Stress fractures occur when normal bone is exposed to abnormal stress over time. While most commonly seen in athletes and military personnel, risk factors include training errors, bone anatomy, nutrition, and menstrual dysfunction in women. Diagnosis involves a history of activities and symptoms followed by imaging like plain films, bone scan, MRI or CT scan. Treatment is usually initial rest from activities followed by a gradual return once symptoms resolve, while displaced fractures may require surgery. Prevention focuses on gradual build up of training intensity with adequate rest and addressing intrinsic risk factors.
Stress fracture: diagnosis, management and return to sportsVaibhav Bagaria
Stress fracture is a common orthopedic condition often seen in athletes and sportsperson. A customised approach is necessary to ensure a rapid return to activity and sports.
Stress fractures occur when normal bone is exposed to abnormal stress over time. They are common in military personnel and athletes. The document discusses stress fractures, defining them and covering their epidemiology, risk factors, pathophysiology, diagnosis and management. Key points: military service often links to stress fractures due to abrupt increases in training intensity; lower limb bones like the tibia are most commonly affected; overtraining, nutrition deficits and bone anatomy influence risk; MRI is a sensitive diagnostic tool; most stress fractures are managed non-operatively with rest, while displaced fractures may require surgery.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise boosts blood flow and levels of neurotransmitters and endorphins which elevate and stabilize mood.
This document provides an overview of principles of orthopaedic care for medical professionals. It describes different types of orthopaedic injuries like fractures, dislocations, and subluxations. It also reviews fracture classifications, open injury grading systems, assessment of orthopaedic injuries, treatment modalities, and critical injuries that can occur during transport. The document aims to help medical providers properly assess and treat orthopaedic issues to minimize long-term disability and maximize patient comfort. It highlights some injuries like pelvic fractures that can lead to major blood loss and discusses approaches to time-sensitive orthopaedic emergencies.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
1. Osteoarthritis of the hip is a degenerative joint disease resulting from the rate of cartilage degeneration exceeding the rate of repair, leading to new bone formation.
2. It can be primary (idiopathic) or secondary to factors like dysplasia, fractures, or avascular necrosis.
3. Pathology includes progressive cartilage destruction, subarticular cyst formation, bone sclerosis, and osteophyte formation.
4. Treatment involves conservative options like exercises and NSAIDs initially, with surgical options like osteotomies, hip replacements, or arthrodesis for advanced cases.
This document defines Vo2max and OBLA, and explains their relationship and importance for athletes. Vo2max measures the maximum amount of oxygen the body can use during exercise, and is important for endurance. OBLA is the point at which lactic acid builds up in the blood due to insufficient oxygen intake. The document outlines how training increases Vo2max through physiological adaptations, and lowers the intensity at which OBLA occurs. It concludes by relating Vo2max, OBLA and lactate threshold to an individual's fitness level and training.
Stress fracture: diagnosis, management and return to sportsVaibhav Bagaria
Stress fracture is a common orthopedic condition often seen in athletes and sportsperson. A customised approach is necessary to ensure a rapid return to activity and sports.
Stress fractures occur when normal bone is exposed to abnormal stress over time. They are common in military personnel and athletes. The document discusses stress fractures, defining them and covering their epidemiology, risk factors, pathophysiology, diagnosis and management. Key points: military service often links to stress fractures due to abrupt increases in training intensity; lower limb bones like the tibia are most commonly affected; overtraining, nutrition deficits and bone anatomy influence risk; MRI is a sensitive diagnostic tool; most stress fractures are managed non-operatively with rest, while displaced fractures may require surgery.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise boosts blood flow and levels of neurotransmitters and endorphins which elevate and stabilize mood.
This document provides an overview of principles of orthopaedic care for medical professionals. It describes different types of orthopaedic injuries like fractures, dislocations, and subluxations. It also reviews fracture classifications, open injury grading systems, assessment of orthopaedic injuries, treatment modalities, and critical injuries that can occur during transport. The document aims to help medical providers properly assess and treat orthopaedic issues to minimize long-term disability and maximize patient comfort. It highlights some injuries like pelvic fractures that can lead to major blood loss and discusses approaches to time-sensitive orthopaedic emergencies.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
1. Osteoarthritis of the hip is a degenerative joint disease resulting from the rate of cartilage degeneration exceeding the rate of repair, leading to new bone formation.
2. It can be primary (idiopathic) or secondary to factors like dysplasia, fractures, or avascular necrosis.
3. Pathology includes progressive cartilage destruction, subarticular cyst formation, bone sclerosis, and osteophyte formation.
4. Treatment involves conservative options like exercises and NSAIDs initially, with surgical options like osteotomies, hip replacements, or arthrodesis for advanced cases.
This document defines Vo2max and OBLA, and explains their relationship and importance for athletes. Vo2max measures the maximum amount of oxygen the body can use during exercise, and is important for endurance. OBLA is the point at which lactic acid builds up in the blood due to insufficient oxygen intake. The document outlines how training increases Vo2max through physiological adaptations, and lowers the intensity at which OBLA occurs. It concludes by relating Vo2max, OBLA and lactate threshold to an individual's fitness level and training.
