Orthopedic Emergencies: Expert Management for the Emergency Physician

Transcription

1 Orthopedic Emergencies: Expert Management for the Emergency Physician

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3 Orthopedic Emergencies: Expert Management for the Emergency Physician Michael C. Bond Associate Professor and Residency Program Director, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA Andrew D. Perron Professor and Residency Program Director, Department of Emergency Medicine, Maine Medical Center, Portland, ME, USA Michael K. Abraham Clinical Assistant Professor at the Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

4 University Printing House, Cambridge CB2 8BS, United Kingdom Published in the United States of America by Cambridge University Press, New York Cambridge University Press is part of the University of Cambridge. It furthers the University s mission by disseminating knowledge in the pursuit of education, learning, and research at the highest international levels of excellence. Information on this title: / Cambridge University Press 2013 This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published 2013 Printed in the United Kingdom by CPI Group Ltd, Croydon CR0 4YY A catalog record for this publication is available from the British Library ISBN Paperback Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.... Every effort has been made in preparing this book to provide accurate and up-to-date information which is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors, and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use.

5 Contents List of contributors Preface ix page vi 1. Hand and wrist emergencies 1 Carl A. Germann 2. Shoulder and elbow emergencies 44 Sanjeev Malik, Molly Weiner, and George Chiampas 3. Pelvic emergencies 81 Michael C. Bond 4. Knee and leg emergencies 105 Arun Sayal 5. Foot and ankle emergencies 142 Brian Tscholl 6. Spine emergencies 154 Kelley Banagan 7. Pediatric orthopedic emergencies 165 Nathan W. Mick and Amy E. Valasek 8. Orthopedic infections and other complications 178 Stephen Y. Liang, Michael C. Bond, and Michael K. Abraham 9. Procedures for orthopedic emergencies 191 Moira Davenport, Dennis Hanlon, and Ryan Friedberg 10. Immobilization and splinting 248 Michael C. Bond and Michael K. Abraham Index 270 v

6 Contributors Michael K. Abraham, MD Clinical Assistant Professor, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA Kelley Banagan, MD Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD, USA Michael C. Bond, MD, FACEP, FAAEM Associate Professor and Residency Program Director, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA George Chiampas, DO Team Physician, Northwestern University Athletics Team Physician, Chicago Blackhawks Medical Director, Bank of America Chicago Marathon Assistant Professor, Department of Emergency Medicine Northwestern University, Feinberg School of Medicine, Chicago, IL, USA Moira Davenport, MD Associate Professor of Emergency Medicine, Temple University School of Medicine, Allegheny General Hospital, Pittsburgh, PA, USA Ryan Friedberg, MD Clinical Instructor, Sports Medicine & Shoulder Surgery Carl A. Germann, MD, FACEP Assistant Professor, Tufts University School of Medicine, Department of Emergency Medicine, Maine Medical Center, Portland, ME, USA Dennis Hanlon, MD Associate Professor of Emergency Medicine, Temple University School of Medicine, Allegheny General Hospital, Pittsburgh, PA, USA Stephen Y. Liang, MD Infectious Disease Fellow, Division of Infectious Diseases, Washington University School of Medicine, Saint Louis, MO, USA Sanjeev Malik, MD Assistant Medical Director and Assistant Professor Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Nathan W. Mick, MD, FACEP Assistant Professor, Tufts University School of Medicine, and Director of Pediatric Emergency Medicine, Maine Medical Center, Portland, ME, USA Arun Sayal, MD, CCFP(EM) Assistant Professor, Department of Family and Community Medicine, University of Toronto, and Staff Physician, Emergency Department and Fracture Clinic, North York General Hospital, Toronto, ON, Canada Brian Tscholl, MD Fellowship Trained Foot and Ankle Surgeon, Orthopedic One, Riverside Methodist Hospital and Dublin Methodist Hospital Columbus, OH, USA vi

7 List of contributors Amy E. Valasek, MD, MS Johns Hopkins Department of Orthopedics Pediatric Division, White Marsh, MD, USA Molly Weiner, MD Resident Physician, Department of Emergency Medicine Northwestern University, Feinberg School of Medicine, Chicago, IL, USA vii

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9 Preface Providers working in Urgent Care centers, Emergency Departments, Casualty Rooms, and Accident and Emergency (A&E) Departments are unlikely to work a single shift without seeing a patient with an orthopedic injury. Providers in these settings evaluate more patients with acute injuries than our sub-specialty colleagues, so it is imperative that we have a good understanding of how to diagnose and treat these acute injuries. Many textbooks have been written on this subject. Most are large tomes that are extremely indepth and designed for the orthopedic surgeon or a sports medicine physician, while others are designed for the beginner. Neither, though, is designed to be a good bedside reference to use as you care for the patient. This orthopedic emergencies book has been designed to be a quick reference for the seasoned provider who is looking to refresh their memory as well as the junior medical student who needs to understand some of the key aspects of care. The authors have worked hard to provide Pearls and Key facts that can be used for quick review, and specific and detailed recommendations on how to treat the various conditions. Finally, we have worked with the publisher to make the book spiral bound so that it can be opened and laid flat to be used as a bedside resource when doing procedures and placing splints. Each chapter is laid out with the description of the injury or fracture, a discussion on how to make the diagnosis, treatment recommendations, and then common complications that the patients should be informed of. Whenever possible we have recommended a definitive treatment plan. For conditions where treatment is more controversial we have recommended that you discuss the case with your local consultant. This textbook is divided into sections based on the area of injury, but also includes a chapter on orthopedic infections, pediatric injuries, common procedures, and finally a chapter on splints that includes step-by-step instructions with photographs. The organization of the book is designed to make it easy to just read up on orthopedic injuries and also to be able to find the necessary information quickly during a busy shift. The authors and editors hope that you find this textbook to be an invaluable resource that is frequently left in the last room you saw a patient in. We welcome suggestions and recommendations for future editions. Best of luck caring for your injured patients. ix