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Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (..)
The knee dislocation dogma is that the incidence of vascular injury is high (around 50%) with posterior dislocation and somewhat lower with non-posterior dislocation. This lovely image from EMDocs.net shows the various dislocation types. Reference: Vascular and Nerve Injury After Knee Dislocation: A Systematic Review.
This one can be thought of as being akin to the radial head subluxation (ie, Nursemaid’s Elbow) of the knee – Proximal Tibiofibular Joint Dislocation : Proximal Tibiofibular Joint Dislocation in Children: Basics Proximal Tibiofibular Joint (PTF) dislocations are relatively rare. MANAGE PAIN!
Although posterior hip dislocation is an uncommon injury, the consequences of delayed recognition or treatment can be dire. The majority are caused by head-on car crashes, and 90% of these are posterior dislocations.
Let’s talk about mandible dislocations & how we can reduce them. First, we need to take a look at the mandible anatomy – can refer back to this as we discuss mandible dislocation: So how does the mandible dislocate (also called temporomandibular joint dislocation)? Iatrogenic : ex.
As a followup to my hip dislocation post on Tuesday, here is a short 5 minute video that goes through the entire process of reducing hip dislocations. There are lots of little tips and tricks. In the next post, a novel variant of the hip reduction technique, the Captain Morgan.
Diagnostic accuracy of point-of-care ultrasound (PoCUS) for shoulder dislocations and reductions in the emergency department: a diagnostic randomised control trial (RCT). BACKGROUND Shoulder injury and dislocations are common reasons for patients to present to the emergency department (ED) for evaluation. 39, 655–661 (2022).
The post EM Quick Hits 51 – Methylene Blue in Septic Shock, TMJ Dislocation, Crohn’s Disease, Analgesia for Renal Colic, Inhaled Steroids for Asthma, Hypocalcemia in Bleeding Trauma Patients appeared first on Emergency Medicine Cases.
Here are the basic dislocation management guidelines. Date implemented – 04/2024Review date – nil plannedAuthor – Nuria O’Mahony (Nurse Practitioner) in consultation with SCGH Orthopaedic Dept and the SCGH ED Advanced Scope Physiotherapists The post Dislocation Management 04/2024 appeared first on Charlie's ED.
I wrote about posterior hip dislocation and how to reduce it using the “standard” technique quite some time ago (see link below). The dislocated hip and the knee are both flexed to 90 degrees. Reference: The Captain Morgan technique for the reduction of the dislocated hip. Ann Emerg Med 58(6):536-540, 2011.
People have been using POCUS to diagnosis shoulder dislocation for a while now, although it is far from standard of care in most places. They measure the glenohumeral distance in an attempt to make a quantifiable cut-off point for dislocation. They also take a look at potential time savings of ultrasound compared to xray!
You suspect a shoulder dislocation. So, you reach for your ultrasound… Why It Matters : Shoulder dislocations are a common presentation to the emergency department and account for approximately 200,000 visits annually [1]. Musculoskeletal Ultrasonography to Diagnose Dislocated Shoulders: A Prospective Cohort.
Any bad layup can cause a shoulder dislocation. We discuss the presentation, epidemiology, diagnosis, and complications of these common dislocations. Any bad layup can cause a shoulder dislocation. We discuss the presentation, epidemiology, diagnosis, and complications of these common dislocations.
Any bad layup can cause a shoulder dislocation. We discuss the presentation, epidemiology, diagnosis, and complications of these common dislocations. Any bad layup can cause a shoulder dislocation. We discuss the presentation, epidemiology, diagnosis, and complications of these common dislocations.
On point-of-care ocular ultrasound of the affected eye using the linear probe a round, mobile structure was noted in the posterior chamber with an absence of the lens in its typical position, consistent with posterior lens dislocation. In this case, ophthalmology was consulted for lens dislocation. and a sensitivity of 96.8% (2).
Background: Many clinicians have transitioned from procedural sedation and analgesia (PSA) in favor of intra-articular lidocaine (IAL) to manage anterior shoulder dislocation. PMID: 36181665 Clinical Question: In patients with acute anterior shoulder dislocations, how does IAL compare to PSA for closed reduction?
What is the biggest myth when it comes to the mechanism of injury for posterior glenohumeral shoulder dislocations? What physical exam maneuvers increase suspicion for posterior glenohumeral dislocation? What are the subtle findings on x-ray we should look for in patients with suspected posterior glenohumeral dislocation?
Sternoclavicular (SC) joint dislocation SC joint dislocation can occur with anterior or posterior displacement of the medial clavicular head. Anterior dislocations are mostly caused by medial impact to the lateral shoulder. Anterior dislocations are more common and generally regarded as less serious.
