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Vapocoolant spray improved pain from digital blocks for repair of finger injuries.
Source
Evaluation of vapocoolant spray effect on pain reduction during digital nerve block: A randomized clinical trial. Am J Emerg Med. 2021 Dec;50:260-263. doi: 10.1016/j.ajem.2021.08.001. Epub 2021 Aug 6.
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Lumbar spinal stenosis affects more than 1 in 10 U.S. citizens and over 100 million patients worldwide. This painful condition is diagnosed clinically with confirmatory imaging. Firstline treatment is activity modification, analgesia, and physical therapy, and careful selection of surgical candidates should be done only if conservative management fails.
Source
Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA. 2022 May 3;327(17):1688-1699. doi: 10.1001/jama.2022.5921.
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Patients with Achilles’ tendon rupture undergoing surgical repair, either open or minimally-invasive, did not have better outcomes at 12 months compared to non-operative treatment. However, those managed nonoperatively had a higher rate of tendon rerupture.
Source
Nonoperative or Surgical Treatment of Acute Achilles’ Tendon Rupture. N Engl J Med. 2022 Apr 14;386(15):1409-1420. doi: 10.1056/NEJMoa2108447.
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This literature review helps emergency physicians systematically approach evaluation of traumatic arthrotomy (TA) while pointing out diagnostic pitfalls.
Source
High risk and low prevalence diseases: Traumatic arthrotomy. Am J Emerg Med. 2022 Jan 21;54:41-45. doi: 10.1016/j.ajem.2022.01.013. Online ahead of print.
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Empiric antibiotics, without aspiration, is safe and effective for most cases of suspected septic olecranon bursitis.
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Following an acceptable closed reduction of a displaced intra-articular distal radius fracture, adults treated with volar plate fixation had better patient-reported functional outcomes through 6 months, but not at 1-year follow-up, compared to those treated nonoperatively. 28% of those initially treated non-operatively ultimately received surgery.
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For acute non-specific low back pain, intradermal sterile water injection + IV NSAID reduced pain and improved patient satisfaction vs IV NSAID alone.
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There was no short-term impact of NSAIDs/COX-2 inhibitors on long-bone fracture healing BUT using NSAIDs >3 weeks was associated with higher rates of non-union or delayed union.
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Children with a toddler’s fracture who were randomized to a CAM boot were easier to care for, walked sooner, and had no difference in fracture healing compared to those in a cast.
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There is a lack of evidence-based treatment standards for low-velocity gunshot wounds (GSW). This review focuses on the best available evidence for the management of civilian, low velocity GSWs to an extremity.
