orthopedics - welcome to dr bhatia medical coaching …test.dbmci.com/dbmci/images/pdf/ortho dr...
TRANSCRIPT
![Page 1: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/1.jpg)
ORTHOPEDICS
![Page 2: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/2.jpg)
1. IDENTIFY THE FRACTURE
1. Fracture Clavicle
2. Fracture Acromion
3. Fracture spine of Scapula
4. Fracture First Rib
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FRACTURE CLAVICLE
![Page 4: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/4.jpg)
IMPORTANT POINTS
1. The most common bone injured in child and
during birth?
2. Which is the most common site for fracture of
this bone?
3. Which is more common malunion/nonunion?
4. Treatment modality?
5. Forces acting on the fragments?
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FRACTURE CLAVICLE
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FIGURE OF 8 BANDAGE
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2. IDENTIFY THE X RAY.
1.ANTERIOR DISLOCATION OF SHOULDER
2.INFERIOR DISLOCATION OF SHOULDER
3.POSTERIOR DISLOCATION OF SHOULDER
4.FRACTURE GLENIOD CAVITY
![Page 8: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/8.jpg)
2. IDENTIFY THE X RAY.
ANSWER :- ANTERIOR DISLOCATION OF SHOULDER
![Page 9: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/9.jpg)
DISLOCATION OF SHOULDER
Can be Anterior Or Posterior or Inferior
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ANTERIOR DISLOCATION
Preglenoid, subcoracoid, Subclavicular or intrathoracic.
Position:- Abduction & external rotation
Most common N injured :- Axillary(circumflex) Nerve
Treatment :- 1. Most common:-Kochers Method :- TEAM
Traction
External rotation
Abduction
Medial Rotation
2. Stimpson’s gravity method
3. Hippocrates Maneuver
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IF RECURRENT ANTERIOR DISLOCATION
1.Hill Sach’s Lesion
2. bankart Lesion
3. Capsular Laxity
Tt:- 1. TUBS:- Traumatic, Unidirectional, Bankart’s lesion, Surgery for management
2. AMBRI:- Atraumatic, Multidirectional instability, Bilateral, Rahabilitation, Inferion capsular shift.
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POSTERIOR DISLOCATION
Attitude:- Adduction and Internal rotation
Abduction and external rotation are restricted.
Xray findings:-
Electric bulb sign (Vacant glenoid sign)
Tt:- Rotating the arm laterally while applying the longitudional traction.
![Page 13: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/13.jpg)
3. IDENTIFY THE FRACTURE
1. FRACTURE SUPRACONDYLAR HUMERUS
2. FRACTURE SHAFT OF HUMERUS
3. FRACTURE OLECRANON
4. FRACTURE CAPITELLUM
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FRACTURE SUPRACONDYLAR
HUMERUS
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DISCUSS THE TYPES
Extension and flexion types
Mode:- Fall on outstreched hand with hyperextension at elbow
Displacement of the distal fragment
(i) Posteromedial 70-80%
(ii) Posterolateral 20-30%
Name the Classification system used?
Gartland’s Classification
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COMPLICATIONS
EARLY COMPLICATION:-
Vascular Injury :- Brachial Artery-- Volkmann’s Ischemic contracture
Nerve Injury AIN>Median N>Radial >Ulnar
LATE COMPLICATION:-
Malunion commonestGunstock Deformity
Myositis Ossificans
VIC.
![Page 17: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/17.jpg)
4. IDENTIFY THE FRACTURE
1.FRACTURE PROXIMAL ULNA ONLY
2.GALEAZZI FRACTURE
3.MONTEGGIA FRACTURE
4.EPPEX LOPRESTI LESION
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DETAILS
TYPES :- 1. Extension type (M.C)- distal ulna &
head of radius angulates anteriorly . 2. Flexion
type
Complication:- 1.Posterior interroseus nerve
palsy 2.Unreduced dislocation of radial head 3.
Malunion 4. Synostosis 5.Myositis Ossificans.
Treatment :- ORIF (Maintain length of ulna)
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5. IDENTIFY THE FRACTURE.
