Orthopedics

When Snow Blowers Attack: How to Use a Rongeur in Finger Amputations

Your patient in the Emergency Department has a Zone II or Zone III finger amputation which requires primary closure of the wound prior to discharge with appropriate outpatient follow up. However, a protruding piece of bone often prevents closure of the skin flap and requires trimming by using a rongeur. While this process is typically carried out by an orthopedic or hand surgical consultant, this post aims to introduce the use of a ronguer during management of finger amputation in the Emergency Department.

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What to Do With Gonococcal Arthritis in Your Emergency Department

You have made the diagnosis of disseminated gonococcal infection in your patient presenting with history and physical exam findings suggestive of purulent arthritis, now what? Treatment for gonococcal arthritis goes beyond the one-time "shot and a pill" given for uncomplicataed gonococcal infections. A quick review of disseminated gonococcal infection:

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Which Patella Fractures Need Involvement of Your Orthopedic Surgeon

Patella fractures represent 1% of all fractures and are commonly seen after direct trauma to the bone (fall onto flexed knee, "dashboard" injury"). When to involve your consulting orthopedic surgeon is a key branch point in the management and care of these patients.

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Can You Name the Three Pelvic Fractures?

Case: 43 year old woman presents to Emergency Department after falling from height of second-story window after locking herself out of the house. Patient reports falling onto her left hip. On physical exam, no leg length discrepancy and no bony tenderness to palpation of left hip. The patient cannot move her left lower extremity at the hip and has significant pain with minimal passive range of motion.

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Orthopedic Injuries Around the NFL: Jordan Reed's Acromioclavicular Joint Separation

During Week 12 of this NFL season, Washington Redskins tight end Jordan Reed injured his shoulder while attempting to catch a pass in the endzone against the Dallas Cowboys. While Reed continued to finish the first half, he was diagnosed with an AC joint separation at halftime. This posts will give an review of the evaluation and management of AC joint separations in the ED.

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Interview with an Orthopedic Surgeon: Tips for a Perfect Reduction

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 podcast interview between Patrick Sheehan, MD of the Department of Emergency Medicine and Joseph Legato, MD of the Department of Orthopedic Surgery at Cooper University Hospital 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.

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Orthopedic Injuries Around the NFL: Tony Romo's Lumbar Spine Compression Fracture

During a preseason exhibition game of this NFL season, Dallas Cowboys quarterback Tony Romo suffered a compression fracture of his lumbar spine against the Seattle Seahawks. While this was not a season-ending injury for Romo, the veteran quarterback lost his starting position to the exceptional play of rookie quarterback Dak Prescott during his absence. Also included in this post is key pearls about a Chance fracture, another important fracture of the thoracic/lumbar spine!

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