A 15 yo male with a Smith’s Fracture. The patient had fallen onto his flexed left wrist during a football match. There were no other injuries, however there was a history of a right sided wrist fracture in the recent past. On examination, the wrist appeared deformed in a classic ‘garden spade shape’, however the patient…
A 35 yo woman presents to the emergency department with a complaint of shoulder dislocation. There is a previous history of multiple dislocations, including two posterior dislocations. There has been no trauma, or seizure or other major force, as might be expected to cause a posterior dislocation, although posterior dislocation can occur in the absence…
How good are you at reading elbow X-rays? Here are some tools and rules that will help you pick up those elbow fractures. Fractures of the elbow usually fall into the following groups: CHILDREN: Supracondylar fractures ADULTS: Radial Head Fractures ELDERLY: Multiple Fractures Fractures are a CLINICAL Diagnosis. The x-ray merely confirms that you have found it….
A Maisonneuve fracture is caused by pronation and external rotation. It can be difficult to find, even if we get fixated on the ankle. The patient may present with a complaint of rolling their ankle and ankle pain. Be vigilant for this type of injury. It is made of two main components: A spiral fracture of…
Infection of the flexor tendon sheaths of the hand, represents a potential surgical emergency, due to these being closed compartments and swelling can result in necrosis. The same does not tend to occur in extensor tendons as they are open compartments. Infections to the flexor tendon sheath usually occur following a penetrating injury to the…
Introduction Scapholunate dissociation, also called rotatory subluxation of the scaphoid and sometimes also known as the Terry Thomas sign. It involves a disruption of the scapholunate ligament resulting in instability. The scapholunate ligament is U shaped and divided into three compartments. A complete fear of the dorsal part, results in dissociation. The cause is usually trauma,…
The forearm X-ray of a young man following a dirt bike accident are shown. Clinically he has a deformed distal radius. The X-ray shows a classic Galeazzi fracture. There is a fracture of the distal radius(usually distal third, with dorsal angulation) and a dislocation of the distal radioulnar joint. They can be split into Type I and type…
Introduction and a case Reflex Sympathetic Dystrophy, also called regional pain syndrome, is usually as a result of surgery or trauma and the diagnosis is made clinically. The presentation will include pain, swelling and vasomotor dysfunction. In the case shown here, a well-looking 45 year old woman, is triaged with a swollen, red and painful forearm….
Pelvic fractures are most often associated with massive trauma. In terms of skeletal injuries they account for about 3% of all injuries. However they have the potential to result in haemodynamic instability, leading to significant mortality. Approximately 10 years ago the mortality from multi trauma with pelvic ring disruptions and haemorrhagic shock approached 60% (J…
Here is a 3 minute video on the Whistler technique for putting in hips. Its quick and easy and really doesn’t allow you to hurt yourself. You use your legs to give you the traction. Just watch and see. Try it for yourself. I call it the under-over technique: I put my arm UNDER the…
Here is the case You have a 24 year old, right-handed tradesman, with who fell over playing football on the weekend. He has injured his right wrist, he has tenderness over distal radius and snuff box and his initial x-ray series is normal. What next? This blog contains the short answers, and the longer answers…
Fractures of the wrist or forearm are one of the most common diagnoses we make in the emergency department. The ability to put on a good plaster or brace is an essential skill. Sometimes what we put on resembles something carved out of a log of wood, certainly mine did. However my techniques has improved…
