EM Ortho: Hip and Knee Emergencies

Here are the answers to the questions posed in the guided notes from today’s EM Ortho session on Hip and Knee emergencies presented by Dr. Kiel.

1. Which pelvic fracture pattern is associated with the highest mortality? 
   • Vertical Sheer

2. In patients with a hip fracture, what is the typical appearance of the limb?
   • Shortened, externally rotated

3. If a patient with hip pain is exquisitely tender on their greater trochanter, what is their diagnosis?
   • (Greater) Trochanteric Pain Syndrome

4. Describe the anatomic chain of the extensor mechanism.
   • Quadriceps, quad tendon, patella, patellar tendon, tibial tubercle

5. What is the best imaging modality for tibial plateau fractures?
   • CT

6. Following a patella dislocation, which anatomic landmark of the knee is most tender?
   • MPFL (medial patellofemoral ligament) at the medial femoral condyle

7. What percentage of knee dislocations reduce prior to arrival to the ED?
   • 50%

8. What is the most likely diagnosis in a patient with atraumatic anterior knee pain?
   • PFPS (patellofemoral knee pain)

9. What is the feared complication of hip dislocations and reason for urgency in management?
   • AVN (avascular necrosis)

10. What immobilization technique can be used to reduce bleeding and risk of hemorrhagic shock in femur fractures?
    • Traction splint or pin