Trauma Guideline Manual - SUNY Upstate Medical University

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90____________ Trauma Guideline ManualUpstate Medial University Trauma CenterARM: (continued)DistalhumerusHumeral shaftProximalhumerus(surgical andanatomicneck)AP/LatelbowAP/LathumerusAP/LathumerusAP/axillaryshoulderAP/LathumerusPosteriorelbow splintBeware ofvascularcompromiseCoaptationsplintBeware ofradial nervecompromiseCoaptationsplintSlingORIFConservativeORIFConservativeORIFSHOULDER:INJURYScapulaClavicleX-RAYSAP/axillary/scapularshoulderAP/axillaryshoulderREDUCTION/IMMOBILZATIONSlingSlingTREATMENTConservativeORIFConservativePELVIS:INJURYAnterior ring,pubicsymphysis,ramiPosterior ring,sacrum, SIfracture/dislocation, iliacwingAcetabulumX-RAYSAP, inlet andoutlet pelvis,CT scanAP, inlet andoutlet pelvis,CT scanAP pelvis,Judet views,thin cut (3mm)CT scanREDUCTION/IMMOBILZATIONInitial bedrestInitial bedrest. If hemodynamicallyunstable consider T-POD,angioembolizaiotn or externalfixationDistal femoral traction, Buck’straction, tibial traction, or nothingTREATMENTNon-operative orORIFORIFORIF
Trauma Guideline Manual______________Upstate Medical University Trauma Center91FEMUR:INJURYFemoral headFemoral neckIntratrochantericfemurSubtrochantericfemurFemoral shaftSupracondylarfemurX-RAYSAP pelvis, AP/lat hipAP pelvis, AP/latboth hips (uninjuredside with templates)AP pelvis, AP/lat hipAP pelvis, AP/latfemurAP/lat femur, AP/latknee, AP pelvisAP/lat femur, AP/latknee, AP pelvisREDUCTION/IMMOBILZATIONDistal femoral traction,or nothingBuck’s traction, ornothingBuck’s traction, ornothingDistal femoral traction,tibial tractionHare traction splint, orSpeed SplintKnee immobilizer, ortibial tractionTREATMENTORIFORIFORIFORIFORIFORIFLOWER LEG:INJURYX-RAYSREDUCTION/IMMOBILZATIONTREATMENTPatella AP/lat knee Knee immobilizer ORIFAP/lat knee,TibialORIF, or spanningCT scan (after spanning Knee immobilizerplateauex-fixex-fix)Tibial shaft AP/lat tibiaPosterior sugar tongsplintORIFANKLE:INJURYPilonMalleolus(medial,lateral,posterior)X-RAYSAP/lat ankle, mortise view,AP/lat tibia, or CT scanafter spanning ex-fixAP/lat ankle, mortise viewREDUCTION/IMMOBILZATIONPosterior sugar tongsplint, calcaneal tractionPosterior sugar tongsplintTREATMENTORIFORIF
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