This document describes a novel surgical technique for primary ACL reconstruction using both autograft and a biomimetic graft. The technique involves a four-stranded anatomical single-bundle reconstruction that places the femoral tunnel low to overlap both the AM and PL bundles. Preliminary results on 18 elite football players showed improved IKDC scores, reduced pivot shift, and allowed return to full athletic performance by 3.5 months. However, long-term follow up is still needed to evaluate the outcomes of this new single-bundle technique.
Open and closed wedging are techniques used to correct deformities in casts. Open wedging involves making a partial cut in the cast and spreading it open to reduce fractures, then securing it with additional material. Closed wedging removes a wedge-shaped piece of cast to manipulate it into a valgus position and reduce fractures. Both techniques require ensuring adequate, even padding to prevent pressure sores.
Prosthetic management of individuals with upper extremity
amputations presents all health professionals, including
prosthetists and therapists, with a set of unique challenges.
For those wearing an upper extremity prosthesis, the terminal
device (TD) of the prosthesis is not covered or obscured
by clothing in the same way that a lower extremity prosthesis
is “hidden” by pants, socks, and shoes. The person with
upper extremity amputation must cope with not only physical
appearance changes, but the loss of some of the most
complex movement patterns and functional activities of
the human body.
In addition, upper extremity limb loss deprives the patient
of an extensive and valuable system of tactile and proprioceptive
inputs that previously provided “feedback” to guide and
refine functional movement. Even the simplest tasks
related to grasp and release become challenging. The ability
to position the prosthetic limb segments in space, as well as
the ability to maintain advantageous postures needed to
manipulate objects, challenge the medical community to
continuously improve the functional and aesthetic outcomes
of prostheses for patients in this population.
1) Conservative treatment of fractures involves recognizing the fracture, reducing it if possible through closed or open means, maintaining the reduction through splinting, casting or other immobilization, and rehabilitating the injured area.
2) There are many options for reducing and immobilizing fractures without surgery, including closed reduction using anesthesia and traction, splinting, casting and bracing. The choice depends on the fracture type and location.
3) It is important to properly position and mold any splint, cast or brace and monitor for complications in order to effectively maintain the fracture reduction until healing is complete.
Total knee replacement (TKR) is a surgical procedure to replace the cartilage and bone surfaces of the knee joint. The knee joint is made up of the femur, tibia, fibula, and patella bones. During TKR, the surgeon removes damaged or diseased bone and cartilage and replaces them with prosthetic components. This allows the knee to function smoothly again. Common reasons for TKR include osteoarthritis and rheumatoid arthritis. With proper rehabilitation, most patients experience reduced pain and improved mobility following surgery. However, there are risks such as infection, blood clots, and prosthesis failure. With exercise and healthy lifestyle choices, TKR typically provides excellent long-term outcomes.
This document discusses the phases of care and rehabilitation for persons with amputations. It outlines the conventional approach, which includes 9 phases from pre-operative planning through long-term follow up. Key points covered include the goals of post-operative management to facilitate healing and prosthetic fitting, the benefits of and potential losses from delays in post-operative stump care, and different dressing strategies selected based on factors like the amputation level and patient's medical status.
1) The document describes the technique for performing a total knee replacement, focusing on ensuring proper bone preparation and component alignment through referencing anatomical landmarks.
2) Key steps include making distal femoral and tibial cuts based on the intercondylar notch and tibial spines, respectively, to maintain the joint line.
3) Accurate rotational alignment of the femoral component is important to avoid increased shear stresses that can lead to loosening.
This document discusses various topics related to traumatic amputations, including:
1) Etiologies of amputations based on prevalence data, which found trauma as a leading cause of upper limb amputations but dysvascular issues as more common for lower limbs.
2) Factors to consider in the decision between salvaging a mangled limb versus amputation, such as weight bearing needs, sensation, and ability to tolerate pressure.
3) Tips for emergency care of patients with traumatic amputations or mangled limbs to control bleeding and protect tissues.
4) Differences in approaches to upper versus lower limb injuries and considerations for various amputation levels.
This document describes a novel surgical technique for primary ACL reconstruction using both autograft and a biomimetic graft. The technique involves a four-stranded anatomical single-bundle reconstruction that places the femoral tunnel low to overlap both the AM and PL bundles. Preliminary results on 18 elite football players showed improved IKDC scores, reduced pivot shift, and allowed return to full athletic performance by 3.5 months. However, long-term follow up is still needed to evaluate the outcomes of this new single-bundle technique.
Open and closed wedging are techniques used to correct deformities in casts. Open wedging involves making a partial cut in the cast and spreading it open to reduce fractures, then securing it with additional material. Closed wedging removes a wedge-shaped piece of cast to manipulate it into a valgus position and reduce fractures. Both techniques require ensuring adequate, even padding to prevent pressure sores.
