General Principles of Orthopedic Injuries

Abstract

Approximately 20% of all emergency department (ED) visits are related to musculoskeletal complaints, about 3% of which are comprised of fractures. Aside from confirmed fractures, other injuries in the setting of suspected fractures include contusions, sprains, strains, dislocations, and other soft tissue injuries. Emergency clinicians should know how to describe, diagnose, and treat these complaints. This chapter offers an overview with a specific emphasis on nomenclature. This chapter describes the pathophysiology of fractures, fracture healing, and fracture complications. In particular, compartment syndrome is described at length, as well as the complications associated with cast and splint care, delayed repair, immobilization, fracture blisters, and fat embolism. The differential diagnosis of fractures includes dislocation, subluxation, contusion, sprain, strain, tendinitis, and bursitis. A general overview of these injuries and other physical conditions is presented. Diagnostic modalities used in the diagnosis of orthopedic injuries, including plain radiography, computed tomography, magnetic resonance imaging, and point of care ultrasound, are described. Common splinting, casting, and other immobilization techniques, both in the pre-hospital and hospital settings, are reviewed.