• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Orthopaedics for the emergency department
 

Orthopaedics for the emergency department

on

  • 1,318 views

 

Statistics

Views

Total Views
1,318
Views on SlideShare
749
Embed Views
569

Actions

Likes
0
Downloads
28
Comments
0

2 Embeds 569

http://emtutorials.com 566
http://feeds.feedburner.com 3

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Orthopaedics for the emergency department Orthopaedics for the emergency department Presentation Transcript

    • MrAnjan K Banerjee
    • A Cook’s Tour Fractures Infection Back Pain & Sciatica Complications
    • Fractures Hand/Wrist Forearm Elbow Humerus Shoulder Foot Ankle/Tibia Knee Femur Hip Spine
    • Wrist & Hand Colles Smith’s Barton’s Perilunate dislocation Metacarpals Fingers
    • Fingers
    • Metacarpal
    • Metacarpal
    • Scaphoid
    • Scaphoid
    • Perilunate Capitate lunate
    • Colles
    • Barton’s
    • Styloid
    • Forearm Radial styloidIsolated ulna # Radial head“Nightstick #”From a direct blow tothe mid forearm.(Night stick is an oldname for a policetruncheon)
    • Galeazzi # Needs ORIF
    • Monteggia #Radius should lineup with thecapitellum.“MonteggiaMoreMedial” (thanGalezzi) (if patient’sarms where stickingout) Capitellum
    • Supracondylar fracturesGartland I & II
    • Gartland II & III
    • Ankle – Images I should not see
    • Ankle – Images I should not see
    • Cervical Spine Canadian Rules. Always Consider the mechanism.
    • Cervical Spine
    • Remember Collar & Blocks
    • Lumbar SpineDirect Axial Compression
    • Thoracic Spine
    • Salter-Harris S Slipped SH1 A Above SH2 L beLow SH3 T Through SH4 ER er, the mnemonic falls apart. Squashed SH5 Usually worse as you go down the list.
    • Extracapsular Hip Fracturesaka Proximal Femoral Fractures
    • Intracapsular Hip Fractures
    • Management Assessment. Analgesia. Immobilize Limb (Where Possible). Be Aware of the Risk of Compartment Syndrome.
    • Open Fractures Tetanus. IV Augmentin/ Cefuroxime. Blood Loss?
    • Infection – Septic Arthritis Fever including Rigors/ Swinging Fever. Pseudoparalysis / unable to move joint due to pain. Hot swollen tender joint. Can affect any joint.
    • Infection - Ix FBC, CRP, Blood Cultures & Aspirate. X-rays. ESR/ Plasma viscosity. Urate
    • Infection - Pitfalls Psuedo/ GOUT. Transient Synovitis. Implants.
    • Cellulitis Upper limb & Hand. Lower Limb & Foot. Peripheral arterial foot problems – Gen Surg. Diabetic Foot with microvascular disease – Gen Surg then Ortho.
    • Tendons Tendo-Achilles/ Calf Tear.  TA may require surgery (or cast in dorsal slab or full equinus cast) EPL/FPL. Quadriceps. Hamstrings.
    • Back Pain & Sciatica Red Flags  Cancer, steroids, IVDU, weight loss, fever, night pain, age > 50, significant trauma, pain worse on lying down. MRI/ X-ray? Treatment.
    • Not All Back pain is Like This!
    • Complications DO NOT TREAT PERIPROSTHETIC INFECTION IN THE COMMUNITY!
    • Complications Fractures in POP can still displace Re-X-ray after applying a cast with Manipulation. Re-Xray if represents with increasing pain. If metal in-situ, Re-X-ray & Inflammatory markers.
    • Not All Ortho Registrars are like this!
    • Questions?
    • Tibial plateau Sometimes difficult to see fracture line  May just have one plateau lower than the other or  One plateau wider than the femur  Typically from a blow to the lateral knee eg from a car bumper  Tender over proximal tibia.