A healthy 23 yo male presents after injuring his knee playing soccer. He is complaining of inability to completely extend his knee. "It's stuck." he reports to the triage nurse. "That seems like a problem..." you think to yourself as you enter the room. How did this happen? How do I unstick his knee? Read on for some quick pearls on the "locked knee."
Do you feel like you pour your heart, soul, blood, sweat, and tears into your fracture/reductions and still come up short? Does the orthopedics consultant always want to "re-do" your attempt? Here is a repost of a podcast interview between former Cooper EM resident Patrick Sheehan, former Cooper Orthopedics Resident Joseph Legatol on how to get a perfect reduction. Inside the interview are 5 tips on positioning yourself for success. Also included is a video of Dr. Sheehan giving an example of "exaggerating the injury" of a distal radius fracture for a more successful reduction.
· Aka Calcium Pyrophosphate Deposition Disease (CPPD)
o Deposits of calcium pyrophosphate crystals within the joint space-> seen as chondrocalcinosis (calcification of the cartilage) on x-ray
· Affected Groups:
o Age >50 years
o Both genders impacted equally
A 45 year-old male with no medical history presents with Right knee pain after a mechanical fall causing him to land onto his right knee. Exam reveals moderate swelling and tenderness. He is unable to extend the knee.
A 24 year old male presents to your emergency department with severe hand pain after a fall while snowboarding. The patient states that he fell onto an outstretched left hand. On exam the patient has dorsal radial wrist tenderness with decreased range of motion. His XRAY is below. What is the diagnosis?
Check out this lateral film of the wrist. See the fracture? Look again! Surprise...there is no fracture, but this patient has sustained a serious wrist injury with the potential for long term disability. This week we highlight some of the most common missed orthopedic injuries in the ED and suggest a few strategies to minimize the errors.