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Orthopedics

A Case Report of the Rapid Evaluation of a High-Pressure Injection Injury of a Finger Leading to Positive Outcomes

Nathaniel Hansen, MD* and Colin Danko, MD*

DOI: https://doi.org/10.21980/J8TD2X Issue 7:2 No ratings yet.
On exam the patient was noted to have a punctate wound to the ulnar aspect of his right index finger, just proximal to the distal interphalangeal joint. The finger appeared pale and taut, with absent capillary refill. The patient displayed diminished range of motion with both extension and flexion of the joints of the finger. Sensation was absent and no doppler flow was appreciated to the distal aspects of the finger. X-ray of the hand was obtained and showed many small foreign bodies in the soft tissue and extensive radiolucent material consistent with gas or oil-based material to the palmar aspect of the index finger tracking up to the level of the metacarpal heads.
Current IssueOrthopedicsVisual EM

Jefferson Fracture and the Classification System for Atlas Fractures, A Case Report

Miguel Angel Martinez-Romo, MD* and Christopher Eric McCoy, MD, MPH*

DOI: https://doi.org/10.21980/J88P9C Issue 6:2 No ratings yet.
Computed tomography (CT) revealed a burst fracture (Jefferson) of the anterior arch (white arrows) and of the posterior arch (yellow arrows) of the first cervical vertebrae (C1). There was also a fracture of the right lateral mass (blue arrow) of C1 with mild lateral subluxation of the lateral masses (curved arrows).
OrthopedicsTraumaVisual EM

Posterior Sternoclavicular Dislocation: A Case Report

Stephanie Songey, DO*, Christopher Goodwill, DO* and Kimberly Sokol, MD, MS, MACM*

DOI: https://doi.org/10.21980/J8363Q Issue 6:1 No ratings yet.
Chest X-ray revealed an inferiorly displaced right clavicle at the right sternoclavicular joint (blue arrow). A computed tomography angiogram (CTA) of the chest was therefore obtained and revealed a right posterior sternoclavicular dislocation with resultant compression of the left brachiocephalic vein (purple arrow). Even though the right clavicle is displaced, the anatomy of the brachiocephalic vein is such that it is positioned to the right of midline, placing the left brachiocephalic vein posterior to the right clavicle. The right brachiocephalic and common carotid artery were normal in appearance. The CTA also revealed a comminuted fracture of the left anterior second rib at the costochondral junction that had not been previously seen on the x-ray.
OrthopedicsTraumaVisual EM

Adult Clavicular Fracture Case Report

Jessica L Sea, PhD*, Nadia Zuabi, MD* and Alisa Wray, MD, MAEd*

DOI: https://doi.org/10.21980/J8FM0TIssue 5:4 No ratings yet.
The patient's chest and clavicular radiographs showed a comminuted displaced acute fracture of the right mid-clavicle (green, blue, yellow). The clavicular fracture was also visible on the chest computed tomography (CT). The remainder of his trauma workup was negative for acute findings.
OrthopedicsTraumaVisual EM

Case Report of Distal Radioulnar Joint and Posterior Elbow Dislocation

Danielle Matonis, MD*, Katelyn Wittel, BS* and Alisa Wray, MD, MAEd*

DOI: https://doi.org/10.21980/J89S6K Issue 5:4 No ratings yet.
Radiographs of the left elbow and wrist were obtained. Left elbow radiographs showed simple posterolateral dislocation of the olecranon (red) without fracture of the olecranon (red) or trochlea (blue). Left wrist lateral radiographs demonstrated DRUJ dislocation with dorsal displacement of the distal ulna (green) without fracture or widening of the radioulnar joint (purple). Post-reduction radiographs demonstrated appropriate alignment of the elbow with the trochlea seated in the olecranon and improved alignment of the DRUJ.
OrthopedicsTraumaVisual EM

Case Report: Talar Neck Fracture

Wilson Frasca, MD* and Nhan Do, MD*

DOI: https://doi.org/10.21980/J8FP75 Issue 5:3 No ratings yet.
ABSTRACT: This report demonstrates a case of a severe talar neck fracture. Although rare, talar neck fractures have a high potential for morbidity. Typically caused by a high energy injury, this patient’s mechanism of injury was relatively minor, and presentation was not immediately concerning for such a severe fracture. Initial x-rays provided a gross demonstration of the fracture, but a
OrthopedicsVisual EM

Case Report of Untreated Pediatric Femoral Neck Fracture with Osteopenia

Sha Yan, DO*

DOI: https://doi.org/10.21980/J8S92K Issue 5:2 No ratings yet.
On her right hip radiograph, the patient was found to have a right femoral neck fracture with superior displacement of the intertrochanteric portion of the right femur. Moreover, the radiograph demonstrated diffuse osteopenia of the right hip and femur from chronic disuse as characterized by the increased radiolucency of the cortical bones compared to the left side.
OrthopedicsPediatrics

High-Pressure Hand Injection Injury Case Report

Mary Rometti, MD* and Patricia Mangel, MD*

DOI: https://doi.org/10.21980/J8NM0P Issue 5:2 No ratings yet.
X-rays of his right hand revealed extensive infiltrates of the right distal and middle phalange without fractures or dislocations.
Orthopedics

Spinal Epidural Abscess

Christine T Luo, MD, PhD* and Jennifer Yee, DO*

DOI: https://doi.org/10.21980/J8T938 Issue 5:1 No ratings yet.
After this simulation case, learners will be able to diagnose and manage patients with spinal epidural abscesses. Specifically, learners will be able to: 1) Obtain a detailed history, including past infectious, surgical, procedural and social history to evaluate for epidural abscess risk factors; 2) describe clinical signs and symptoms of spinal epidural abscesses and understand that initial clinical presentations can be variable; 3) perform a focused neurological exam including evaluation of motor, sensory, reflexes, and rectal tone; 4) order appropriate laboratory testing and imaging modalities for spinal epidural abscess diagnosis, including a post-void bladder residual volume; 5) select appropriate antibiotics for empiric treatment of spinal epidural abscess depending on patient presentation; 6) disposition the patient to appropriate inpatient care.
Infectious DiseaseOrthopedicsSimulation

Make and Break Your Own Hand: A Review of Hand Anatomy and Common Injuries

Gabriel Sudario, MD*, Alisa Wray, MD, MAEd* and Robin Janson, OTD, MS, OTR, CHT^

DOI: https://doi.org/10.21980/J8PH0Z Issue 5:1 No ratings yet.
By the end of this session, learners should be able to name and identify all bones of the hand; arrange and construct an anatomically correct bony model of the hand; build functional phalangeal flexor and extensor tendon complexes onto a bony hand model; describe the mechanism of injury, exam findings, and management of the tendon injuries Jersey finger, Mallet finger, and central slip rupture; draw/recreate injury patterns on a bony hand model; and describe the mechanism of injury, exam findings, imaging findings, and management of scapholunate dissociation, perilunate dislocation and lunate dislocation, Bennett’s fracture, Rolando fracture, Boxer’s fracture and scaphoid.
Orthopedics
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