This document discusses the classification and management of fractures, including compound fractures. It describes several classification systems for fractures based on their relationship to the environment, degree of displacement, fracture pattern, and etiology. It also discusses the Gustilo classification system for open fractures. For treatment of compound fractures, the document emphasizes the importance of antibiotic prophylaxis, debridement of the wound and fracture, stabilization of the fracture, and early wound coverage. It describes various methods of fracture stabilization, including external and internal fixation.
Colles fracture is the fracture at the distal end of radius, at its
cortico cancellous junction(about 2cm from the distal articular
surface).
It is not just the fracture of distal radius but the fracture
dislocation of the inferior radio-ulnar joint.
Colles fracture is the fracture at the distal end of radius, at its
cortico cancellous junction(about 2cm from the distal articular
surface).
It is not just the fracture of distal radius but the fracture
dislocation of the inferior radio-ulnar joint.
Instruments orthopaedics for mbbs studentsTONY SCARIA
plates
screws
cortical
cancellous
shanz pin plates
screws
cortical
cancellous
shanz pin
derhums pin
k wire
k nail
Radius square nail
DCP
dynamic hip screw
ulna square nail
prosthesis
derhums pin
k wire
k nail
Instruments orthopaedics for mbbs studentsTONY SCARIA
plates
screws
cortical
cancellous
shanz pin plates
screws
cortical
cancellous
shanz pin
derhums pin
k wire
k nail
Radius square nail
DCP
dynamic hip screw
ulna square nail
prosthesis
derhums pin
k wire
k nail
This lecture is brief introduction into principles of fractures management.
The lecture presented and made by a 4th year medical student at kufa university.
management priorities in high energy trauma
Define the terms of fracture, dislocation and Subluxation
Identify the clinical and radiological pictures of fractures
Classify the different types of fractures
general principles of fracture management
Principles of open fracture management
fracture is the breakdown in the continutity of the bone alignment this has many types as the fracure this topic include its definition , etiology, pathophysiology, clinical menisfestation, diagnosis and its treatment which can be used by nursing students for taking care of the patient suffering from fracture and for learning for their examination and knowledge purpose
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
4. Open Fractures
• A break in the skin
and underlying soft
tissue leading to a
communicating
fracture hematoma
5. Gustilo Classification
• The Gustillo classification is used to classify open
fractures.
• Three grades that try to quantify the amount of soft
tissue damage associated with the fracture
Grade 1 — <1cm wound, min soft t/s injury
Grade 2 — >1cm wound, mod soft t/s inury
Grade 3 — >10cm wound, severe muscle devitalization
Subgrades A,B,C
6.
7. Grade 3A
• Limited stripping of periosteum and soft tissue
from bone.
• Adequate soft tissue coverage for bone,
tendons and neurovascular bundle.
8. Type 3B
• Extensive stripping of soft tissue and
periosteum from bone.
• Requires a local flap or free tissue transfer
Type 3C
• A major vascular injury requiring repair
9. Muller’s (AO/OTA) Classification
• Each long bone has 3 segments
Proximal, Diaphyseal and Distal
• Diaphyseal Fractures:
– Simple
– Wedge
– Complex
• Proximal & Distal
– Extra-Articular
– Partial Articular
– Complete Articular
11. Displacement - Translation
• Translation is sideways
motion of the fracture -
usually described as a
percentage of movement
when compared to the
diameter of the bone -- ---
-------direction of distal
fragment decides
12. Displacement - Angulation
• Angulation is the
amount of bend at a
fracture described in
degrees. Described
with respect to the
apex of the angle .
13. Displacement - Shortening
• Shortening is the
amount a fracture is
collapsed/ shifted
proximally, expressed
in centimeters.
14. Classification: Based on Pattern
1. Transverse
2. Oblique
3. Spiral
4. Comminuted
5. Segmental
6. Stellate
15. According to the Path of the # Line
Transverse Fracture
A fracture in which the #
line is perpendicular to the
long axis of the bone .
Oblique Fracture
A fracture in which the # line is
at oblique angle to the long axis
of the bone.
16. According to the Path of the # Line
Spiral Fracture
A severe form of oblique
fracture in which the # plane
rotates along the long axis of
the bone. These #s occur
secondary to rotational force.
