orhopidics

1. orthopedics
Dr. Mkhadar Ali

2. Outline of presentation
• Gross anatomy of MSS, bone structure
• Definition of fractures
• Mechanisms, types of #s,
• Basic principles of long bone fracture management
• Dislocations and dislocation fractures
• Definition
• Common types, management
• Childhood fractures and complications

3. Anatomy :The Locomotor System
• Includes the bones, muscles, tendons and ligaments – the skeletal
system and all that makes it move
• The art and science of the Diagnosis and Treatment of all the
disorders of the human locomotor system – Orthopaedics

4. Functions
• Locomotion
• Weight bearing
• Axial skeleton, hip and lower extremities
• Purposeful activities
• Forearm and hand
• Metabolic
• Calcium, phosphate metabolism, deposition

5. Fracture
• A break in the continuity of a bone as a result of different causes
• Often follows application of energy which is beyond its intrinsic
resistance

6. Mechanism of injury
-falls
-direct blow on the arm
-automobile injuries
-crashing injuries from
machinery
-Missiles from firearms
-A fall on the elbow
-Fall on outstretched hand
- Violent muscle contraction
-In sport’s man :
-baseball
Direct trauma Indirect trauma:

7. Types or Classification of
• Criteria for classification
-communication with external
environment
-location of fracture
-degree of fracture
-direction and character of fracture
line
-associated injuries
-intrinsic condition of bone

8. • Communication with external environment
-A :open
-B : closed
• Location of fracture:
-proximal, mid, distal
-methaphysial, diaphysial, epiphysial
-base, head…
• Degree of fracture:
-incomplete fracture
-complete fracture

9. +
• Direction and character of fracture line : depends on
magnitude and direction of force applied on the bone
-Longitudinal -spiral
-Transverse -segmental
-Oblique -comminuted
• Alighnment : displaced, undisplaced, angulated, rotated,
stable, unstable
• Associated injuries
-A: nerve injury [radial,ulnar,medial]
-B: blood vessels [brachial artery and vein]

12. continuation
• Intrinsic condition of the bone
A: Normal
B:Pathology
 Due to local bone change
-bone atrophy
-inflammatory process
-neoplasm
-benign
-malignant
 Due to disorders affecting entire skeleton
-congenital abnormality
-metabolic bone disease
-disseminated bony disorders of unknown etiology

13. Evaluation and diagnosis
• Clinical
• History
• Examination
• Look, feel, move…., distal neurovascular status
• Radiography
• Pertinent
• Always include both joints in long bone #
• Two views perpendicular to each other ( AP & Lateral)
• Rule of two
• ? Angiographs
• MRI

14. • Clinical signs and symptoms
 complete and displaced fracture
-the extremity is shortened
-abnormal mobility
- crepitus on gentle manipulation
-swelling
-pain
 undisplaced and incomplete fracture
-swelling
-pain
- disability
-point tenderness