BOOK
Orthopedic Emergencies, An Issue of Emergency Medicine Clinics of North America, E-Book
(2015)
Additional Information
Book Details
Abstract
For this issue, Drs. David Della-Giustina and Katja Goldflam have provided an excellent array of topics and authors concerning Orthopedic Emergencies. Articles include: Evaluation and Treatment of the Neck and Cervical Spine, Evaluation and Treatment of Hand Injuries,Evaluation and Treatment of Wrist Injuries,Evaluation and Treatment of Elbow and Forearm Injuries,Evaluation and Treatment of the Shoulder and Humerus, Evaluation and Treatment of Pelvic Injuries, Evaluation and Treatment of Foot and Ankle Injuries, and more!
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Orthopedic Emergencies | i | ||
| Copyright\x0B | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Foreword: Orthopedic Emergencies\r | vii | ||
| Preface: The Evaluation and Management of Orthopedic Trauma and Emergencies\r | vii | ||
| Emergency Department Evaluation and Treatment of Cervical Spine Injuries\r | vii | ||
| Emergency Department Evaluation and Treatment of Wrist Injuries\r | vii | ||
| Emergency Department Evaluation and Treatment of the Shoulder and Humerus\r | vii | ||
| Evaluation and Treatment of Acute Back Pain in the Emergency Department\r | viii | ||
| Emergency Department Evaluation and Treatment of Acute Hip and Thigh Pain\r | viii | ||
| Evaluation and Management of Traumatic Knee Injuries in the Emergency Department\r | viii | ||
| Emergency Department Evaluation and Management of Foot and Ankle Pain\r | viii | ||
| The Emergent Evaluation and Treatment of Hand Injuries\r | ix | ||
| Evaluation and Treatment of the Elbow and Forearm Injuries in the Emergency Department\r | ix | ||
| Evaluation and Treatment of the Elbow and Forearm Injuries in the Emergency\rDepartment\r | ix | ||
| Orthopedic Emergencies: A Practical Emergency Department Classification (US-VAGON) in Pelvic Fractures\r | ix | ||
| EMERGENCY MEDICINE\rCLINICS OF NORTH AMERICA\r | xi | ||
| FORTHCOMING ISSUES | xi | ||
| August 2015 | xi | ||
| November 2015 | xi | ||
| February 2016 | xi | ||
| RECENT ISSUES | xi | ||
| February 2015 | xi | ||
| November 2014 | xi | ||
| August 2014 | xi | ||
| PROGRAM OBJECTIVE | xii | ||
| TARGET AUDIENCE | xii | ||
| LEARNING OBJECTIVES | xii | ||
| ACCREDITATION | xii | ||
| DISCLOSURE OF CONFLICTS OF INTEREST | xii | ||
| UNAPPROVED/OFF-LABEL USE DISCLOSURE | xii | ||
| TO ENROLL | xii | ||
| METHOD OF PARTICIPATION | xiii | ||
| CME INQUIRIES/SPECIAL NEEDS | xiii | ||
| Foreword: Orthopedic Emergencies \r | xv | ||
| Preface: The Evaluation and Management of Orthopedic Trauma and Emergencies \r | xvii | ||
| Erratum | xix | ||
| Emergency Department Evaluation and Treatment of Cervical Spine Injuries | 241 | ||
| Key points | 241 | ||
| EPIDEMIOLOGY | 242 | ||
| ANATOMY | 242 | ||
| INITIAL MANAGEMENT | 246 | ||
| AIRWAY MANAGEMENT | 246 | ||
| Immobilization | 247 | ||
| SHOCK | 248 | ||
| IMAGING OF THE CERVICAL SPINE | 249 | ||
