Charcot Joint: What do Emergency Physicians Need to Know?
What is a Charcot joint, and what do you need to do in the ED?
Charcot Joint: What do Emergency Physicians Need to Know? Read More »
orthopedics
CORE EM: Lisfranc Injuries
The Lisfranc Injury can be easy to miss. This post from Core EM gives you what you need to know.
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The Hand: An Expedited Examination and Key Points Regarding ED Diagnoses
Looking to hone your hand examination skills and quickly review can’t miss ED hand diagnoses? Read on for a number of pearls.
The Hand: An Expedited Examination and Key Points Regarding ED Diagnoses Read More »
MEDICAL MALPRACTICE INSIGHTS: Don’t miss a posterior shoulder dislocation
Orthopedic complaints are one of the top causes for litigation. This second post in the Medical Malpractice Insights Series evaluates posterior shoulder dislocation.
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Septic Arthritis
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.
EM Cases: Hand Emergencies
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?
EM Cases: Hand Emergencies Read More »
Bleeding Hand Wounds
Hand and digital wound bleeding should be managed with hemorrhage control, an adequate exam and proper treatment. There are many tools to help manage bleeding and allow for an adequate exam. Using a topical analgesic such as lidocaine, can be helpful with pain control. The addition of epinephrine to a topical analgesic in hand and digital wounds may not be as scary as once thought and may be considered to help with hemorrhage control in certain wounds.
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Diagnostic accuracy of ankle x-rays: How often do we miss fractures? How can we improve?
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.
Diagnostic accuracy of ankle x-rays: How often do we miss fractures? How can we improve? Read More »
EM Cases: Occult Fractures and Dislocations
Missed occult fractures and dislocations, in general, may result in significant morbidity for the patient and law suites for you. Six cases are presented in this episode, ranging from common scaphoid fractures to rarer dislocations. Dr. Sayal & Dr. Mamen answer questions such as: Which fractures can mimic ankle sprains and how do you avoid missing them? What are the most reliable signs of scaphoid fracture? In which occult orthopaedic injuries should we anticipate limb threatening ischemia? Which is better to diagnose occult fractures – MRI or CT? Which calcaneus fractures require surgery and which ones can be managed conservatively? and many more……
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Open Fractures – Pearls and Pitfalls
A great update on the classification and management of open fractures. What can you do better?
Open Fractures – Pearls and Pitfalls Read More »