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.
This is a short presentation on avascular necrosis of femoral head. This presentation gives brief description of causes of AVN, investigations and modes of treatment options available.
AVN TREATMENT IN HYDERABAD
Core decompression for AVN
Stem cell treatment for AVN
Surgery for AVN
Avascular necrosis treatment options
Hip replacement in hyderabad
Hip specialist in hyderabad
Hip surgery in hyderabad
Total hip replacement in hyderabad
cemented hip replacement
uncemented hip replacement in hyderabad
ceramic hip replacement
delta motion hip
ceramic on ceramic hip replacement
metal on poly hip replacement
affordable hip replacement in hyderabad
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.
This is a short presentation on avascular necrosis of femoral head. This presentation gives brief description of causes of AVN, investigations and modes of treatment options available.
AVN TREATMENT IN HYDERABAD
Core decompression for AVN
Stem cell treatment for AVN
Surgery for AVN
Avascular necrosis treatment options
Hip replacement in hyderabad
Hip specialist in hyderabad
Hip surgery in hyderabad
Total hip replacement in hyderabad
cemented hip replacement
uncemented hip replacement in hyderabad
ceramic hip replacement
delta motion hip
ceramic on ceramic hip replacement
metal on poly hip replacement
affordable hip replacement in hyderabad
David: Femoral Neck Fracture with Avascular Necrosis of the Hip Case StudyDavid S. Feldman, MD
David is an avid hiker who fell and fractured his femoral neck during a hike. He underwent a successful surgery which fixed his femoral neck but later developed avascular necrosis of the hip. I ultimately recommended a multi-faceted course of treatment that included bisphosphonates, core decompression, BMP/Calcium phosphate, and arthrodiastasis. This course of treatment has successfully resolved his avascular necrosis of the hip and prevented the collapse of his femoral head.
http://www.davidsfeldmanmd.com/patient-education/case-studies/david-femoral-neck-fracture-w-avascular-necrosis-hip
2. Female 50 ปี
Cause of injury : วูบหมดสติตกจากยุ้งข้าว
Community hospital : 23/1/60 15.30
MNRH : 23/1/60 18.30
Mechanism : blunt injury
3. ABCDE : OK at รพช. ให้ Dx. CFx distal end of radius
Refer
4. A : Patient can speak , patent airway , Not tender at posterior midline of neck
B : Equal Chest move, Equal breath sound, chest compression test negative
C : BP 119/61 mmHg , pulse 60 bpm , no active external hemorrhage
D : E4V5M6 , pupil 3 mm RTLBE
E : No wound at back
6. A : No drugs allergy
M : No current medication
P : No underlying disease
L : 15.30 23/1/60 เป็นยา Paracetamol 2 เม็ด + น้า 1 แก้ว
E : ผู้ป่วยให้ประวัติว่า วูบหมดแรงตกจากยุ้งข้าวสูง 1.5 เมตร ใช้มือยันพื้นแล้วตัวของผู้ป่วยไปทับแขนตัวเอง หลังเกิดเหตุการณ์เจ็บมือมาก
จึงกินยา 2 เม็ดแล้วมาโรงพยาบาล ปฏิเสธประวัติชักเกร็งกระตุก ปฏิเสธปัสสาวะอุจจาระราด
7. Head & maxillofacial : no wound, no skull deformities
Cervical spine and Neck : No wound at neck , not tender at posterior midline of
cervical spine , can movement neck without pain
Chest: Equal breath sound, CCT –ve , Heart no murmur
Abdomen&pelvis : no wound, no visceral organ evisceration , normoactive bowel
sound , soft , no guarding , PCT negative
Perineum : no wound , no ecchymosis
PR : not done
Musculoskeletal : to be continue
Neurologic : E4V5M6 , pupil 3 mm RTLBE motor power grade V all Ext.
8. ดู: Swelling at Left distal forarm,
radial deviation deformites, dorsal
displacement
คลา: Stepping at distal radius,
tender at ulnar styloid
ขยับ: limit ROM at wrist joint due to
pain
วัด: not done
Speacial test: piano key sign
Positive
Neuro vasculr: radial pulse 2+
Motor 3 nerve OK
9. Film :
CXR PA upright
Lt.Wrist AP/Lat
DTX
EKG
10.
11.
12. Close fracture left distal end of radius with Intra-articular involving both
radiocarpal and distal radioulnar joints (Colles’ fracture Type VIII)
Transient lost of consciousness
13. MO 4 mg iv stat at ER
Close reduction at ER
On long arm AP slab supination position with three point fixation
Repeat film wrist AP/Lat หลัง on slab
EKG 12 lead, CBC, BUN, Cr, Elyte, Anti HIV
Pain control Tramol 50 mg iv prn q 6 hr, plasil 10 mg iv prn q 6 hr
Admit for consult cardiologist เรื่อง syncope, Pre-Op
Consult anesthesiologist for pre-op
Set OR for close pinning
14.
15.
16.
17.
18.
19. History falling onto their outstretched hand
Complains of wrist pain, and possibly deformity
PE: Swelling, tenderness, deformity. Do thorough neurovascular exam.
30. No dorsal tilt of the distal radial articular surface
Less than 5 mm of radial shortening
Less than 2 mm of displacement of fracture fragments