Category: Orthopedics

Shoulder Dislocations

What’s the best maneuver for reducing a dislocated shoulder? My guess is as good as yours. There are multiple maneuvers that work – and work well for anterior (AKA anterior-inferior) dislocations. This episode reviews how to manage shoulder dislocations in the Pediatric population.

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References

Fox, Shoulder Dislocations. Pediatric EM Morsels. July 31, 2015. https://pedemmorsels.com/shoulder-dislocation/. Accessed June 23, 2021.

Zacchilli MA Owens BD. Epidemiology of shoulder dislocations presenting to emergency departments in the United States. J Bone Joint Surg Am. 2010 Mar;92(3):542-9. PMID: 20194311.

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Orthopedics

Finger Dislocations

It is much more common for children to break a finger than dislocate one. Why? Those darn growth plates. Nevertheless reducing a dislocated digit is one of the most common emergency procedures around and can generally be performed without much difficulty. However there are some situations where you shouldn’t just yank in the digit. Learn about these situations and more in this episode.

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References

Borchers et al. Common Finger Fractures and Dislocations. Am Fam Physician. 2012 Apr 15;85(8):805-810.

Ahn and Blomberg. Phalanx Dislocations. Ortho Bullets. https://www.orthobullets.com/hand/6038/phalanx-dislocations. Updated 5/17/21. Accessed June 23, 2021.

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Orthopedics

Patella Dislocations

Reducing a dislocated patella is super satisfying – both for the clinician and the patient. This episode reviews management of this common orthopedic concern so that you can perform a reduction maneuver without needing to call Orthopedics.

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References

Fithian DC,Paxton EW,Stone ML,Silva P,Davis DK,Elias DA,White LM, Epidemiology and natural history of acute patellar dislocation. The American journal of sports medicine. 2004 Jul-Aug; [PubMed PMID: 15262631]

Jain NP,Khan N,Fithian DC, A treatment algorithm for primary patellar dislocations. Sports health. 2011 Mar; [PubMed PMID: 23016004]

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Orthopedics

Nursemaid’s Elbow

Never has there been a more anachronistic name for such a common malady. Hailing from the time when the wealthy had female domestic workers who cared for children within their large household, this outmoded eponym describes a common orthopedic condition that impacts young children. I’ll cast my vote for calling it “pulled elbow” like they do in Australia – because it describes when happens when the radial head subluxes from its usual position nestled in the annular ligament. This episode discusses the diagnosis and management of this can’t miss condition, that I suspect our residents and students aren’t seeing as much as they should.

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References

Macias CG, Bothner J, Wiebe R. A comparison of supination/flexion to hyperpronation in the reduction of radial head subluxations. Pediatrics. 1998 Jul;102(1):e10. doi: 10.1542/peds.102.1.e10. PMID: 9651462.

Nardi NM, Schaefer TJ. Nursemaid Elbow. [Updated 2020 Nov 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.

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Orthopedics

Foot Fractures

Don’t toe the line when it comes to your education. Step up, don’t be a heel, and listen to this episode of PEM Currents: The Pediatric Emergency Medicine Podcast focusing on fractures of the feet and toes. Learn all about metatarsal fractures, including the Jones fracture, Lisfranc injuries, why you should worry about a fracture of the talar neck, and more in this seventh and final epode of the Fracture Season.

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

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References

Inokuchi et al. Calcaneal fractures in children. J Pediatr Orthop. 1998;18(4):469.

Lim et al. Pediatric Forefoot Fractures: Assessment of Fracture Patterns and Predictors of Complicated Outcome. Pediatr Emerg Care. 2018;34(4):233.

Mahan et al. Likelihood of surgery in isolated pediatric fifth metatarsal fractures. J Pediatr Orthop. 2015 Apr;35(3):296-302.

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Orthopedics

Femur Fractures

The fifth episode of the Fracture Season of PEM Currents, the Pediatric Emergency Medicine podcast focuses on fractures of the tibia and fibula, including the ankle. This episode also features a review of the neurovascular assessment of the lower extremity.

