Simple shie

1. WEEKLY REVIEW MEET
ORTHO UNIT 2
(07/03/2024)

2. CASE 1
A 24 yr/M with A/H/O RTA and sustained injury to left Lowerlimb
C/o pain in left leg
C/o inability to bear weight on left lower limb
On examination – Left Lowerlimb
-Swelling present over distal 1/3rd leg.
-Tenderness present over distal 1/3rd leg.
-Abnormal mobility over distal 1/3rd leg.
- ROM painful and restricted at left knee and ankle
-Active toe movements present
-Distal pulses palpable
-No DNVD’s

3. Pre-op X-rays

4. Pre-op CT

5. Pre-op CT

6. DIAGNOSIS
Diagnosis : Left closed distal 1/3rd both bone leg fracture with medial malleolus fracture
AO Classification : 42B3(Tibia) ,4F3B(Fibula) ,43B1(Medial malleolus)

7. AO Classification

8. TREATMENT
Procedure Planned : CRIF with ILN for tibia + CRIF with Rush nail for fibula + ORIF with
CC screw for Medial malleolus
Procedure Done : CRIF with ILN for tibia + CRIF with Rush nail for fibula + ORIF with C
C screw for Medial malleolus

9. Post-op X-rays

10. Post-op Advice
▪IV antibiotics
▪Adequate analgesia
▪Walker assisted non weight bearing ambulation
▪Active quadriceps strengthening exercises
▪Knee and ankle ROM exercise
▪Regular dressing and follow up

11. CASE 2
A 15 yr/M with A/H/O Slip and fell 10 days back and sustained injury to Left upper limb
C/o pain in left forearm
C/o swelling in left forearm and wrist region
H/o Osteopath treatment taken.
On examination – Left Upper Limb
-Swelling present over left wrist and forearm.
-Tenderness present over proximal 1/3rd forearm.
-Abnormal mobility and deformity present proximal 1/3rd forearm.
-Active finger movements present
-Distal pulses palpable
-No DNVD’s

12. Pre-op Xrays

13. Diagnosis
▪Diagnosis : Left closed both bone forearm fracture
▪AO Classificatoin : 2R2B2 & 2U2A1

14. AO Classification

15. Treatment
▪Procedure planned : ORIF + DCP for radius and ulna
.
▪Procedure done : ORIF + DCP for radius and ulna

16. Post-op X-rays

17. Post-op Advice
▪IV antibiotics.
▪Adequate analgesia andlimb elevation.
▪Avoid heavy weight lifting.
▪Active ROM exercises at wrist and elbow.
▪Regular dressing and follow up.

18. CASE 3
A 14 yr/M with A/H/O Slip and fell 1 day back and sustained injury to Left upper limb
C/o pain in left forearm
C/o swelling in left forearm and wrist region
On examination – Left Upper Limb
-Swelling present over left wrist and forearm.
-Tenderness present over distal1/3rd forearm.
-Abnormal mobility and deformity present distal1/3rd forearm.
-Active finger movements present
-Distal pulses palpable
-No DNVD’s

19. Pre-op Xrays

20. Diagnosis
▪Diagnosis : Left closed both bone forearm fracture
▪AO Classificatoin : 2R3A3 & 2U3A2

21. AO Classification

22. Treatment
▪Procedure planned : ORIF/CRIF with K wire/plate
.
▪Procedure done : ORIF with 1/3rd tubular plate for radius and ORIF with K wiring fo
r ulna

23. Post-op X-rays

24. Post-op Advice
▪IV antibiotics.
▪Adequate analgesia and limb elevation.
▪Avoid heavy weight lifting.
▪Active ROM exercises at wrist and elbow.
▪Regular dressing and follow up.

25. CASE 4
A 36 yr/M with A/H/O self fall and sustained injury to left upper limb
C/o pain in left shoulder
C/o inability to move left shoulder
On examination – Left upper limb
-Swelling present over left shoulder
Tenderness present over left shoulder
-ROM painful and restricted at left shoulder
-Active finger movements present
-Distal pulses palpable
-No DNVD’s

26. Pre-op X-rays

27. Pre-op CT

28. DIAGNOSIS
Diagnosis : Left closed proximal humerus fracture
AO Classification : 11C3
Neer Classification :4 part fracture

29. AO and Neer Classification

30. TREATMENT
Procedure Planned : CRIF / ORIF with K wire/CC screw/ PHILOS plate
Procedure Done : CRIF with K wire + CC screw

31. Post-op X-rays

32. Post-op Advice
▪IV antibiotics
▪Adequate analgesia
▪Pendular movement exercise
▪Regular dressing and follow up

33. CASE 5
A 35 yr/M with A/H/O RTA and sustained injury to right Lower limb
C/o pain in right leg
C/o inability to bear weight on right lower limb
On examination – Right Lower limb
-Swelling and varus deformity present over foot and ankle
-Tenderness present over proximal foot
-ROM painful and restricted at right ankle
-Active toe movements present
-Distal pulses palpable
-No DNVD’s

34. Initially patient had ankle dislocation w
hich was reduced in casualty

35. Pre-op X-rays

36. DIAGNOSIS
Diagnosis : Right closed base of 5th metatarsal fracture
Lawrence and Botte classification :Zone 1
Torge : Type 2b

37. Classification

38. TREATMENT
Procedure Planned : CRIF with K wire
Procedure Done : CRIF with K wire

39. Post-op X-rays

40. Post-op Advice
▪IV antibiotics
▪Adequate analgesia
▪Limb elevation and boot slab
▪Walker assisted non weight bearing ambulation
▪Regular dressing and follow up

41. ▪
▪ Thank you