Prosthetic management of individuals with upper extremity
amputations presents all health professionals, including
prosthetists and therapists, with a set of unique challenges.
For those wearing an upper extremity prosthesis, the terminal
device (TD) of the prosthesis is not covered or obscured
by clothing in the same way that a lower extremity prosthesis
is “hidden” by pants, socks, and shoes. The person with
upper extremity amputation must cope with not only physical
appearance changes, but the loss of some of the most
complex movement patterns and functional activities of
the human body.
In addition, upper extremity limb loss deprives the patient
of an extensive and valuable system of tactile and proprioceptive
inputs that previously provided “feedback” to guide and
refine functional movement. Even the simplest tasks
related to grasp and release become challenging. The ability
to position the prosthetic limb segments in space, as well as
the ability to maintain advantageous postures needed to
manipulate objects, challenge the medical community to
continuously improve the functional and aesthetic outcomes
of prostheses for patients in this population.
1) Conservative treatment of fractures involves recognizing the fracture, reducing it if possible through closed or open means, maintaining the reduction through splinting, casting or other immobilization, and rehabilitating the injured area.
2) There are many options for reducing and immobilizing fractures without surgery, including closed reduction using anesthesia and traction, splinting, casting and bracing. The choice depends on the fracture type and location.
3) It is important to properly position and mold any splint, cast or brace and monitor for complications in order to effectively maintain the fracture reduction until healing is complete.
Total knee replacement (TKR) is a surgical procedure to replace the cartilage and bone surfaces of the knee joint. The knee joint is made up of the femur, tibia, fibula, and patella bones. During TKR, the surgeon removes damaged or diseased bone and cartilage and replaces them with prosthetic components. This allows the knee to function smoothly again. Common reasons for TKR include osteoarthritis and rheumatoid arthritis. With proper rehabilitation, most patients experience reduced pain and improved mobility following surgery. However, there are risks such as infection, blood clots, and prosthesis failure. With exercise and healthy lifestyle choices, TKR typically provides excellent long-term outcomes.
This document discusses the phases of care and rehabilitation for persons with amputations. It outlines the conventional approach, which includes 9 phases from pre-operative planning through long-term follow up. Key points covered include the goals of post-operative management to facilitate healing and prosthetic fitting, the benefits of and potential losses from delays in post-operative stump care, and different dressing strategies selected based on factors like the amputation level and patient's medical status.
1) The document describes the technique for performing a total knee replacement, focusing on ensuring proper bone preparation and component alignment through referencing anatomical landmarks.
2) Key steps include making distal femoral and tibial cuts based on the intercondylar notch and tibial spines, respectively, to maintain the joint line.
3) Accurate rotational alignment of the femoral component is important to avoid increased shear stresses that can lead to loosening.
This document discusses various topics related to traumatic amputations, including:
1) Etiologies of amputations based on prevalence data, which found trauma as a leading cause of upper limb amputations but dysvascular issues as more common for lower limbs.
2) Factors to consider in the decision between salvaging a mangled limb versus amputation, such as weight bearing needs, sensation, and ability to tolerate pressure.
3) Tips for emergency care of patients with traumatic amputations or mangled limbs to control bleeding and protect tissues.
4) Differences in approaches to upper versus lower limb injuries and considerations for various amputation levels.
Prosthetic Management of Different Types of Partial Foot AmputationRohan Gupta
This document discusses different types of partial foot amputations and their prosthetic management. It describes 7 types of partial foot amputations ranging from toe amputations to Syme's amputation, which is an ankle disarticulation. For each amputation type, it discusses the bones and joints involved, potential complications, prosthetic goals in managing the condition, and examples of prosthetic solutions used. The document provides an overview of evaluating each partial foot amputation case and designing an appropriate prosthesis to address the patient's functional requirements and minimize complications.
This document discusses the history and development of bone cement. Some key points:
- Bone cement was first used in the 1870s to fix ivory knee prostheses. Modern cementing techniques using PMMA were developed in the 1950s-60s.
- Bone cement is composed of PMMA polymer powder mixed with MMA monomer liquid. Various types of bone cement have been developed with different viscosities.
- Bone cement is used to fix joint prostheses during arthroplasty and is contraindicated in active infection or allergy to components.
- The polymerization process after mixing cement has mixing, waiting, working, and hardening phases. Factors like temperature and mixing technique affect the process.
1. Congenital radial deficiency is a musculoskeletal birth defect characterized by partial or total absence of the radius bone, resulting in wrist deformity and hand positioning issues.
2. Treatment involves splinting and therapy for mild cases, while more severe cases may require surgical centralization or ulnarization/radialization procedures to reposition the wrist and improve hand function.
