The Quigley Maneuver for Ankle Fractures

​Certain emergency department procedures bring us a sense of accomplishment. We cheer after a shoulder returns to its correct position from our relocation technique and smile when a laceration closes just right. Emergency department procedures can be very rewarding for providers and patients, especially during times of stress in the workplace. Sometimes, just stapling a scalp or molding the perfect splint may seem cathartic. There are days where we can only see so much abdominal and chest pain—and COVID-19.The double-person Quigley maneuver technique for an ankle fracture. Photo by Martha Roberts.This month we want to show you a special procedure mastered by our orthopedic colleagues. As we discussed last month, trimalleolar fractures of the ankle are painful, troublesome, and unstable. Quick and simple reduction and temporary splinting of these injuries are important ED procedures in preparation for transfer or surgery. These fractures often require advanced imaging and always require surgery. This is a temporary procedure to stabilize the ankle before surgery, which is typically done the next day.Ankle fractures can be tricky and occasionally need conscious sedation. But if you premedicate a patient with oral ibuprofen, acetaminophen, and possibly oxycodone and do a hematoma block in advance, you may be able to reduce a trimalleolar fracture without sedation. This may be particularly useful during the pandemic when resources may be light and airway procedures should be ...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs