SAQ 442 – Trauma – open knee fracture with gas in joint

Review Completed

Marked out of 11.00

The same patient has AP and lateral knee x-rays performed. The images are shown below.

AP knee x-ray showing lateral femoral condyle fracture. — AP knee x-ray

Lateral knee x-ray showing gas in the joint after open injury. — Lateral knee x-ray

List two (2) major abnormalities on the x-rays.

(Marked out of 2.0)

/ 2

List five (5) essential ED management steps and provide details.

(Marked out of 5.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Management</th> <th>Details</th> </tr> </thead> <tbody> <tr> <td>1.</td> <td></td> </tr> <tr> <td>2.</td> <td></td> </tr> <tr> <td>3.</td> <td></td> </tr> <tr> <td>4.</td> <td></td> </tr> <tr> <td>5.</td> <td></td> </tr> </tbody> </table> <p>

/ 5

The orthopaedic registrar advises ED washout, suturing, discharge, and clinic review next week. Describe your response.

(Marked out of 4.0)

/ 4

Total Score: 0 / 11

Percentage: 0%

Management	Details
Analgesia	Give appropriate titrated analgesia.
Antibiotics	Give early IV antibiotics for open fracture/joint injury and document/adjust for penicillin allergy.
Tetanus	Assess and update tetanus prophylaxis.
Wound care	Apply sterile dressing, avoid ED closure, and document contamination; gross irrigation only if appropriate.
Immobilisation and neurovascular checks	Splint the limb and repeat distal neurovascular assessments.
Disposition and theatre preparation	Keep fasted, admit, and arrange urgent operative washout/debridement with senior orthopaedic input.

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