1. SMITH’S FRACTURE
2. COLLES’ FRACTURE
3. BARTON’S FRACTURE
4. FRACTURE SHAFT RADIUS
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COLLES’ FRACTURE
![Page 22: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/22.jpg)
ENNUMERATE THE DISPLACEMENTS
1.Impaction of fragments
2.Dorsal displacement
3. Dorsal tilt
4. Lateral displacement
5.Lateral tilt
6. Supination
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CLASSICAL CLINICAL DEFORMITY
DINNER FORK DEFORMITY
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TREATMENT
Mainly conservative
Closed Reduction :- Technique
Palmar Flexion & Ulnar Deviation
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COMPLICATIONS
1. Stiffness of fingers,wrists,elbow, shoulder
most common avoidable complication of
COLLES’ fracture. Malunion Dinner fork deformity.
Sudeck’s Dystrophy (Reflex Sympathetic dystrophy)
Carpal Instability
Rupture of Extensor pollicis tendon
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6. IDENTIFY THE FRACTURE
1. SMITH’S FRACTURE
2. COLLES’ FRACTURE
3. BARTON’S FRACTURE
4. FRACTURE SHAFT RADIUS
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SMITH’S FRACTURE
Distal Radius with Palmar displacement
Deformity seen :- Garden Spade deformity
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7.IDENTIFY THE FRACTURE
1.FRACTURE CAPITATE
2.FRACTURE SCAPHOID
3.FRACTURE TRIQULATERAL
4.FRACTURE LUNATE
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SALIENT FEATURES
Most common carpal bone fractured.
Most common site :-
Waist (70-80%), Proximal Pole (20%), Distal pole(10%), Tuberosity, Osteochondral Fractures.
Most common clinical finding :- Tenderness in Anatomical Snuff box. And
A force transmitted along the axis of 2nd metacarpal or pressure along the thumb produce pain in region of scaphoid.
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RADIOGRAPHY
Best view is
Oblique view
Or Routine AP and Lateral views
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TREATMENT
If undisplaced :- Scaphoid cast in dorsiflexion
and radial deviation.
If displaced :- Herbert Screw
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MOST COMMON COMPLICATION
Avascular necrosis. Mostly at fracture of
proximal segment.
Others:- delayed union
Nonunion
OA of wrist
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8.IDENTIFY THE FRACTURE
1. ROLANDO FRACTURE
2.BENNET’S FRACTURE
3.FRACTURE HAMATE
4.DISLOCATION MCP JOINT
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FORCES ACTING
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9.IDENTIFY THE XRAY
1. JEFFERSON’S FRACTURE
2. HANGMAN’S FRACTURE
3. IMPROPER VIEW OF CERVICAL SPINE
4. DEGENERATIVE ARTHRITIS
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HANGMAN’S FRACTURE
1. Fracture of Pars Interarticularis of the C2
vertebrae with traumatic spondylolystheis of
C2 over C3.
2. Its basically a Fracture dislocation
3. Mode of Injury :- Extension with distraction.
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10. IDENTIFY THE FRACTURE
1. FRACTURE NECK OF FEMUR
2. FRACTURE INTERTROCHANTRIC
3. DISLOCATION HEAD OF FEMUR
4. FRACTURE GREATER TROCHANTER
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FRACTURE NECK OF FEMUR
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NAME THE CLASSIFICATION SYSTEM USED
ANATOMICAL
PAUWEL’S GARDEN’S
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GARDEN’S CLASSIFICATION
Incomplete fracture:- valgus impacted. Complete fracture but undisplaced
Complete fracture partial displacement Complete fracture total displacement
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CLINCAL EVALUATION
External Rotation of the limb
Shortening of the limb
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COMPLICATION
AVN femoral head
Non Union
Secondary OA
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TREATMENT
1. Undisplaced fracture :- 3 parallel srew
fixation
2. Displaced <60 yrs:- CRIF with parallel screws
(Transcervical and subcapital)
For Basicervical DHS & rotation screw
60-70 years CRIF
firstfailsHemiarthroplasty
>70 yearsHemiarthroplasty, if pre existing
arthritisTHR
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11.IDENTIFY THE IMAGE
1. POSTERIOR DISLOCATION OF HIP
2. ANTERIOR DISLOCATION OF HIP
3. FRACTURE ACETABULUM
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POSTERIOR DISLOCATION OF HIP
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MAIN CLINICAL FEATURE
Flexion,adduction and internal rotation.
Marked shortening of the limb.
