Indications:
1. Fractures with severe soft-tissue damage in which the wound can be left open for inspection and dressing.
2. Comminuted & Unstable fractures.
3. Fractures of pelvis.
4. Fractures associated with injuries of nerve & blood vessel.
5. Infected fractures.(eg. osteomyelitis)
6. Non-united fractures where the dead fragments can be excised and combine with elongation in normal shaft.
Indication:
1. Fracturees which cannot be reduced.
2. Unstable fractures & prone to redisplacement after reduction.
3. Pathological fractures in bone diseases.
4. Multiple fractures
5. Fractures which poorly unite. eg. femoral neck.
6. Fractures in patient with nursing difficulties.
5 types of
Physis Growth Plate Injuries.
Children are mostly affected.
Type 1 & 2 are uncommon for growth disturbances.
While
Type 3 may damage reproductive zone,
Type 4 causing aysmmetrical growth
Type 5 result from compression to the growth plate result
in growth cessation.
CVP Monitoring usually has 20% of complication in total.
Haemorrhage - due to puncture.
Internal Jugular Cannulation - air embolism
Pneumothorax ; Hemothorax - punctured the pleural space.
Phlebitis - thrombus formation on tip or in vein.
Rx: continuous infusion of unfrac. heparin may reduce the risk.
Bacterial Colonisation - cellulitis & sepsis.
