Evidence-Based Updates in Orthopedic Emergencies
Management of common orthopedic injuries in the emergency department continues to evolve as emerging evidence challenges traditional approaches. Recent literature has introduced new perspectives on the diagnosis and treatment of frequently encountered injuries, highlighting opportunities to update clinical practice.
At the AAEM 32nd Annual Scientific Assembly (AAEM26) in Seattle, WA, Marco E. Propersi, DO, FAAEM, presented a session titled “Breaking Bones, Breaking Myths: Evidence-Based Ortho Updates for the Emergency Clinician.” Dr Propersi is Chair of Emergency Medicine at Vassar Brothers Hospital–Nuvance Hospital System in Park Ridge, New Jersey. He reported no financial relationships to disclose.
This session provided evidence-based updates on the management of common orthopedic injuries in the emergency department, with a focus on recent studies that challenge established practices. Topics included nailbed injury repair, scaphoid fracture management, toddler’s fractures, and reduction techniques for nursemaid’s elbow. Using case-based examples and critical appraisal of recent literature, the presentation reviewed findings from new studies and meta-analyses relevant to bedside care.
In a brief interview with Consultant360, Dr Propersi noted the key takeaways from his lecture:
1. For anterior shoulder dislocation, consider intraarticular lidocaine as first line for reduction.
2. In patients with wrist injuries with negative x-rays but persistent snuffbox tenderness, use a ace wrap instead of reflexively casting.
3. For patients with nail bed avulsions, replacing the nail bed is optional.
Learning objectives for the session included describing evidence-based approaches to the diagnosis and management of occult scaphoid fracture using recent literature, evaluating the necessity of nail plate replacement following nailbed repair based on current evidence, and comparing treatment options for toddler’s fractures and nursemaid’s elbow using findings from recent studies and meta-analyses.
Reference
Propersi ME. Breaking bones, breaking myths: evidence based ortho updates for the emergency clinician. Presented at: AAEM26 Scientific Assembly; April 15, 2026; Seattle, WA. Accessed April 14, 2026. https://aaem26.eventscribe.net/SearchByBucket.asp?f=TrackName&bm=Abstract&pfp=Abstracts