SAQ 150 – Orthopaedics – open ankle fracture-dislocation with vascular compromise

Review Completed

Marked out of 12.00

A 30 year old man has had his left leg run over by a car. He has isolated left lower limb injuries.

A left ankle x-ray is shown below.

Left ankle x-ray for Geelong SAQ 017 question 2 — Left ankle x-ray

List four (4) features of the abnormalities shown in this x-ray that suggest that this is a significant injury.

(Marked out of 4.0)

/ 4

There are open wounds over the medial border of his left foot / ankle and his left foot is pale. What is the significance / implication of these findings? List five (5) and three (3) points respectively.

(Marked out of 8.0)

Finding	Significance / implication
Open wound
Foot is pale

/ 8

Total Score: 0 / 12

Percentage: 0%

Finding	Significance / implication
Open wound	Infection risk with risk of non-union / osteomyelitis; irrigate if dirty; dressing coverage; early IV antibiotics; early definitive washout and closure; increased risk if vasculopathic or diabetic.
Foot is pale	Vascular compromise; potential vascular injury versus reversible kinking; needs urgent reduction.

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