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Orbital fractures Orbital fractures may be isolated or more commonly occur in conjunction with zygomatic or maxillary complex fractures. They most frequently involve the orbital floor, followed by the medial wall, lateral wall or the roof, which may present in ...

Panfacial fractures Combined fractures involving multiple levels such as the mandible, maxilla, zygoma, orbit or frontal bone are described as panfacial fractures. These are some of the most complex of facial injuries and indicate that a significant amount of ...

SPECIFIC INJURIES Soft-tissue injuries Lacerations Soft-tissue injuries of the face are a result of blunt or sharp trauma and should be carefully examined to exclude any associated nerve, parotid duct or underlying bony injury ( Figure 31.7 ). These can most...

Soft-tissue injury Lacerations are a result of crushing injuries where the soft tissues are compressed onto the underlying bone, usually by a blunt object. Sharp implements, such as a knife or glass, cause incised wounds. Any soft-tissue injury can present wi...

Zygomatic fractures Zygomatic (cheek/malar) bone fractures are often the result of blunt trauma to the midface, such as from a fist. From a clinical perspective, it is helpful to consider the zygomatic bone as a four-legged stool, as shown in Figure 31.10 . Th...

Achilles tendon rupture Complete rupture of the Achilles tendon is a common injury; 20% of acute injuries are missed. Active plantarflexion of the ankle is still possible, although weak, through the use of the toe plantarflexors. A classic history is a feelin...

Ankle fractures Ankle fractures are very common. As with all intra-articular fractures one should strive for an anatomical reduction. Because of the biconvex saddle shape of the articular surface, small amounts of talar shift significantly increase joint sur...

Bony injury Description Describing the bony injury depends on several characteristics and includes the: /uni25CF name of the bone that has been injured; /uni25CF region of bone injured (epiphysis, metaphysis, diaphysis); /uni25CF pattern of fracture line: t...

COMPARTMENT SYNDROME Compartment syndrome is raised pressure in a fascial compart - ment to a level that compromises tissue perfusion. There are several causes of compartment syndrome, fractures being the most common (70%), followed by soft-tissue contusions ...

CONCLUSION The correct identification of extremity trauma, combined with timely and appropriate treatment, is essential to return patients to normal function as safely and as quickly as possible. The same injury may be treated in di ff erent ways based on patie...

Carpal instability The most commonly involved carpal bone is the lunate. A lunate dislocation is where the lunate bone dislocates out of the radiocarpal joint. In a perilunate dislocation the lunate remains in the radiocarpal joint and the rest of the carpus ...

Clavicle fractures Diaphyseal fractures of the middle third of the clavicle have traditionally been treated non-operatively with a broad arm sling for comfort and social protection, followed by increasing use of the arm. Most mid-third fractures of the cla...

DESCRIPTION AND CLASSIFICATION OF THE INJURY Soft-tissue injury There are several classification systems for soft-tissue injuries: the Tscherne classification for closed injuries, the Gustilo and Anderson for open injuries ( Table 32.2 ) and the Ganga classi - fi...

DESCRIPTION AND CLASSIFICATION OF THE INJURY Soft-tissue injury There are several classification systems for soft-tissue injuries: the Tscherne classification for closed injuries, the Gustilo and Anderson for open injuries ( Table 32.2 ) and the Ganga classi - fi...

DIAGNOSIS The diagnosis of extremity trauma begins with the taking of a pertinent history followed by focused physical examination and appropriate special tests. DIAGNOSIS The diagnosis of extremity trauma begins with the taking of a pertinent history foll...

Diaphyseal fractures Extra-articular fractures do not require an anatomical reduc - tion, but rather a mechanical restoration by correction of length, alignment and rotation ( Figure 32.18 ). Angular malunion of a diaphyseal fracture of the weight-bearing lo...

Distal femoral fractures Metaphyseal osteoporotic fractures of the distal femur are amenable to internal fixation with locked intramedullary nails or plate and screw fixation. If the fracture extends into the articular surface, reconstruction may be undertaken...

Distal humerus (supracondylar fracture) Supracondylar humeral fractures are very common injuries in children. The distal humerus may go into flexion or extension, extension being by far the most common. Treatment depends on the degree of displacement. Undispla...