Podcast 722: Lower Extremity Dislocations

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



Avsnitt(1146)

Podcast #375: Retrograde Urethrogram

Podcast #375: Retrograde Urethrogram

Author: Jared Scott, MD Educational Pearls: Blood at urethral meatus in trauma can be a sign of bladder/urethral injury Blind placement of a Foley catheter can make an undiagnosed urethral injur...

6 Sep 20185min

Podcast #374:  Iliac Artery Endofibrosis

Podcast #374: Iliac Artery Endofibrosis

Author:  Sue Chilton, MD Educational Pearls:   An unusual cause of leg pain that can mimic sciatica/claudication Predominantly occurring in high endurance athletes, particularly cyclists and runner...

4 Sep 20183min

Podcast # 373: Legionnaires Disease

Podcast # 373: Legionnaires Disease

Author: Gretchen Hinson, MD Educational Pearls: Legionnaires disease refers to a severe pneumonia caused by Legionella pneumophilia and occurs typically at the extremes of age Associated gastroi...

1 Sep 20183min

Podcast # 372:  The Latest on Epinephrine in Cardiac Arrest

Podcast # 372: The Latest on Epinephrine in Cardiac Arrest

Author: Don Stader, MD Educational Pearls: 8014 patients with out-of-hospital cardiac arrest randomized to epinephrine vs placebo 30-day survival was not dramatically better between groups (3.2%...

30 Aug 20183min

Podcast # 371: EKG changes of Hyperkalemia

Podcast # 371: EKG changes of Hyperkalemia

Author: Jared Scott, MD Educational Pearls: EKG changes do not necessarily correlate to degree of hyperkalemia Traditional progression through peaked T-waves, flattened p-waves, QRS widening, an...

28 Aug 20183min

Podcast # 370:  Rapid Fire Neonatal Resuscitation

Podcast # 370: Rapid Fire Neonatal Resuscitation

Author:  Erik Verzemnieks, MD Educational Pearls:   In the panic of a precipitous ED delivery, remember: Warm. Dry. Stim.  It will solve most of your problems in most scenarios Start compressions i...

24 Aug 20181min

Podcast # 369:  Five powerful toxins - the definitive list?

Podcast # 369: Five powerful toxins - the definitive list?

Author: Michael Hunt, MD Educational Pearls: Here is a list of some very toxic natural substances:     #5: Tetrodotoxin: Found in pufferfish and other aquatic species #4: Ricin: made from castor beans...

22 Aug 20183min

Podcast # 368: Prehospital Plasma

Podcast # 368: Prehospital Plasma

Author: Aaron Lessen, MD Educational Pearls: Non-blinded randomized study assessing 30-day mortality benefit from plasma-first resuscitation in patients at risk hemorrhagic shock Study involved a...

20 Aug 20182min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
rss-ufo-bortom-rimligt-tvivel
sexet
rss-vetenskapsradion
pojkmottagningen
rss-vetenskapsradion-2
dumforklarat
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
halsorevolutionen
rss-spraket
bildningspodden
hacka-livet
rss-experimentet
medicinvetarna
rss-lara-fran-larda-en-fackbok-och-en-forfattare