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Lower Extremity Injuries

Lower Extremity Injuries. All You Need to Know. Asses CSM Immobilize Injury Transport. Introduction . Epidemiology of Ski Injuries Types of Knee Injuries Sprains/ligament tears Fractures Dislocations Other Lower Extremity Injuries Prehospital Care Questions.

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Lower Extremity Injuries

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  1. Lower Extremity Injuries

  2. All You Need to Know • Asses CSM • Immobilize Injury • Transport

  3. Introduction • Epidemiology of Ski Injuries • Types of Knee Injuries • Sprains/ligament tears • Fractures • Dislocations • Other Lower Extremity Injuries • Prehospital Care • Questions

  4. Epidemiology of Ski Injuries • 1970s: 5 to 8 per 1000 skier days • 1990s: 2 to 3 per 1000 skier days • Lower Ext. Injury:Upper Ext. Injury • 4:1 in 1980 • 2:1 in 1990

  5. Epidemiology of Lower Extremity Injuries • in Ankle Injuries • in ACL Injuries • Knee sprains most common (30% of all injuries in adults)

  6. Knee Anatomy

  7. Knee Anatomy

  8. Types of Knee Injury • Sprains • Dislocations • Fractures

  9. Sprains • Injury to ligaments supporting a joint • Secondary to abnormal motion of the joint • Range from minor tearing to complete disruption

  10. Anterior Cruciate Ligament • Prevents tibia from moving forward on the femur • Involved in 40% of sprains • Usually injured by deceleration, flexion and rotation

  11. Medial Collateral Ligament

  12. Patellar Tendon/Quad. Ligament

  13. Dislocations • Loss of continuity between articular surfaces • Patellar dislocation • Knee dislocation

  14. Patella Dislocation • Secondary to twisting injury on an extended knee • Patella is displaced laterally • Usually easily reduced by hyperextending knee and flexing hip

  15. Knee Dislocation • Secondary to hyperextension, and rotary or direct force • Associated ligamentous and possibly artery and nerve injury • May reduce spontaneously but will be grossly unstable

  16. Fracture • Can occur secondary to direct trauma or forceful twisting. • Incidence has been declining • between 1972 and 1994 there was an 89% decrease in adult tibial fractures

  17. Other Lower Extremity Injuries • Pelvis • Hip • Femur • Tibia/Fibula • Ankle • Foot

  18. Pelvis Fracture

  19. Pelvis Fracture • Direct Blow - Skier vs Tree • Many Types • Potential for Significant Injury • Laceration of blood vessels • Proximity of other organs • Examination • Treatment

  20. Hip Injuries • Relatively Uncommon • Fracture • Shortened and externally rotated • Dislocation • Hip and knee flexed, thigh internally rotated

  21. Femur Fracture • Direct Blow or Violent Twisting • Possibility of Significant Blood Loss • CSM assessment • Traction Splint • Reassess • Transport

  22. Tibia/Fibula Fracture • “Boot-Top Fracture” • Frequently Angulated and/or Rotated • Re-alignment • Painful • Reduce bleeding and preserve function • Allows splint placement

  23. Ankle Injuries • Snowboarders and Telemarkers • Sprains • Fractures • Dislocations • CSM Assessment • Splint • Realignment

  24. Foot • Uncommon in Snowsports • Falls From Heights • Heel Fx Associated with Back Injury

  25. Prehospital Care • Assess neuro-vascular status • Realignment • especially if greater than 1 hour from help • Immobilize • Transport

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