ortho

We have discussed several entities that may lead to a child limping. We have covered osteomyelitis, plantar punctures, and toddler’s fractures. We have also touched upon Osgood Schlatter’s Disease, SCFE, osteosarcoma and even Growing Pains. Now let us review a topic that always crosses our minds when considering the painful extremity: Septic Arthritis.

Dr. Andrew Arcand & Dr. Laura Tate discuss the key clinical pearls and pitfalls in the recognition and management of many apparently benign hand emergencies that have serious morbidity, including high pressure injection injury, flexor tenosynovitis, gamekeeper’s thumb (or skier’s thumb), fight bites, hook of the hamate fractures and many more important hand emergencies. Dr. Tate & Arcand answer such questions as: which lacerations require prophylactic antibiotics? Which hand lacerations do not require sutures? How is rotational deformity best tested for metacarpal fractures? What are the pearls of tendon repair? How do you test for instability when you suspect a Gamekeeper’s thumb? How is compartment syndrome of the hand different to compartment syndrome in the leg? What are Kanavel’s signs of tenosynovitis? How should felons be managed in the ED? What are the most common errors that plastic surgeons see ED docs make?

Traumatic ankle pain is a common presenting problem to emergency departments. While sprains are the most common injuries (most common = anterior talofibular ligament), the patient still needs to be assessed for fracture. Since its derivation and validation in 1992, the Ottawa ankle rules are the most frequently used clinical decision tool when considering to obtain ankle x-rays.

Knee dislocation pearls and pitfalls….don’t be fooled!