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Emergency Room Orthopaedic Procedures PDF
Emergency Room Orthopaedic Procedures is a concise, “How to” guide to the diagnosis and treatment of common musculoskeletal injuries and conditions in the emergency room. The book provides step by step instructions and evaluations of techniques such as reducing and splinting a radius fracture, repairing a nail bed laceration, fracture management and methods used for procedural sedation. Authored by recognised experts at the New York University Hospital for Joint Diseases, USA, each chapter is organised in an easy to follow format, with numerous illustrative images, colour photographs and detailed demonstrations.
1. Nerve Blocks Around the Hand……………………………………………..1
• Materials 4
• Steps 4
–– Finger Web Space Block 4
–– Transthecal Technique (Through Flexor Tendon Sheath) 6
–– Wrist Block-Median Nerve 6
–– Wrist Block-Ulnar Nerve 7
–– Wrist Block-Radial Nerve 8
2. The Evaluation and Management of Ankle Fractures:
Reduction and Splinting Techniques……………………………………10
• Relevant Anatomy 10
• Presentation And Evaluation in The Emergency Room 12
• Radiographic Evaluation 13
• Ankle Fracture Reduction 16
–– Splint Application 17
• Post-Reduction Care 24
3. Closed Reduction of Shoulder Dislocations…………………………25
• Anterior Dislocation 26
–– Scapular Manipulation Technique 26
–– External Rotation Technique 27
–– Stimson Technique 27
–– Milch Technique 28
–– Traction-Countertraction Technique 29
–– Modified Hippocratic Technique 30
–– Reduction Under Anesthesia 31
• Posterior Dislocations 31
• Inferior Dislocations 31
–– Two-Step Approach 32
• Post-Reduction Care 32
4. Closed Reduction of Elbow Dislocations……………………………..34
• Anatomy of The Elbow 34
• Emergency Room Evaluation 35
• Radiographic Evaluation 36
Emergency Room Orthopaedic Procedures
• Reduction and Immobilization of a Simple
Elbow Dislocation 36
–– Steps for Reduction 37
–– Applications of Posterior Long Arm Splint 39
5. Joint Aspiration and Injection Techniques…………………………..44
• Necessary Materials 44
• Shoulder Aspiration and Injection Technique 46
• Elbow Aspiration and Injection Technique 50
–– Steps 50
• Wrist Aspiration and Injection Technique 52
–– Steps 52
• Knee Aspiration and Injection Technique 54
–– Superolateral Approach 55
–– Inferolateral Approach 57
• Ankle Aspiration and Injection Technique 59
–– Steps 59
6. Reduction of the Dislocated Total Hip Arthroplasty……………62
• Clinical Evaluation 63
• Physical Examination 64
• Treatment 64
–– The Allis Method 65
–– The Bigelow Maneuver 66
–– The Reverse Bigelow Maneuver 69
–– Stimson Technique (Gravity Method) 69
• Post-Reduction Care 70
7. Insertion of Femoral and Tibial Traction Pins……………………..72
• Materials Required 73
• Steps 73
–– Distal Femoral Pins 73
–– Proximal Tibial Pins 78
8. The Evaluation and Management of Nursemaid’s Elbow……80
• Physical Examination 81
–– Reduction Maneuvers for Nursemaid’s Elbow 84
• Discharge Plans Following Successful Reduction 88
9. Closed Reduction of Distal Radius Fractures……………………….90
• Introduction 90
• History And Physical Examination 91
–– Evaluation of Open Distal Radius Fractures 91
• Post Reduction Care 100
10. Nail Bed Repair……………………………………………………………………104
• Emergency Room Evaluation 104
• Treatment of Nail Bed Injuries 106
–– Necessary Supplies for Nail Bed Repair 106
11. Closed Reduction of Pediatric Forearm Fractures 114
• Mechanisms of Injury 114
• Presentation and Evaluation in The Emergency Room 115
–– Radiographic Evaluation and Classification 115
• Reduction of Pediatric Forearm Fractures 116
–– Technique 117
• Post-Reduction Care 123
12. Diagnosis of Compartment Syndrome……………………………….125
• Pathophysiology 125
• Pertinent Anatomy 126
–– Leg 126
–– Thigh 126
–– Forearm 126
–– Arm 127
• Diagnosis 127
13. Suturing Lacerations in the Emergency Room……………………133
• Anesthesia 134
• Supplies 134
• Materials 135
• Steps 135
–– Simple Interrupted Stitch 135
–– Simple Running Suture 136
–– Vertical Mattress Suture 137