VASCULAR SIGN OF NARATH ABSENT
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COMPLICATION
Injury to sciatic nerve
Avascular necrosis of femoral head
Myositis ossificans
Osteoarthritis
![Page 52: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/52.jpg)
TREATMENT
It should be reduced under general anesthesia
as soon as possible.
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ANTERIOR DISLOCATION
Clinically, limb is marked external rotation,
Flexion and abduction
Femoral head can be felt in the groin
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12.IDENTIFY THE FRACTURE
1. FRACTURE LOWER END TIBIA
2. FRACTURE NAVICULAR
3. FRACTURE CALCANEUM
4. FRACTURE TALUS
![Page 56: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/56.jpg)
SALIENT FEATURES
Only bone without a muscle attachment
Blood supply:- 1. Posterior Tibial Artery 2. Anterior Tibial artery. 3. Peroneal artery
Tt:- Undisplaced B/k pop cast in PF (8-10 wk) Displaced – ORIF with CC screws
Cx:- AVN of body+Hawkin’s sign, Malunion , Non-union, Secondary OA.
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13.IDENTIFY THE INDICATION IN XRAY
1.WHITE LINE OF FRENKEL
2.HAWKIN’S SIGN
3. SHENTON’S LINE
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14. IDENTIFY THE DEFORMITY
1. KLUMPKE’S PARALYSIS
2. ERB’S PALSY
3. DISLOCATION OF SHOULDER
4. FRACTURE RADIAL HEAD
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ERB’S PALSY
![Page 61: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/61.jpg)
DETAILS
Injury at Erb’s point C5-C6 (upper trunk)
Cause:- Birth Injury, Fall on shoulder, During anesthesia
Deformity :- Arm hangs by side adductd, medially rotated, forearm extended and pronated.
“Policeman tip or porter’s hand deformity”
Biceps and Supinator jerk lost
![Page 62: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/62.jpg)
15.IDENTIFY THE IMAGE
1.MEDIAL CLAW HAND
2.ULNAR CLAW HAND
3.DUPUYTREN’S CONTRACTURE
4.VIC
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ULNAR CLAW HAND
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ULNAR NERVE INJURY
Can be High or Low
Low ulnar nerve palsy
FDP and FCU are spared
Muscles of hand paralysed
Hypothenar muscles:- Palmaris brevis
Adductor pollicis
All interossei(Palmar and Dorsal) and medial
two lumbricals.
![Page 65: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/65.jpg)
ULNAR PARADOX
Ulnar claw hand is seen in lower ulnar n.palsy
due to involvement of Interossei but not in high
nerve palsy as in high lesion FDP of 3rd & 4th
Finger also paralysed.
![Page 66: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/66.jpg)
16. IDENTIFY THE XRAYS
1. EWING’S SARCOMA
2. GIANT CELL TUMOR
3. CHONDROBLASTOMA
4. OSTEOCHONDROMA
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GIANT CELL TUMOR
![Page 68: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/68.jpg)
NAME OTHER EPIPHYSEAL TUMORS
Chondroblastoma
Giant cell tumor (Osteoclastoma)
Clear cell chondrosarcoma
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DETAILS
Age group :- 20-40 years
Epiphysis
Malignant transformation 5%
Common sites:- Lower end of femur, upper end
tibia, lower end radius & upper end of humerus
Egg-shell crackling sensation on palpation.
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RADIOLOGICAL
Solitary may be loculated, lytic lesion
Soap bubble appearance
None or minimal reactive sclerosis around the
tumor
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TREATMENT
Curettage and bone grafting
Enblock excision/complete resection
Arthrodesis by using fibula
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17.IDENTIFY THE TUMOR
![Page 73: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/73.jpg)
Ewing’s Sarcoma
![Page 74: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/74.jpg)
DETAILS
Malignant sarcoma arise in the bone marrow
(Medullary cavity).
Second most sarcoma in children (after
osteogenic sarcoma)
Age10-15 years
Sex M>F
Usually arise in Diaphysis, M.C femur & Tibia.
Translocation 11:22 seen in 85-95% cases.
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RADIOLOGY
Onion-skin periosteal reaction.
Sun ray appearance
Codman’s triangle
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TREATMENT
Highly Radiosensitive, Melts like snow.
Tt:- Radiotherapy, Chemotherapy and Surgery.