3. Thumb abnormalities associated with radial deficiency are also addressed, through reconstruction if possible, or using the index finger as a replacement thumb if the thumb is severely deficient.
The document provides a history and overview of external fixators. Some key points:
- External fixators were first developed in the 1840s and have since been improved, including the addition of threaded pins, rods, and adjustable clamps.
- They are used to stabilize and immobilize long bone fractures, especially open or complicated fractures.
- Components include Schanz pins, tubes, and universal clamps. Proper placement of pins is important for stability.
- External fixators can be used temporarily to stabilize injuries before definitive fixation, or as the final fixation in cases where soft tissue healing is problematic. They provide less invasive fracture stabilization than internal fixation.
This document discusses principles for managing acute infection after operative fracture fixation. It notes an infection rate of 1-2% for closed fractures and 6-7% for open fractures. Risk factors for surgical site infection include older age, comorbidities, drugs, prior infections, and emergency operations. Factors contributing to acute infection include contamination, a medium for bacteria to grow, mechanical instability, and dead soft tissues. Strict protocols around cleaning, masking, handwashing, and isolating MRSA patients can reduce contamination risk. Careful surgical technique, debridement, hemostasis, and temporary fixation can address other risk factors. Signs of acute infection include swelling, pain, fever and elevated inflammatory markers. Aggressive wound revision
The document discusses complications that can occur after total knee replacement surgery. Some specific complications mentioned include blood clots, infection, problems with the prosthetic implant like loosening or dislocation, complications from anesthesia like heart attack or stroke, injuries to nerves or blood vessels during surgery, and differences in leg length after surgery. Reducing risks requires preventative measures like blood thinners, support stockings, and antibiotics for future procedures to prevent infection.
Splints are devices that immobilize and protect injured limbs. They are used for fractures, sprains, dislocations and other injuries. Common splinting materials include plaster, fiberglass, pre-fabricated splints and air splints. Traction involves applying a pulling force to the skeletal system using weights, ropes and pulleys. The objectives are to reduce fractures and dislocations, relieve pain, and prevent deformities. Common types are skin traction, which applies force through the skin, and skeletal traction, which attaches directly to bone. Complications can include infection, pressure sores, and effects of prolonged immobilization.
Total ankle replacement is an option for patients with end-stage ankle arthritis to relieve pain and preserve joint motion. First-generation ankle replacements had high failure rates due to design flaws like excessive bone resection and unstable constructs. Newer mobile-bearing designs like STAR and Salto have shown improved outcomes with survivorship around 90% at 5 years. Candidate indications include post-traumatic arthritis in younger patients, while contraindications include talar avascular necrosis and infection. Outcomes studies found total ankle replacement improved gait and function over ankle fusion while aiming to restore more natural ankle biomechanics. Continued advances may expand the capability of ankle replacements.
Proximal femoral focal deficiency is a congenital condition caused by a defect in the primary ossification center of the proximal femur, resulting in a spectrum of abnormalities from an absent hip to a shortened femur. It is usually sporadic but can be autosomal dominant. Treatment is individualized based on leg length discrepancy, foot deformities, muscle adequacy, and joint stability, and may involve observation, prosthetics, limb lengthening, knee fusion, femoral-pelvic fusion, rotationplasty, or amputation. The goal is to enable ambulation with or without a prosthesis.
This document provides information about amputation, limb prostheses, and rehabilitation for lower limb amputees. It discusses the purpose of prostheses in replacing missing limbs and describes different types including immediate post-operative, temporary, and definitive prostheses. Characteristics of successful prostheses and considerations for choosing one are outlined. The rehabilitation process in 5 stages is summarized, from healing to learning to use the artificial limb. Exercise and complications of amputations are also briefly mentioned.
This document outlines the principles of fracture management. It discusses fracture classification, diagnosis, treatment principles including emergency care, definitive treatment methods like casting, internal and external fixation, and rehabilitation. Management depends on factors like fracture type, soft tissue injury, and patient condition. The goals are to obtain fracture union in an anatomical position to allow maximal function. Complications can include infection, malunion, and failure of treatment.
This document discusses the history and design of ankle replacement implants. It describes the evolution from first-generation constrained implants requiring extensive bone resection to current third-generation semi-constrained implants with three components. Fixed-bearing and mobile-bearing designs are compared, along with factors in determining candidacy, surgical technique, outcomes, and complications of total ankle replacement.
The document discusses various foot deformities that can occur in cerebral palsy, including varus, valgus, equinovarus, and equinovalgus deformities. It describes how these deformities can be addressed through both soft tissue procedures like tendon lengthenings and transfers, as well as bone procedures like osteotomies of the calcaneus when deformities are rigid. Specific procedures discussed in detail include posterior tibial tendon lengthening and transfers, anterior tibial tendon splits, and Dwyer's calcaneal osteotomy.