Musculoskeletal Ultrasonography to Diagnose Dislocated Shoulders: A ProspectiveCohort. Musculoskeletal Ultrasonography to Diagnose Dislocated Shoulders: A ProspectiveCohort. You suspect the patient may have a shoulder dislocation. He has no history of shoulder dislocations in the past. Reference: Secko et al.
Illustration by Yvonne Chow The Lisfranc Injury The lisfranc injury is any disruption of the joint and is a spectrum including ligamentous injury, dislocations and fractures. High energy mechanisms, such as MVCs or falls, are more likely to cause fracture-dislocations. Normal Lisfranc joint and ligament.
Most commonly caused by fracture or dislocation of vertebrae. Pathophysiology Primary injury happens at the time of the traumatic event or shortly after in the high cervical to mid-thoracic spine. This leads to descending sympathetic tracts being disrupted. Secondary spinal cord injury occurs hours to days after the initial insult.
The post Ep 179 Hand Injuries – Finger Tip Injuries, Jersey Finger, PIP Dislocations, Metacarpal Fractures, Thumb Injuries, Tendon Lacerations appeared first on Emergency Medicine Cases.
The post EM Quick Hits 21 TXA in GI Bleed, Pediatric DKA, POCUS for Shoulder Dislocations, Lisfranc Injuries, Dexamethasone for COVID Pneumonia, Consultation Tips appeared first on Emergency Medicine Cases.
Triquetrum fracture / dislocation or carpal ligamentous injury stage III – stage II injury + dislocated triquetrum; can be associated … Continue reading →
The final post about relocating dislocated shoulders – if you want to teach you patient with recurrent shoulder dislocations how to relocate … Continue reading →
We cover the new ACEP opioid policy statement, PE response teams during COVID-19, a SMART balanced fluid trial spin-off in septic shock, an AHA statement on drug-induced arrhythmia, and use of POCUS for shoulder dislocation.
Here are the factoids: Mean age was only 34 years, and only fractures of T11 to L5 were included Two-thirds of the injuries were due to falls, and most of the remaining ones were from car crashes Three-quarters were burst fractures, and the remaining were wedge or fracture-dislocation injuries There were no differences in early mobilization, residual (..)
Lower-extremity dislocations are less common in the emergency department (ED) than shoulder and elbow dislocations, and emergency clinicians’ experience with evaluation and reduction techniques is often limited. Nonetheless, these dislocations can be serious because of their association with vascular injury.
Join hosts Jeff Nusbaum, MD, and Nachi Gupta, MD on this episode of EMplify as they take you through the June 2018 issue of Emergency Medicine Practice: Managing Shoulder Injuries in the Emergency Department Fracture, Dislocation, and Overuse. Management of prehospital shoulder dislocation: feasibility and need of reduction.
Due to increased ligamentous laxity in this age group Occurs in children <8 yrs of age due to increased ligamentous laxity (> 8yrs, c-spine films should be similar to adults) Present at C2-C3 level (40%) or at the C3-C4 level (14%) Pseudosubluxation: Determination of Must obtain good lateral cervical spine radiographs in flexion and extension The (..)
The AP View Evaluates the ankle mortise, lateral process of the talus and soft tissue edema adjacent to the malleoli Image is obtained with the foot in dorsiflexion The adequate AP view should have: Distal tibiofibular overlap (normal is >6 mm) The lateral and medial malleoli in view Tibiotalar joint space open, but the mortise is not completely (..)
Michael Gibbs MD Adult Ortho Cases 004 Shoulder Dislocations. A review of Xray and ultrasound (POCUS) evaluation, dislocation types and reduction techniques Adult Orthopedic case interpretation.
Monteggia fracture-dislocation. There is fracture involving proximal third of ulna & disruption of radio capitellar line indicating dislocation of the … Continue reading →
The frontal chest x-ray shows a dislocated left shoulder. Subsequent dedicated left shoulder x-rays confirmed a posterior dislocation of left … Continue reading →
The x-rays show a posteriorly dislocated left shoulder. The frontal shoulder x-ray shows 3 signs of posterior shoulder dislocation. Light … Continue reading →
With thanks to Prathiba. Your patient is a 18 yo man who presents with left shoulder pain after falling off his skateboard directly onto the shoulder. When you examine him, he seems particularly te…
Anterior fat pads can be normal Galeazzi injuries are a radial shaft fracture with an ulna dislocation whereas Monteggia injuries are ulna fractures with radial dislocations Scaphoids injuries are prone to avascular necrosis due to variable blood supply r2 cpc: Acute Salicylate toxicity WITH drs. C above historical average.
Eponym: Monteggia fracture (1812) ulna fracture, radial head dislocation Mike Cadogan Giovanni Battista Monteggia Giovanni Battista Montéggia (1762-1815) was an Italian surgeon.
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