Deformities observed with Pes cavus includes :
*clawing of the toes
*posterior hind foot deformity (described as an increased calcaneal angle)
*contracture of the plantar fascia
*cock-up deformity of the great toe
Following References were used to prepare this powerpoint presentation which makes the slides accurate and relaible for studying purpose; Therapeutic Exrercise – Carolyn Kisner
Orthopaedic Physical Assessment – Magee
Orthopaedic Medicine – L. Ombregt
Campbell’s Operative Orthopaedics
Slides includes following headings;
DEFINITION
TYPES
ORTHOPAEDIC ASSESSMENT
MEDICAL MANAGGEMENT
PHYSIOTHERAPY MANAGEMENT
SURGICAL MANAGEMENT
The document discusses knee osteoarthritis (OA), including its causes, symptoms, diagnosis, and physiotherapy treatment approaches. It notes that OA is the most common joint disorder worldwide, usually resulting from wear and tear of cartilage over time. Common symptoms include knee pain that worsens with use, stiffness, and swelling. Physiotherapy is an important part of OA management and focuses on exercises to strengthen the knee, education on lifestyle changes like weight loss, manual therapy, and electrotherapy modalities to reduce pain and improve function.
low back pain is very common in population occurring at least once a lifetime in nearly 60-80% of population.
This presentation was presented as a webinar in coordination with ypta and serving hands on 12-8-2021.
The document provides an overview of the role of ultrasound in orthopedics. It begins with a description of normal sonographic appearances of structures like tendons, bones, cartilage and ligaments. It then discusses various sonographic artifacts and basic pathology concepts for evaluating musculoskeletal injuries and conditions like muscle/tendon injuries, bone injuries, infections, arthritis and soft tissue foreign bodies. Specific applications of ultrasound for assessing conditions in different body regions like shoulder, elbow, wrist, hip, knee, ankle and foot are covered. The document highlights advantages of ultrasound for diagnosis, interventions and treatments in orthopedics.
Hamstring strains are common injuries that occur during activities involving sprinting or kicking. They frequently happen during the swing phase of sprinting when the hamstrings are lengthened. Risk factors include age, previous injury, low flexibility, weakness, fatigue, and improper warm-up. Prevention strategies include stretching, strengthening, sport-specific training, and combined programs addressing multiple risk factors.
This document discusses patellofemoral pain syndrome (PFPS). PFPS is characterized by anterior knee pain that is most common in young, active populations. It is typically caused by an imbalance of forces across the patellofemoral joint from issues like increased Q-angle, foot overpronation, and weakness of the vastus medialis obliquus muscle. Symptoms include pain around or behind the kneecap that is aggravated by activities involving knee bending like squatting or going up and down stairs. Treatment focuses on reducing pain/inflammation, addressing contributing biomechanical factors, and strengthening exercises for the quadriceps muscles.
this presentation is about the spondylosis of the cervical region.
there is information about cervical spondylosis, its etiology, epidemiology, sign symptoms and its treatment options.
Pp for lumbarization and sacralization by Dr Dhruv Taneja Assistant ProfessorDhruv Taneja
Lumbarization is a condition where the first sacral vertebra appears like a lumbar vertebra rather than being fused with the sacrum. This occurs when the first and second sacral segments fail to fuse during development. A lumbarized S1 vertebra may have its own disc or an underdeveloped disc space, making it difficult to accommodate and more prone to injury with age. Sacralization is a related condition where the fifth lumbar vertebra fuses with the sacrum, reducing mobility and increasing stress on the L4 vertebra. Both conditions can potentially lead to back pain and disc problems.
The document discusses Jones fractures, which are fractures of the fifth metatarsal at the proximal end. It provides details on the history, diagnosis, treatment, prognosis, and predictors of outcome for Jones fractures. Treatment options discussed include non-surgical (RICE method, casting) and surgical (screw fixation). Predictors of poor outcome from non-surgical treatment included longer periods without weight bearing. Studies showed non-operative treatment can effectively treat early chronic or subacute Jones fractures without sclerosis, allowing athletes to return to play within 12 weeks.
Limb length discrepancy can be congenital or acquired. It is defined as a difference in leg length of 2.5 cm or more. A short leg causes an awkward gait, increased energy expenditure, and back pain. Treatment depends on the severity and includes shoe lifts for mild cases and epiphysiodesis, shortening, or lengthening procedures for larger discrepancies. Limb lengthening uses either external fixators like the Ilizarov or internal devices to gradually lengthen the bone through the process of distraction osteogenesis, where the bone is slowly pulled apart to stimulate new bone growth. Treatment must be tailored based on the individual's age, growth remaining, and specific condition.
This document provides an overview of patellofemoral pain syndrome. It defines the syndrome and discusses relevant anatomy, biomechanics, causes, clinical evaluation, imaging, and treatment options. Regarding treatment, non-operative options including rehabilitation are usually successful for 90% of cases. Surgical techniques are reserved for the remaining 10% and include arthroscopic procedures such as debridement and lateral release as well as bony procedures like tibial tubercle transfer to address malalignment issues.
Spinal orthotics are external devices that limit spinal motion, correct deformities, reduce loading, or improve spinal function. They include flexible braces made of fabric or elastic and rigid braces made of thermoplastics or metals. Cervical collars come in soft and hard varieties and are used for neck injuries or post-operatively. Thoracic-lumbar-sacral orthoses (TLSO) and lumbosacral corsets (LSO) are used for lumbar injuries or fractures. The halo cervical orthosis provides the greatest cervical immobilization using pins in the skull. Drawbacks of orthotics include discomfort, skin issues, and decreased function with prolonged use.
