Key Concepts Knee dislocation often causes vascular injury to the popliteal artery. Early revascularization is crucial. Hard signs of vascular injury include absent pedal pulses, cool mottled foot, expanding popliteal hematoma, or popliteal hemorrhage. When any of these are present,…
Key Concepts A hip dislocation is an orthopedic emergency. The likelihood of avascular necrosis (AVN) is related to both the initial degree of trauma and the amount of time the femoral head remains out of joint. Reduction of the hip…
Key Concepts The most serious pelvic ring injuries caused by high-energy impact are (1) anteroposterior compression fractures (“open-book” fracture), (2) vertical shear fractures, and (3) fractures involving significant displacement. These injuries are associated with major blood loss and transfusion requirements.…
Key Concepts Axillary nerve function is best evaluated by testing the motor function of the deltoid muscle. The three-view trauma series of the shoulder (true anteroposterior, scapular Y, and axillary views) leads to an accurate radiographic diagnosis of most fractures…
Key Concepts Clinical decision rules for the elbow joint have not been validated. Radiographs should be obtained when there is limitation in range of motion, moderate to severe pain, obvious deformity, joint effusion, or significant tenderness or crepitus over any…
Acknowledgment We would like to thank David Williams, Karen G.H. Woolfrey, Michael Woolfrey, and Mary A. Eisenhauer for their contributions to previous versions of this chapter. Key Concepts On plain radiographs of the wrist, three distinct arcs, known as Gilula’s…
Acknowledgments The authors would like to acknowledge the assistance of Ronald Barry, MD, FACS in the preparation of this chapter, including providing many of the images. Key Concepts For general testing of the motor nerve function of the hand, have…
Key Concepts Many orthopedic injuries can be stabilized and treated definitively by the emergency clinician. Consultation with an orthopedist should be sought for the treatment of some long bone fractures, open fractures, injuries with joint violation, tendon injuries, and injuries…
Key Concepts The overall condition of the patient with an acute peripheral vascular injury determines the extent of emergency department (ED) evaluation and stabilization. Critically injured patients may require immediate surgery, which should not be delayed for confirmatory studies of…
Key Concepts Microscopic or gross hematuria is suggestive of genitourinary trauma; however, the degree of hematuria does not correlate well with either the severity or anatomy location of injury. The kidney is the most frequently injured genitourinary organ, and imaging…