Orthopedics

A

• Achilles Tendon Rupture — Diagnosis & Functional Rehab

  Diagnose with positive Thompson test and gap; ultrasound helpful. Nonoperative functional rehab yields comparable outcomes to surgery with early mobilization; surgery for high‑demand or large gaps.
• Acute Compartment Syndrome - Recognition and Fasciotomy

  Severe pain out of proportion and pain with passive stretch are early signs; do not delay fasciotomy for pressure measurements when the exam is reliable.
• Acute Compartment Syndrome — Clinical Diagnosis and Emergent Fasciotomy

  Severe pain out of proportion, pain with passive stretch, and tense compartments suggest compartment syndrome. Do not delay for imaging. Measure compartment pressures if uncertain; delta pressure ≤30 mmHg indicates fasciotomy. Remove constrictive dressings and keep limb at heart level.
• Acute Compartment Syndrome — Clinical Diagnosis and Fasciotomy Timing

  Emergent limb‑threatening condition recognized by severe pain out of proportion, pain with passive stretch, tense compartments, paresthesias, and evolving motor deficits. When exam is equivocal, measure pressures; a delta‑pressure (diastolic minus intracompartment) ≤30 mmHg supports diagnosis. Remove constrictive dressings, keep limb at heart level, and perform prompt fasciotomy—ideally within 6 hours of ischemia.
• Adhesive Capsulitis — Staging & Treatment

  Frozen shoulder progresses through painful, stiff, and recovery phases. Treat with analgesia and structured PT; consider intra‑articular steroid injection; MUA or arthroscopic release for refractory cases.
• Ankle Injury - Ottawa Rules and Initial Management

  The Ottawa ankle rules identify many patients with acute ankle or midfoot trauma who do not need radiographs. Apply the rule only in appropriate patients, evaluate for neurovascular or tendon injury, treat uncomplicated sprains with functional support and progressive weight bearing, and image or refer when red flags are present.
• Anterior Shoulder Dislocation - Reduction and Aftercare

  Anterior shoulder dislocation requires prompt pain control, pre-reduction neurovascular documentation, confirmation of associated fracture risk, gentle reduction with adequate analgesia or sedation, and post-reduction imaging and examination. Early orthopedic consultation is needed for fracture-dislocation, vascular injury, irreducibility, or recurrent complex instability.

C

• Cauda Equina Syndrome — Red Flags, MRI, and Urgent Decompression

  Back pain with bilateral sciatica, saddle anesthesia, and urinary retention/incontinence suggests CES. Obtain emergent MRI and perform urgent decompression (usually L4–S1) to maximize neurologic recovery; treat underlying causes (disc herniation, tumor, abscess).
• Compartment Syndrome — Recognition and Fasciotomy

  Acute compartment syndrome is a surgical emergency in which rising pressure within a closed fascial compartment compromises muscle and nerve perfusion. Diagnose primarily from the clinical trajectory: escalating pain out of proportion, pain with passive stretch, tense swelling, paresthesia, and later weakness. Normal pulses do not exclude the diagnosis. Remove external constriction, keep the limb near heart level, obtain immediate orthopedic or trauma consultation, and perform urgent fasciotomy when clinica

F

• Fat Embolism Syndrome — Long-Bone Fractures to ARDS

  After long‑bone fracture or orthopedic trauma, patient develops hypoxemia, neurologic changes, and petechial rash—consistent with fat embolism syndrome (FES).

H

• Hip Fracture in Older Adults - Perioperative Care

  Hip fracture in an older adult is a time-sensitive geriatric emergency associated with pain, immobility, delirium, thromboembolism, functional decline, and excess mortality. Management combines prompt analgesia, medical optimization without avoidable delay, early surgery, delirium prevention, thromboprophylaxis, mobilization, nutrition, and secondary fracture prevention.
• Hip Labral Tear — Diagnosis & Nonoperative Care

  Labral tears often occur with femoroacetabular impingement. Initial management is activity modification and PT; consider intra‑articular injections; arthroscopy for persistent symptoms with imaging correlation.
• Humeral Shaft Fracture - Radial Nerve Palsy

  Most closed humeral shaft fractures can be treated nonoperatively, and primary radial nerve palsy commonly recovers spontaneously. Document radial nerve function carefully, splint the fracture, obtain appropriate imaging, and reserve early exploration for open injury, vascular damage, penetrating trauma, irreducible fracture, or other specific operative indications.