This document discusses total ankle replacement (TAR). It begins with the anatomy of the ankle joint and causes of ankle arthritis. Symptoms of ankle arthritis are described. The physical exam and tests to assess ankle stability are outlined. Treatment options for ankle arthritis include nonsurgical methods as well as different types of surgical procedures like arthrodesis (ankle fusion) and TAR. The history of TAR is summarized, including early constrained and unconstrained designs that had high failure rates. Modern TAR designs are classified and various implant systems currently in use are described, including their characteristics. The surgical approach and postoperative protocol for TAR are also summarized.
Blount's disease is a skeletal disorder that causes bowing of the legs. It is classified into infantile and adolescent types based on age of onset. Infantile Blount's disease is the more common type and is often bilateral. Treatment options include bracing, guided growth, osteotomy, and hemiplateau elevation depending on the stage and severity of deformity. Recurrence rates remain high, so long-term follow up is important. New techniques like percutaneous osteotomy and combined procedures aim to address more advanced or recurrent cases.
Plaster and splints are used to immobilize fractures and injuries. They provide stabilization and prevent further soft tissue damage. Advantages include being readily applied, reasonably comfortable, and allowing immobilization. Complications can include pressure sores, burns, stiffness, edema, and malpositioning if not applied properly. It is important to ensure adequate padding and molding without wrinkles or tension to prevent complications and allow for inspection of the injury. Patients should be monitored for neurovascular issues and given instructions to return if new symptoms arise.
Orthopedics, which is a branch of clinical medicine that specializes in the diagnosis and treatment of musculoskeletal disease and trauma in the spine and extremities, owes its current status of advanced care to the development of biomaterial science more than any other clinical medical specialty
Tendon transfers involve rerouting a functioning muscle tendon unit to restore lost function according to established principles. The key principles are having supple joints at the donor and recipient sites, maintaining soft tissue equilibrium, ensuring the donor has adequate excursion and strength, choosing an expendable donor, maintaining a straight line of pull, selecting donors and recipients with synergistic functions, and performing single tendon transfers for single functions. Tendon transfers can restore grasp, pinch and upper extremity motions according to these principles.
3 d printing in orthopaedics seminar_mukul jain_12.10.2019MukulJain81
3D printing has applications in orthopaedics such as creating anatomical models for surgical planning, custom cutting guides and implants. There are various 3D printing technologies like fused deposition modeling (FDM), stereolithography (SLA) and selective laser sintering (SLS) that use materials like plastics, metals and ceramics. 3D printed models and custom guides help improve surgical accuracy and reduce time. Metal 3D printing allows customized implants. Tissue engineering aims to 3D print cartilage and bone grafts but remains a research area. 3D printing is revolutionizing orthopaedics by enabling personalized surgical tools and implants.
Onko hallinnolla ja politiikalla selkeää rajaa? Täytyykö politiikka ja hallinto erottaa toisistaan?
Näihin kysymyksiin olemme yrittäneet löytää vastauksia tässä diasarjassa.
Prosthetic Management of Different Types of Partial Foot AmputationRohan Gupta
This document discusses different types of partial foot amputations and their prosthetic management. It describes 7 types of partial foot amputations ranging from toe amputations to Syme's amputation, which is an ankle disarticulation. For each amputation type, it discusses the bones and joints involved, potential complications, prosthetic goals in managing the condition, and examples of prosthetic solutions used. The document provides an overview of evaluating each partial foot amputation case and designing an appropriate prosthesis to address the patient's functional requirements and minimize complications.
This document discusses the history and development of bone cement. Some key points:
- Bone cement was first used in the 1870s to fix ivory knee prostheses. Modern cementing techniques using PMMA were developed in the 1950s-60s.
- Bone cement is composed of PMMA polymer powder mixed with MMA monomer liquid. Various types of bone cement have been developed with different viscosities.
- Bone cement is used to fix joint prostheses during arthroplasty and is contraindicated in active infection or allergy to components.
- The polymerization process after mixing cement has mixing, waiting, working, and hardening phases. Factors like temperature and mixing technique affect the process.
1. Congenital radial deficiency is a musculoskeletal birth defect characterized by partial or total absence of the radius bone, resulting in wrist deformity and hand positioning issues.
2. Treatment involves splinting and therapy for mild cases, while more severe cases may require surgical centralization or ulnarization/radialization procedures to reposition the wrist and improve hand function.
3. Thumb abnormalities associated with radial deficiency are also addressed, through reconstruction if possible, or using the index finger as a replacement thumb if the thumb is severely deficient.