| Clinical Decision-making Tools | 249 | ||
| National Emergency X-Radiography Utilization Study | 250 | ||
| Canadian C-spine Rule | 251 | ||
| Comparing the Clinical Decision-making Tools | 251 | ||
| Imaging Modalities | 252 | ||
| Plain radiography | 252 | ||
| Computed tomography | 252 | ||
| MRI | 253 | ||
| Spinal Cord Injury Without Radiographic Abnormality | 253 | ||
| TYPES OF CERVICAL SPINE INJURIES | 253 | ||
| Upper Cervical Spine Injuries | 253 | ||
| Atlanto-occipital dislocation | 254 | ||
| Fracture of the atlas | 256 | ||
| Atlantoaxial ligamentous injuries | 257 | ||
| Fractures of the dens | 259 | ||
| Traumatic spondylolisthesis of the axis | 259 | ||
| The Hangman’s fracture | 260 | ||
| Other injuries of the atlas and axis | 261 | ||
| Subaxial Cervical Spine Injuries | 261 | ||
| Cervical hyperflexion injuries | 261 | ||
| Rotational injuries | 263 | ||
| Cervical hyperextension injuries | 264 | ||
| Compression injuries | 265 | ||
| ASSOCIATED INJURIES | 265 | ||
| Spinal Cord Injuries | 265 | ||
| Glucocorticoid and Cooling: Use for Traumatic Spinal Cord Injury | 270 | ||
| Vascular Injuries | 271 | ||
| Soft Tissue Injuries | 272 | ||
| INJURED ATHLETE | 273 | ||
| SUMMARY | 278 | ||
| REFERENCES | 278 | ||
| Emergency Department Evaluation and Treatment of Wrist Injuries | 283 | ||
| Key points | 283 | ||
| NORMAL ANATOMY, RADIOGRAPHY, AND PHYSICAL EXAMINATION | 284 | ||
| Normal Anatomy and Radiography | 284 | ||
| Normal Physical Examination | 284 | ||
| DISTAL RADIUS FRACTURES | 285 | ||
| Background | 285 | ||
| Diagnosis | 286 | ||
| Treatment | 287 | ||
| Complications | 288 | ||
| SCAPHOID INJURIES | 289 | ||
| Background | 289 | ||
| Diagnosis | 289 | ||
| Treatment | 290 | ||
| Complications | 290 | ||
| CARPAL FRACTURES EXCLUDING THE SCAPHOID | 290 | ||
| Lunate | 290 | ||
| Triquetrum | 291 | ||
| Pisiform | 291 | ||
| Trapezium | 292 | ||
| Trapezoid | 292 | ||
| Capitate | 292 | ||
| Hamate | 292 | ||
| CARPAL DISLOCATIONS | 293 | ||
| Scapholunate Dissociation | 293 | ||
| Lunate and Perilunate Dislocations | 293 | ||
| Treatment of Carpal Dislocations | 295 | ||
| REFERENCES | 295 | ||
| Emergency Department Evaluation and Treatment of the Shoulder and Humerus | 297 | ||
| Key points | 297 | ||
| BACKGROUND | 297 | ||
| EPIDEMIOLOGY | 297 | ||
| IMAGING | 298 | ||
| Anteroposterior Projection | 298 | ||
| Axillary View | 298 | ||
| Y View | 298 | ||
| PROXIMAL HUMERUS FRACTURES | 298 | ||
| HUMERAL SHAFT FRACTURES | 299 | ||
| CLAVICLE FRACTURES | 300 | ||
| SCAPULA FRACTURES | 300 | ||
| Scapular Body Fractures | 301 | ||
| Acromion Fractures | 301 | ||
| Scapular Neck Fractures | 301 | ||
| Glenoid Fractures | 301 | ||
| ACROMIOCLAVICULAR DISLOCATIONS | 302 | ||
| ANTERIOR GLENOHUMERAL SHOULDER DISLOCATIONS | 303 | ||
| Prereduction Radiography | 303 | ||
| ANTERIOR SHOULDER DISLOCATION REDUCTION TECHNIQUES | 303 | ||
| Traction-Countertraction Technique | 304 | ||
| Scapular Manipulation | 304 | ||
| Stimson Technique | 304 | ||
| External Rotation | 304 | ||
