Orthopedics

Not Just an Ankle Sprain! Demystifying the Maisonneuve Fracture

Independently interpreting plain film imaging is an essential skill for the Emergency Medicine provider. Among the most notorious of injuries likely to be missed is the Maisonneuve fracture. In this post we demonstrate the "can't miss" imaging findings to ensure that you don't make the mistake of thinking this is "just an ankle sprain!"

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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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