The document provides a history and overview of external fixators. Some key points:
- External fixators were first developed in the 1840s and have since been improved, including the addition of threaded pins, rods, and adjustable clamps.
- They are used to stabilize and immobilize long bone fractures, especially open or complicated fractures.
- Components include Schanz pins, tubes, and universal clamps. Proper placement of pins is important for stability.
- External fixators can be used temporarily to stabilize injuries before definitive fixation, or as the final fixation in cases where soft tissue healing is problematic. They provide less invasive fracture stabilization than internal fixation.
This document discusses principles for managing acute infection after operative fracture fixation. It notes an infection rate of 1-2% for closed fractures and 6-7% for open fractures. Risk factors for surgical site infection include older age, comorbidities, drugs, prior infections, and emergency operations. Factors contributing to acute infection include contamination, a medium for bacteria to grow, mechanical instability, and dead soft tissues. Strict protocols around cleaning, masking, handwashing, and isolating MRSA patients can reduce contamination risk. Careful surgical technique, debridement, hemostasis, and temporary fixation can address other risk factors. Signs of acute infection include swelling, pain, fever and elevated inflammatory markers. Aggressive wound revision
The document discusses complications that can occur after total knee replacement surgery. Some specific complications mentioned include blood clots, infection, problems with the prosthetic implant like loosening or dislocation, complications from anesthesia like heart attack or stroke, injuries to nerves or blood vessels during surgery, and differences in leg length after surgery. Reducing risks requires preventative measures like blood thinners, support stockings, and antibiotics for future procedures to prevent infection.
Splints are devices that immobilize and protect injured limbs. They are used for fractures, sprains, dislocations and other injuries. Common splinting materials include plaster, fiberglass, pre-fabricated splints and air splints. Traction involves applying a pulling force to the skeletal system using weights, ropes and pulleys. The objectives are to reduce fractures and dislocations, relieve pain, and prevent deformities. Common types are skin traction, which applies force through the skin, and skeletal traction, which attaches directly to bone. Complications can include infection, pressure sores, and effects of prolonged immobilization.
Total ankle replacement is an option for patients with end-stage ankle arthritis to relieve pain and preserve joint motion. First-generation ankle replacements had high failure rates due to design flaws like excessive bone resection and unstable constructs. Newer mobile-bearing designs like STAR and Salto have shown improved outcomes with survivorship around 90% at 5 years. Candidate indications include post-traumatic arthritis in younger patients, while contraindications include talar avascular necrosis and infection. Outcomes studies found total ankle replacement improved gait and function over ankle fusion while aiming to restore more natural ankle biomechanics. Continued advances may expand the capability of ankle replacements.
Proximal femoral focal deficiency is a congenital condition caused by a defect in the primary ossification center of the proximal femur, resulting in a spectrum of abnormalities from an absent hip to a shortened femur. It is usually sporadic but can be autosomal dominant. Treatment is individualized based on leg length discrepancy, foot deformities, muscle adequacy, and joint stability, and may involve observation, prosthetics, limb lengthening, knee fusion, femoral-pelvic fusion, rotationplasty, or amputation. The goal is to enable ambulation with or without a prosthesis.
This document provides information about amputation, limb prostheses, and rehabilitation for lower limb amputees. It discusses the purpose of prostheses in replacing missing limbs and describes different types including immediate post-operative, temporary, and definitive prostheses. Characteristics of successful prostheses and considerations for choosing one are outlined. The rehabilitation process in 5 stages is summarized, from healing to learning to use the artificial limb. Exercise and complications of amputations are also briefly mentioned.
This document outlines the principles of fracture management. It discusses fracture classification, diagnosis, treatment principles including emergency care, definitive treatment methods like casting, internal and external fixation, and rehabilitation. Management depends on factors like fracture type, soft tissue injury, and patient condition. The goals are to obtain fracture union in an anatomical position to allow maximal function. Complications can include infection, malunion, and failure of treatment.
This document discusses the history and design of ankle replacement implants. It describes the evolution from first-generation constrained implants requiring extensive bone resection to current third-generation semi-constrained implants with three components. Fixed-bearing and mobile-bearing designs are compared, along with factors in determining candidacy, surgical technique, outcomes, and complications of total ankle replacement.
The document discusses various foot deformities that can occur in cerebral palsy, including varus, valgus, equinovarus, and equinovalgus deformities. It describes how these deformities can be addressed through both soft tissue procedures like tendon lengthenings and transfers, as well as bone procedures like osteotomies of the calcaneus when deformities are rigid. Specific procedures discussed in detail include posterior tibial tendon lengthening and transfers, anterior tibial tendon splits, and Dwyer's calcaneal osteotomy.