L

• Lateral Epicondylitis — Nonoperative Treatments

  Overuse tendinopathy of wrist extensors (ECRB). Eccentric strengthening and activity modification are mainstays; injections provide short‑term relief but limited long‑term benefit.
• Limb Compartment Syndrome — Diagnosis and Fasciotomy

  Severe pain out of proportion, pain with passive stretch, and tense compartments suggest the diagnosis; obtain pressures when unclear and arrange urgent fasciotomy.
• Lumbar Spinal Stenosis — Diagnosis & Management

  Neurogenic claudication with pain improved by flexion. First‑line: exercise therapy, analgesics; consider epidural steroids for short‑term relief; surgery (decompression ± fusion) for refractory disabling symptoms.

M

• Meniscal Tear — Nonoperative vs Arthroscopic Management

  Degenerative tears often respond to exercise therapy; reserve arthroscopy for persistent mechanical symptoms or locked knees. Acute traumatic tears in young athletes may benefit from repair.

O

• Open Fracture - Initial Management and Antibiotics

  Open fractures combine skeletal injury with direct communication between the fracture and external environment. Early priorities are hemorrhage control, neurovascular assessment, sterile coverage, prompt IV antibiotics, tetanus prophylaxis, stabilization, and timely operative irrigation and debridement with orthopedic trauma involvement.

P

• Patellofemoral Pain Syndrome — Diagnosis & Therapy

  Anterior knee pain from overload/maltracking. Treat with activity modification, hip/glute strengthening, taping, and footwear/orthoses; avoid routine arthroscopy.
• Plantar Fasciitis — Evaluation & Treatment

  Heel pain due to plantar fasciopathy. First‑line: activity modification, stretching (plantar fascia/calf), heel cups, night splints, and gradual load. Most improve within 6–12 months; injections/ESWT for refractory cases.
• Prosthetic Hip Dislocation - Reduction and Aftercare

  Prosthetic hip dislocation is a painful loss of congruity after hip arthroplasty that requires confirmation of component position, fracture status, and neurovascular integrity before reduction. Most uncomplicated first dislocations can undergo closed reduction with adequate sedation, followed by post-reduction imaging and orthopedic follow-up.

S

• Scaphoid Fracture — Imaging & Immobilization

  High suspicion with snuffbox tenderness after FOOSH. Initial radiographs can be negative; immobilize and repeat imaging or obtain MRI. Non‑displaced waist fractures often cast; proximal pole and displaced need surgery.
• Septic Arthritis - Native Joint Urgent Management

  Perform urgent arthrocentesis for cell count, gram stain, and culture, start empiric IV antibiotics after cultures, and arrange operative washout for hip or shoulder or when poor response.
• Septic Arthritis — Adult

  Septic arthritis of a native joint is bacterial infection of the synovial space and can rapidly destroy cartilage, cause sepsis, and impair long-term function. Diagnosis requires urgent arthrocentesis before antibiotics when the patient is stable enough, with synovial fluid sent for cell count, differential, Gram stain, culture, and crystal analysis. No synovial white-cell cutoff alone proves or excludes infection. Treatment combines prompt antimicrobial therapy with drainage or surgical washout, most often
• Septic Bursitis - Olecranon and Prepatellar

  Septic bursitis most often affects the olecranon or prepatellar bursa and is commonly caused by Staphylococcus aureus after minor skin disruption. Distinguish it from septic arthritis, aspirate when diagnosis or severity is uncertain, treat with antistaphylococcal antibiotics, and escalate for systemic illness, loculation, or failure of medical therapy.
• Shoulder Dislocation — Reduction Techniques & Rehab

  Anterior dislocation most common. Use analgesia/sedation or intra‑articular lidocaine, choose gentle reduction techniques, and immobilize briefly with early rehab; assess for Bankart/Hill‑Sachs and recurrent instability.
• Suspected Scaphoid Fracture - Negative Radiograph

  A clinically suspected scaphoid fracture can be radiographically occult on the day of injury. Persistent anatomic snuffbox or scaphoid tubercle tenderness after a compatible mechanism warrants immobilization and early MRI or CT, or repeat evaluation when advanced imaging is unavailable, because missed fractures can progress to nonunion and avascular necrosis.