| Milch Technique | 304 | ||
| Spaso Technique | 305 | ||
| POSTERIOR DISLOCATION | 305 | ||
| INFERIOR DISLOCATION (LUXATIO ERECTA) | 305 | ||
| SUPERIOR DISLOCATION | 305 | ||
| ROTATOR CUFF INJURIES | 306 | ||
| Tendonitis | 306 | ||
| Impingement Syndrome | 306 | ||
| Rotator Cuff Tears | 306 | ||
| REFERENCES | 307 | ||
| Evaluation and Treatment of Acute Back Pain in the Emergency Department | 311 | ||
| Key points | 311 | ||
| INTRODUCTION: NATURE OF THE PROBLEM | 311 | ||
| PATIENT HISTORY | 312 | ||
| Duration of Symptoms | 312 | ||
| Age | 313 | ||
| Location and Radiation of the Pain | 313 | ||
| History of Trauma | 313 | ||
| Systemic Complaints | 313 | ||
| Atypical Pain Features | 314 | ||
| Associated Neurologic Deficits | 314 | ||
| History of Cancer | 314 | ||
| Urinary, Abdominal, or Chest Complaints | 314 | ||
| PHYSICAL EXAMINATION | 315 | ||
| Vital Signs | 315 | ||
| General Appearance | 315 | ||
| Abdomen | 315 | ||
| Back | 315 | ||
| Perform a Straight Leg Raise Test | 315 | ||
| Neurologic Examination | 316 | ||
| Rectal Examination | 316 | ||
| IMAGING AND ADDITIONAL TESTING | 316 | ||
| Laboratory Tests | 317 | ||
| DIAGNOSTIC IMAGING | 317 | ||
| Plain Radiographs | 317 | ||
| MRI | 317 | ||
| Computed Tomography | 317 | ||
| DIFFERENTIAL DIAGNOSIS | 317 | ||
| Nonspecific Back Pain | 317 | ||
| Treatment options | 318 | ||
| PHARMACOLOGIC TREATMENT OPTIONS | 318 | ||
| Nonsteroidal Anti-inflammatory Drugs | 318 | ||
| Acetaminophen | 318 | ||
| Opiate Analgesics | 318 | ||
| Muscle Relaxants | 318 | ||
| Steroids | 318 | ||
| NONPHARMACOLOGIC TREATMENT OPTIONS | 318 | ||
| Activity Modification | 318 | ||
| Spinal Manipulation | 319 | ||
| Other Physical Modalities | 319 | ||
| HERNIATED DISC | 319 | ||
| Treatment Options | 319 | ||
| PHARMACOLOGIC TREATMENT OPTIONS | 320 | ||
| Nonsteroidal Anti-inflammatory Drugs, Acetaminophen, and Muscle Relaxants | 320 | ||
| Steroids | 320 | ||
| NONPHARMACOLOGIC TREATMENT OPTIONS | 320 | ||
| Activity Modification | 320 | ||
| Manipulation and Other Physical Modalities | 320 | ||
| Surgical Treatment Options | 320 | ||
| SPINAL INFECTION | 321 | ||
| Treatment Options | 321 | ||
| EPIDURAL COMPRESSION SYNDROME | 321 | ||
| Treatment Options | 322 | ||
| BACK PAIN IN THE PATIENT WITH A HISTORY OF CANCER | 323 | ||
| SUMMARY | 324 | ||
| REFERENCES | 324 | ||
| Emergency Department Evaluation and Treatment of Acute Hip and Thigh Pain | 327 | ||
| Key points | 327 | ||
| INTRODUCTION | 327 | ||
| APPROACH | 328 | ||
| TRAUMA | 328 | ||
| Epidemiology and Mechanism | 328 | ||
| Relevant Anatomy | 328 | ||
| Imaging Choices | 329 | ||
| Femur Fracture | 329 | ||
| Femoral Head Fractures | 329 | ||
| Femoral Neck Fractures | 329 | ||
| Intertrochanteric and Subtrochanteric Fractures | 330 | ||
| Trochanteric Fractures | 330 | ||
| Femoral Shaft Fractures | 331 | ||
| Stress Fractures | 332 | ||
| HIP DISLOCATION | 332 | ||
| Treatment of Uncomplicated Dislocations | 333 | ||
| AVASCULAR NECROSIS | 334 | ||