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18. IDENTIFY THE INFECTION
1. OSTEOCLASTOMA
2. ACUTE OSTEOMYELITIS
3. CHRONIC OSTEOMYELITIS
4. TUBERCULAR OSTEOMYELITIS
![Page 79: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/79.jpg)
SALIENT FEATURES
Hematogenous/exogenous
Age gp:- <2 years or 8 to 12 yrs
Site:- Metaphysis
Mc.Org:- Staph aureus
I.V drug abusers :- Pseudomonas
Parenteral Therapy :- Fungal
SC hemoglobinopathies:- Salmonella
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SALIENT FEATURES
ESR-24-48 hrs, CRP-12-24 hrs
Skeletal changes may not be seen upto 10-12
days.
Soft tissue swelling after 1to 3 days
Technitium99 scan confirm the diagnosis
within 24-48 hrs.
Tt:- Antibiotics (I.V-2weeks+oral 4 weeks)
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COMPLICATIONS
1. Chronic Osteomyelitis
2. Acute exxacerbation
3. Growth abnormalities
4. Sinus Tract malignancies (SCC-very rare)
5. Pathological fractures
6. Joint stiffness
7. Amyloidosis-AA type
![Page 82: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/82.jpg)
Sequestrum Infected dead bone within a soft
tissue envelope
Its avascular so leaves antibiotic ineffective
and appears dense than normal bone as no
decalcification.
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19. IDENTIFY THE CONDITION
1. OSTEOARTHRITIS
2. RHEUMATOID ARTHRITIS
3. GOUT
![Page 84: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/84.jpg)
RHEUMATOID ARTHRITIS
![Page 85: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/85.jpg)
DETAILS
Multisystem disorder, mainly attacks joints.
Inflammatory synovitis.
F>M
Importanat feature :- Sparing of the DIP joint.
![Page 86: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/86.jpg)
DEFORMITIES
1. Boutonniere deformity
2. Swan neck deformity
3. Z- Deformity
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FELTY SYNDROME
Chronic Rheumatoid Arthritis
Splenomegaly
Neutropenia
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TREATMENT
1. Rest , NSAID’s, Splintage
2. Drugs
3. Intraarticular Injections
4. Physiotherapy
5. Surgery :- Correction of Deformities
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20. IDENTIFY THE XRAYS
1. METASTASIS
2. DEGENERATIVE CHANGES ONLY
3. OSTEOPOROSIS
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OSTEOPOROSIS
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Commonest metabolic disease
Abnormally low bone mass
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CLINICAL FEATURES
Back pain secondary to vertebral compression
fracture
Most common site dorso lumbar spine
Other Colles’ fracture and Fracture Neck of Femur
S.Ca, S.Ph and S.Alkpo4 are normal
![Page 93: ORTHOPEDICS - Welcome To Dr Bhatia Medical Coaching …test.dbmci.com/DBMCI/images/pdf/Ortho Dr Sushil.pdf · · 2015-09-21DEFORMITIES 1. Boutonniere ... CTEV 3. TIBIAL TORSION](https://reader035.vdocument.in/reader035/viewer/2022070607/5aa1207e7f8b9a1f6d8b6ddd/html5/thumbnails/93.jpg)
RADIOLOGICAL
Cod fish appearanceBiconvex vertebral
bodies
Ground glass appearance of bones
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GOLD STANDARD FOR DIAGNOSIS
Dexa scan
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DRUGS USED FOR TREATMENT
Inhibit Resorption :- Bisphosphonates
(Etidronate/Alendronate), Calcitonin, Estrogen,
SERM
Stimulate formation :- Teriparatide, Calcium,
calcitriol
Both actions:- Strontium ranelate
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21. IDENTIFY THE CONDITION
1. OSTEOPOROSIS
2. BONE ISLAND
3. OSTEOARTHRITIS
4. AVASCULAR NECROSIS HEAD OF FEMUR
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AVASCULAR NECROSIS HEAD OF
FEMUR
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COMMON SITES
Head of Femur Fracture Neck of femur
Proximal Pole of scaphoidThrough waist
Body of Talusthrough neck of talus
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COMMON CAUSES
Fracture Neck of femur
Alcohol, Corticosteroids abuse, Smoking
Gauchers Disease
Sickle Cell disease
Perthes disease, SCFE
Polycyhtemia
Pancreatitis
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GOLD STANDARD TO DIAGNOSE
MRI
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22. IDENTIFY THE CONDITION
1. OSTEOMYELITIS
2. MYOSITIS OSSIFICANS
3. ELBOW DISLOCATION
4. FOREIGN BODY
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DEFINATION
Extraskeletal heterotropic ossification that
occur in muscle and other soft tissues
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CAUSES
Traumatic (most common)
Non traumatic (Pseudomalignant myositis
ossificans)
Progressive (Myositis ossificans progressive)
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COMMON SITE
Elbow- Most common,
Following injuries
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MUSCLES SPARED
Diaphgram
Cardiac muscles
Extraocular muscle
Smooth muscle
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23.IDENTIFY THE APPLIANCE
1. MINERVA JACKET
2. LUMBAR CORSET
3. PAVLIK HARNESS
4. TLSO
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CDH or DDH
Congenital Dislocation of Hip or Developmental
dysplasia of Hip.
