Diabetic foot
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Diabetes can damage nerves and reduce blood flow to the feet, putting people at risk for foot problems. Left untreated, these problems like infections, ulcers or wounds can become severe and may require amputation. Proper foot care is important for diabetics to check their feet daily and see a podiatrist regularly to prevent or treat issues early.
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Wrist drop
The radial nerve innervates the extensor muscles of the forearm and hand. Damage to the radial nerve causes wrist drop where the patient is unable to extend the wrist and fingers, impairing grasping. Symptoms include pain, numbness, weakness of hand grip and drooping of the wrist and fingers. Diagnosis involves assessing range of motion, imaging tests and electrodiagnostic tests. Treatment depends on the underlying cause but may include medications, injections, bracing and physical therapy.
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The Achilles tendon connects the calf muscles to the heel bone and is active during walking, running, and jumping. It is vulnerable to rupture, which commonly occurs in the watershed area 2-6cm above the heel in males ages 25-50 during sports. Diagnosis involves physical exam findings like inability to raise the toes and a gap or defect being felt. Treatment options include immobilization in a cast or surgical repair, with the goal of restoring proper tension and length. Post-operative care focuses on protecting the repair during healing over 6 months using casts, braces, and physical therapy.
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- Symptoms include bleeding gums, loose teeth, bruising of the skin, and bone fractures. In infants, scurvy can cause pseudoparalysis and swelling over bones from subperiosteal hemorrhaging.
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Reverse shoulder arthroplasty involves replacing the humeral head and glenoid fossa with prosthetics to alter the center of rotation and increase deltoid tension and function. It is indicated for rotator cuff tear arthropathy, proximal humeral fractures in the elderly, failed shoulder replacements, and other conditions. The procedure involves an deltopectoral approach to expose the joint, removal of the humeral head and shaping of the glenoid, then implantation of the glenosphere and humeral cup components. Outcomes are best for osteoarthritis and worse for trauma or revision cases. Complications can include infection, nerve injury, implant loosening or breakage.
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This document discusses painfull arc syndrome, also known as impingement syndrome of the shoulder. It describes the history and evolution of understanding of this condition. Impingement syndrome occurs when the rotator cuff tendons are pinched between the head of the humerus and the acromion process during arm elevation. There are three main types of impingement: primary, secondary, and subcoracoid. Treatment involves conservative measures like medication and physical therapy initially but may require arthroscopic or open surgery like acromioplasty in resistant cases. Complications of acromioplasty can include infection, nerve injury, or loss of shoulder function.
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Paget's disease is a chronic bone disease first described in 1876 where there is increased and disorderly bone remodeling resulting in weakened bones. It typically affects older individuals and involves overactive osteoclasts and osteoblasts, leading to abnormal bone formation. While the cause is unknown, genetic and viral factors have been implicated. Patients may be asymptomatic but can experience bone pain, pathological fractures, or neurological complications depending on the bones affected. Diagnosis involves x-rays and blood tests, while treatment focuses on reducing bone turnover through medications like calcitonin and bisphosphonates.
Ottopelvis
Otto Pelvis, also known as primary protrusio acetabuli, was first described by German pathologist Otto in 1824. It is characterized by medial protrusion of the acetabulum. There are two types: primary, which remains a diagnosis of exclusion, and secondary. Clinical features include a marked female predilection and bilateral involvement. Radiographs can identify protrusio using Kohler's line or central edge angle. Management depends on age and degeneration, ranging from valgus osteotomy in younger patients to total hip arthroplasty with grafting in older patients. Surgical techniques aim to restore the hip center through lateralization and reconstruction of bone defects.
Osteomyelitis
1) Osteomyelitis is an inflammation of bone caused by an infecting organism that may remain localized or spread through the bone.
2) Staphylococcus aureus is the most common infecting organism and can remain dormant in bone for years.
3) Chronic osteomyelitis is characterized by infected dead bone surrounded by avascular tissue, making systemic antibiotics ineffective. Surgical debridement is usually required.
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Osteogenesis imperfecta is a genetic disorder characterized by fragile bones that break easily from minor trauma. The document discusses the various types of osteogenesis imperfecta based on severity and inheritance. Clinical features include fractures, skeletal deformities, blue sclera, and hearing loss. The disorder results from defects in the genes that encode type 1 collagen. Treatments include conservative management with bracing and bisphosphonates to reduce fractures, and surgical interventions like intramedullary rods to correct deformities and facilitate mobility.
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- 37. Thank you