Cast Index
•
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The document discusses the Cast Index, which is the ratio of the anteroposterior (A-P) diameter to the mediolateral (M-L) diameter of a limb. An ideal Cast Index matches these ratios, preventing slipping or displacement of fractures under plaster casts. Specific ideal Cast Index ratios are provided for different parts of the upper and lower limbs. Maintaining the proper Cast Index through a well-contoured, lightweight cast is the most important factor in ensuring fractures remain reduced and heal properly.
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TENS
The document discusses the history and development of elastic stable intramedullary nailing (ESIN) for fractures in children. It describes early techniques using rigid pins and wires, and the development of the modern ESIN method in the 1980s using pre-bent titanium nails inserted from opposite sides of the bone for axial, lateral, and rotational stability. Key aspects of ESIN technique are outlined, including nail sizing, insertion points, pre-bending, and final positioning to stabilize fractures while minimizing soft tissue injury and allowing callus formation. Risks and special considerations for different bone fractures are also mentioned.
dynamic hip screw
The document provides instructions for performing dynamic hip screw (DHS) surgery to treat fractures of the proximal femur. It describes:
1) Positioning the patient supine on a traction table and obtaining x-rays to visualize the hip.
2) Performing closed reduction of the fracture if possible, or open reduction if needed.
3) Making an incision over the femoral neck and inserting guide wires under fluoroscopy to align the placement of screws and plate.
4) Reaming and inserting a lag screw to stabilize the fracture followed by placement of the DHS plate and fixation screws to complete the procedure.
Tips, tricks and pitfalls of proximal femoral nailing (PFN)
1. Proximal femoral nailing (PFN) requires thorough pre-operative planning including imaging and assessment of fracture pattern and patient comorbidities.
2. It is important to reduce the fracture before making the entry point, as the entry point will determine surgical success.
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This document discusses the treatment of intertrochanteric hip fractures with different fixation devices. It notes that cephalomedullary devices are preferable to dynamic hip screws for fractures with posteromedial comminution or subtrochanteric extension due to their ability to provide controlled collapse and reduce bending forces. The document emphasizes the importance of pre-operative planning, proper reduction techniques, and achieving a tip-apex distance under 25mm for successful fixation with cephalomedullary devices.
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This document discusses the concept of the center of rotation of angulation (CORA) in orthopedic surgery. The CORA is the point about which a deformed bone may be rotated to achieve correction of an angular deformity without introducing a translational deformity. Proper identification of the CORA allows selection of the optimal correction axis and type of osteotomy, such as opening, closing, or dome osteotomy, to realign the bone. Correction along the bisector line passing through the CORA ensures pure angular correction without residual translation. Identification of multiple CORAs indicates more complex multi-apical or translational deformities requiring different surgical techniques.
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2. It describes the different types of bone plates used in AO technique including neutralization, compression, and buttress plates. Dynamic compression plates and limited contact dynamic compression plates are discussed in detail.
3. Additional internal fixation principles covered include the tension band effect, prebending plates, and the use of reconstruction and tubular plates.
Evolution of Intramedullary Nails
This document summarizes the evolution of intramedullary nails for long bone fracture fixation from the 16th century to modern times. It describes the early use of wooden sticks and ivory implants, the introduction of metallic rods during WWI, and the development of modern locked intramedullary nails in the mid-20th century. Key figures who advanced nail design include Kuntscher, who introduced reamed nailing in 1940, and Russell and Taylor, who developed the first closed section interlocking nail in the 1980s. The document outlines the progression from first to fourth generation nails, incorporating improvements in materials, locking mechanisms, and designs to optimize stability and healing.
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Poller or blocking screw
Poller or blocking screws are used to stabilize fractures treated with small diameter intramedullary nails. They guide the nail like "poller" traffic devices guide vehicles. Blocking screws increase stability of distal and proximal metaphyseal fractures after nailing and can help manage malunited fractures. They work by narrowing the canal to guide the nail anteriorly and prevent sagittal plane deformity. Blocking screws are typically placed medially and laterally as close to the fracture as possible for optimal stabilization. Their placement on the concave side of deformities helps improve reduction by deflecting the nail.
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This document discusses tuberculosis of the hip joint. It begins by describing the causative organism, Mycobacterium tuberculosis, which is an acid-fast bacillus. It then covers the pathophysiology of tuberculosis infection in the hip, including the formation of tubercles and caseation necrosis. The document outlines the clinical presentation of TB of the hip and its radiographic appearance. It discusses the different stages of TB arthritis in the hip and associated radiographic findings. The document concludes by covering treatment approaches for TB of the hip including chemotherapy, traction, arthroplasty, arthrodesis and osteotomy.
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This document summarizes the experience with dual mobility cups at Khoula Hospital. It discusses that dual mobility cups are effective at reducing dislocation rates in high-risk patients such as those over 65, with prior hip surgery, neurological disorders, or revision THR. The document then provides details of 47 cases at Khoula Hospital using dual mobility cups, finding a low 2% dislocation rate. It concludes that dual mobility cups provide good early results in high-risk patients in Oman and can reduce dislocation compared to conventional THR.
