Orthopedic Archives - The Emergency Medical Minute

Orthopedic

Podcast 652: Prosthetic Hip Dislocation

Contributor:  Jared Scott, MD Educational Pearls: While it is rare to have a native hip dislocation, it is relatively common to dislocate a prosthetic hip The mechanism for dislocation is usually adduction, flexion, and internal rotation the hip which can occur when walking Arthroplasty in the setting of trauma or fracture, posterior approach during surgery,…

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Podcast 633: Pathologic Femur Fractures   

Contributor: Jared Scott, MD Educational Pearls: Pathologic bone fractures occur due to weakened bones from chronic disease and with less force when compared to non-pathologic fractures Can be due to bone tumors, bone cysts, infections (osteomyelitis), osteogenesis imperfecta, Paget’s disease of bone, and multiple myeloma Have moth bitten or lytic appearance and you can sometimes…

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Oh, You Weren’t Just Waving at Me?

Erect sHoulder Chief Complaint: Shoulder Pain HPI: 63 year old female presents after falling while walking down the stairs outside. She notes it was icy on the steps and was using the railing for support with her left hand. She states when she slipped that she tried to catch herself and all of her weight…

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If the Patient Gets Stuck, Know Where to Turn

If the patient gets stuck, know where to turn Chief Complaint: Left hand pain and swelling HPI: 73 year-old right hand dominant female presents about 6 hours after accidentally self-injecting her left hand with about 2 mL of bovine viral vaccine (most of the vaccine got into the cow but when it moved she slipped)….

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Podcast 603: Don’t Sedate. Block.

Contributor: Don Stader, MD Educational Pearls: Fractures and dislocations that require reduction do not necessarily require sedation  Nerve blocks are an effective alternative that can provide analgesia to reduce fractures and dislocations and provide sustained pain relief after the reduction is completed Hematoma blocks are effective for distal radius and various ankle fractures Shoulder dislocations…

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Podcast 563:  DC ACs

Contributor: Nick Hatch, MD Educational Pearls: An AC (acromioclavicular joint) separation in the shoulder is a common traumatic injury XRs can help rule out other injuries as well as help with grading the injury There are six different grades for AC separations: Grade I: is stretching of the AC ligament without disruption or displacement of…

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Podcast 538:  Low Maintenance Boxer’s Fracture

Contributor: Jared Scott, MD Educational Pearls: A distal 5th metacarpal neck fracture is often referred to as a “boxer’s fracture” and a common fracture encountered in the emergency department Splinting with an ulnar gutter splint is the typical management of uncomplicated boxer’s fractures A recent study randomized patients to buddy taping or ulnar gutter splint…

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Podcast 527: Knee Dislocations

Contributor:  Erik Verzemnieks, MD Educational Pearls: Knee dislocations are most common in high energy trauma, such as a motor vehicle accident The knee may appear grossly normal on initial inspection since dislocations can spontaneously reduce – Look for such findings as hemarthrosis, instability, or ecchymosis, as clues to an occult dislocation.  Knee dislocations are often…

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Podcast 506: Seymour Fracture

Contributor:  Don Stader, MD Educational Pearls: Seymour fracture is an eponym for a Salter-Harris I/II fracture of the distal phalanx of the finger or toe in children, associated with a nailbed injury These may present and subtle as a subungal hematoma with a fracture on x-ray but carry a significant risk of complications While in…

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Podcast # 498: Ortho Tips

Author: Susan Ryan, DO Educational Pearls: General orthopedic principles: Examine above and below the injury Document neurovascular status X-ray imaging typically requires three different views Fracture description should include name the bone, location of fracture, degree of displacement, and if it is closed or open Osgood-Schlatter (tibia) and Sever’s (calcaneus) disease are apophyseal injuries caused…

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