Podcast 722: Lower Extremity Dislocations
Emergency Medical Minute19 Loka 2021

Podcast 722: Lower Extremity Dislocations

Contributor: Donald Stader, MD

Educational Pearls:

  • Hip Dislocation
    • Prolonged dislocations can impair blood supply to femoral head
    • Hip dislocation for >6 hours puts patient at high risk for needing a hip replacement in the next two year
  • Knee Dislocation
    • High mechanism
    • Often looks anatomically normal on knee x-ray
    • Vascular injuries of the popliteal artery can cause significant morbidity with some studies suggesting an 80% amputation rate if not treated within 6 hours
  • Ankle Dislocation
    • Common dislocation and often co-occurs with ankle fractures (bimalleolar/trimalleolar)
    • Pressure on the skin from the displaced joint can cause skin tenting, which can lead to skin necrosis
    • Hematoma blocks work well for ankle reductions as an adjunct to or substitute for procedural sedation

References

Arnold C, Fayos Z, Bruner D, Arnold D. Managing dislocations of the hip, knee, and ankle in the emergency department. Emerg Med Pract. 2017;19(12):1-28.

Dawson-Amoah K, Raszewski J, Duplantier N, Waddell BS. Dislocation of the Hip: A Review of Types, Causes, and Treatment. Ochsner J. 2018;18(3):242-252. doi:10.31486/toj.17.0079

Patterson BM, Agel J, Swiontkowski MF, Mackenzie EJ, Bosse MJ; LEAP Study Group. Knee dislocations with vascular injury: outcomes in the Lower Extremity Assessment Project (LEAP) Study. J Trauma. 2007;63(4):855-858. doi:10.1097/TA.0b013e31806915a7

Ross A, Catanzariti AR, Mendicino RW. The hematoma block: a simple, effective technique for closed reduction of ankle fracture dislocations. J Foot Ankle Surg. 2011;50(4):507-509. doi:10.1053/j.jfas.2011.04.037

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD



Jaksot(1145)

Podcast #293: Transient Global Amnesia

Podcast #293: Transient Global Amnesia

Author: Sam Killian, M.D. Educational Pearls Transient global amnesia is a paroxysmal, transient memory issue. Remote and immediate memory is preserved, but new memories cannot be made. Patients will...

19 Tammi 20184min

Podcast #292: Hypercalcemia

Podcast #292: Hypercalcemia

Author: John Winkler, M.D. Educational Pearls Normally, the parathyroid is the master regulator of serum Ca levels. It secretes PTH, which stimulates calcium uptake from the bone and gut. Causes of ...

17 Tammi 20182min

Podcast #291: Cincinnati Stroke Scale

Podcast #291: Cincinnati Stroke Scale

Author: Nick Hatch, M.D. Educational Pearls The Cincinnati Stroke Scale uses 3 measures to screen for ischemic stroke. The measures are: facial asymmetry, speech quality and arm drift. This scale is ...

15 Tammi 20182min

Podcast #290: The Biochemistry of DKA

Podcast #290: The Biochemistry of DKA

Author: Dave Rosenberg, M.D. Educational Pearls DKA commonly causes hyperkalemia, leading to peaked T-waves on ECG. However, DKA causes hypokalemia at the same time. In DKA, glucose cannot be taken i...

12 Tammi 20186min

Podcast #289: Cannabinoid Hyperemesis

Podcast #289: Cannabinoid Hyperemesis

Author: Dylan Luyten, M.D. Educational Pearls Cannabinoid Hyperemesis syndrome is a relatively new diagnosis that presents with vomiting and abdominal pain without a clear etiology in the setting of ...

10 Tammi 20183min

Podcast #288: Diarrhea

Podcast #288: Diarrhea

Author: Peter Bakes, M.D. Educational Pearls Chronic diarrhea is defined as 3 or more loose, watery stools lasting more than 2-3 weeks. Look for clues in the history, including travel (could suggest...

8 Tammi 20187min

Podcast #287: Sepsis Bundles

Podcast #287: Sepsis Bundles

Author: Aaron Lessen, M.D. Educational Pearls Treatment "bundles" are a popular approach to the rapid resuscitation of septic patients. A recent study in New York, where sepsis bundles are mandatory,...

5 Tammi 20182min

Podcast #286: Coronary Vascular Conditions that aren't STEMI

Podcast #286: Coronary Vascular Conditions that aren't STEMI

Author: Don Stader, M.D. Educational Pearls While we usually associate the coronary vasculature with STEMIs, there are other pathologies that can affect the heart's blood supply. Kounis syndrome: an ...

3 Tammi 20184min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
rss-duodecim-lehti
docemilia
utelias-mieli
filocast-filosofian-perusteet
rss-ammamafia
rss-astetta-parempi-elama-podcast
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-sosiopodi
rss-tiedetta-vai-tarinaa