Carolinas Core Concepts Core Concepts in EM; a repository for Carolinas lecture summaries.


Minor Mechanism; Major Trauma

Stephen Colucciello, MD

  • Occult Knee dislocation/relocations leading to popliteal artery injury can occur in pts with appropriate mechanisms (ie stepping in a hole). Xrays will likely be normal so you must rely on your physical exam. Look for an expanding knee hematoma, decrease in pedal pulses or color/warmth changes compared with the contralateral foot. Also an Ankle-Brachial index of <.90 is concerning for vascular damage.
  • A seatbelt sign is associated with an increased incidence of visceral injury especially in children. A chance fracture increases this incidence. So always expose the belly and do a good spine exam.
  • Lower extremity compartment syndrome evaluation:
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