SplintER Series: My Foot Doesn’t Work Right

Achilles tendon rupture

A 35-year-old male felt a painful “pop” in his posterior left lower leg while playing football. Afterward, his “foot didn’t work right anymore.” X-ray of the left ankle and tib/fib was normal but he was unable to ambulate. You plan an ultrasound over the area of maximal tenderness and discover the above image (Image 1.Ultrasound of the left posterior ankle 11cm proximal to the calcaneal insertion of the Achilles tendon.  Case courtesy of Robert Lystrup.)

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SplintER Series: Fracture After a Fall From a Bunk Bed

 

A 6-year-old male presents to the ED after a fall from his 5 foot high bunk bed causing elbow trauma. On exam, there is significant focal swelling, ecchymosis, and tenderness at the lateral left elbow. The forearm, wrist, hand and shoulder are nontender. He is neurovascularly intact. You  suspect a fracture and obtain x-rays (Figures 1 and 2).
 
Elbow x-ray

Figure 1: Initial radiographs in the ED with the elbow slightly flexed.

Elbow x-ray

Figure 2: AP and lateral radiographs of the elbow.

 

 

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SplintER Series: One Big Bounce

 

A 5-year-old boy presents with right leg pain and a limp. His parents report it started after he was bouncing on the trampoline with his older sibling but they did not notice any specific trauma. He has tenderness over his proximal shin with no obvious injury. You suspect a fracture and obtain x-rays of the right knee (Figure 1).

Figure 1. AP and Lateral x-rays of the right knee. Case courtesy of Dr Andrew Dixon, Radiopaedia.org, rID: 16139

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SplintER Series: To Immobilize or Not to Immobilize: That is the Question

A patient presents to the Emergency Department after sustaining a twisting knee injury while skiing. She felt a pop and was unable to bear weight afterward secondary to pain and a feeling of instability. Shortly after the injury, she noted increased swelling and pain. On examination, she has a moderate effusion and a positive Lachman test. An x-ray was obtained and is shown above (Image 1. Case courtesy of Mikael Häggström, M.D. – Author info – Reusing images, CC0, via Wikimedia Commons).

 

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