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

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References

Bauer JM et al. Toddler’s Fractures: Time to Weight-bear With Regard to Immobilization Type and Radiographic Monitoring. J Pediatr Orthop. 2017.

Boutis K et al. Sensitivity of a clinical examination to predict need for radiography in children with ankle injuries: a prospective study. Lancet. 2001;358(9299):2118.

Sapru K et al. Management of the Toddler’s fracture with and without initial radiological evidence. Eur J Emerg Med. 2014;21(6):451.

Schuh AM wt al. Management of Toddler’s Fractures in the Pediatric Emergency Department. Pediatr Emerg Care. 2016;32(7):452.

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Orthopedics Podcast

Tibia and Fibula Fractures

Post author By bradsobo
Post date September 13, 2019
No Comments on Tibia and Fibula Fractures

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

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Check out PEMBlog for more great educational content, including seven years worth of Fracture Fridays posts

References

Bauer JM et al. Toddler’s Fractures: Time to Weight-bear With Regard to Immobilization Type and Radiographic Monitoring. J Pediatr Orthop. 2017.

Boutis K et al. Sensitivity of a clinical examination to predict need for radiography in children with ankle injuries: a prospective study. Lancet. 2001;358(9299):2118.

Sapru K et al. Management of the Toddler’s fracture with and without initial radiological evidence. Eur J Emerg Med. 2014;21(6):451.

Schuh AM wt al. Management of Toddler’s Fractures in the Pediatric Emergency Department. Pediatr Emerg Care. 2016;32(7):452.

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Orthopedics

Hand Fractures

This is the 4th episode in the Fracture Season of PEM Currents. You will learn about carpal fractures – especially the dreaded scaphoid fracture, metacarpal fractures, and fractures of the phalanges.

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

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References

Abzug et al. Pediatric Phalanx Fractures. Journal of the American Academy of Orthopaedic Surgeons: November 2016 – Volume 24 – Issue 11 – p e174–e183. doi: 10.5435/JAAOS-D-16-00199

Watts. Seymour Fracture: Ortho Bullets. Accessed August 10, 2019. https://www.orthobullets.com/hand/6000/seymour-fracture

Simon et al. Emergency Orthopedics: the Extremities. 6th Edition. McGraw Hill Medical, NY. 2011.

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Orthopedics

Humerus Fractures

This episode in the Fracture Season of PEM Currents, the Pediatric Emergency Medicine podcast focuses on humerus fractures. The humerus is a super duper forgiving bone in pediatrics that almost never requires reduction or surgeries if there is a mid shaft or proximal shaft fracture. Don’t forget to listen to the Forearm and Wrist Episode if you’d like to brush up on your neuromuscular assessment.

This episode is shorter – so I can’t offer CME in the same manner as the previous two. But you can still get CME for other episodes in the series. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

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References

Kohler R, Trillaud JM. Fracture and fracture separation of the proximal humerus in children: report of 136 cases. J Pediatr Orthop 1983; 3:326.

Shrader MW. Proximal humerus and humeral shaft fractures in children. Hand Clin 2007; 23:431.

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Orthopedics

Elbow Fractures

This episode in the Fracture Season of PEM Currents, the Pediatric Emergency Medicine podcast focuses on elbow fractures. Did you know that the elbow has there joints? Did you know that supracondylar fractures can happen after a fall from something other than monkey bars? Don’t forget to listen to the Forearm and Wrist Episode if you’d like to brush up on your neuromuscular assessment.

I am now proud to offer CME through Cincinnati Children’s. To claim CME & ABP MOC Part 2, visit Cincinnati Children’s Online Courses and search ‘PEM Currents’.

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Check out PEMBlog for more great educational content, including seven years worth of Fracture Fridays posts

References

Mazda K, Boggione C, Fitoussi F, Penneçot GF. Systematic pinning of displaced extension- type supracondylar fractures of the humerus in children. A prospective study of 116 consecutive patients. J Bone Joint Surg Br 2001; 83:888.

Woon, C. Supracondylar Fracture – Pediatric: Ortho Bullets. Accessed 8/5/2019. https://www.orthobullets.com/pediatrics/4007/supracondylar-fracture–pediatric

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