Episode 52: Commonly Missed Uncommon Orthopedic Injuries

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 13 October 2014

⏱️ 53 minutes

🔗️ Recording | iTunes | RSS

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Summary

We rarely discuss medico-legal issues on EM Cases because it misguides us a bit from good patient centered care – which is what emergency medicine is really all about. Nonetheless, missed orthopedic injuries are the most common reason for an emergency doc to be sued in Canada. This is partly because missed orthopedic injuries are far more common than missed MIs for example, but it’s also because it’s easy to miss certain orthopedic injuries – especially the ones that aren’t super common. And orthopedics is difficult to learn and remember for the EM practitioner as there are so many injuries to remember. And so, you guessed it – on this episode we’re going to run through some key not-so-common, easy to miss orthopedic injuries, some of which I, personally had to learn about the hard way, if you know what I mean. After listening to this episode, try some cognitive forcing strategies – for every patient with a FOOSH that you see, look for and document a DRUJ injury. Wait, hold on….I don’t wanna give it all away at the top of the post. Let’s hear what EM doc and sports medicine guru Ivy Cheng, and the orthopedic surgeon who everyone at North York General turns to when they need help with a difficult ortho case, Hossein Medhian, have to say about Commonly Missed Uncommon Orthopedic Injuries.

Transcript

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0:00.0	Welcome to the Emergency Medicine Cases Podcast.
0:05.8	I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine
0:10.5	from EMC Studios in Toronto. In this episode on commonly missed uncommon orthopedic injuries,
0:30.5	we have guest experts Dr. I.B. Chang and Dr. Hussain Median.
0:34.6	Dr. Chang is an emergency and sports medicine specialists at Sunnybrook Health Sciences Center and at Sports Medicine Specialists in Toronto,
0:41.3	and an assistant professor at the University of Toronto. She's a co-founder and editor of MRAD, the online emergency medicine radiology database.
0:50.3	Dr. Median is an orthopedic surgeon at North York General Hospital and faculty at the
0:56.1	University of Toronto Department of Orthopedic Surgery. Most orthopedic surgeons think that a lestphraic
1:02.8	injury needs an open reduction. Make sure you get the proper views of the foot.
1:14.8	In the past orthopedics, her used to miss this quite often, too.
1:19.9	Paralyneate dislocation, acute carpal tunnel syndrome.
1:27.1	Just a quick announcement before we jump into Ortho Misses.
1:32.7	The University Health Network EM conference is coming up in just a couple of weeks in Toronto.
1:35.9	It's a fantastic conference that's been around for a few years now,
1:41.4	and this year there's a great lineup of speakers that have been EMK's guest experts at one time or another.
1:47.1	We've got David Carr, Anil Chopra, Eric Latovsky, Jason Fisher,
1:53.9	Amalmatu, Joel Yaffi, and Don Malady, just to name a few. If you do a web search for University Health Network Emergency Medicine Conference 2014, you'll hit the page that you need to
1:59.0	register at. So do come on down and introduce yourself as I'll be speaking there as well.
2:04.2	And here we go.
2:05.5	Now, I rarely talk about medical legal issues in emergency medicine cases because I think it misguides
2:11.0	us a bit from what's really important, which is good patient-centered care.
2:16.3	Nonetheless, missed orthopedic injuries are the most common reason
	...

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