This document provides an overview of the history and types of spinal orthoses. It begins with a brief history of spinal orthotic use dating back to ancient times. It then describes various types of cervical, cervicothoracic, and thoracolumbosacral orthoses, including their indications, biomechanics, design features, and how they control spinal motion. Examples of custom-fit and prefabricated options are discussed. The document concludes with descriptions of specific orthosis designs like the halo, SOMI, and TLSO and how they immobilize different spinal regions.
The document discusses upper limb orthosis, devices used to modify the structural and functional characteristics of the upper limb. It covers the objectives of upper limb orthosis including protection, correction, and assistance. It also discusses the classification, biomechanics, principles, and assessment of upper limb orthosis and provides descriptions and examples of specific upper limb orthoses including shoulder orthoses, arm slings, arm abduction orthoses, elbow/forearm/wrist orthoses, and elbow or wrist mobilization orthoses.
Olecranon bursitis is an inflammation of the bursa located over the point of the elbow. It can be caused by direct trauma, repetitive rubbing on hard surfaces, or underlying conditions like gout or rheumatoid arthritis. Acute cases present as a tender, fluid-filled swelling while chronic cases appear as a painless swelling. Treatment involves rest, ice, compression, and anti-inflammatory medications. Septic bursitis requires antibiotics while surgery may be needed for cases that do not improve with conservative care.
This document discusses the anatomy and physiology of the thoracolumbar spine and classifies different types of thoracolumbar spine injuries. It describes the anatomy of the spinal cord, blood supply, and biomechanics of the thoracic and lumbar regions. Various injury mechanisms are outlined including compression fractures, burst fractures, and chance fractures. Imaging techniques like x-rays, CT, and MRI are discussed. The Denis three-column theory and TLICS classification system are introduced to classify injuries as stable or unstable. Non-operative and surgical treatment options are provided based on the injury classification.
COXA VARA AND COXA VALGA, DEVLOPMENTAL COXA VARA.pptxKisanNepali
Coxa vara and coxa valga refer to reductions or increases in the neck shaft angle of the femur. Developmental coxa vara is caused by a defect in endochondral ossification, resulting in a decreased neck shaft angle and shortening of the femoral neck. This puts increased shear stress on the femoral neck. Left untreated, it can progress and cause premature arthritis. Treatment involves valgus-producing osteotomies to redirect forces from shear to compression and allow normal remodeling. Outcomes depend on the pre-operative neck shaft and epiphyseal-head angles. Complications include recurrence, coxa valga, and avascular necrosis.
Stress fractures occur when normal bone is exposed to abnormal stress, such as seen in athletes and military personnel. The lower limb is most commonly affected, especially the tibia. Risk factors include training regimen, nutrition, bone anatomy, sex, and smoking. Diagnosis involves history, exam, and imaging like MRI which is sensitive and specific. Management is usually initially non-operative with rest, but surgery may be needed for delayed healing. Specific sites like the femoral neck require careful management due to risk of displacement. Prevention focuses on gradual build up of training and early identification of signs of stress fracture.
Effects of ACL injuries on female performanceAmtulS24
Effect of ACL injuries on female performance which help to reduce chances of injuries on female and increase performance in physical activities and athletic events.
Deformities observed with Pes cavus includes :
*clawing of the toes
*posterior hind foot deformity (described as an increased calcaneal angle)
*contracture of the plantar fascia
*cock-up deformity of the great toe
Following References were used to prepare this powerpoint presentation which makes the slides accurate and relaible for studying purpose; Therapeutic Exrercise – Carolyn Kisner
Orthopaedic Physical Assessment – Magee
Orthopaedic Medicine – L. Ombregt
Campbell’s Operative Orthopaedics
Slides includes following headings;
DEFINITION
TYPES
ORTHOPAEDIC ASSESSMENT
MEDICAL MANAGGEMENT
PHYSIOTHERAPY MANAGEMENT
SURGICAL MANAGEMENT
The document discusses knee osteoarthritis (OA), including its causes, symptoms, diagnosis, and physiotherapy treatment approaches. It notes that OA is the most common joint disorder worldwide, usually resulting from wear and tear of cartilage over time. Common symptoms include knee pain that worsens with use, stiffness, and swelling. Physiotherapy is an important part of OA management and focuses on exercises to strengthen the knee, education on lifestyle changes like weight loss, manual therapy, and electrotherapy modalities to reduce pain and improve function.
low back pain is very common in population occurring at least once a lifetime in nearly 60-80% of population.
This presentation was presented as a webinar in coordination with ypta and serving hands on 12-8-2021.
The document provides an overview of the role of ultrasound in orthopedics. It begins with a description of normal sonographic appearances of structures like tendons, bones, cartilage and ligaments. It then discusses various sonographic artifacts and basic pathology concepts for evaluating musculoskeletal injuries and conditions like muscle/tendon injuries, bone injuries, infections, arthritis and soft tissue foreign bodies. Specific applications of ultrasound for assessing conditions in different body regions like shoulder, elbow, wrist, hip, knee, ankle and foot are covered. The document highlights advantages of ultrasound for diagnosis, interventions and treatments in orthopedics.
