Orthopedics

Bilateral Hip Dislocation in Unrestrained Driver

Samer Assaf, MD^* and Ghadi Ghanem^*

DOI: https://doi.org/10.21980/J8HD0C Issue 2:4 No ratings yet.

The initial radiograph of the pelvis revealed bilateral hip dislocations. Small bony fragments were noted in the right hip joint, suggestive of an underlying fracture. The sacroiliac joints and the pelvic ring were intact. In the emergency department, bilateral hip reductions were performed using the Captain Morgan technique.1 The post-reduction film showed reduction of the bilateral hip dislocations with extensive comminuted and displaced fractures of the right and left acetabula.

Orthopedics Visual EM

Open Book Pelvic Fracture

Samer Assaf, MD^* and Ghadi Ghanem^*

DOI: https://doi.org/10.21980/J8CK7H Issue 2:3 No ratings yet.

The initial radiograph of the pelvis shows an open-book pelvic fracture deformity with pubic symphyseal dislocation, left greater than right sacroiliac diastases, and fractures of the left superior and inferior pubic rami, right inferior pubic ramus, and left acetabular anterior column. The additional inlet and outlet radiographs of the pelvis after application of a pelvic binder also show an open book fracture with significant improvement of the widened pubic symphysis.

Orthopedics Trauma Visual EM

Subcutaneous Emphysema in Non-Necrotizing Soft Tissue Injury

Hamid Ehsani-Nia, MS, DO^* and Lauren Sylwanowicz MD^{^}

DOI: https://doi.org/10.21980/J8432M Issue 2:4 No ratings yet.

X-Rays of the elbow revealed diffuse striated lucencies throughout the soft tissue, consistent with extensive subcutaneous air throughout the superficial and deep tissues. There was no evidence of a fracture.

Infectious Disease Orthopedics Visual EM

Acetabular Fracture

Chad Correa^* and Sari Lahham, MD^{^}

DOI: https://doi.org/10.21980/J8BK8K Issue 2:4 No ratings yet.

The non-contrast CT images show a minimally displaced comminuted fracture of the right acetabulum involving the acetabular roof, medial and anterior walls (red arrows), with associated obturator muscle hematoma (blue oval).

Orthopedics Visual EM

A Simulation Model for Extensor Tendon Repair

Elizabeth Aronstam, DO^* and David T Overton, MD^*

DOI: https://doi.org/10.21980/J8VS7X Issue 2:3 No ratings yet.

By the end of this educational session, the learner will be able to: 1) List the indications for extensor tendon repair in the emergency department, 2) recognize the indications for referral to orthopedic or hand surgery, 3) list the risks and benefits of emergency department extensor tendon repair, 4) perform an appropriate physical examination for a patient with a potential extensor tendon laceration, 5) list the maximum time limit of tourniquet application for this procedure, 6) list the materials needed for extensor tendon repair in the emergency department, 7) successfully repair a completely severed extensor tendon using four different techniques: horizontal mattress, figure of eight, modified Kessler and modified Bunnell, and 8) describe the appropriate splinting of a repaired extensor tendon.

Procedures Innovations Orthopedics

$Introducing point-of-care ultrasound through competency-based simulation education using a fractured chicken bone model 12$

Introducing point-of-care ultrasound through competency-based simulation education using a fractured chicken bone model

Nathan L Haas, MD,^* Elise Hart, MD,^† Mary RC Haas, MD,^* and Trent Reed, DO^{^}

DOI: https://doi.org/10.21980/J8GG95 Issue 2:3 No ratings yet.

To introduce medical students to PoCUS with an inexpensive, reproducible, and educationally effective model using fractured chicken bones set in gelatin, and to assess medical students’ abilities to identify simulated long-bone fractures using PoCUS.

Ultrasound Innovations Orthopedics

Supracondylar Fracture

Jessica Andrusaitis, BS, MS^* and Ben Feldman, MD^*

DOI: https://doi.org/10.21980/J8492P Issue 2:3 No ratings yet.

History of present illness: A 15-year-old male presented to the emergency department with right elbow pain after falling off a skateboard. The patient denied a decrease in strength or sensation but did endorse paresthesias to his hand. On exam, the patient had an obvious deformity of his right elbow with tenderness to palpation and decreased range of motion at the

Orthopedics Visual EM

Galeazzi Fracture

Reid Honda, MD^*

DOI: https://doi.org/10.21980/J8HS39 Issue 2:2 No ratings yet.

The X-ray showed an acute comminuted fracture of the distal diaphysis of the radius with disruption of the distal radioulnar joint, consistent with a Galeazzi fracture. The patient was then splinted and taken for operative reduction and internal fixation the following day.

Orthopedics Visual EM

A Formalized Three-Year Emergency Medicine Residency Musculoskeletal Emergencies Curriculum

Andrew King, MD, FACEP^*, Jeffrey Yu^{^}, Mark J Conroy, MD^*, Robert Cooper, MD^*, Jennifer Mitzman, MD^*, Colin Kaide, MD, FACEP^* Sarah Greenberger, MD^*, Sorabh Khandelwal, MD^* and Michael Barrie, MD^*

DOI: https://doi.org/10.21980/J8RG6HIssue 2:1 No ratings yet.

Resident learners will master the diagnosis and management of emergent musculoskeletal conditions including fractures/dislocations, soft tissue injuries, compartment syndrome, joint complaints, infections, and complex injuries.

Orthopedics Curricula

Irreducible Traumatic Posterior Shoulder Dislocation

Blake Collier, DO^* and Christopher Trigger, MD^*

DOI: https://doi.org/10.21980/J8V884Issue 2:1 No ratings yet.

Radiographs demonstrated posterior displacement of the humeral head on the “Y” view (see white arrow) and widening of the glenohumeral joint space on anterior-posterior view (see red arrow). The findings were consistent with posterior dislocation and a Hill-Sachs type deformity. Sedation was performed and reduction was attempted using external rotation, traction counter-traction. An immediate “pop” was felt during the procedure. Post-procedure radiographs revealed a persistent posterior subluxation with interlocking at posterior glenoid. CT revealed posterior dislocation with acute depressed impaction deformity medial to the biceps groove with the humeral head perched on the posterior glenoid, interlocked at reverse Hill-Sachs deformity (see blue arrow).

Orthopedics Visual EM