Acute non-traumatic temporomandibular joint (TMJ) dislocations occur after extreme opening of the mouth (yawning, eating, laughing, singing or dental treatment. TMJ dislocation is when the anterior condyle moves too anteriorly and becomes locked in the eminence. This also results in stretching of ligaments and is associated with severe spasm that results in difficulty closing the mouth […]
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55 yo F presents with shoulder pain after fall from bicycle: Also known as “luxatio erecta” – to place upward Inferior shoulder Dislocation Mechanism of injury: fall and sudden grasp of object above head resulting in hyperabduction Presentation: Patients hold arm above head and is unable to adduct, looks like a person […]
You get a patient in triage with an anterior shoulder dislocation that happened 10 minutes prior to arrival. It’s happened to him multiple times on the same shoulder and all he did to dislocate it was to push up from a chair. You really want to get it reduced quickly because you are smart enough […]
Let’s talk about mandible dislocations & how we can reduce them. First, we need to take a look at the mandible anatomy – can refer back to this as we discuss mandible dislocation: So how does the mandible dislocate (also called temporomandibular joint dislocation)? Causes: Now that we know mandible is out, can we reduce […]
The PENG block is an effective, easy and safe way to provide analgesia to acute traumatic hip injuries
Anatomy First, we’ll refresh our bony anatomy to contextualize the radiographic images. The ankle is composed of the distal tibia and fibula and the superior talus, which is stabilized by several ligaments and the fibrous syndesmosis. The standard ankle radiographic series consists of the AP, mortise and lateral views. The AP View The Mortise View […]
Summary Summary Anatomy of the Lisfranc Joint The Lisfranc joint consists of the articulation of the first three metatarsal bases with their respective cuneiforms and the 4th/5th metatarsal bases with the cuboid, along with associated ligaments. The lisfranc ligament, which joins the medial cuneiform (1st cuneiform) and the base of the 2nd metatarsal, provides primary […]
So today, we’re gonna talk about shoulder dislocations. This should resonate with a lot of you residents considering the weather conditions currently, or if you were worried about what would happen if a certain SuperBowl performer were to have fallen: If a shoulder dislocation is suspected, make sure a thorough neurovascular exam is conducted! Are the […]
He dribbles calmly at the top of the key. Fakes right, crossover, drives forward, spin move. 2 ankles down, 0 to go. He takes a step and finishes with a huge dunk. Boom, right shoulder comes out. …Alright, so this never happened, but I wanted you to open this article about a technique for anterior shoulder […]
In a totally hypothetical situation, imagine a resident’s foot got run over by a bus and looked like this after arriving in your ED… What sort of things should you be concerned about in injuries like this of extremities? 1. Vascular: Has a vessel been compromised, especially an artery? It is important to control hemorrhage. […]
Knee dislocations are a dangerous and easily missed diagnosis. Morbidity is high as 20% have a serious vascular injury, many of which lead to amputation. This can occur with even ground levels falls in elderly and obese patients, so a high index of suspicion is warranted. What kind of dislocation? These are tibiofemoral dislocations, not patellofemoral […]
Try an interscalene block! It anesthetizes C5-7 and is used in shoulder surgery- surely that is good enough for a measly little reduction. Studies in the ED have shown decreased time in the ED and good anesthesia for shoulder reduction. Here is how: Place patient in supine position Using the linear ultrasound probe oriented like […]
4 Reduction Techniques of Anterior Mandible Dislocation Classic intra-oral reduction Place thumbs over the patient’s inferior molars Apply downward force and then guide the mandible posteriorly Wrist Pivot Method Place thumbs at the chin Place other fingers on the inferior molars Pivot your wrists Syringe Place a syringe between the molars of one side Ask […]
You’re in the middle of a busy Resus shift, no available beds, and someone asks you if they can bring back a patient for a procedural sedation to reduce a dislocated shoulder. “Arghhhhghgh” you think to yourself, “just what I need.” Tons of paperwork, consent forms, an extra nurse, getting the resident, attending, and patient […]
Inspired by the mysterious and salacious Jon Mishoe. Trying to explain ultrasound via text just won’t work. Instead I will attempt to describe various ultrasound concepts and possibilities and I encourage you to grab ultrasound faculty for hands-on demonstrations if the clinical scenario is appropriate. Given the small amount of subcutaneous tissue and small surface […]
