Approach to the Critical Patient

Immediate priorities

Limb-threatening features

Open fracture

Compartment syndrome surveillance

Monitoring and targets

Limb monitoring bundle

Escalation triggers

Immediate consults

Consultation triggers

History

Injury characterization

Mechanism of injury

Onset and course

Risk factors

Host risk factors

Healing and complication risk

Functional and medication context

Baseline function and supports

Medication and exposure history

Important clues

Mechanism-specific clues

Associated injury clues

Physical Exam

Inspection and skin

Deformity and swelling

Skin integrity

Palpation

Bony tenderness mapping

Associated structures

Neurovascular and special maneuvers

Neurovascular exam

Stability and provocative tests

PITFALLS

Missed associated injury

Unreliable exam settings

Differential Diagnosis

Ankle fracture spectrum

Malleolar fracture patterns

Proximal and high-energy patterns

Mimics and coexisting injuries

Ligamentous and tendon injuries

Other osseous causes

Laboratory Tests

Role of labs in isolated injury

Routine testing

Thrombosis evaluation

Preoperative labs

Surgical optimization panel

Glycemic and bone health

Diagnostic Tests

Scoring Systems

Ottawa Ankle Rules

Fracture classification systems

VTE and pressure tools

MRI

MRI indications

Limitations

CT

CT indications

Protocol and interpretation

Ultrasound

Point-of-care ultrasound role

Procedural guidance

Disposition

Admission criteria

Operative and limb-threat admissions

Medical and social admissions

Discharge criteria and follow up

Safe discharge requirements

Follow up plan

Treatment

ED stabilization

Closed reduction for fracture-dislocation

Immobilization

Analgesia

Acute analgesia

Procedural analgesia for reduction

Definitive management

Operative fixation

Conservative management

Postoperative and adjunctive care

Weight-bearing protocol

Open fracture measures

VTE prophylaxis

Prophylaxis selection

Targeted approach

Special Populations

Pregnancy

Imaging approach

Medication and anesthesia

Geriatric

Fracture characteristics

Management modifications

Pediatrics

Growth plate considerations

Procedural and dosing differences

Background

Epidemiology

Frequency and demographics

Burden and outcomes

Pathophysiology

Mechanism of instability

Soft tissue and complication pathways

Therapeutic Considerations

Reduction and timing principles

Analgesia and prophylaxis strategy

Rehabilitation principles

Patient Discharge Instructions

copy discharge instructions

Ankle fracture home care

Warning signs to return to ER

Follow up

Recovery expectations

References

Guidelines and key sources

Decision tools and classifications

Landmark trials and reviews

Society and imaging guidance

Coding standards

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.