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Terminology of bone healing after fracture Union The fracture has healed su ffi ciently from a clinical perspective to withstand physiological loads, with very little pain and mini mal tenderness at the fracture site. Radiologically a fracture has united when th...

Thumb metacarpophalangeal ulnar collateral ligament Injury to the thumb metacarpal ulnar collateral ligament is a unique injury often termed ‘gamekeeper’s thumb’ or ‘skier’s thumb’. Owing to the unique anatomical arrangement of adductor pollicis, if the liga...

Thumb metacarpophalangeal ulnar collateral ligament Injury to the thumb metacarpal ulnar collateral ligament is a unique injury often termed ‘gamekeeper’s thumb’ or ‘skier’s thumb’. Owing to the unique anatomical arrangement of adductor pollicis, if the liga...

Tibial plateau fractures Intra-articular fractures of the tibial plateau are common. Injuries may involve the lateral or medial side or both. The joint articular surface may be split, depressed or a combination of both. A CT scan should be performed to see th...

Tibial shaft fractures Tibial fractures in children are often very amenable to non-operative treatment, starting with an above-knee cast, followed by conversion to a Sarmiento patellar tendon somewhat limited; as such, less angular deformity (only 10–15°) ca...

0 0 I I II II III III Figure 33.7 Triage tags ( (a) courtesy of TACDA & METTAG products, The American Civil Defense Association; Management Systems). 0 0 I I II II III III Figure 33.7 Triage tags ( (a) courtesy of TACDA & METTAG products, The American Civil De...

0 I II III First aid Care for patients with minor injuries involves cleaning and dressing wounds, suturing lacerations and splinting simple - fractures. Most of these ‘walking wounded’ can be sent away with antibiotics and simple pain relief. Damage control s...

COMMON FEATURES OF MAJOR DISASTERS Any event that results in the loss of human life is disastrous, but most accidents, such as aeroplane and train crashes, are limited in the number of people involved. Conversely , natural disasters, such as earthquakes and ...

Coordination with relief agencies A laudable aspect of globalisation is the outpouring of help from governments and non-governmental organisations in response to a disaster. Some, such as Rescue And Prepared - ness In Disasters (RAPID), deal with search and ...

Crush injury and syndrome A crush injury occurs when a body part is subjected to a high degree of force or pressure, usually after being squeezed between two heavy or immobile objects. Damage related to a crush injury includes lacerations, fractures, bleeding...

DEFINITIVE MANAGEMENT The hospitals designated to undertake de�nitive management should be selected on the basis of the facilities available and the number of injured that they can handle. The resources required for trauma patients are more than the typica...

DISASTER PLANS Disasters are unforeseen events and planning for them may seem paradoxical. It has, however, been shown that disaster - planning not only works but also saves lives. Disaster planning is a wide field but a résumé of the important aspects follows...

Damage assessment The first objective in disaster management is an assessment of the damage and the number of casualties. All sources of information must be employed. The 24-hour news services are frequently the first on the scene and can be an important sourc...

Dealing with the media Disasters act like a magnet for the media. In today’s world of 24-hour news coverage, this plays an important part in shaping public opinion. It is essential to establish a working relationship between the media and the rescue teams. Wit...

Debridement Taken from the French, meaning to ‘unleash or cut open’, debridement plays a crucial part in the management of trauma. Wounds sustained in disasters are often heavily contaminated, containing foreign bodies and non-viable tissues ( Figure 33.9 Deb...

Designated centres Initially , the casualties may be scattered among many hospitals. After the first few weeks most of the acute problems have been dealt with and only those patients who require longer term treatment remain. At this point it is advisable to de...

Establishment of a national disaster management organisation This is the first step in the planning for disasters. Most resource-rich countries already have such an agency , which can formulate policy at the national level and has the infrastructure to react qu...

Establishment of a national disaster management organisation This is the first step in the planning for disasters. Most resource-rich countries already have such an agency , which can formulate policy at the national level and has the infrastructure to react qu...