Achilles Tendon Rupture

A 41 year-old male without significant past medical history presents to the emergency department after sudden onset right leg pain while playing soccer. The patient reports jumping for the ball, landing on his feet, and immediately feeling sharp pain in his right ankle. On exam, he has mild swelling to the posterior ankle overlying the Achilles tendon, and the area is tender to palpation. Plantarflexion is absent with calf squeeze, neurovascular exam is normal, and the remainder of patient’s exam is unremarkable…

Orthopedics, Sports MedicineJessie WernerSeptember 13, 2019Orthopedics, Achilles tendon, Tendon rupture, Sports medicineComment

Give 'Em the Old One-Two: Boxer's Fracture

OrthopedicsSamuel GoldmanAugust 16, 2019Orthopedics, #FOAMed, Boxer's Fracture, Metacarpal FractureComment

Non-Accidental Trauma

A hypothetical 7 month-old infant presents to the emergency department for mild respiratory distress. There is no recent illness or symptoms to explain the infant’s tachypnea and mild hypoxia. There is no visible bruising on exam. The parent states that the infant is starting to pull to stand but does not yet cruise. They have had several falls onto their tile kitchen floor. The CXR (below) is read by the radiologist left posterior rib fractures in ribs 4-8…

Orthopedics, PediatricsGuest UserAugust 2, 2019Orthopedics, PediatricsComment

Acromioclavicular Joint Injury

A 19 year-old male presents to the emergency department with a complaint of right shoulder pain. He was tackled from behind in a rugby game three days prior to presentation and has been experiencing pain over the anterior aspect of his right shoulder since that time. Physical exam is notable for tenderness over the right acromioclavicular (AC) joint and pain with both active and passive range of motion of the right shoulder. X-rays (Figure 1) show “no obvious fracture or subluxation.” However, based on your exam and clinical suspicion, closer inspection reveals abnormal alignment between the clavicle and the acromion consistent with AC joint injury…

OrthopedicsAlexander DaytonJuly 26, 2019Orthopedics, Acromioclavicular Joint, Shoulder traumaComment

An Open-and-Shut Case? Diagnosis and Management of Open Fractures in the Emergency Department

A 53 year-old woman with no past medical history stepped out of the house to walk her dog when she slipped on the icy front stairs. She noted immediate pain and an obvious deformity of her right ankle, but denied head strike, loss of consciousness, or other symptoms…

OrthopedicsAustin QuinnApril 26, 2019Orthopedics, Open Joint, Fracture, Saline load test, AntibioticsComment

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