Return to Scenario ListShow Learning Points most relevant to Phase 1:

Forearm / wrist injury

Clinical Discipline(s)/Organ System(s)
Musculoskeletal System, Orthopaedics
Progress Test Topic(s)
A 24 year old male Māori forestry worker presents with severe and worsening left forearm and wrist pain after his arm was crushed between two heavy logs of wood at work. An X-ray shows comminuted mid-shaft fractures of the radius and ulna. He develops compartment syndrome. This is not diagnosed immediately and despite surgical decompression he goes on to suffer serious disability.
Progress Test-Type Questions:   Question 1 | Question 2
Applied Science for Medicine 
   - Anatomy of the elbow, forearm and wrist
   - Common fractures of forearm and wrist
   - Pathophysiology of compartment syndrome
   - Healing processes for bones and joints
Clinical and Communication Skills 
   - History of a musculoskeletal trauma
   - Perform neurovascular assessment of periphery and examination of the joints of the upper limb
   - Interpretation of X-rays of the wrist and forearm and identify common fracture patterns
   - Recognise the features of compartment syndrome and outline its management
   - Indications for urgent fasciotomy and effects of delay in treatment
Personal and Professional Skills 
   - Appropriateness of prompt analgesia prior to detailed history and examination
   - Recognition that ongoing severe pain requires immediate review
   - Open disclosure and apology in the event of medical error
   - The role of ACC, Health and Disability Commissioner and NZ Medical Council in medical misadventure claims
Hauora Māori 
   - ACC evidence of reduced delivery of care for Māori
   - Root causes of educational disparities that result in Māori being more likely to be employed in occupational groups with a higher incidence of work-related injury (manual labour, machine operating, agriculture, fisheries)
Population Health 
   - Workplace accidents; the role of the Department of Health and Safety and ACC
   - Societal costs of injuries and associated long-term disability
   - Preventive strategies for work-related injuries
Conditions to be considered relating to this scenario