This document discusses total ankle replacement (TAR). It begins with the anatomy of the ankle joint and causes of ankle arthritis. Symptoms of ankle arthritis are described. The physical exam and tests to assess ankle stability are outlined. Treatment options for ankle arthritis include nonsurgical methods as well as different types of surgical procedures like arthrodesis (ankle fusion) and TAR. The history of TAR is summarized, including early constrained and unconstrained designs that had high failure rates. Modern TAR designs are classified and various implant systems currently in use are described, including their characteristics. The surgical approach and postoperative protocol for TAR are also summarized.
Blount's disease is a skeletal disorder that causes bowing of the legs. It is classified into infantile and adolescent types based on age of onset. Infantile Blount's disease is the more common type and is often bilateral. Treatment options include bracing, guided growth, osteotomy, and hemiplateau elevation depending on the stage and severity of deformity. Recurrence rates remain high, so long-term follow up is important. New techniques like percutaneous osteotomy and combined procedures aim to address more advanced or recurrent cases.
Plaster and splints are used to immobilize fractures and injuries. They provide stabilization and prevent further soft tissue damage. Advantages include being readily applied, reasonably comfortable, and allowing immobilization. Complications can include pressure sores, burns, stiffness, edema, and malpositioning if not applied properly. It is important to ensure adequate padding and molding without wrinkles or tension to prevent complications and allow for inspection of the injury. Patients should be monitored for neurovascular issues and given instructions to return if new symptoms arise.
Orthopedics, which is a branch of clinical medicine that specializes in the diagnosis and treatment of musculoskeletal disease and trauma in the spine and extremities, owes its current status of advanced care to the development of biomaterial science more than any other clinical medical specialty
Tendon transfers involve rerouting a functioning muscle tendon unit to restore lost function according to established principles. The key principles are having supple joints at the donor and recipient sites, maintaining soft tissue equilibrium, ensuring the donor has adequate excursion and strength, choosing an expendable donor, maintaining a straight line of pull, selecting donors and recipients with synergistic functions, and performing single tendon transfers for single functions. Tendon transfers can restore grasp, pinch and upper extremity motions according to these principles.
3 d printing in orthopaedics seminar_mukul jain_12.10.2019MukulJain81
3D printing has applications in orthopaedics such as creating anatomical models for surgical planning, custom cutting guides and implants. There are various 3D printing technologies like fused deposition modeling (FDM), stereolithography (SLA) and selective laser sintering (SLS) that use materials like plastics, metals and ceramics. 3D printed models and custom guides help improve surgical accuracy and reduce time. Metal 3D printing allows customized implants. Tissue engineering aims to 3D print cartilage and bone grafts but remains a research area. 3D printing is revolutionizing orthopaedics by enabling personalized surgical tools and implants.
Onko hallinnolla ja politiikalla selkeää rajaa? Täytyykö politiikka ja hallinto erottaa toisistaan?
Näihin kysymyksiin olemme yrittäneet löytää vastauksia tässä diasarjassa.
Tässä koulutuksessa käydään läpi sähköisiin kokouksiin liittyviä käytäntöjä ja lainmukaisuutta selkeällä ja ymmärrettävällä tavalla. Koulutus on suunniteltu erityisesti uusille luottamushenkilöille, joiden osaamisen testaaminen kokouskäytännöistä on erityisen tärkeää. Uusille luottamushenkilöille sähköiset kokoukset ja käytänteet sekä tietosuoja eivät välttämättä ole itsestään selviä asioita, joten koulutuksessa opitun testaaminen on tarpeellista.
Koulutuspakettiin on koottu tiiviisti ydinasiat sähköisistä kokouskäytännöistä ja tietosuojasta tunnin mittaiseen kokonaisuuteen. Koulutus sisältää oleellisimmat asiat lainsäädännöstä ja auttaa ymmärtämään syitä sääntöjen taustalla. Koulutustallenne on saatavilla 24.9.2021-31.1.2022.
Tilaa tallenne osoitteesta: https://hallintoakatemia.fi/koulutukset/217998/
Mistä Whistleblower-direktiivissä on kyse? Tässä koulutuksessa käydään läpi, mitä työntekijän tulee tietää direktiivistä. Whistleblower-direktiivi pannaan täytäntöön 17.12.2021. Hallituksen esitys direktiivistä on tarkoitus antaa eduskunnalle lokakuussa 2021. Käytännössä direktiivi velvoittaa tietyn kokoisia organisaatioita ottamaan käyttöönsä sisäisen ilmoituskanavan, jossa voi ilmoittaa luottamuksellisesti väärinkäytöksistä ja rikkeistä.
