Management protocols for Fractures in Uganda
Uganda Clinical Guidelines 2023 · all from source →
General Adult
Diagnosis
Clinical Features
Pain, tenderness, swelling, deformity. Inability to use/move the affected part. May be open (with wound) or closed.
Investigations
X-ray: 2 views (AP and lateral) including joints above and below the injury site.
Treatment
Polytrauma — Primary Survey
Assess and manage airways. Assess and treat shock (see Hypovolaemic Shock protocol).
Closed Fractures (HC2)
Assess nerve and blood supply distal to the injury — if no sensation or pulse, refer as an emergency. Immobilise the affected part with a splint. Apply ice or cold compresses. Elevate any involved limb.
Antibiotic Prophylaxis — All Fractures (HC2)
Give Tetanus Toxoid if not fully vaccinated. Amoxicillin 500 mg every 8 hours (adult). Child: 25 mg/kg every 8 hours OR 40 mg/kg every 12 hours.
Severe Soft Tissue Damage (HC3)
Add Gentamicin 2.5 mg/kg every 8 hours. Refer URGENTLY to hospital for further management.
Notes
Treat sprains, strains, and dislocations as above. Do NOT give pethidine or morphine for rib fractures or head injuries — these cause respiratory depression. Suspected fractures should be referred to HC4 or Hospital after initial care.
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