Hamstring strains are common injuries that occur during activities involving sprinting or kicking. They frequently happen during the swing phase of sprinting when the hamstrings are lengthened. Risk factors include age, previous injury, low flexibility, weakness, fatigue, and improper warm-up. Prevention strategies include stretching, strengthening, sport-specific training, and combined programs addressing multiple risk factors.
This document discusses patellofemoral pain syndrome (PFPS). PFPS is characterized by anterior knee pain that is most common in young, active populations. It is typically caused by an imbalance of forces across the patellofemoral joint from issues like increased Q-angle, foot overpronation, and weakness of the vastus medialis obliquus muscle. Symptoms include pain around or behind the kneecap that is aggravated by activities involving knee bending like squatting or going up and down stairs. Treatment focuses on reducing pain/inflammation, addressing contributing biomechanical factors, and strengthening exercises for the quadriceps muscles.
this presentation is about the spondylosis of the cervical region.
there is information about cervical spondylosis, its etiology, epidemiology, sign symptoms and its treatment options.
Pp for lumbarization and sacralization by Dr Dhruv Taneja Assistant ProfessorDhruv Taneja
Lumbarization is a condition where the first sacral vertebra appears like a lumbar vertebra rather than being fused with the sacrum. This occurs when the first and second sacral segments fail to fuse during development. A lumbarized S1 vertebra may have its own disc or an underdeveloped disc space, making it difficult to accommodate and more prone to injury with age. Sacralization is a related condition where the fifth lumbar vertebra fuses with the sacrum, reducing mobility and increasing stress on the L4 vertebra. Both conditions can potentially lead to back pain and disc problems.
The document discusses Jones fractures, which are fractures of the fifth metatarsal at the proximal end. It provides details on the history, diagnosis, treatment, prognosis, and predictors of outcome for Jones fractures. Treatment options discussed include non-surgical (RICE method, casting) and surgical (screw fixation). Predictors of poor outcome from non-surgical treatment included longer periods without weight bearing. Studies showed non-operative treatment can effectively treat early chronic or subacute Jones fractures without sclerosis, allowing athletes to return to play within 12 weeks.
Limb length discrepancy can be congenital or acquired. It is defined as a difference in leg length of 2.5 cm or more. A short leg causes an awkward gait, increased energy expenditure, and back pain. Treatment depends on the severity and includes shoe lifts for mild cases and epiphysiodesis, shortening, or lengthening procedures for larger discrepancies. Limb lengthening uses either external fixators like the Ilizarov or internal devices to gradually lengthen the bone through the process of distraction osteogenesis, where the bone is slowly pulled apart to stimulate new bone growth. Treatment must be tailored based on the individual's age, growth remaining, and specific condition.
This document provides an overview of patellofemoral pain syndrome. It defines the syndrome and discusses relevant anatomy, biomechanics, causes, clinical evaluation, imaging, and treatment options. Regarding treatment, non-operative options including rehabilitation are usually successful for 90% of cases. Surgical techniques are reserved for the remaining 10% and include arthroscopic procedures such as debridement and lateral release as well as bony procedures like tibial tubercle transfer to address malalignment issues.
Spinal orthotics are external devices that limit spinal motion, correct deformities, reduce loading, or improve spinal function. They include flexible braces made of fabric or elastic and rigid braces made of thermoplastics or metals. Cervical collars come in soft and hard varieties and are used for neck injuries or post-operatively. Thoracic-lumbar-sacral orthoses (TLSO) and lumbosacral corsets (LSO) are used for lumbar injuries or fractures. The halo cervical orthosis provides the greatest cervical immobilization using pins in the skull. Drawbacks of orthotics include discomfort, skin issues, and decreased function with prolonged use.
This document provides an overview of the history and types of spinal orthoses. It begins with a brief history of spinal orthotic use dating back to ancient times. It then describes various types of cervical, cervicothoracic, and thoracolumbosacral orthoses, including their indications, biomechanics, design features, and how they control spinal motion. Examples of custom-fit and prefabricated options are discussed. The document concludes with descriptions of specific orthosis designs like the halo, SOMI, and TLSO and how they immobilize different spinal regions.
The document discusses upper limb orthosis, devices used to modify the structural and functional characteristics of the upper limb. It covers the objectives of upper limb orthosis including protection, correction, and assistance. It also discusses the classification, biomechanics, principles, and assessment of upper limb orthosis and provides descriptions and examples of specific upper limb orthoses including shoulder orthoses, arm slings, arm abduction orthoses, elbow/forearm/wrist orthoses, and elbow or wrist mobilization orthoses.
Olecranon bursitis is an inflammation of the bursa located over the point of the elbow. It can be caused by direct trauma, repetitive rubbing on hard surfaces, or underlying conditions like gout or rheumatoid arthritis. Acute cases present as a tender, fluid-filled swelling while chronic cases appear as a painless swelling. Treatment involves rest, ice, compression, and anti-inflammatory medications. Septic bursitis requires antibiotics while surgery may be needed for cases that do not improve with conservative care.