| TOURNIQUETS | 335 | ||
| MUSCULOTENDINOUS INJURIES OF THE HIP AND THIGH | 335 | ||
| Compartment Syndrome of the Thigh | 336 | ||
| PERIPHERAL NERVE BLOCKADE | 336 | ||
| SUMMARY | 337 | ||
| REFERENCES | 337 | ||
| Evaluation and Management of Traumatic Knee Injuries in the Emergency Department | 345 | ||
| Key points | 345 | ||
| KNEE ANATOMY AND FUNCTION | 345 | ||
| Osseous and Meniscal Structures | 346 | ||
| Ligaments | 346 | ||
| Neurovascular Structures | 346 | ||
| HISTORY AND EXAMINATION OF THE UNDIFFERENTIATED KNEE INJURY | 346 | ||
| History | 346 | ||
| Physical Examination | 346 | ||
| EMERGENCY DEPARTMENT IMAGING OF THE UNDIFFERENTIATED KNEE INJURY | 346 | ||
| Clinical Decision Rules | 346 | ||
| Plain Radiography | 347 | ||
| Ultrasonography | 347 | ||
| Computed Tomography | 347 | ||
| MRI | 348 | ||
| DISPOSITION OF A PATIENT WITH AN UNDIFFERENTIATED KNEE INJURY | 348 | ||
| ANTERIOR CRUCIATE LIGAMENT INJURIES | 348 | ||
| History | 348 | ||
| Physical Examination | 348 | ||
| POSTERIOR CRUCIATE LIGAMENT INJURIES | 349 | ||
| History | 349 | ||
| Physical Examination | 349 | ||
| COLLATERAL LIGAMENT INJURIES | 350 | ||
| History | 350 | ||
| Physical Examination | 350 | ||
| RADIOGRAPHIC EVALUATION OF LIGAMENTOUS INJURIES | 350 | ||
| MANAGEMENT OF LIGAMENTOUS INJURIES | 351 | ||
| MENISCAL INJURIES | 351 | ||
| History | 351 | ||
| Physical Examination | 351 | ||
| Imaging | 352 | ||
| Management | 352 | ||
| QUADRICEPS AND PATELLAR TENDON INJURIES | 352 | ||
| History | 352 | ||
| Physical Examination | 352 | ||
| Imaging | 353 | ||
| Management | 353 | ||
| PATELLAR SLEEVE FRACTURE | 354 | ||
| PATELLAR DISLOCATION | 354 | ||
| History | 354 | ||
| Physical Examination | 354 | ||
| Emergency Department Evaluation and Management of Foot and Ankle Pain | 363 | ||
| Key points | 363 | ||
| FOOT AND ANKLE | 363 | ||
| THE FOOT | 363 | ||
| Anatomy | 364 | ||
| History | 365 | ||
| PHYSICAL EXAMINATION | 365 | ||
| Radiographic Imaging | 367 | ||
| HINDFOOT INJURIES | 367 | ||
| Talus | 367 | ||
| Calcaneal Fractures | 369 | ||
| MIDFOOT INJURIES | 370 | ||
| Navicular Fracture | 370 | ||
| Cuboid Fractures | 371 | ||
| Lisfranc Injuries | 371 | ||
| FOREFOOT | 372 | ||
| Metatarsal Injuries | 372 | ||
| Traumatic metatarsal fractures | 372 | ||
| Metatarsal stress fractures | 372 | ||
| Fifth metatarsal injury | 373 | ||
| Phalangeal injuries | 374 | ||
| Management of phalangeal dislocations | 375 | ||
| SUMMARY | 375 | ||
| THE ANKLE | 376 | ||
| Anatomy | 376 | ||
| Laterally | 376 | ||
| Medially | 377 | ||
| Anteroposterior | 377 | ||
| History | 377 | ||
| Physical Examination | 378 | ||
| Specific tests | 378 | ||
| Anterior drawer | 378 | ||
| Talar tilt | 378 | ||
| Squeeze test | 379 | ||
| Thompson test | 380 | ||
| Radiographic Imaging | 380 | ||
| Ottawa Ankle Rules | 380 | ||
| Adjunctive studies | 381 | ||
| Fractures | 382 | ||
| Treatment | 382 | ||
| Unimalleolar Fractures | 383 | ||
| Bimalleolar and Trimalleolar Fractures | 384 | ||
