Extremity Fracture Clinical Pathway, Emergency Department – Dislocation Fractures

Extremity Fracture Clinical Pathway — Emergency Department

Clavicle Fracture

  • Urgent Ortho consult for clavicle fractures with skin tenting/color change.
  • Consult ortho for distal clavicle fractures.
  • All other clavicle fractures do not require Ortho consultation and can be discharged home with a sling. Follow up with Ortho as clinically indicated.

Sternoclavicular Joint Dislocation

  • Usually due to fall onto shoulder or direct blow to clavicle/superior part
    of sternum.
  • Most are anterior and present with anterior prominence next to manubrium.
  • Posterior dislocations can cause vasculature damage, tracheal compression
    or pneumothorax.
  • Obtain CT of the chest with IV contrast and 3D reconstruction if concern for SC joint dislocation.

Femur Fracture

  • For spica placement, send CBC.
  • For all other procedures, send CBC, T&S and blood type confirmation.
  • If Buck’s traction required, perform prior to admission to inpatient bed benzodiazepine may be required for muscle spasms,