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PubMed1980

The use of immediate internal fixation in open fractures.

Internal fixation of open fractures can be carried out according to the same indications employed in closed fractures in the presence of a type I wound. In type II and type III wounds early internal fixation may be indicated in victims of multiple trauma, in the elderly, in intra-articular fractures, in mutilated limbs, and in some fractures with associated vascular injuries. In these cases the higher risk of infection should be justified by the salvage of limb, life, or joint function. The risk of infection can be minimized by meticulous irrigation and debridement of the fractures, atraumatic surgical technique, and rigid fixation and by leaving the wound open.

Adolescent↗
PubMed1984

Current concepts in the diagnosis and treatment of musculotendinous injuries.

A strain, by definition, is a stretching or tearing of a musculotendinous unit. The degree of disability associated with this injury is dictated by the location and severity of the injury and the specific needs of the patient. A strain can be arbitrarily classified as first, second, or third degree. A first-degree strain consists of minimal stretching of the musculotendinous unit without permanent injury; a second-degree strain indicates partial tearing of the musculotendinous unit; and a third-degree strain indicates complete disruption of a portion of this unit. Swelling, bleeding, and localized discomfort accompany the injury which may produce temporary disability. Initial treatment following an acute strain should consist of the use of ice, immobilization of the musculotendinous unit, and subsequent rehabilitation. Depending on the degree of disability and the specific structure injured, surgery may be indicated. Rehabilitation to a normal state following the initial healing phase is required prior to return to athletic competition.

Abdominal Muscles↗
PubMed1984

Principles and techniques of splinting musculocutaneous injuries.

Splinting should be used as soon after a musculoskeletal injury as possible, and the splint should be maintained (in some form) until the injury is healed to the extent that protected limb function can be resumed without pain. This principle is the overriding guide to the appropriate pre-hospital management of these injuries. In the emergency department, the physician performs a careful physical examination, without removing the splint if possible, and takes the patient's history in order to arrive at an accurate diagnosis before the splinted patient is sent for x-ray evaluation.

Adult↗