| Pilon Fractures | 385 | ||
| Talar Dome Fractures | 385 | ||
| Maissonneuve Fracture | 386 | ||
| Sprains | 387 | ||
| Lateral Sprains | 387 | ||
| Grade I | 387 | ||
| Grade II | 388 | ||
| Grade III | 388 | ||
| Medial Sprains | 388 | ||
| Syndesmotic Injuries | 389 | ||
| Tendon Injuries | 389 | ||
| Achilles tendon rupture | 389 | ||
| Peroneal tendon injuries | 389 | ||
| SUMMARY | 390 | ||
| REFERENCES | 390 | ||
| The Emergent Evaluation and Treatment of Hand Injuries | 397 | ||
| Key points | 397 | ||
| BACKGROUND | 397 | ||
| EPIDEMIOLOGY | 397 | ||
| HAND ANATOMY | 398 | ||
| Digital Metacarpals | 398 | ||
| Phalanges | 398 | ||
| Soft Tissue Structures | 398 | ||
| EXAMINATION | 399 | ||
| IMAGING | 399 | ||
| GENERAL TREATMENT | 401 | ||
| FRACTURES | 401 | ||
| Metacarpals | 401 | ||
| Thumb metacarpal | 401 | ||
| Bennett fracture | 401 | ||
| Rolando fracture | 402 | ||
| Extra-articular fractures of the thumb metacarpal | 402 | ||
| Metacarpal head fractures (of all 5 digits) | 402 | ||
| Metacarpal neck fractures | 402 | ||
| Metacarpal shaft fractures | 402 | ||
| Metacarpal base fractures | 403 | ||
| Complications of Metacarpal Fractures | 403 | ||
| Phalangeal Fractures | 403 | ||
| Distal phalanx | 403 | ||
| Middle phalanx | 403 | ||
| Proximal phalanx | 403 | ||
| DISLOCATIONS | 404 | ||
| LIGAMENT INJURIES | 404 | ||
| TENDON INJURIES | 405 | ||
| Extensor Tendon Injuries | 405 | ||
| Boutonniere Deformity | 406 | ||
| Flexor Tendon Injuries | 406 | ||
| SUMMARY | 407 | ||
| REFERENCES | 407 | ||
| Evaluation and Treatment of the Elbow and Forearm Injuries in the Emergency Department | 409 | ||
| Key points | 409 | ||
| BACKGROUND | 409 | ||
| EPIDEMIOLOGY | 410 | ||
| ELBOW AND FOREARM ANATOMY | 410 | ||
| Elbow | 410 | ||
| Forearm | 410 | ||
| IMAGING | 411 | ||
| Anteroposterior View | 411 | ||
| Lateral View | 411 | ||
| Oblique View | 412 | ||
| Forearm | 412 | ||
| SIMPLE ELBOW DISLOCATIONS | 412 | ||
| Evaluation | 413 | ||
| Treatment | 413 | ||
| ELBOW FRACTURES | 414 | ||
| Distal Humerus Fracture | 414 | ||
| Olecranon Fracture | 414 | ||
| Radial Head Fractures | 415 | ||
| Coronoid Process Fractures | 415 | ||
| The Terrible Triad | 416 | ||
| FOREARM FRACTURES | 416 | ||
| Diaphyseal Radius and Ulna Fractures | 416 | ||
| Monteggia Lesions | 417 | ||
| Galeazzi Fracture–Dislocations | 417 | ||
| Essex–Lopresti Injuries | 418 | ||
| REFERENCES | 418 | ||
| Emergency Department Evaluation and Treatment of Pediatric Orthopedic Injuries | 423 | ||
| Key points | 423 | ||
| INTRODUCTION: NATURE OF THE PROBLEM | 423 | ||
| PEDIATRIC ORTHOPEDIC BASICS | 424 | ||
| PHYSEAL FRACTURES | 424 | ||
| Salter-Harris Classification | 424 | ||
| Type I | 424 | ||
| Type II | 424 | ||
| Type III | 425 | ||
| Type IV | 425 | ||
| Type V | 425 | ||
| TREATING THE ORTHOPEDICALLY INJURED CHILD | 426 | ||
| History | 426 | ||
| Physical and Diagnostic Evaluation | 426 | ||
| UPPER EXTREMITY INJURIES | 426 | ||
| Clavicle | 426 | ||
| Shoulder Dislocations | 426 | ||
