The document provides a history and overview of external fixators. Some key points:
- External fixators were first developed in the 1840s and have since been improved, including the addition of threaded pins, rods, and adjustable clamps.
- They are used to stabilize and immobilize long bone fractures, especially open or complicated fractures.
- Components include Schanz pins, tubes, and universal clamps. Proper placement of pins is important for stability.
- External fixators can be used temporarily to stabilize injuries before definitive fixation, or as the final fixation in cases where soft tissue healing is problematic. They provide less invasive fracture stabilization than internal fixation.
This is a lecture presentation on applying external fixator on open fracture specially on tibia. This method is a classical method. Various new and dynamic fixators are there but the basics are the same.
This is a lecture presentation on applying external fixator on open fracture specially on tibia. This method is a classical method. Various new and dynamic fixators are there but the basics are the same.
Intertrochanteric fractures and its management with DHS or PFN or Arthroplasty
SUMMARY
We should be able to minimize the morbidity associated with an intertrochanteric fracture by:
• Recognizing the fracture pattern.
• Choosing the appropriate fixation device.
• Performing accurate reduction.
• Ideal implant placement.
• Being conscious of implant COSTS.
Intertrochanteric fractures and its management with DHS or PFN or Arthroplasty
SUMMARY
We should be able to minimize the morbidity associated with an intertrochanteric fracture by:
• Recognizing the fracture pattern.
• Choosing the appropriate fixation device.
• Performing accurate reduction.
• Ideal implant placement.
• Being conscious of implant COSTS.
Nail plate and matrix selective resection is the proposed technic to resolve ingrowing toenail.
Experience of prospective fifty cases over forty two patients were considered.
No skin incision and no wedge or nailbed resection are the main differences with other cold knife techniques.
its a presentation showing some detailed informations about external fixation in orthopedic , talking about indications , methods , materials , and all what an undergraduate student might need .
also discussing the safe areas for insertion and application of external fixator , and also the pin site inection and the main treatment outlines
you will find it in a simple and summarized way , that the student can get benefit from and can use it well .
#orthopedic #external_fixation #external #fixation #pins #rods #clamps #titanium #infection #bone #surgery
A periodontal flap is a section of gingiva and/mucosa that is surgically separated from the underlying tissue to provide visibility and the access to the bone and the root surface. The flap also allows the gingiva to be displaced to a different location in patients with mucogingival involvement.
In this PowerPoint presentation, the periodontal flap is described under the headings: indication, contraindications, classification of flaps, flap design, horizontal and vertical incisions and various flap technique such as modified widman flap, undisplaced flap, palatal flap, apically displaced flap, papilla preservation flap and distal molar surgery for maxillary and mandibular molars. It also contains healing after flap surgery.
Amputation in simple definition is defined as cutting of bone which can be differentiated from Disarticulation as cutting through a joint.
Amputation is derived from latin words Amputare.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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
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.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
7. History
In 1917. Humphry is the 1st man who uses threaded pins,
but he uses only one pin above fracture and one below
the fracture site.
In 1948, Charnley popularized his compression device to
facilitate arthrodesis of joints.
7
8. History
In 1966 and 1974,Anderson et al. uses transfixing pins
incorporated into a plaster cast for management of
large series of tibial shaft fractures .
From 1968 to 1970 Vidal and Vidal et al. modified
original Hoffmann device from a single half –pin unit to a
quadrilateral bicortical frame , greatly increasing rigidity.
8
14.
Intrinsic
stability of frame (S)
EX I
S = ----------L
E=modulus of elasticity =constant
I= moment of intertia= constant
L= distance of frame from axis.
14
15. Biomechanics
Thus Stability is inversely proportional to the distance of
the assembly from the bone
(closer the frame to bone -more stable assembly)
15
16. To increase stability of bone –pin interface
1. Adequate no. of pins in each fragments
( 2 for most bone & 3 for femur)
2. Increase pin pitch (3.5mm)
3. Increase size of pin
16
17. Basic Components
A. Schanz Pin
4. 5mm short threaded for diaphysis
5/6 mm long threaded for metaphysis
B. Clamps
1) Universal Clamps
11) Open ended clamps
111) Transverse pin adjusting clamps
1v) Tube to tube clamps.
C. Tubes 11mm
17
19. Required instruments
Drill : Hand Drill
Drill bits – Long drill bits( 200mm) 3.5 and 4.5 mm
diameter.
Triple guide assembly , consist of trocar(3.5mm), inner
Sleeve and outer sleeve
T Handle for insertion of the Schanz pin.
