Orthopaedics

The Knee and leg fractures page has been updated with some additional information about isolated fibula fractures.

The Soft tissue injuries of the ankle and foot page has been updated with a new section on Morton’s metatarsalgia.

The information about discitis and epidural abscess on the Low back pain page has been extensively revised and updated.

The Management of the severely injured limb has been revised and the capacity of the MES to predict the need for amputation revised in light of advances in treatment.

The Soft tissue injuries of the ankle and foot page has been updated with additional information about the management of ankle ligament injuries following the publication of the following article. Brison, RJ, Day, AG, Pelland, L, et al. Effect of early supervised physiotherapy on recovery from acute ankle sprain: randomised controlled trial. BMJ 2016;355:i5650. 

The Distal forearm injuries page has been updated with a new segment called Other causes of pain around the wrist and a segment on Madelung deformity.

The Shoulder and arm region injuries page has been updated with information about joint aspiration for pain relief in patients with #NOH.

The Elbow injuries page has been updated with additional information about imaging options (including US) for elbow injuries.

The Dislocations of the hip page has been updated with the technique for anterior dislocation reduction.

The Dislocations of the hip page has been updated including a description of the Captain Morgan relocation technique.

Some additional information about the management and complications of elbow dislocation has been added to the Elbow injuries page.

Some additional information regarding luxatio erecta has been added to the Glenohumeral joint dislocation page.

The Hand injuries page has been updated with more details about IP joint dislocations.

The Hand injuries page has been updated with information about the test characteristics of US for the detection of distal phalangeal fractures.

The Hand injuries page has been updated with information about the test characteristics of US for the detection of metacarpal fractures.

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.

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.