This document discusses the anatomy and physiology of the thoracolumbar spine and classifies different types of thoracolumbar spine injuries. It describes the anatomy of the spinal cord, blood supply, and biomechanics of the thoracic and lumbar regions. Various injury mechanisms are outlined including compression fractures, burst fractures, and chance fractures. Imaging techniques like x-rays, CT, and MRI are discussed. The Denis three-column theory and TLICS classification system are introduced to classify injuries as stable or unstable. Non-operative and surgical treatment options are provided based on the injury classification.
COXA VARA AND COXA VALGA, DEVLOPMENTAL COXA VARA.pptxKisanNepali
Coxa vara and coxa valga refer to reductions or increases in the neck shaft angle of the femur. Developmental coxa vara is caused by a defect in endochondral ossification, resulting in a decreased neck shaft angle and shortening of the femoral neck. This puts increased shear stress on the femoral neck. Left untreated, it can progress and cause premature arthritis. Treatment involves valgus-producing osteotomies to redirect forces from shear to compression and allow normal remodeling. Outcomes depend on the pre-operative neck shaft and epiphyseal-head angles. Complications include recurrence, coxa valga, and avascular necrosis.
Stress fractures occur when normal bone is exposed to abnormal stress, such as seen in athletes and military personnel. The lower limb is most commonly affected, especially the tibia. Risk factors include training regimen, nutrition, bone anatomy, sex, and smoking. Diagnosis involves history, exam, and imaging like MRI which is sensitive and specific. Management is usually initially non-operative with rest, but surgery may be needed for delayed healing. Specific sites like the femoral neck require careful management due to risk of displacement. Prevention focuses on gradual build up of training and early identification of signs of stress fracture.
Effects of ACL injuries on female performanceAmtulS24
Effect of ACL injuries on female performance which help to reduce chances of injuries on female and increase performance in physical activities and athletic events.
Spinal injuries can range from mild strains to severe fractures and spinal cord damage. A spinal fracture occurs when excessive force is applied to the spine, resulting in broken bones. Symptoms depend on the location and severity of the injury, and may include back pain, numbness, weakness, and paralysis in severe cases. Treatment options include bracing, pain management, or surgery such as vertebroplasty, kyphoplasty, or spinal fusion to stabilize and fuse fractured vertebrae.
Pelvic fractures are caused by high-energy trauma and can be stable or unstable depending on the fracture pattern. Stable fractures involve a single break while unstable fractures have multiple breaks or displacement of bones. Treatment depends on factors like fracture pattern and displacement, and may involve nonsurgical or surgical methods. Recovery requires medications, physical therapy, and weight restrictions to regain mobility and prevent complications like blood clots.
The role of Cement Augmentation in the Prevention of Spinal Insufficiency Fra...Winston Rennie
The Role of Cement Augmentation in the Prevention of Spinal Insufficiency Fractures. Spinal Vertebral fractures and percutaneous cement augmentation, vertebroplasty and kyphoplasty. The arguments for a role in preventing new spinal fractures and those against it. The flaws in experimental biomechanical studies and the importance of clinical spinal stability. Biplanar bipedicular percutaneous imaging approaches and formal trainig schemes to be established to train new practitioners with a biomechanically based cement placement.
Ankylosing spondylitis is a type of inflammatory arthritis associated with the HLA-B27 gene. It typically causes stiffness and fusion of the spine over time. Diagnosis involves evidence of sacroiliac joint inflammation on imaging and a positive HLA-B27 test in most cases. Treatment focuses on exercises to maintain mobility, nonsteroidal anti-inflammatory drugs, and TNF inhibitors for severe cases. Surgery may be needed to correct spinal deformities or replace affected hips in advanced ankylosing spondylitis.
Repetitive strain injury (RSI) refers to musculoskeletal disorders caused by repetitive movements over time. Common RSIs include carpal tunnel syndrome and tendinitis. RSIs develop due to ergonomic and psychosocial stressors and cause pain, numbness, and functional limitations. Occupations involving repetitive computer use or manual labor pose the highest risk. Diagnosis is based on symptoms and physical exam. Treatment focuses on rest, stretching, splinting, and therapies to address underlying muscle imbalances and stresses.
The document discusses the anatomy, functions, and fractures of the patella bone. It describes the patella's location in front of the knee joint and role in improving knee extension. Common types of patellar fractures include open and closed fractures caused by direct impacts or twisting forces. Treatment involves immobilization, physical therapy to regain motion, and sometimes surgery like internal fixation using screws, plates or wires if the fracture is unstable. Post-operative rehabilitation focuses on early range of motion and weight bearing exercises while avoiding resisted extension for 6-12 weeks to allow healing.
Training and sports injuries july 2015 kadarpurjayarams6
The document discusses common training and sports injuries among members of the Central Reserve Police Force. It notes that musculoskeletal injuries are the greatest health threat to paramilitary readiness, with over 25 million days of limited duty each year. Some key injuries discussed include sprains, strains, low back pain, tendon injuries, knee injuries, ankle sprains, osteorarthritis, and stress fractures. The document provides details on preventing, diagnosing, and managing these injuries. It emphasizes the importance of physical fitness and conditioning to prevent injuries and stresses gradually increasing training loads to avoid injuries like stress fractures.
This document summarizes stress fractures, which occur through normal bone subjected to repeated stress. Key points:
- They result from repetitive submaximal forces exceeding bone's adaptive ability, common in athletes and military.
