compound

Epidemiology

Usually young patients

- 15 - 40

15% compound

Aetiology

High velocity injury

- MBA

- MVA

- pedestrian v car

- fall from height

Emergency Managment

EMST principles

- need for transfusion not uncommon

Anatomy

Radial bow radius

- important for rotation

Interosseous membrane

- Z pattern

- proximal radius to distal ulna

Mechanism

Direct blow

- ulna / night stick

Definition

Fracture with break in skin communicating with fracture haematoma or fracture

- contamination with micro-organisms

- coupled with damage to ST and vascular supply

- leads to increased risk in infection and healing problems

Gustillo Classification

Grade I

- low velocity / wound < 1cm

- minimal contamination & minimal tissue injury

Grade II

Anatomy

Bony

- 90% load through plafond to talus

- 10% load through lateral talofibular articulation

Ligaments

A.  Lateral Ligament Complex

ATFL (Anterior Talo-Fibular Ligament) 

- tight in plantar flexion