Tilaa tallenne osoitteesta: https://hallintoakatemia.fi/koulutukset/mista-whistleblower-direktiivissa-on-kyse-tallennekoulutus-henkilostolle/
Tässä diapaketista saat tietoa esittelijän riippumattomuudesta. Tule kuulemaan lisää riippumattomuudesta ja esittelijän vastuista ja velvollisuuksista 20.9.2021 klo 9-11. Kouluttajana toimii Riikka Liljeroos. Lisätietoa ja ilmoittautuminen: https://hallintoakatemia.fi/koulutukset/esittelijan-vastuut-ja-velvollisuudet/
Opetushallinnon tutkintoon valmentava verkkokurssi alkaa jälleen 1.10.2021! Ilmoittaudu mukaan: https://hallintoakatemia.fi/project/opetushallinnon-tutkintoon-valmentava-verkkokurssi/
Diapaketti asian riittävästä selvittämisestä. Valmistelijan perehdytyspaketti- verkkokurssi aukeaa 1.9.2021 ja suoritusaikaa on koko syyskuu. Lisätietoja ja ilmoittautuminen: https://hallintoakatemia.fi/project/valmistelijan-perehdytyspaketti-verkkokurssi/
Tässä diapaketissa on nostoja kuntalain muutoksista. Hallintoakatemia järjestää 1.9. klo 15-16 Kuntalain muutokset- webinaarin. Lue lisää ja ilmoittaudu: https://hallintoakatemia.fi/koulutukset/kuntalain-muutokset/
Lisätietoja koulutuksesta Sihteerin velvollisuudet kunnan asiakaspalvelussa 23.8.2021 klo 9-11:
https://hallintoakatemia.fi/koulutukset/sihteerin-velvollisuudet-kunnan-asiakaspalvelussa/
The document provides guidelines for roles and responsibilities in meetings. It discusses the duties of the presenter, chairperson, and secretary. The presenter is responsible for preparing and presenting matters under discussion. The chairperson ensures the meeting follows proper procedures and rules. The secretary takes minutes of the meeting. The document also covers dividing responsibilities between members, invitees, and experts. It provides tips for when minutes have been recorded well and outlines elements that should be included in meeting minutes like decisions made and appendices. The document gives guidance on titles, summaries, decisions and confidential information in meeting minutes.
3. Asia liikkuu
prosessin mukana:
Asiakirjat on kytkettävä asiayhteyteensä ja
asioiden käsittelyprosesseihin.
Asian käsittelyä on vaivatonta seurata; tiedetään,
missä vaiheessa asian käsittely on ja kuka sitä
käsittelee.
Mitä tietoja julkaistaan netissä ja miten
tietosuoja huomioidaan.
Miten arkistointi huomioidaan alusta loppuun.
VIREILLETULO
VALMISTELU
PÄÄTÖKSENTEKO
TOIMEENPANO,
TIEDOKSIANTO
MUUTOKSENHAKU
SEURANTA
Asia liikkuu ->
ARKISTOINTI
LAINSÄÄDÄNTÖ §
4. 4
Hyvän valmistelun ABC
•Huomioi asianosaisen asema ja oikeudet
•Huomioi taustalla vaikuttavina hyvää hallintoa turvaavina: hallintomenettelyn julkisuus,
käsittelyn viivytyksettömyys, käsittelyn puolueettomuus ja esteellisyysperusteet, hyvä
kielenkäyttö sekä viranomaisen neuvontavelvollisuus
•Selvittämisvelvollisuus
•Mahdolliset kuulemiset
•Osallisuus, avoin valmistelu (uusi kuntalaki, osallistaminen)
•Asianosaisen tiedonsaantioikeus
•Suulliset selvityskeinot
•Selkeästi ja hyvin laadittu selvitys siitä, miten asiaa on käsitelty ja valmisteltu
•Kaiken ajantasaisen lainsäädännön huomioiminen
•Hyvin laadittu ja perusteltu päätös valmistelun lopputuloksena
5. Hallintolain vaatimukset päätöksen
sisällölle
Päätöksen muoto
Hallintopäätös on annettava kirjallisesti. Päätös voidaan antaa
suullisesti, jos se on välttämätöntä asian kiireellisyyden vuoksi.
Suullinen päätös on viipymättä annettava myös kirjallisena
oikaisuvaatimusohjeineen tai valitusosoituksineen.
Määräaika oikaisuvaatimuksen tekemiseen tai
muutoksenhakuun alkaa kirjallisen päätöksen
tiedoksisaannista siten kuin siitä erikseen säädetään.
Päätöksen sisältö Kirjallisesta päätöksestä on käytävä selvästi
ilmi:
1) päätöksen tehnyt viranomainen ja päätöksen tekemisen
ajankohta;
2) asianosaiset, joihin päätös välittömästi kohdistuu;
3) päätöksen perustelut ja yksilöity tieto siitä, mihin
asianosainen on oikeutettu tai velvoitettu taikka miten asia on
muutoin ratkaistu; sekä
4) sen henkilön nimi ja yhteystiedot, jolta asianosainen voi
pyytää tarvittaessa lisätietoja päätöksestä.