- Lower limb weight-bearing bones like tibia are most prone. Specific sites include femoral neck, tibia, navicular.
- Causes include increased activity without rest, muscle fatigue concentrating forces, and nutritional/hormonal imbalances.
- Diagnosis involves history of increased activity and focal bone pain worsened by stress. Imaging includes xray, CT, MRI, bone scan.
- Treatment depends on fracture location and risk but typically involves initial rest, then progressive return to
Rib fractures are commonly caused by blunt chest trauma and are often seen following motor vehicle crashes and falls. While usually not life-threatening on their own, they can indicate more severe underlying injuries to the chest or abdomen. Treatment focuses on pain management to prevent respiratory complications and complications are more common in elderly patients and those with multiple rib fractures.
1. The document discusses paediatric distal femoral injuries, including knee anatomy, Salter-Harris classification, mechanisms of injury, physical exam findings, imaging, and treatment options.
2. Distal femoral physeal fractures are rare, typically result from high-energy trauma, and have risks of growth disturbance and vascular compromise that require emergent assessment and management.
3. Treatment depends on the fracture type and includes closed reduction, percutaneous pinning, splinting/casting, external fixation, and open reduction with internal fixation.
Muscle tears are extremely common and are often recurrent. They are not as simple as we used to think and the advent of better imaging has proven that the site, size and location of the tear, together with the presence or otherwise of the tendon is crucial information especially for elite or professional athletes, who need accurate information about return to play. Traditional treatments of electrotherapy are simply placebos. The challenge ahead is to optimise treatments for the various diagnostic categories.
Intertrochanteric fractures / hip fractureMannan Ahmed
This document discusses intertrochanteric hip fractures, including:
- Risk factors like age, comorbidities, and prior fractures.
- Mechanisms of injury, usually a fall in elderly patients.
- Signs and symptoms ranging from ambulatory to severe pain.
- Classification systems including Evans and OTA.
- Treatment options including nonoperative management, sliding hip screws, and intramedullary devices. Operative treatment is usually indicated to reduce complications from prolonged immobilization.
This document provides an overview of musculoskeletal injuries, focusing on fractures. It discusses the healing process for bones, classifications of fractures, and typical timescales for fracture healing. The functions and composition of bone tissue are explained. The stages of fracture healing are outlined, from initial inflammation and hematoma formation to remodeling. Principles of fracture management include reduction, immobilization, and rehabilitation. Complications of fractures like infection, malunion, and nonunion are also reviewed.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the 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 lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
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. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
2. Introduction
• Military service and stress fractures are closely
linked.
• The first report of a stress fracture in the
literature was in 1855. Briethaupt, a Prussian
Army Physician recorded the painful swollen
feet of marching soldiers.
• In 1987, this condition was shown to be due
to a fractured metatarsal shaft and
subsequently termed a ‘march fracture’.
3. Definition
Stress fractures occur when normal bone is
exposed to abnormal stress.
– They are seen in professional athletes and in
military personnel.
• Insufficiency fractures are fractures which
occur in abnormal bone when exposed to a
normal stress.
– They most commonly occur secondary to
untreated osteoporosis.
4. Epidemiology
• Since Briethaupt’s report, much of the published
literature on stress fractures relates to military
recruits because of the high incidence and because
they are an easy to study cohort of athletes.
• Studies reporting the incidence of stress fracture in
civilian athletes are probably much less accurate
than those reporting on military recruits because
they are a disparate group.
– Running athletes appear to have the highest incidence of
stress fractures.
5. Epidemiology
The part of the skeleton at risk of
stress fracture clearly depends on the
activity undertaken.
• The vast majority of stress fractures
occur in the lower limb.
– atheson et al reported that the tibia
was the most common site in civilian
athletes (49.1%), followed by the tarsals
(25.3%), metatarsals (8.8%) and femur
(
7.2
.)%
• Stress fractures can occur in the
upper limb in throwing athletes and
rowers
Stress fracture of the proximal
tibia
6. Pathophysiology
• Bone is a dynamic tissue constantly
remodelling under the influence of multiple
hormonal and mechanical factors.
• There is a balance between bone resorption,
carried out by osteoclasts, and bone synthesis,
carried out by osteoblasts.
• Bone has a remodelling response to
mechanical stress so that the greatest amount
of bone is laid down in areas of greatest
applied stress (Wolff’s Law).
7. Pathophysiology
• When bone is subject to repetitive daily subthreshold loading,
microcracks may occur within cement lines: the normal
remodelling process repairs these cracks.
• However, if the bone continues to be subjected to high stresses
then crack propagation occurs.
• If crack propagation outstrips repair then over a period of time a
painful established stress fracture will develop.
• Given time, bone subjected to increased stress will lay down
more bone.
• It has been shown that during this process, osteoblastic activity
lags behind resorptive osteoclastic activity.
• Bone that is subject to a sudden increase in repetitive stress is
particularly vulnerable to stress fracture during this lag period.
• Military recruit training and poorly designed ‘get fit quick’ training
programs are examples of this phenomenon.
8. Risk factors
• Risk factors for stress fractures are either extrinsic or
intrinsic.
