Ortho Pearls - The Maisonneuve Fracture

The Case:

A 43-year-old otherwise healthy man presented to the ED with ankle pain and swelling. Patient was playing basketball 5 days ago and twisted his left ankle. He initially presented to an outside hospital where he was told he had an “ankle” fracture and was splinted with a short leg posterior splint. He presented to our ED for worsening pain and swelling of his lower leg. On exam, the patient has ecchymosis and edema of the ankle extending proximally just inferior to the knee. There was pain with tibio-fibular compression and point tenderness was present over the medial malleolus and proximal fibula with overlying ecchymosis. The compartments were soft and the leg was neurovascularly intact. The patient was sent for radiographs.

Maria Gomez, MD

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Bat To The Bone: A Rabies Review

A 37-year-old man with no past medical history presented after he was bit by a bat on the index finger of the right hand. He stated he reached into a box to remove what he thought was a rag. In fact, it was a bat that had its wing trapped by a paint can (Figure 1). He was concerned about rabies and presented to the ED for further care.

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