| Humerus | 427 | ||
| Supracondylar Fractures | 427 | ||
| Elbow Injuries | 429 | ||
| ANATOMY | 429 | ||
| Radial Head Subluxation | 430 | ||
| Elbow Fractures | 432 | ||
| Condylar fractures | 432 | ||
| Forearm Fractures | 432 | ||
| Physeal Fractures | 432 | ||
| Complete Fractures | 433 | ||
| Buckle (Torus) Fractures | 434 | ||
| Greenstick Fractures | 434 | ||
| Ulnar Styloid Fractures | 435 | ||
| LOWER EXTREMITY INJURIES | 435 | ||
| Hip Pain | 435 | ||
| Transient Synovitis Versus Septic Arthritis | 436 | ||
| Legg-Calvé-Perthes Disease | 438 | ||
| Slipped Capital Femoral Epiphysis | 439 | ||
| Toddler’s Fracture | 440 | ||
| Tillaux and Triplane Fractures | 440 | ||
| CHILD ABUSE | 442 | ||
| Diagnosis | 443 | ||
| History | 443 | ||
| Physical Examination | 444 | ||
| Radiography | 444 | ||
| Radiographic Features of Child Abuse | 444 | ||
| SUMMARY | 445 | ||
| REFERENCES | 445 | ||
| Orthopedic Emergencies | 451 | ||
| Key points | 451 | ||
| TRADITIONAL CLASSIFICATIONS OF PELVIC FRACTURES | 452 | ||
| EMERGENCY DEPARTMENT CLASSIFICATION OF PELVIC FRACTURES | 453 | ||
| UNSTABLE PELVIC FRACTURES | 453 | ||
| STABLE PELVIC FRACTURES | 454 | ||
| Class I. Potential Hemorrhagic/Vascular Complications | 454 | ||
| Class II. Potential Genitourinary or Gastrointestinal Complications | 455 | ||
| Class III. Potential Orthopedic Complications | 455 | ||
| Class IV. Potential Neurologic Complications | 455 | ||
| Class V. Uncomplicated | 455 | ||
| Class I Fractures (Potential Hemorrhagic Complications) | 455 | ||
| Any pelvic fracture with 5 mm or more displacement | 455 | ||
| Open-book injury/pelvic dislocation | 455 | ||
| Open pelvic fracture | 456 | ||
| Emergency department management of class I fractures (potential hemorrhagic complications) | 457 | ||
| Class II Fractures (Potential Genitourinary and Gastrointestinal Complications) | 457 | ||
| Subluxation of the pubic symphysis | 457 | ||
| Straddle fracture | 457 | ||
| Malgaigne fracture and bucket handle fracture | 458 | ||
| Open-book fracture/pelvic dislocation | 459 | ||
| Emergency department management of class II fractures (potential genitourinary/gastrointestinal complications) | 459 | ||
| Class III Fractures (Potential Orthopedic Complication) | 460 | ||
| Emergency department management of class III fractures (potential orthopedic complications) | 460 | ||
| Class IV Fractures (Potential Neurologic Complications) | 461 | ||
| Sacral fractures | 461 | ||
| Acetabular fractures | 462 | ||
| Emergency department management of class IV fractures (potential neurologic complications) | 464 | ||
| Class V Fractures (Uncomplicated) | 464 | ||
| Avulsion fractures | 464 | ||
| Single pubic and ischial rami fractures and unilateral double rami fractures | 466 | ||
| Iliac wing fracture (Duverney fracture) | 467 | ||
| Coccyx fractures | 468 | ||
| Ischial body fractures | 468 | ||
| Emergency department management of class V fractures (uncomplicated) | 468 | ||
| SUMMARY | 468 | ||
| REFERENCES | 468 | ||
| Index | 475 |