II. Types: Soft Tissue Injury

  1. See Skin Foreign Body
  2. See Burn Injury
  3. Laceration
    1. Consider open Fracture (some Lacerations originate from the inside)
  4. Ligament Sprain
    1. Injury to ligament or capsule
  5. Tendon Strain (Tendinopathy)
    1. Injury translated at musculotendinous junctions
  6. Contusion
    1. Blunt injury disrupts soft tissue (skin, Muscle) capillaries and venules, resulting in Hemorrhage into local interstitial tissue
  7. Apophyseal Injury (children)
    1. Secondary ossification sites for tendon insertions, which may be injured with overuse prior to Growth Plate closure
    2. Examples
      1. Little Leaguer's Elbow
      2. Osgood-Schlatter Disease (knee)
      3. Sever's Disease (heel)

III. Types: Fractures

VII. History

  1. See Trauma History (SAMPLE History)
  2. Background
    1. Hand dominance (for upper extremity injuries)
    2. Profession or sports
  3. History of Present Illness
    1. Mechanism of injury
    2. Protective equipment
    3. Regions of injury
  4. Past medical history
  5. Last Tetanus Vaccination (if skin penetration)

VIII. Exam

  1. See Brief Musculoskeletal Exam
  2. See Neurologic Exam
  3. See Trauma Secondary Survey
  4. See Hand Neurovascular Exam
  5. Approach: Every extremity injury
    1. Mnemonic: "joint above, joint below, circulation, motor and Sensation, skin and compartments"
    2. Include examination of joint above and below the involved joint
    3. Include Sensory Exam, Motor Exam, Reflex Exam and vascular exam (pulses, Capillary Refill)
    4. Include skin and compartment exam
    5. Mallon (2013) Shoulder Disorders, EM Bootcamp, Las Vegas
  6. Upper extremity
    1. Shoulder Exam
    2. Elbow Exam
    3. Hand Exam
    4. Wrist Exam
  7. Lower extremity
    1. Hip Exam
    2. Knee Exam
  8. Spine
    1. Neck Exam
    2. Low Back Exam

IX. Precautions: Assess for Fracture (Especially in children)

  1. Ligaments and Tendons are stronger than Growth Plate
  2. Bone Fractures less often after Growth Plate fusion

X. Complications: Pitfalls

  1. Injuries with risk of vascular compromise (consider angiography)
    1. Posterior Knee Dislocation
    2. Supracondylar Femoral Fracture
    3. Suprecondylar Humeral Fracture
  2. Compartment Syndrome
    1. Consider Compartment Pressures
  3. Epiphyseal Fracture (children)
    1. Ligaments and Tendons are stronger than Growth Plate
    2. Bone Fractures less often after Growth Plate fusion

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Related Studies

Ontology: Soft Tissue Injuries (C0037578)

Definition (MSH) Injuries of tissue other than bone. The concept is usually general and does not customarily refer to internal organs or viscera. It is meaningful with reference to regions or organs where soft tissue (muscle, fat, skin) should be differentiated from bones or bone tissue, as "soft tissue injuries of the hand".
Concepts Injury or Poisoning (T037)
MSH D017695
SnomedCT 282026002
English Injuries, Soft Tissue, Soft Tissue Injuries, Injury, Soft Tissue, Soft Tissue Injury, SOFT TISSUE INJ, INJ SOFT TISSUE, Soft tissue injury NOS, Soft Tissue Injuries [Disease/Finding], injuries soft tissue, soft tissue injury, Injury;soft tissue, injury soft tissue, injuries soft tissues, soft tissue injuries, Soft tissue injuries, STI - Soft tissue injury, Soft tissue injury, Soft tissue injury (disorder)
Italian Traumatismo del tessuto molle, Traumatismo del tessuto molle NAS, Lesioni del tessuto molle
Dutch wekedelenletsel NAO, wekedelenletsel, Letsel, weke delen, Letsels, weke delen, Weke delenletsel, Weke delenletsels
French Lésion des tissus mous SAI, Lésion des tissus mous, Lésions des tissus mous, Traumatismes des tissus mous
German Weichteilverletzung NNB, Weichteilverletzung, Weichteilverletzungen
Portuguese Lesão traumática dos tecidos moles NE, Traumatismos dos Tecidos Moles, Lesão dos tecidos moles, Lesões dos Tecidos Moles
Spanish Lesión traumática de tejidos blandos NEOM, lesión traumática de los tejidos blandos, Lesiones de los Tejidos Blandos, Lesión traumática de tejidos blandos, lesión de tejidos blandos, lesión traumática de los tejidos blandos (trastorno), lesión traumática de partes blandas (trastorno), lesión traumática de partes blandas, Traumatismos de los Tejidos Blandos
Japanese 軟部組織損傷NOS, ナンブソシキソンショウNOS, ナンブソシキソンショウ, 軟部組織傷害, 軟部組織損傷
Swedish Mjukdelsskador
Czech měkké tkáně - poranění, Poranění měkkých tkání, Poranění měkkých tkání NOS
Finnish Pehmytkudosvammat
Polish Urazy tkanek miękkich
Hungarian Lágyrészsérülés, Lágyrészsérülés k.m.n.
Norwegian Skader, bløtdel, Skader, bløtvev, Bløtdelsskader, Bløtvevsskader

Ontology: Injury of musculoskeletal system (C0272448)

Definition (NCI) Damage to the muscles, bones and their supportive structral attachments.
Definition (CSP) damage inflicted on any part of musculoskeletal system as the direct or indirect result of an external force, with or without disruption of structural continuity.
Concepts Injury or Poisoning (T037)
SnomedCT 105606008
English injury musculoskeletal, Injury;musculoskeletal, musculoskeletal injury, injuries musculoskeletal, injury of musculoskeletal system (diagnosis), Injury of Musculoskeletal System, Musculoskeletal Injury, Musculoskeletal injury, Injury of musculoskeletal system (disorder), Injury of musculoskeletal system, Injury musculoskeletal nos
Czech Muskuloskeletální poranění
Dutch skeletspierletsel, Ander letsel bewegingsapparaat
French Lésion musculo-squelettique
German Muskuloskelettale Verletzung
Hungarian Mozgásszervi sérülés
Italian Lesione muscoloscheletrica
Japanese 筋骨格系損傷, キンコッカクケイソンショウ
Portuguese Lesão musculosquelética
Spanish Lesión traumática musculoesquelética, injuria del sistema musculoesquelético, lesión traumática del sistema musculoesquelético (trastorno), lesión traumática del sistema musculoesquelético