14. Pediatric and Adult Procedural Sedation and Analgesia…….140
• Procedural Sedation and Analgesia 140
–– Requirements Prior to Procedural Sedation 141
–– Techniques for Procedural Sedation and Anesthesia 143
Emergency Room Orthopaedic Procedures PDF Ebook
• Materials 4
• Steps 4
–– Finger Web Space Block 4
–– Transthecal Technique (Through Flexor Tendon Sheath) 6
–– Wrist Block-Median Nerve 6
–– Wrist Block-Ulnar Nerve 7
–– Wrist Block-Radial Nerve 8
2. The Evaluation and Management of Ankle Fractures:
Reduction and Splinting Techniques……………………………………10
• Relevant Anatomy 10
• Presentation And Evaluation in The Emergency Room 12
• Radiographic Evaluation 13
• Ankle Fracture Reduction 16
–– Splint Application 17
• Post-Reduction Care 24
3. Closed Reduction of Shoulder Dislocations…………………………25
• Anterior Dislocation 26
–– Scapular Manipulation Technique 26
–– External Rotation Technique 27
–– Stimson Technique 27
–– Milch Technique 28
–– Traction-Countertraction Technique 29
–– Modified Hippocratic Technique 30
–– Reduction Under Anesthesia 31
• Posterior Dislocations 31
• Inferior Dislocations 31
–– Two-Step Approach 32
• Post-Reduction Care 32
4. Closed Reduction of Elbow Dislocations……………………………..34
• Anatomy of The Elbow 34
• Emergency Room Evaluation 35
• Radiographic Evaluation 36
Emergency Room Orthopaedic Procedures
• Reduction and Immobilization of a Simple
Elbow Dislocation 36
–– Steps for Reduction 37
–– Applications of Posterior Long Arm Splint 39
5. Joint Aspiration and Injection Techniques…………………………..44
• Necessary Materials 44
• Shoulder Aspiration and Injection Technique 46
• Elbow Aspiration and Injection Technique 50
–– Steps 50
• Wrist Aspiration and Injection Technique 52
–– Steps 52
• Knee Aspiration and Injection Technique 54
–– Superolateral Approach 55
–– Inferolateral Approach 57
• Ankle Aspiration and Injection Technique 59
–– Steps 59
6. Reduction of the Dislocated Total Hip Arthroplasty……………62
• Clinical Evaluation 63
• Physical Examination 64
• Treatment 64
–– The Allis Method 65
–– The Bigelow Maneuver 66
–– The Reverse Bigelow Maneuver 69
–– Stimson Technique (Gravity Method) 69
• Post-Reduction Care 70
7. Insertion of Femoral and Tibial Traction Pins……………………..72
• Materials Required 73
• Steps 73
–– Distal Femoral Pins 73
–– Proximal Tibial Pins 78
8. The Evaluation and Management of Nursemaid’s Elbow……80
• Physical Examination 81
–– Reduction Maneuvers for Nursemaid’s Elbow 84
• Discharge Plans Following Successful Reduction 88
9. Closed Reduction of Distal Radius Fractures……………………….90
• Introduction 90
• History And Physical Examination 91
–– Evaluation of Open Distal Radius Fractures 91
• Post Reduction Care 100
10. Nail Bed Repair……………………………………………………………………104
• Emergency Room Evaluation 104
• Treatment of Nail Bed Injuries 106
–– Necessary Supplies for Nail Bed Repair 106
11. Closed Reduction of Pediatric Forearm Fractures 114
• Mechanisms of Injury 114
• Presentation and Evaluation in The Emergency Room 115
–– Radiographic Evaluation and Classification 115
• Reduction of Pediatric Forearm Fractures 116
–– Technique 117
• Post-Reduction Care 123
12. Diagnosis of Compartment Syndrome……………………………….125
• Pathophysiology 125
• Pertinent Anatomy 126
–– Leg 126
–– Thigh 126
–– Forearm 126
–– Arm 127
• Diagnosis 127
13. Suturing Lacerations in the Emergency Room……………………133
• Anesthesia 134
• Supplies 134
• Materials 135
• Steps 135
–– Simple Interrupted Stitch 135
–– Simple Running Suture 136
–– Vertical Mattress Suture 137
14. Pediatric and Adult Procedural Sedation and Analgesia…….140
• Procedural Sedation and Analgesia 140
–– Requirements Prior to Procedural Sedation 141
–– Techniques for Procedural Sedation and Anesthesia 143
Emergency Room Orthopaedic Procedures PDF Ebook
Kenneth A Egol MD
Professor and Vice Chairman
Professor and Vice Chairman
Eric J Strauss MD
Assistant Professor
Both at Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, USA
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