Orthopedic Trauma: Extremity Fracture Clinical Practice Guideline



Listen to COL Mark Pallis, Orthopedic Surgery Consultant for the US Army Surgeon General, discuss the Orthopedic Trauma Extremity Fracture Clinical Practice Guideline (CPG).

Upwards of 70-80% of combat injuries involve extremity fractures.  The podcast discusses the importance of fracture management for all providers in the deployed environment.  With protective equipment worn on today’s battlefield, the survivability of wounding patterns increases the likelihood of fracture management.  In austere environments, assessment equipment can be limited, and evacuation routes can be lengthy in time.  The following topics are discussed by COL Pallis:

  • Treatment of the casualty with awareness of austere constraints
  • Treatment options in far-forward environments before evacuation
  • Initial management of extremity fractures
  • Options for stabilizing fractures before and during evacuation
  • Fracture management in sequence of care for multi-injury casualties
  • Antibiotics in early fracture management
  • Documentation and marking of splints
  • External versus internal fixation in the austere environment
  • External fixator resources for the austere environment
  • Considerations for the external fixator frame placement
  • Splints versus fixator considerations
  • Differences between management of upper and lower extremity fractures
  • Factors to consider in austere scenarios

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