• Extrinsic factors pertain to the environment in which the
athlete trains and intrinsic factors pertain to the athlete
• Extrinsic risk factors
– Training regimen
– Training surface
• Intrinsic risk factors
– Bone anatomy
– Sex
– Nutrition
– Fitness
– Smoking
– Non-steroidal antiinflammatory
drugs
9. Extrinsic Risk Factors
Training Regimen
• Activities with the highest loads for the most number of cycles
confer the highest risk of stress fracture such as long distance
running which has been shown to have an increased stress
fracture risk.
• Abrupt increases in training intensity without adequate rest
days also predisposes to stress fracture for a number of
reasons.
• As osteoblastic bone synthesis lags behind osteoclastic bone
resorption, hence there is period of decreased bone strength
following increased bone stress.
• If the athlete does not rest sufficiently to allow repair of the
cracks, then crack propagation occurs and an established stress
fracture can develop.
10. Extrinsic Risk Factors
Training Surface
• Load through the lower limb is related to the
ground reaction force.
• Running shoes should be replaced every 6
months, especially with cheaper EVA foam
shoes, as the foam compacts, losing shock
absorption, over time.
11. Intrinsic Risk Factors
Bone Anatomy
• The ability of a cylinder to resist bending and
torsional stress is proportional to the fourth
power of the cylinder radius.
– It follows that a wider long bone is stronger than
a thin long bone.
• Studies have demonstrated that small tibial
bone width, such as in females, correlates with
stress fracture risk.
12. Intrinsic Risk Factors
Sex
• Women are at increased risk of stress fracture
for a number of reasons.
– They have narrower bones and lower bone mineral
density.
– Women training for events where low body weight
is considered advantageous, such as gymnastics
and long distance running, are particularly at risk
from “ Female Athlete Triad” (disordered eating,
amenorrhoea, and osteoporosis).
13. Intrinsic Risk Factors
Nutrition
• Inadequate calcium and vitamin D intake may
increase the risk of stress fracture.
• Inadequate caloric intake is probably of
greater relevance in athletes, as dietary
energy restriction has been found to be
accompanied by reduced bone mass.
14. Intrinsic Risk Factors
Fitness
• A number of studies have demonstrated that
the aerobic fitness and previous sporting
experience of military recruits prior to starting
training are protective against stress fracture.
• This is likely to be because their skeleton is
better adapted to stress and because they
suffer less muscle fatigue.
15. Intrinsic Risk Factors
Smoking
• A survey of 915 female military recruits found
that those who smoked one or more cigarettes
in the year prior to commencement of basic
training were more likely to suffer a stress
fracture, with an increased relative risk of 2.2.
16. Intrinsic Risk Factors
NSAIDs
There is theoretical evidence based on animal
studies that NSAIDs can have an adverse effect
on fracture healing.
• The evidence available regarding the effect in
humans is inconclusive.
– Until better quality evidence is available it is
reasonable to minimize the use of NSAIDs during
the management of stress fractures.
17.
18. Diagnosis
• Early diagnosis is important to minimize not
only time away from training but to preclude
non-union or a catastrophic displaced
fracture.
• Delay in diagnosis can lead to medical
discharge from the Services for military
personnel or early retirement from sport.
19. Diagnosis
History
• A thorough history should establish whether
the athlete has been exposed to any of the
risk factors discussed above; whether they
have undergone an abrupt increase in training
and in women whether they have had any
disruption of their menstrual cycle.
• Typically, the athlete describes an insidious
onset localized dull aching pain which is worse
with activity.
20. Diagnosis
Clinical Examinatiom
• On examination, the fracture site will normally be
tender and percussion of the bone at a site away from
the fracture may reproduce the pain.
• A high index of suspicion is necessary, especially for
femoral stress fractures which cannot be directly
palpated and frequently present with poorly localized
pain.
– Provocative tests such as pain on hopping can be
helpful
when establishing a diagnosis of femoral stress fracture.
21. Diagnosis
Imaging
• Plain radiographs can be useful because they
are very specific and if a stress fracture is seen
then further imaging is rarely necessary.
– However, plain radiographs can be falsely
negative for up to 3 months after symptom onset.
– Early radiographs are often normal, with detection
rates as low as 15%, and serial radiographs are
diagnostic in only 50% of cases.
– Plain films generally reveal a range of relatively
late skeletal responses, from endosteal or
periosteal reactions to frank fractures.
22. The initial AP radiograph of the left foot in a
patient with a
stress fracture of the 2nd metatarsal, which
appears normal.
A follow-up AP radiograph of the left
foot in a patient with a stress
fracture of the 2nd metatarsal, which
shows a periosteal reaction (arrow)
23. Diagnosis
Imaging
• Isotope bone scans (scintigrams) are very
sensitive for stress fracture; however, it is not
specific.
– It detects the osteoblastic activity associated
with
remodelling.
25. Diagnosis
Imaging
• MRI is able to depict abnormalities weeks
before a radiographic lesion.
• It has comparable sensitivity and superior
specificity with bone scintigraphy.
• It is extremely sensitive in the detection of
pathophysiological soft-tissue, bone and
marrow changes associated with stress
fractures and also demonstrates surrounding
muscular or ligamentous injury.
26. Diagnosis
Imaging
• The MR technique should include an oedema
sensitive sequence, such as a fat-suppressed
T2W or STIR (short tau inversion recovery)
images.