19
23. Indications
severe open fractures (Gustilo 3b,3c)
closed fractures with severe soft-tissue injury or severely
comminuted fractures or floating knee #
open fractures involving bone loss
compartment syndrome after fasciotomy
adjunct to internal fixation
limb lengthening or bone transport
fracture associated with severe burn
Arthrodesis
Infected fractures or nonunions
Correction of malunions
Fixation after radical tumor excision with autograft or allograft
23
24. External fixator as temporary device
Soft tissue healed
If the soft-tissue injuries
have healed satisfactorily
within 2 weeks without pin
track infection, the external
fixation can be removed.
It is then replaced by
internal fixation with either
a plate or a nail.
24
25. External fixator as temporary device
Soft-tissue problems persist
Remove the external fixator
Temporarily stabilize in cast
Let pin track infection heal
If there is pin track infection, using a nail (especially with
reaming technique) can lead to intramedullary infection.
In this case plate osteosynthesis is clearly preferable.
25
26. External fixation as final fixation
In the event that soft-tissue
healing is not satisfactory after
4-6 weeks, and there is no pin
track infection, the external
fixator can be left on until the
fracture has healed.
In children fracture healing is
often completed within a period
of approximately 6-8 weeks.
26
28. Advantages
Less damage to blood supply of bone
Minimal interference with soft-tissue cover
Useful for stabilizing open fractures
Rigidity of fixation adjustable without surgery
Good option in situations with risk of infection
Requires less experience and surgical skill than
standard ORIF
Quite safe to use in cases of bone infection
28
30. IM nails vs External fixator
Henley (Clin. Orth., 1989) randomised study of
104 case II-IIIB tibial fractures by unreamed IM nail;
70 treated by external fixation.
Infection rates 7% IM nail, 11% external fixation.
There was no difference in time to union.
Follow up in 1998 (Journal Orth. Trauma.): “The severity
of soft tissue injury rather than the choice of implant
appears to be the predominant factor influencing
rapidity of bone healing and rate of infection”.
30
31. Site of insertion
Open fracture Tibia and Fibula
Open fracture Femur
Floating Knee
Open Fracture Humerus
Communited fracture distal Radius
Pelvic fracture.
31
38.
After adequate skin incision Insert assembled triple
sleeve and push onto bone.
Hold the sleeve steady and lightly tap the trocer on to
the bone surface in order to create the initial
impression. This prevents slipping of the drill bit during
drilling.
38
39. Technique of Applications
Remove the trocar, insert the long 3.5 drill bit through
inner sleeve and drill through both cortices.
Withdraw the drill bit along with inner sleeve. Insert 4.5
mm drill bit through the outer sleeve and over drill the
near cortex.
39
40. Technique of Applications
Place a 4.5 mm Schanz Pin onto the T-handle.
Introduce through the outer sleeve and insert into the
bone till the thread are securely engaged into the far
cortex.
40
41. Technique of Applications for metaphysis
Insert the triple sleeve through an adequate skin
incision and push onto bone.
Drill the both cortex bone with 3.5 mm drill bit.
Insert 5mm long threaded Schanz Pin with T-handle.
41
42. Application of external fixator
Place the most distal
Schanz Pin using the
standard technique.
Place a universal clamp
onto the schanz pin
Fix a 11mm tube in this
clamp, so that it is
posterior to the schanz
pin.
42
43. Application of external fixator…
Slide 3 Universal clamps
onto this tube.
Insert most proximal
schanz pin.
Reduction of bone.
Fix the proximal schanz
pin.
43
44. Application of external fixator…
Insert the 3rd 4th schanz
pin accordingly.
Connect frame with
another Tube.
Second tube is clamped
in “mirror image” fashion
after prestressing.
44
48. Built as uni- and multi- plane constructs
Areas prone to soft tissue problems
◦ Knee
◦ Ankle
◦ Open Fractures
When multiple injuries prevent
definitive fixation
48
51.
Temporary stabilization of long bone injuries in
unstable patient
◦
◦
◦
◦
◦
Minimally invasive
Decreases bleeding
Pain control
Nursing care
“Damage control”
51
52. Certain intraarticular fracture can be treated by
ex-fix using traction by fixator on the capsule and
ligamentous structure around the joint.
This work well for comminuted intraarticular
fracture of the distal radius.
52
53. Temporary stabilization for closed fractures
Controls hemorrhage
Decreases clot shear
Open pelvic fractures
53
58.
Micro-motion at fracture Site.
It is bi-lateral
More lighter than traditional External Fixator.
More ligamentotasis
Less chance of pin tract infections.
58
60.
The modular external fixator allows the
surgeon to reduce the fracture by
manipulation and to hold the reduction.
Free pin placement allows the surgeon:
◦ to spread both pins, thereby increasing
frame stiffness,
◦ to position pins according to the fracture
pattern or soft-tissue injury,
◦ to avoid injury to nerves or vessels.
60
63.
External Fixator is a good device for the management of
open and complicated fractures.
Surgeon must have knowledge about neurovascular
plane of the involved Organ.
Skill for applying the fixator.
63