JUNIORBONES
Orthopaedics and trauma for junior orthopaedic trainees and medical students
  • Home
    • About
  • Patient evaluation
    • History
    • Examination >
      • Shoulder examination
      • Hip examination
      • Knee examination
      • Foot & ankle examination
      • Spine examination
  • Trauma
    • Orthopaedic emergencies
    • Common trauma referrals >
      • Proximal humerus injuries >
        • Shoulder dislocation
        • Proximal humerus (shoulder) fractures
      • Upper-limb long bone fractures
      • Elbow injuries >
        • Adult elbow fractures
        • Paediatric supracondylar elbow fracture
      • Distal radius fractures
      • Spine trauma
      • Pelvic & acetabular fractures
      • Proximal femur fracture
      • Lower-limb long bone fractures
      • Knee injuries >
        • Fractures at the knee
        • Soft tissue knee injuries
      • Foot & ankle injuries >
        • Ankle fractures
        • Foot fractures
      • Peri-prosthetic fractures
      • Paediatric trauma
      • Septic arthritis >
        • Septic native joints
        • Septic joint replacement
  • Orthopaedic conditions
    • Osteoarthritis
    • Inflammatory & infective arthritis
    • Other joint disorders
    • Spine
    • Paediatric orthopaedics
    • Orthopaedic pathology
  • Cases blog
  • Trauma guidelines
  • Book downloads
  • Authors
  • Contact

Patient history

As in all medical specialities, a thorough history is vital to allow a patient to be treated safely and without delay. Often requiring surgery, patients must be assessed for co-morbidities that may need optimising. A surgical history must include:
  • Other medical problems
  • Regular medication
  • Medication that may require stopping or reversal (eg. warfarin)
  • Allergies to medication
  • Previous surgery (and problems with anaesthetics)
  • Time of last meal and drink


Orthopaedic patients are often elderly and frail and particularly require careful management. Early administration of analgesia, intravenous fluids and skin traction for comfort will keep them optimised for surgery. Asking for the input of the physicians on site is vital and should be done early. In patients with dementia, history may be augmented via questioning carers and family, nursing home staff and GP's.

Major trauma patients should be assessed for other injuries with a high suspicion of injury to the brain and cervical spine.
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