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: 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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