Orthopedic Consultation In The Emergency Department

In many cases, such as hip fracture or both-bone fracture of the forearm, the need for hospital admission and/or orthopedic consultation in the emergency department is obvious. In some situations, however, differences of opinion may exist among emergency physicians, as well as among orthopedists, as to whether the patient needs to be seen by an orthopedist in the emergency department, or whether the patient may be treated in preliminary fashion and referred for subsequent definitive orthopedic management. Even patients with injuries that may ultimately require surgical repair, such as an unstable ankle fracture, may sometimes be immobilized and discharged for prompt orthopedic follow-up.

Some entities or situations that may warrant orthopedic consultation while the patient is still in the emergency department are discussed below. Compartment Syndrome

The physiology and potentially catastrophic consequences of compartment syndrome are described later in this chapter. In cases of known or suspected compartment syndrome, orthopedic consultation should be obtained promptly. Emergency surgical intervention may be required to try to avert permanent tissue damage and muscle contracture.

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