Pediatric non-accidental trauma (child abuse) can be one of the most emotional and stressful diagnoses to work up. Your job as the physician is (1) to recognize the potential for non-accidental trauma, (2) bring the patient into the hospital for safe evaluation, (3) provide an objective assessment of the injury pattern, (4) treat the injuries, and (5) notify the appropriate authorities who can ensure the patient’s safety upon discharge.
This is what surgeons live for. The adrenaline rush of life and limb saving surgical intervention. Orthopaedic emergencies are rare and can be life and limb threatening without prompt intervention. For the USMLE, you should know of the open fracture, compartment syndrome, necrotizing fasciitis, and septic arthritis.
Hip fractures in the elderly are common, with a prevalence of 0.2% in men and 0.5% in women, which means you can expect to see a question or two on the USMLE. Not only does this condition encompass orthopaedic surgical management of a very common fracture, but it also serves to review medical management of a fragile patient who is at risk for a fracture through osteoporotic bone. In a nutshell, an insufficiency or fragility fracture of the hip occurs when a person falls onto an osteoporotic hip. Patients often present with anterior thigh or groin pain, a shortened and externally rotated lower extremity (the adductors shorten, gluteus medius and maximus abduct, iliopsoas flexes, and the short external rotators, you guessed it, externally rotate), and inability to ambulate.