• A T1W image is better to define the anatomy
and more advanced fractures.
• Contrast imaging is not considered essential.
• The sensitivity of MR relies on its ability to
detect early bone marrow oedema, the
hallmark of the stress response.
27. Diagnosis
Imaging
• CT is less sensitive than scintigraphy or MRI in
the early detection of stress injury, but it is
more sensitive for the detection of cortical
fracture lines.
– It is therefore useful in demonstrating stress
fractures of the sacrum, pars interarticularis,
navicular and tibia.
28. Management
Non-operative
• The most important aspect of management is
early diagnosis.
• The vast majority of stress fractures can be
successfully treated non-operatively by
avoidance of the stressing activity.
• The general principles of non-operative
treatment are to avoid activity levels which
reproduce pain and a very gradual return to
training.
29. Management
Operative
• Most authors recommend operative
treatment for cases of delayed union or failed
non-operative treatment.
• The aims of surgical treatment are to improve
the mechanical environment for fracture
healing with a fixation device and/or improve
the biological environment with debridement
or bone graft.
31. Femoral Neck
• Femoral neck fractures constitute 8% of all
stress fractures in military personnel.
• As always, the key to management is
early diagnosis.
–The diagnosis should be considered in
any high risk patient with groin pain.
32. Femoral Neck
• Femoral neck fractures in
athletes usually occur in
the medial cortex which is
under compression.
– Undisplaced fractures are
stable and can be
successfully treated nonoperatively
with an initial
period of nonweightbearing.
– Displaced fractures should
always be reduced and
fixed surgically with large
cannulated screws.
33. Femoral Neck
• Stress fractures can affect the lateral cortex
which is subject to tensile forces, but this is
usually an insufficiency type fracture occurring
in older patients.
– These lateral stress fractures are associated with a
high risk of displacement and avascular necrosis of
the femoral head.
– Therefore, even undisplaced fractures of the
lateral cortex should normally be internally fixed.
34. Tibial Shaft
• Approximately 50% of all stress fractures in
runners and military recruits occur in the tibial
shaft.
• They can occur anywhere in the tibial shaft,
but most commonly affect the posteromedial
cortex.
• The majority can be successfully managed
non-operatively.
– The use of a pneumatic leg brace has been shown
to be helpful.
35. Tibial Shaft
• The less common stress fracture affecting the
anterior tibial cortex is more difficult to manage
because the incidence of delayed union is much
higher.
• This is probably because the anterior cortex is
subject to repetitive tensile rather than compressive
loading.
• Non-operative management will normally take at
least 6 months so early surgical management may be
an option.
– Borens et al report good results with anterior tension band
plating in a four high performance female athletes.
36. Metatarsals
• The metatarsals most
commonly affected by stress
fractures are the 2nd and 3rd –
the classic ‘march fracture.’
• These are prone to stress
fracture because they have a
thin shaft but are subject to
high levels of strain during the
propulsive phase of running.
• They usually do well with nonoperative
management.
Stress fracture of the 3rd
MT with surrounding
tissue oedema
37. Navicular
• The majority of tarsal bone stress fractures occur in the navicular.
• They are usually linearly orientated in the central third of the navicular.
• They are often complicated by slow healing, delayed/nonunion,
osteonecrosis and re-fracture.
• Non displaced and non comminuted tarsal bone fractures may be treated
with conservative management with casting and non-weight bearing for
6 weeks.
• Displaced or comminuted fractures are indications for surgical
intervention, which may include screw fixation or autologous
bone grafting, depending on the nature and age of the fracture.
• Evaluation of footwear is important to prevent recurrence.
38. Metatarsals
• Stress fractures of the 5th metatarsal typically
occur at the proximal junction of diaphysis and
metaphysis and have a higher incidence of
delayed and non-union.
39. Talus
• The classic pattern of a talus stress fracture is
linear bone marrow oedema perpendicular to
the trabecular flow, paralleling the
talonavicular articulation at the talar neck.
40. Calcaneus
• Stress injury of the
calcaneum is due to
axial compression
forces and is often
seen in jumpers.
• It most commonly
involves the dorsal
posterior aspect.
Sagittal fat-saturated T2-weighted image
of the left ankle demonstrating a calcaneal
stress fracture. The hypointense fracture
line is seen surrounded by bone marrow
oedema (arrow).
41. Sacrum
• Sacral stress fractures are caused by vertical body forces from
the spine to the sacrum and then dissipated onto the sacral ala.
• These may present as low back or buttock pain, mimicking disk
disease, sciatica, or sacroiliac joint pathology.
• These fractures more commonly affect the female runner.
• MRI is highly sensitive in the detection of early sacral insufficiency
fractures, but as diagnosis may be difficult, CT and scintigraphy
may also be required.
– Bone scan classically shows uptake paralleling the sacroiliac joints.
– CT may show linear sclerosis with cortical interruption.
– MRI may show linear signal alteration paralleling the sacroiliac
joints.
43. Prevention
• Training intensity should be built up gradually with rest
periods built in to the regimen.
• Signs of stress fracture should be identified and
treated early.
• Female athletes and their trainers should be aware
of the high risk associated with menstrual dysfunction.
• Diet should be optimized to avoid oligomenorrhoea.
• Early MRI scanning is the key to diagnosis, prognosis
and intervention.