Musculoskeletal Trauma

Objectives
Differentiate between sprains, strains,
contusions, dislocations and fractures.
Discuss emergency care of orthopedic injuries.
Discuss nursing management of the patient with
a cast and other forms of immobilization.
Discuss nursing management of the patient
undergoing joint replacement or amputation.
Summarize neurovascular assessment.
Explain common complications associated with
orthopedic injuries.

Safety

National Trauma Institute

Trauma and Emergency Care Research Is Critically Important to Public Health

Traumatic injury is a major, largely unrecognized public health problem in the United States. Trauma
knows no bounds trauma deaths cut across age, race, gender and economic boundaries.
Each year, trauma accounts for 37 million emergency department visits and 2.6 million hospital
admissions and kills three times the number of Americans killed during the entire Vietnam conflict.
Injury remains the leading cause of death in the population between the ages of 1 and 44. Trauma
is the leading cause of the death of children in this country. Among people 65 years and older, falls
are the leading cause of injury deaths and the most common cause of nonfatal injuries and hospital
admissions for trauma, adding significantly to Medicare costs. Moreover, the combined number of
deaths from Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF) just reached
5,000, and the number of injuries resulting from these wars exceeds 34,000.
The effect of trauma on productive life years lost exceeds that of any other disease. The economic
cost of 50 million injuries in the year 2000, alone, was $406 billion.1 This includes estimates of $80
billion in medical care costs, and $326 billion in productivity losses.

Sprain Ligament injury

Strain Tendon or muscle injury
Contusion soft tissue injury
Dislocation
Subluxation
Fracture

Casting

Drugs
Antispasmodic
Narcotics
Mu Receptors
Analgesia, resp depression, euphoria, sedation, dependence,
decreased GI motility

Kappa Receptors
Analgesia, sedation, Decreased GI motility

NSAIDS/Acetaminophen
COX

Specific Fxs
Colles

Hips

Amputations

Joint Surgeries

Synovectomy
Hip Arthroplasty
Knee Arthroplasty
Arthrodesis

Complications:

Infection
Compartment Syndrome
Thromboembolism
Fat Embolism