Perusteluissa on ilmoitettava, mitkä seikat ja selvitykset ovat
vaikuttaneet ratkaisuun sekä mainittava sovelletut säännökset.
Päätöksen perustelut voidaan jättää esittämättä, jos:
1) tärkeä yleinen tai yksityinen etu edellyttää päätöksen välitöntä
antamista;
2) päätös koskee kunnallisen monijäsenisen toimielimen
toimittamaa vaalia;
3) päätös koskee vapaaehtoiseen koulutukseen ottamista tai
sellaisen edun myöntämistä, joka perustuu hakijan ominaisuuksien
arviointiin;
4) päätöksellä hyväksytään vaatimus, joka ei koske toista
asianosaista eikä muilla ole oikeutta hakea päätökseen muutosta;
taikka
5) perusteleminen on muusta erityisestä syystä ilmeisen
tarpeetonta. Perustelut on kuitenkin 2 momentissa tarkoitetuissa
tilanteissa esitettävä, jos päätös merkitsee olennaista muutosta
vakiintuneeseen käytäntöön.
6. 6
Toimielimen pöytäkirja
➢ Pöytäkirjasta säädetään kuntalaissa
➢ Toimielimen kokouksista on laadittava pöytäkirja, laissa ei ole säännöksiä pöytäkirjan
sisällöstä, mutta siitä otetaan tarpeelliset määräykset hallintosääntöön
➢ Pöytäkirja voi muodostua myös sähköisen päätöksenteon päätösten koonnista.
Pöytäkirjan muoto voi vaihdella teknisen toteutustavan mukaan. Pöytäkirjan päätökset
voi olla myös rakenteisessa muodossa, joka mahdollistaa niiden jatkokäytön (ns. avoin
data). Tällöinkin kuntien olisi huolehdittava tietosuojaan liittyvistä näkökohdista.
➢ Pöytäkirjan arkistointi suoritetaan arkistolainsäädännön mukaisesti, eikä kuntalain
säännöksellä poiketa arkistolain mukaisista velvoitteista.
7. 7
Tietojen käsittely osana pöytäkirjaa
❖ Asiakirjojen on oltava hyvin saatavilla, käytettävissä ja niiden tulee säilyä.
❖ Päätöksenteossa olevien asiakirjojen on säilyttävä muuttumattomina koko asian käsittelyn
ajan, joka käsittelyvaiheessa.
❖ Alkuperäisen päätösasiakirjan, asianhallintajärjestelmässä olevan asiakirjan ja sähköisessä
muodossa olevan version sekä otteiden ja jäljennösten on oltava saman sisältöisiä.
❖ Julkisuuden näkökulmasta: tiedot ja merkinnät asian koko käsittelyn ajan ajantasalla
julkisuudesta, henkilötiedoista
❖ Valmistelija määrittelee: otsikon, käsittelytiedot, käyttörajoitukset (julkinen/salainen),
sisältääkö asia henkilötietoja
❖ Pöytäkirjoista ilmettävä selvästi, mikä versio kyseessä luonnos, esisopimus, allekirjoitettu
versio jne.
8. 8
Tietojen käsittely
❖ Päätöksenteon perustana hyvä hallinto, hyvä tiedonhallintatapa ja julkisuusperiaate. Päätöksentekoa ohjaavat
lainsäädäntö ja hallintosääntö
❖ Päätöksentekoprosessi: vireille tulo, rekisteröinti, valmistelu, päätöksenteko, täytäntöönpano ja valvonta
→ asian käsittelyn ja asiakirjan elinkaaren hallinta
❖Yhtenäiset käytännöt seuraaviin:
• Kokouskutsuihin liittyvät menettelyt
• Esityslistan ja pöytäkirjaamisen perusteet (ml. salassapidettävät tiedot)
• Pöytäkirjan ulkoasu ja luettavuus
• Pöytäkirjan sisältö, hallintosäännön määräykset ja hyvät yhtenäiset käytännöt
• Oheismateriaalit/liitteet, selkeät käsitykset siitä, mikä aineisto nimetään mitenkin
• Esityslistan ja pöytäkirjan julkisuus, henkilötietonäkökulman huomioiminen
• Pöytäkirjanotteet ja joustavat otemenettelyt (esim. sähköisyys)
• Tiedoksianto ja muutoksenhaku
• Pöytäkirjan korjaamismenettelyt ja tietojen säilyminen oikeina
• Pöytäkirjan ja siihen liittyvän aineiston arkistointi
• Päätöksistä tiedottaminen, nettijulkisuus