Question

You are an intern in casualty. Among the following fracture patients, who should be your first priority to call the orthopaedic resident about?

• A. A patient whose finger is blackening
• B. A patient who cannot extend his arm
• C. A 10 cm abrasion
• D. An intra-articular fracture of the elbow joint

Hint:

Vascular compromise (a blackening, ischaemic digit) trumps everything.

Answer 1

The Correct Option is A

Step 1: In triage of fracture patients, the priority is whatever threatens limb viability or life. Vascular compromise is a true emergency because tissue dies within hours without blood flow.
Step 2: Blackening of a finger after a fracture signals loss of blood supply (ischaemia heading toward gangrene). This is the most time-critical problem and demands the orthopaedic resident first. So option 1 is the correct first priority.
Step 3: Why the others can wait comparatively. Inability to extend the arm suggests a nerve or tendon problem that needs assessment but is not immediately limb-threatening. A 10 cm abrasion is a soft-tissue wound managed with cleaning and dressing. An intra-articular elbow fracture needs orthopaedic care and possibly surgery, but without vascular compromise it does not outrank a dying, blackening digit.