Journal of Urgent Care Medicine

Urgent Care Diagnosis and Management of Midshaft Ulnar (Nightstick) Fractures

Urgent Message: Fractures of the midshaft ulna, commonly referred to as “nightstick fractures,” typically occur after direct injury to a forearm outstretched above the head as a protective mechanism. Evaluation includes inquiry into the circumstances of the assault, assessment for any other areas of trauma, examination of the skin, wrist and elbow joints, and radiography of the forearm. Management of closed, nondisplaced midshaft ulnar fractures centers around splint immobilization and arrangement of appropriate follow-up. Chandrika …

Urgent Care Recognition and Management of Proximal Humerus Fractures

Urgent Message: Proximal humerus fractures most commonly occur in older patients after a fall and can be sentinel events that offer an opportunity to identify undiagnosed medical conditions or unsafe home environments. Lauren Schuermann, MS4; Shivani Kothari, MS4; W. Bradley Strauch, MD Citation: Schuermann L, Kothari S, Strauch B. Urgent Care Recognition and Management of Proximal Humerus Fractures. J Urgent Care Med. 2024; 19(2): 13-19 Questions for the Clinician at the Bedside Clinical Scenario A …

Urgent Care Diagnosis and Management of Distal Radial (Colles) Fractures

Urgent Message: Fractures of the distal radius, commonly referred to as Colles fractures, most often occur after a fall onto an outstretched hand. Their immediate urgent care management may require only splinting or a same day emergency department visit depending on certain factors. Citation: Bunstine JL, Hartz C. Urgent Care Diagnosis and Management of Distal Radial (Colles) Fractures. J Urgent Care Med. 2024; 19(1):15-19 Editor’s Note: While the images presented here are authentic, the patient …

Urgent Care Recognition and Management of Maisonneuve Fractures

Urgent Message: Clinicians should inquire about the mechanism of injury when a patient presents with ankle pain and consider x-ray that includes the ankle, tibia, and fibula to evaluate for the possibility of Maisonneuve fracture, especially when pain in the inferiolateral knee is also present. Willie O’Neal, MD; Bradley Strauch, MD Citation: O’Neal W, Strauch B. Urgent Care Recognition and Management of Maisonneuve Fractures. J Urgent Care Med. 2024; 18 (11): 21-28 Editor’s Note: While …

Urgent Care Management of Scaphoid Fracture

Naushair Hussain, DO; Shahmeer Hussain, DO; Clinton A. Hartz, MD Urgent Message: Scaphoid fractures most frequently occur at the mid aspect, or “waist,” of the scaphoid, and require about 10 weeks of prolonged immobilization before slow return to normal function. Such fractures have high risk of complications and subsequent chronic pain and/or disability if not appropriately immobilized. Citation: Hussain N, Hussain S, Hartz C. Urgent Care Management of Scaphoid Fracture. J Urgent Care Med. 2024; …

Urgent Care Evaluation and Management Of Injury to the Ulnar Collateral Ligament of the Thumb (Gamekeeper’s Thumb)

Urgent Message: With hyperabduction and hyperextension of the thumb, the ulnar collateral ligament may be stretched or torn, or may avulse a segment of bone from its insertion point. Radiographic imaging of suspected “gamekeeper’s thumb” must be obtained to evaluate for an associated fracture, which may change the decision for conservative vs surgical management. Omar Jafry, MS-3; W. Bradley Strauch, MD Citation: Jafry O, Strauch WB. Urgent Care Evaluation and Management Of Injury to the …

Urgent Care Evaluation and Management of Boxer’s Fractures

Urgent Message: Boxer’s fractures are among the most common hand fractures and should be suspected in cases of closed fist injury. Additionally, a laceration that accompanies a boxer’s fracture may represent a fight bite, which should be treated to reduce the risk of infection. Jennifer Hicks, DO; Bradley Strauch, MD Citation: Hicks J, Strauch WB. Urgent Care Evaluation and Management of Boxer’s Fractures. J Urgent Care Med. 2024; 18(8):32-36 Editor’s Note: While the images presented …

Urgent Care Evaluation and Management Of Proximal 5th Metatarsal Fractures

Urgent Message: It’s important to recognize the difference between a proximal 5th metatarsal fracture of the tuberosity alone and a proximal metaphyseal fracture, commonly referred to as a “Jones fracture.” A Jones fracture requires full immobilization with urgent surgical referral. Michael B. Weinstock, MD; Kelly Moore, BS Citation: Weinstock M, Moore K. Urgent Care Evaluation and Management Of Proximal 5th Metatarsal Fractures. J Urgent Care Med. 2024 18(7):25-28 Editors’ Note: While the images presented here …