Question

You are posted as an intern in casualty. Among the following patients with fracture, which will be your first priority to call the ortho PG and inform?

• A. Patient's finger is blackening
• B. Patient cannot extend his arm
• C. A 10 cm abrasion
• D. Intra-articular fracture of the elbow joint

Hint:

Which sign points to lost blood supply and looming gangrene?

Answer 1

The Correct Option is A

Step 1: In triage the priority is the limb-threatening or life-threatening problem that needs urgent intervention. Vascular compromise after a fracture is a true emergency because tissue dies within hours.
Step 2: Blackening of a finger after a fracture indicates that the blood supply has been cut off. This signals impending or established ischaemia that can progress to gangrene and limb loss if not addressed immediately, so it is the top priority - option a.
Step 3: The other findings are important but less time-critical. Inability to extend the arm suggests a nerve or tendon problem, a 10 cm abrasion is a soft-tissue wound, and an intra-articular elbow fracture needs proper fixation but is not an immediate vascular emergency.
Step 4: Because a compromised blood supply threatens viability of the part within hours, the blackening finger must be escalated to the orthopaedic PG first.