need of respiratory support the options may include:
Intubation
Ventilator management
ICU monitoring
Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)
- When muscle get damage muscle relase myoglubin
if there is no signs of healing for more than 6 months after fractures called non union
before this 6 months it will be delayed complication called Delayed union
happens in very specific area ,when radius and ulna get fractured and mange them convetavly and then calus is formed we will have uniting bone together same with lower
-Certain regions more than others include:
Head of femur
Proximal part of scaphoid
Lunate
Body of talus
- local :could be at the site of injury or surrounding
systematic : involve all the body
#systemic: no deled complications at all. more dangerous than the local
The worst things in local complication ampulate the limb
- the worst things in systemic complication death