Dr.S.Senthil Sailesh-functional cast bracing,PTBcast,sarmiento principle
The document discusses functional casting and bracing techniques used to treat fractures while allowing restricted movement. It describes the principles of functional casting which include maintaining stability and reduction while promoting blood flow and muscle contraction to encourage healing. Specific casts for treating fractures of the humerus, tibia, femur and hip are outlined, including the Sarmiento cast and hip spica cast. The timing, positioning and complications of different casts are summarized. Functional casting aims to continue function during fracture healing to accelerate rehabilitation.
Evolution of Total Hip Replacement
This document discusses the history and evolution of total hip arthroplasty (THA) and hip replacement component designs. It outlines key developments from the late 19th century experiments with ivory and tissue replacements, to modern THA pioneered by Professor Charnley in the 1960s using bone cement and low friction materials. Current designs aim to restore normal hip biomechanics and include cemented or cementless femoral and acetabular components with various fixation methods and bearing surfaces to reduce wear. Future advances focus on minimally invasive techniques, computer navigation, and developing more durable and compliant bearing materials to improve implant longevity.
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Tips, tricks and pitfalls of proximal femoral nailing (PFN)
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Description of 13 years of orthopaedic practice in a prison, without facilities under desperate situations. During this time not only were 14000 patients treated, many startling orthopaedic discoveries were made. This is an award winning talk by Dr L.Prakash
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Accused of grave charges and convicted of offences that I would never even imagine committing, I was sentenced to numerous terms of imprisonment including life imprisonment.
I spent 13 years as a prisoner, eight as an under trial and seven as a life convict, under difficult, desperate and depressing circumstances.This is my experience of practicing orthopaedics in those times, with limited or no facilities, treating desperate patients who had nowhere else to go.
Accused of grave charges and convicted of offences that I would never even imagine committing, I was sentenced to numerous terms of imprisonment including life imprisonment.
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Fracture healing and reasons for non union
Man doesn’t heal fractures, Nature does, What happens to animals with fractures??
When was the first metal put in the human body?
Why occasionally fractures don’t heal despite multiple surgeries?
Is there any absolute indication for internal fixation??
I have tried to answer these and other questions in this paper
Biomechanics of fracture healing
- Untreated fractures in animals heal on their own through immobilization and gradual return to function, showing nature can heal fractures without medical intervention.
- The earliest known case of a metal implant in the human body dates back to an Egyptian mummy from around 2600 years ago.
- Fractures heal through the biological process of hematoma resolution, callus formation, calcification, consolidation, and remodeling. Rigid immobilization or plating can disrupt this process by damaging blood supply and delaying healing compared to conservative treatment.
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Design criteria for a Total Knee prosthesis for the Indian population
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Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
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chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
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Pollen and Fungal allergy
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June 14, 2024STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
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because the population to be treated is known to include substantial numbers of
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PGx Analysis in VarSeq: A User’s Perspective
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
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Fallopian tube blockage may cause female infertility. For treatment, herbal medicine Fuyan Pill can be a solution.
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- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
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These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
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Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
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Cast Index
- 2. The Cast Index Dr L.Prakash Chennai
- 3. Cast Index The most important factor that determines slipping of reduction after plaster or cast application
- 4. Neither implants nor plaster reduce the fracture. They only retain the reduction in the position first achieved.
- 5. Ilizarov is probably the only system which can be used to reduce a displacement during course of treatment.
- 6. The term Cast Index was coined by a Canadian surgeon D. G. Chess in the year 19941.
- 7. The Cast Index as shown in Chess’s article.
- 8. The Cast Index is the ratio of A-P versus M-L dimensions
- 9. The correct Cast Index is proportionate to the A-P and M-L diameter of the limb to which a plaster is applied
- 10. No limb is a perfect cylinder. All are oval in various axes. Thus no plaster should be cylindrical in cross section.
- 11. Plasters with correct and incorrect Cast Index
- 12. Lower Forearm cross section showing an ideal Cast Index of 0.7 Cast shape is in yellow.
- 13. Mid and upper Forearm cross section showing an ideal Cast Index of 0.7 Cast shape is in yellow.
- 14. Lower arm cross section showing an ideal Cast Index of 1.3 Cast shape is in yellow.
- 15. Upper arm cross section showing an ideal Cast Index of 1.3 Cast shape is in yellow.
- 16. Lower Leg cross section showing a cast index of 1.4
- 17. Upper Leg cross section showing a cast index of 1.3
- 18. Lower thigh cross section showing a cast index of 1.3
- 19. Upper thigh cross section showing a cast index of 1
- 20. Example of a removed forearm cast with a cast index of .6 to .7
- 21. Example of a removed arm cylinder cast with a cast index of 1.3
- 22. A displaced mid forearm fracture in an adult treated with a properly fitting extension cast. Cast index here is .7 for forearm, and becomes 1.2 for the arm.
- 23. The short forearm cylinder used for the last four weeks. See the cast index of .7
- 24. A Correct Index cast for wrist
- 25. A Correct Index cast for forearm
- 26. A Correct Index cast for arm
- 27. A Correct Index cast for leg
- 28. A Correct Index cast for thigh
- 29. Cast Index is the most important factor that determines slipping of reduction after plaster or cast application Take home message
- 30. The cast should be light weight and extremely well contoured to the limb. Take home message
- 31. Only pad the bony protuberances. Use just the stockinette Take home message
- 32. Most upper limb casts are around 100 grams and lower limb casts below 220 grams Take home message
- 33. Help the patient to resume activities and function as early as possible; as they WANT it! Take home message