Orthopedics

Posterior Elbow Dislocation

Victoria Oppenheim^* and Megan Boysen Osborn, MD, MHPE^*

DOI: https://doi.org/10.21980/J8X593Issue 1:2 No ratings yet.

Elbow dislocations are classified by the position of the radio-ulnar joint relative to the humerus.1 Images 1, 2, and 3 show a left posterior elbow dislocation; the radius and ulna (red lines) are displaced posteriorly with respect to the distal humerus (blue line). The lateral view of the elbow most clearly shows this: trochlear notch of the ulna (red line) is empty and displaced posteriorly relative to the trochlea (blue line). There is no associated fracture. Images 4 and 5 show the elbow status-post reduction, demonstrating proper alignment of the distal humerus (blue line) with the radius and ulna (red lines).

Orthopedics Visual EM

Odontoid Fracture, CT Coronal. JETem 2016

Odontoid Fracture: Computed Tomography

Jonathan Peña, MD^* and Alisa Wray, MD^*

DOI: https://doi.org/10.21980/J8NP4WIssue 1:2 No ratings yet.

Computed Tomography (CT) of the cervical spine showed a stable, acute, non-displaced fracture of the odontoid process extending into the body of C2, consistent with a Type III Odontoid Fracture. He was evaluated by orthopedic spine service who recommended conservative, non-operative management.

Orthopedics Visual EM

5th Finger Dislocation Photograph JETem 2016

Open Dislocation of Fifth Digit

Robert Rowe, MD^* and Alisa Wray, MD^*

DOI: https://doi.org/10.21980/J8J01XIssue 1:2 No ratings yet.

Physical exam revealed an open dislocation of the proximal interphalangeal joint (PIP) of the right fifth digit. X-ray confirmed dislocation and revealed no fractures. The patient received a tetanus booster, Cefazolin, and the dislocation was then washed out and reduced. Multiple reduction attempts were made and were only successful once the metacarpophalangeal joints were held in 90 degree flexion, which relaxed the lateral bands and enabled the finger to be reduced.

Orthopedics Visual EM

Morel-Lavallée Lesion

Grant G Simpson* and Brandon R Allen, MD^*

DOI: https://doi.org/10.21980/J88G65Issue 1:2 No ratings yet.

On physical examination, the patient was noted to have a nearly “watermelon-sized” fluctuant mass to his right lateral superior quadriceps with multiple overlying abrasions (Image 1). Computed tomography (CT) scans of the area showed a large heterogeneous collection measuring roughly 37x9.5x16 centimeters in the subcutaneous adipose layer of the lateral right thigh (Image 2), while ultrasonography revealed a complex fluid collection containing some nodular solid components and debris (Image 3). Additionally, radiographs confirmed multiple fractures including most significantly a pelvic ring fracture. Surgical debridement, evacuation, and sclerodhesis were performed nine weeks post injury to allow overlying abrasions to heal prior to intervention.

Orthopedics Visual EM

Thompson Test in Achilles Tendon Rupture

Spencer Albertson^* and Megan Boysen Osborn, MD, MHPE^*

DOI: https://doi.org/10.21980/J8VC7SIssue 1:1 No ratings yet.

The left Achilles tendon had a defect on palpation, while the right Achilles tendon was intact. When squeezing the right (unaffected) calf, the ankle spontaneously plantar flexed, indicating a negative (normal) Thompson test. Upon squeeze of the left (affected) calf, the ankle did not plantar flex, signifying a positive (abnormal) Thompson test. The diagnosis of left Achilles tendon rupture was confirmed intraoperatively one week later.

Orthopedics Trauma Visual EM