Injury to the posterolateral corner of the knee: emergency department assessment and management

Patellar dislocation: Not the bees knees

BACKGROUND

Patellar dislocations are common, particularly in the adolescent polulation. Registered Advanced Nurse Practitioners are healthcare professionals who can appropriately manage these injuries to minimise the risk of chronicity.

METHODS

This is a case study which uses a clinical examplar from the authors practice focusing on the assessment, diagnosis and managment of patellar dislocations. Particular reference is made of the significance of the MPFL.

RESULTS

This paper highlights the importance of recognition of appropriate management of patellar dislocations in the ED setting. Discussion points include the role of the MDT and the role of exercise prescription in the injury management.

CONCLUSION

The diagnosis of patellar dislocation is heavily dependant on eliciting a comprehensive history and conducting an appropriate clinical exam. Patient outcomes may be optimised by adopting an MDT approach.

'A torn shoulder': an emergency department case study

BACKGROUND

Rupture of the biceps is not a very common presentation to the emergency departments; as a result, it is poorly documented, especially in nursing literature. It is important that these patients are appropriately managed by registered advanced nurse practitioners. As the diagnosis of rupture is usually made on clinical grounds with imaging assisting in the diagnosis, left untreated these injuries can lead to considerable functional deficits.

METHODS

The following paper is a case study based on a patient who presented to the emergency department with a proximal biceps rupture following trauma. The paper focuses on the clinical assessment and management of patients who present to the emergency department with these injuries.

RESULTS

This case study increases awareness of bicep ruptures and its management in the ED. Discussion points include the neurovascular assessment of these patients, the appropriateness of diagnostic imaging, and in-depth clinical examination techniques.

CONCLUSION

Rupture of the biceps tendon is often a result of a sudden forceful extension of the elbow against a previously contracted biceps and flexed elbow. The patient often describes a popping noise and presents with a 'popeye' deformity over their biceps. It is important to be vigilant with these injuries as early recognition will optimise the patients' outcomes.