Find the fracture

-Gunshot wound. Ouch.

Don't really need an xray to see this one.

"Nightstick" fracture. What badguys get when trying to block a nightstick blow... or ladies get when trying to block a blow from an angry husband.

Random radius fracture.

This is what happens when fractures don't get mananged well. Actually, this isn't too bad, because she's pain free and has a functional arm. It just doesn't look right, which is a sad deal for a sweet little girl.

This is the first real jaw fracture I've seen. Hard to miss, both clinically and on xray.

Another Nightstick fracture. This was dude on dude violence if I remember right.

Bennett's fracture from previous blog.

Hope you enjoyed the show. I've seen several more, but this is a good smattering. On a side note, I saw paraphimosis for the first time tonight. When I saw it, I knew what it was from reading about it in med school, but I'd never seen a picture, couldn't remember the medical word for it ,and didn't really know what to do. (In the States this is really uncommon, and you just call a urologist.) I called up Scott Dooley, my backup for the night, and we worked on this thing for at least a good 30 minutes before finally reducing it. But now I'm getting "ahead" of myself. You see, paraphimosis is when the glans of the penis is stuck outside the uncircumcised foreskin. The longer it's out, the harder it is to get back in because the blood keeps pumping in, but no blood is getting out. The glans on this kid was hugely swollen, and the outer ring of his foreskin was reeaally small. It was like trying to shove a golfball back through a straw. I shot the kid up druggie style with 50 mg of ketamine with some valium, then another 50 of ketamine when he started waking up after 20 min or so of work. Poor kid! The good news is that (1)he won't remember any of his time in our ER and (2) we finally got his tallywhacker all put back like it should be. Unfortunately for him, he just might need a circ to keep this from happening again. Double ouch!