Self-Reduction of Shoulder Dislocation – Like a Boss
The Boss-Holzach-Matter (aka Davos, self-reduction) technique was less painful than the physician-driven Spaso technique and just as successful and efficient.
Musculoskeletal Ultrasound
Watch this video on MSK ultrasound techniques for the ED.
Myth – MRI the Back and They Won’t Return to the ED
Getting an MRI for back pain does not reduce recurrent patient visits within a week. The only time we should get an MRI for back pain in the ED is if there is a clinical concern that the findings may prompt emergent surgery, such as for cauda equina, epidural abscess, or impinging mass (may need radiation), etc.
Just Put the Clavicle in a Sling – Not Any More
More patients are having operative repair for displaced midshaft clavicle fractures. This meta-analysis of 6 RCTs found that the rate of nonunion was markedly reduced and final functional outcome was also improved (though not as strikingly) with operative management.
How to Tell a Septic Hip from Transient Synovitis
These 4 predictors are somewhat helpful in distinguishing transient synovitis of the hip from septic arthritis. Note the limitations of the Kocher Criteria when using it in practice, and err on the side of orthopedic consultation and/or admission.
Why We Use the Ottawa Ankle Rule
The Ottawa ankle rule may reduce x-ray utilization for foot/ankle injuries.
Velcro Wrist Splint vs. Cast for Torus Fracture
A simple volar slab or velcro wrist splint or soft cast was better than a rigid cast for pediatric torus fractures of the forearm.
Clavicle Surgery Improves Outcome
Midshaft clavicle fractures were once treated non-operatively but are increasingly repaired surgically with improved outcomes over non-op treatment.
Hyperpronation Romps Supination-Flexion
Hyperpronation is more effective than supination/flexion for nursemaid's elbow.
Myth – Ibuprofen and Non-union of Fractures
The dogma is - no NSAIDs for fractures - because it increases the risk of bone healing complications, but this study challenges that.