Head Injuries
Introduction The brain is arguably the human’s most precious organ. It is well protected by the skull, but it is large and heavy and so is prone to injury, especially…
Peripheral and Spinal Nerve Injuries
Diagnosis Nerve injuries are easily missed in the turmoil of major injuries, or if the patient is drunk or upset. Testing should be done by comparing sides, not by asking…
Initial Management of the Polytraumatised Patient
42 Initial management of the polytraumatised patient Introduction Patients involved in serious accidents are becoming rarer and rarer in developed countries, but are more likely than ever to arrive at…
Orthopaedics in Children
38 Orthopaedics in children Antenatal and birth checks Screening, genetic counselling, the withdrawal of teratogenic drugs and appropriate nutrition have greatly reduced the incidence of spina bifida and other congenital…
Case Studies: Answers
Case 1: Acute joint disease 1 The most crucial piece of information is that the patient is well. The diagnosis to rule out in every case is septic arthritis, and…
Case Studies: Questions
Case 1: Acute joint disease A 42-year-old man presents to casualty with a painful and swollen right knee, which he attributes to an old football injury ‘flaring up again’. He…
Compartment Syndrome
Pathophysiology If there has been damage to the blood supply of a limb or severe damage to the soft tissues (with or without a fracture), then there may be swelling…
Fractures and Dislocations
Causes If the load on a limb exceeds the strength of the bone, joint capsule or ligaments, then a fracture, dislocation, or joint sprain will occur. If the load is…
Wound Management
General assessment Carry out a rapid general assessment of the whole patient to make sure that their airway, breathing and circulation are satisfactory (ABC, then D and E; see Chapter…