17. Anatomical Classification of Fractures
Comminuted Fracture :
The bone is broken into many
fragments.
Stellate Fracture:
This # occurs in the flat bones of
the skull and in the patella,
where the fracture lines run in
various directions from one
point.
18. Anatomical Classification of Fractures
Impacted Fracture:
This # where a vertical force
drives the distal fragment of
the fracture into the proximal
fragment.
Depressed Fracture:
This # occurs in the skull
where a segment of bone
gets depressed into the
cranium.
19. Anatomical Classification of Fractures
Avulsion Fracture:
A chip of bone is avulsed by the sudden and unexpected
contraction of a powerful muscle from its point of insertion,
Examples
1. ASIS Avulsion
2. JONE’S 5th MT base Avulsion
20. Anatomical Classification of Fractures
Stress Fracture :
• It is a fracture occurring at a site in the bone subject to
repeated minor stresses over a period of time.
Birth Fracture:
• It is a fracture in the new born
children due to injury during
birth
21. Classification: Based on Etiology
1. TRAUMATIC
2. PATHOLOGICAL
– Tumors
– Bone cysts
– Osteomyelitis
– Osteoporosis
– Osteogenesis imperfecta
– Rickets
29. Aim
• To convert contaminated wound into clean wound
• To convert the open # into a closed one.
• To establish a union in a good position
• To prevent pyogenic and clostridial infection.
Order of Priority
• Patient
• Limb
• Wound
• Fracture
30. 4 Essentials of Treatment
• Antibiotic Prophylaxis
• Urgent Wound and Fracture Debridement
• Stabilization of the Fracture
• Early Debridement Wound Cover
31. Sterility and Antibiotic Cover
• In most cases, Co-amoxiclav or Cefuroxime (or
Clindamycin in case of penicillin allergy) is
given ASAP
• At time of debridement, Gentamycin is added
to a second dose of the 1st antibiotic given
• Wounds of Gustilo Grade 1 fractures can be
closed at time of debridement; Antibiotic
prophylaxis for up to 24hrs
32. • Grade 2 and 3A fractures, delayed closure
after ‘second look’ is sometimes preferred
• Grade 3B & C, delayed cover is usually
practiced.
• Total period of antibiotics is up to 72hrs.
33. Debridement
• Thorough irrigation of wound with copious
amounts of NS to remove all foreign material
in wound, followed by excision of dead tissue
• Tourniquet may be used to provide bloodless
field, but it can cause ischemia and make it
difficult to identify devitalized structures
34. • Principles observed during debridement:
– Wound margin excision
– Wound extension
– Delivery of fracture
– Removal of devitalized tissue
– Wound cleansing
• Uncontaminated wound in Grade 1 or 2 can
be sutured
35. Fracture Stabilization
• Important in reducing risk of infection and
assisting recovery of soft tissues
• Method of fixation depends on
– Degree of contamination
– Length of time from injury to operation
– Extent of soft tissue damage
• If there is no contamination and definitive
wound cover can be achieved at time of
debridement, all open #s can be treated as
closed injury
36. • Internal or external fixation may be
appropriate depending on individual
characteristics of fracture and wound.
• If wound cover is delayed, then external
fixation is safer; however fixator pins should
be inserted away from potential flaps
• Internal fixation can be used at time of
definitive wound cover as long as
– delay to wound cover is < 7 days
– No visible wound contamination
– Internal fixation can control the # as well as
external fixator
37. Stabilization of Open Fractures
METHODS
1.PLASTER IMMOBILISATION
2.PINS & PLASTER
3.SKELETAL TRACTION
4.EXTERNAL FIXATION
5.INTERNAL FIXATION
6.HYBRID FIXATION
38. External Fixators
Method of choice in most open fractures
Advantages:
• Easily applied
• Good skeletal & soft tissue stability
• Anatomical reduction.
• No additional trauma
• Risk of infection is comparatively less.
• Allows wound inspection & wound dressing.
• Assist in restoring the limb to length until definitive
fixation
• Allows transportation
• Better nursing care
39. Amputation
Indications:
• Vascular injury – no repair possible
• Functional outcome better with prosthesis
• Life saving to arrest bleeding
• Associated diseases (DM)