US for metacarpal fractures
The Hand injuries page has been updated with information about the test characteristics of US for the detection of metacarpal fractures.
Orthopaedics
Opioid therapy for chronic back pain
The Low back pain has been updated with information about the lack of significant clinical benefit of opioid therapy for chronic back pain. Abdel Shaheed, C, Maher, CG, Williams, KA, et al. Efficacy, tolerability, and dose-dependent effects of opioid analgesics for low back pain: A systematic review and meta-analysis. JAMA Internal Medicine 2016.
PE following #NOF
The Femoral fractures page has been updated with information about the frequency and timing of PE following injury, with ~50% of PEs occurring within 24 hours. Kim, YJ, Choi, DH, Ahn, S, et al. Timing of pulmonary embolisms in femur fracture patients: Incidence and outcomes. J Trauma Acute Care Surg 2016;80(6):952-6.
Type B periprosthetic femoral fracture image
An Xray image of a Type B periprosthetic femoral fracture has been added to the Assessment of fractures and dislocations page.
US image of quadriceps rupture
The Soft tissue injuries around the knee page has been updated with an US image demonstrating a complete rupture of the quadriceps tendon.
Dislocated lunate relocation technique
The Dislocations around the wrist page has been updated with an improved description of the reduction technique for a lunate dislocation.
Anterior hip dislocation images
A plain Xray and CT image of a native anterior hip dislocation have been added to the Dislocations of the hip page.
Segmental radial head fracture images
2 images of a segmental radial head fracture have been added to the Elbow injuries page.
Shoulder dislocation management with associated fractures
The Anterior shoulder dislocation management page has been updated with guidance about management in cases with associated fractures.
Metastatic spinal cord compression
The Low back pain page has been updated with a segment on metastatic spinal cord compression following the recent publication of Al-Qurainy, R, Collis, E. Metastatic spinal cord compression: diagnosis and management. BMJ 2016:i2539.
Low back pain
The Low back pain page has been revised including a clearer explanation of the indications for surgery.
Metacarpal fractures
The Hand injuries page has been updated with a revised section on metacarpal fracture management. In particular, the lack of evidence of benefit from surgical management of most metacarpal fractures has been re-emphasised. Neumeister, MW, Webb, K, McKenna, K. Non-surgical management of metacarpal fractures. Clin Plast Surg 2014;41(3):451-61. Sletten, IN, Hellund, JC, Olsen, B, et … Read more
Osteoid osteoma
The segment on Osteoid osteoma on the Bone tumours page has been revised.
Femoral periprosthetic fracture image
An image of a Type B3 periprosthetic femoral fracture has been added to the Assessment of fractures and dislocations page.
Periprosthetic fractures
A large segment on the classification and management of peri-prosthetic fractures has been added to the Assessment of fractures and dislocations page.
Surgical repair of ankle ligament injuries
The Soft tissue injuries of the ankle and foot page has been updated with the indications for operative repair of grade 3 ligamentous injuries around the ankle.
Supracondylar fractures
The segment on Supracondylar fractures on the Elbow injuries page has been updated including more specific information about reduction of these injuries in the ED
Peri-prosthetic joint infections
A short segment on periprosthetic joint infections has been added to the Septic arthritis page.
Salter Harris Type 1 management
Some additional information about the management of suspected Salter Harris Type 1 injuries has been added to the Assessment of fractures and dislocations page.
Spinal canal stenosis
A short segment on spinal canal stenosis has been added to the Lower back pain page.