Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · May 2015
ReviewEvaluation and Management of Traumatic Knee Injuries in the Emergency Department.
Posttraumatic knee pain is a common presentation in the emergency department (ED). The use of clinical decision rules can rule out reliably fractures of the knee and reduce the unnecessary cost and radiation exposure associated with plain radiographs. ⋯ Patients presenting after high-energy mechanisms are at risk for occult fracture and vascular injuries. ED providers must consider these injuries in the proper clinical setting.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEmergency Department Evaluation and Treatment of Acute Hip and Thigh Pain.
Although the incidence of hip fractures is decreasing, the overall prevalence continues to increase because of an aging population. People older than 65 suffer fractures at a rate of 0.6% per year--2% per year for persons older than 85. ⋯ Additionally, the emergency physician must consider entities such as avascular necrosis, compartment syndrome, and muscular disruption. This article reviews patterns and complications of acute hip and thigh injuries and clinically relevant diagnostic, anesthetic, and treatment options that facilitate timely, appropriate, and effective emergency department management.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEmergency Department Evaluation and Treatment of the Shoulder and Humerus.
Shoulder injuries are among the most common musculoskeletal complaints seen in US emergency departments (EDs). ED evaluation of the shoulder must account for the broad range of potential fracture patterns seen in the clavicle, scapula, and humerus. ⋯ Dislocation of the shoulder is frequently seen, and the ED physician must be skilled in several reduction techniques to optimize a successful reduction. An understanding of when orthopedic consultation is appropriate and when patients can be dispositioned with timely follow-up are integral to complete patient recovery.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEvaluation and Treatment of the Elbow and Forearm Injuries in the Emergency Department.
Elbow and forearm injuries result most commonly from direct blows to the area, or from fall on outstretched hand. The elbow may be injured if it is locked at the time of impact. Elbow or forearm bone dislocations may occur alone or in conjunction with fractures and generally require reduction to minimize future morbidity. The primary goal of management is to achieve anatomic reduction of any fracture or dislocation, while allowing for early range of motion to minimize future morbidity, including in particular elbow stiffness and consequently limited mobility of the joint.
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Emerg. Med. Clin. North Am. · May 2015
ReviewEvaluation and Treatment of Acute Back Pain in the Emergency Department.
Back pain is a common presenting complaint to the emergency department. The key to proper evaluation is a history and physical examination focused on determining if any red flags for serious disease are present. ⋯ No diagnostic testing is required. For patients with red flags, a focused history and examination in conjunction with diagnostic laboratory tests and imaging determine whether the patient has an emergent condition such as herniated disc, epidural compression, or spinal infection.