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SALIENT FEATURES
Risk Factors:-
First borns, females , Faulty IU positions, Familial, Oligohydroamnios
Pathology
Head is small
Femoral neck is excessively anteverted.
Acetabulum is shallow
Inverted Limbus Labrum of acetabulum is folded in cavity of acetabulum.
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CLINICAL FEATURES
Limitation of abduction and external rotation
Limb in adduction, Internal rotation and flexion
Asymmetrical thigh fold.
Galeazzi sign
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BILATERAL CDH
Waddling gait Duck like waddling
Lordosis
Short stature
Compensatory genu valgum
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INVESTIGATION OF CHOICE
USG
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CLINICAL TESTS
Ortolani Test
Barlow Test
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TREATMENT
1-6 months von rosen splint
6-18 months Batchelors cast or frog leg
cast
18 months Open reduction with
femoral shortening
3-8 years OsteotomySalter’s
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24. IDENTIFY THE DISEASE
1. METATARSUS ADDUCTUS
2. CTEV
3. TIBIAL TORSION
4. CONGENITAL VERTICAL TALUS
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SALIENT FEATURES
Primary or Idiopathic
Or Secondary to:-
Neurologic disorders
Paralytic disorders
Arthrogryposis multiplexa
Etc.
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TREATMENT
Correction and splintage
Ponsetti method
CAVE- Correct Cavus, Adduction, Varus and
equinus
Denis brown splint
In failed/neglected Even triple arthrodesis
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25. IDENTIFY THE DISEASE
1. OSTEOPOROSIS
2. RICKETS
3. SCURVEY
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RICKETS
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DEFINATION
Metabolic disorder of growing bone(immature
skeleton).
Can be due to lack of
Vitamin D, Calcium or Phosphate
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CHANGES SEEN
Thickening of growth plate
Widening of growth plateif at costochondral junctionRachitic rosary
Cupping or flaring of metaphysis
Fraying of metaphysis
Softening and deformity of long bones
Bowiing of diaphysis
Widening of epiphysis
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SKULL
CraniotabesEarliest Manifestation
Delayed closure of anterior fontanelle
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26. IDENTIFY THE IMAGE GIVEN
1. HALO CAST
2. MINERVA JACKET
3. TLSO
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MINERVA CAST
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USE
For stabilization of fracture of cervical spine
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27. IDENTIFY THE OBJECT
1. CRAMER WIRE SUPPORT
2. HUGH OWEN THOMAS SPLINT
3. BB SPLINT
4. BOHLER’S TRACTION SUPPORT
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Hugh Owen Thomas splint
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WHERE IT IS USED
Initially made to support the T.B of the knee
Now also used to support the fractures around
the shaft of femur.
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28. NAME THE INSTRUMENT
1. JESS FIXATOR
2. ILIAROV FIXATOR
3. PIN TRACTION SYSTEM
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USED FOR
Elongation of the bone or to cover the
segmental loss of bone.
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29.IDENTIFY THE PROSTHESIS
AUSTIN MOORE PROSTHESIS
THOMPSON PROSTHESIS
BIPOLAR PROSTHESIS
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THOMPSON PROSTHESIS
AUSTIN MOORE PROSTHESIS
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THANK YOU FOR YOUR COOPERATION
HOPE WE HAD A NICE AND INTERESTING
SESSION