Medical Screening for Traumatic Fractures

Flashcards on medical screening for traumatic fractures.

Goal of Medical Screening

Recognize when patients need to see another healthcare provider, physician in particular, because it may fall outside the scope of practice.

Red Flag

A term commonly used to describe history or physical examination findings that suggest the potential presence of serious pathology.

Three Scenarios to Consider Fracture

Major trauma, minor trauma, and repetitive unusual activity.

Ottawa Ankle Rules

Pain in the malleolar region plus palpatory pain over the lateral or medial malleolus, or inability to weight bear four steps or more.

Ottawa Foot Rules

Pain in the midfoot zone plus palpatory pain at the base of the fifth metatarsal or navicular, or inability to weight bear four steps or more.

Sensitivity and Specificity of Ottawa Rules

Good sensitivity, poor specificity.

Special Tests for Fractures

Tuning fork for pain provocation or auscultation with bony percussion.

Ottawa Knee Rules

55 years of age or older, isolated palpatory tenderness of the patella, palpatory tenderness at the fibular head, inability to flex the knee to 90 degrees, or inability to weight bear four steps.

Pittsburgh Knee Rules

Blunt trauma to the knee or fall on their knee, plus they're under the age of 12 or over the age of 50, and/or the inability to walk four steps or more at the time of the clinic visit.

Canadian C-Spine Rules

Patients who suffered head and neck trauma and who are alert and mentally stable if they're 65 years or older or they've sustained a dangerous mechanism of injury, upper extremity paresthesias, and inability to rotate their neck more than 30 degrees.

Criteria to safely assess cervical range of motion

Simple rear end motor vehicle accident, patient can assume a sitting position in the clinic, delayed onset of neck pain, and no palpatory tenderness in the midline.