Orthopedics EM

Question 1

What joints are included in the Ottawa Rules?

Answer 1

Knee, ankle, and foot injuries

Question 2

When should range of motion be defered in the physical exam of a possible fracture?

Answer 2

Concern for vascular injury or severe fracture

Note in your documentation rational

Question 3

What are the 4 Steps of the Ottawa Rules for Ankle and foot?

Answer 3

• Location of pain
• Point tenderness (two spots)
• Inability to bear weight both immediately after injury AND in ED: 4 steps

Question 4

What are the 5 steps of the Ottawa Rules for Knee?

Answer 4

• Age >/= 55
• TTP patella (isolated)
• TTP fibular head (proximal fibula)
• Unable to flex knee to 90 degrees
• Unable to bear weight both immediately and in ED

Question 5

When do you order labs in a orthopedic trauma/fracture?

Answer 5

• Multi-system trauma
• Concern for pathologic fracture
• Concern for infection
• Pre-surgical planning (CBC, CMP, Coags, Blood type)

Question 6

Is casting typically done in the ER?

Answer 6

No, due to swelling and risk for compartment syndrome

Question 7

What are the indications for postop shoe splints?

Answer 7

Metatarsal or toe fractures

Question 8

A 65 year old female presents to the ED after a fragility fall from standing. Imaging shows a superior rami fracture, hip is unaffected. Can this patient bear weight and be discharged home?

Answer 8

Yes, can bear weight because hip is not involved. Should be sent home with a walker and PT.