Thursday, August 17, 2017

General Guidelines for Orthopaedic Emergencies


·      ALL pelvic and acetabular fractures are treated at UKHeathCare.

·      Long bone fractures, isolated or multiply injured, are taken to the operating room for initial or definitive fixation within 24 hours of presentation to UKHealthCare unless not medically cleared by the primary team. Refer to “Determining Extent of Orthopaedic Intervention in Acute Multi-System Trauma” for damage control priorities.

·      Open fractures are taken to operating room for surgical irrigation & debridement within 24 hours of presentation to UKHealthCare. Initial washout at bedside will be performed when appropriate. Refer to “Determining Extent of Orthopaedic Intervention in Acute Multi-System Trauma” for priorities of care in the multi-injured patient.

·      Open fractures receive the first dose of antibiotics within 60 minutes of arrival at UKHealthCare. See “Antibiotic and Tetanus in Open Fractures Guideline” for identification of appropriate antibiotics and dosage.

·      Supracondylar humerus fractures, Gartland type III or greater, are taken for repair at least 18 hours from time of injury.

The Orthopaedic team provides immediate consultation in a time-sensitive response (30 minutes) when requested by the surgical team leader for multiply injured patients with time-sensitive injuries:
  • fractures with neurovascular compromise
  • pelvis fractures with hemodynamic instability
  • joint dislocations
  • Suspected compartment syndrome
  • Pulseless extremity
Response times are tracked in the PIPS program. 

Posted 8/17/17; Revised 9/26/24 (A Bernard/C Reynolds)