SplintER Series: Funny Looking Finger

right 5th digit xray mallet finger

Figure 1: Terminal extensor tendon avulsion at distal interphalangeal joint of 5th digit

A 17-year-old baseball player presents complaining of finger pain and difficulty straightening his finger after a baseball game. You obtain x-rays and see the following fracture (photo credit).

What is your diagnosis and emergency department management?

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Fascia iliaca nerve block: A hip fracture best-practice

fascia iliaca nerve block hip fracture

An 82-year-old woman presents with left hip pain after a mechanical fall while cleaning the kitchen floor. When EMS arrived, the left leg was foreshortened and externally rotated. The paramedics administered 10 mg of IV morphine, but she is still writhing in pain on arrival. The AP pelvic x-ray demonstrates a left femoral neck fracture (arrow). You consider performing a fascia iliaca nerve block for better pain control.

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By |2020-11-27T19:04:06-08:00Aug 21, 2019|Orthopedic, Ultrasound|

SplintER Series: Ankle Dislocation | Leg Day #4

Welcome to Leg Day #4 of the SplintER Series! Ankle dislocations are an emergent condition in the Emergency Department (ED) that requires expert-level examination and management. We review the pertinent and subtle sports medicine examination and management techniques that will help you feel in control from time of presentation to disposition. 

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SplintER Series: A Case of Traumatic Wrist Pain After Fall on Outstretched Hand

lunate dislocation xray

A 46 year-old male presents with wrist pain after sustaining a mechanical fall and catching himself on his outstretched hand. An anteroposterior (left) and lateral (right) plain films of the wrist are obtained (photo credit).

What is the diagnosis (hint – there are 2 findings), injury classification system, associated findings, and the recommended management plan?

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SplintER Series: Case of a First Metacarpal Fracture



first metacarpal fracture

Click image to enlarge view

A 22 year-old male was playing football when he fell, landing on his outstretched left arm with his thumb flexed. He now has pain at the base of his thumb. This AP view of the hand best demonstrates the injury (photo credit).

What is this fracture, what additional imaging is needed, and what should be the management plan?

 

 

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By |2019-05-09T18:07:02-07:00May 13, 2019|Orthopedic, SplintER|

SplintER Series: 2-Minute Knee Exam | Leg Day #3 | MSK Exam Series

Knee Pain

Welcome to Leg Day #3 of the SplintER Series! Performing a fast and focused history and physical examination of a patient with an acute knee injury is an important skill that has the potential to be overlooked in our busy Emergency Departments. Our hope is that after reviewing this post and with enough practice you will be able to complete your exam within 2 minutes! These are can’t-miss points and expert tips on the knee exam for your next shift in the ED.

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