- A 59-year-old Thai female presented to the emergency department with left wrist pain after falling on her outstretched left hand 4 hours prior.
- Physical examination revealed swelling and tenderness of the left wrist with limited range of motion due to pain. X-rays showed a left distal end radius fracture with an associated left ulnar styloid fracture.
- The patient was diagnosed with left distal radius and ulnar styloid fractures. She received sedation and closed reduction with application of a long arm splint.
We present a novel surgical technique, that involves the use of two unilateral placed portals to accomplish a full cervical endoscopic laminoforaminotomy on a 39 yo male suffering from a left C7 radiculopathy. See the presentation and video included.
We present a novel surgical technique, that involves the use of two unilateral placed portals to accomplish a full cervical endoscopic laminoforaminotomy on a 39 yo male suffering from a left C7 radiculopathy. See the presentation and video included.
Dr.MD.Monsur Rahman,PT
MPT-Musculoskeletal Disorders
Maharishi Markandeshwar Institute Of Physiotherapy And Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana - Ambala,133-207 (Haryana)
Detail case discussion of dupuytren's contracture including clinical aspect and theoretical aspects.
Dupuytren's is progressive superficial palmar fibromatosis, involves superficial palmar fascia of hand and causes contracture and severe disability in advance disease.
Case discussion done under Platiquest channel.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
3. Primary Survey
• A : able to talk, not tender along C-spine
• B : Trachea in midline, spontaneous breathing, equal and
clear breath sound both lungs, no subcutaneous emphysema
• C : BP 154/75 mmHg, PR 99 bpm, no external bleeding
• D : E4V5M6, Pupil 3 mm RTLBE
• E : Tender and swelling at radial side of left wrist, Limit ROM
of left wrist due to pain, full ROM of finger,elbow and shoulder,
cap refill < 2 sec, Radial artery 2+, Left fingers full ROM
3
4. Secondary Survey
• A : ปฏิเสธประวัติแพ้ยา แพ้อาหาร
• M : รับประทานยาลดความดันโลหิตสูง
• P : no known u/d , no history of surgery
• L : Last meal 12.00
• E :สะดุดล้มใช้มือซ้ายยันพื้น ไม่สลบ จาเหตุการณ์ได้ เจ็บบริเวณข้อมือซ้าย ไม่มีส่วนอื่นกระแทก
4
5. Physical Examination• GA : Good consciousness
• HEENT : Not pale conjunctivae, no facial deformity, full ROM of
neck, not tender along c-spine
• Heart : Pulse full and regular, Normal S1S2, No murmur
• Lungs: trachea in midline, equal chest movement, equal and clear
breath sound both lungs
• Abdomen, No distension, Soft, Not tender
• Extremities : Tender and swelling at radial side of left wrist, Limit
ROM of left wrist due to pain, full ROM of finger,elbow and shoulder,
cap refill < 2 sec, Radial artery 2+, Pinprick sensation intact, Left
fingers full ROM
• Neurological exam: E4V5M6, Pupil 3 mm RTLBE, Motor grade V all 5
14. Distal end radius fracture
• Approximately 17.5% of all fractures treated by orthopedic surgeons
• Three main peaks of fracture distribution:
- Children age 5-14
- Males under age 50 (High velocity)
- Females over the age of 50 years (Low velocity)
• Elderly (Mostly extra-articular)
• Young (Mostly intra-articular)
• Elderly patient risk factors : Osteoporosis(Decreased bone mineral density),
female gender and early menopause
14
15. Anatomy
• Scaphoid and lunate fossa
- Ridge normally exists between these two
• Sigmoid notch
- Second important articular surface
• Triangular fibrocartilage complex (TFCC)
- Distal edge of radial to base of ulnar styloid
• Interosseous Ligament
- scapholunate and lunatriquetral ligament
15
17. Assessment&Diagnosis
• History of mechanism of injury
• A visible deformity of the wrist is usually noted, with the hand most
commonly displaces in the dorsal direction.
• Movement of the hand and wrist are painful
• Adequate and accurate assessment of the neurovascular status of the hand
Is imperative. (Median nerve involvement – Carpal tunnel syndrome)
17
18. Assessment&Diagnosis
• Evaluation of the injured joint, and a joint above and below (ipsilateral elbow
and shoulder joint)
• Radiographs of the injured wrist (PA & Lateral)
• Radiographs of other areas, if symptoms warrant
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26. Indication for Non-operative treatment
• Low-energy fracture
• Low-demand patient
• Medical co-morbidities
• Minimal displacement-acceptable
alignment
26
27. 27
• Apply well-molded splint or cast, with wrist in
neutral to slight flexion
• Check X-ray to confirm the acceptable
reduction
• Follow up x-rays needed in 1-2weeks to
evaluate reduction
• Change to short arm cast after 2-3 weeks,
continue until fracture healing.
28. Indication for Operative treatment
• Unstable
• Fernandez type II, IV, V and some case in I, III
• Lafontaine criteria >3 of 5 instability parameters
• Dorsal angulation >20 degree
• Dorsal comminuted
• Intra-articular radiocarpal fracture
• Ulnar fracture
• Age >60
• Secondary displacement after casting
28
29. Indication for Operative treatment
• Irreducible fracture
• Double die punch
• Displaced comminuted fragment
• Articular step off > 2mm
• Severe comminution
• Shortening > 5mm
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30. Indication for Operative treatment
• Unacceptable alignment
• Radial inclination < 15 degree
• Shortening > 5 mm
• Dorsal tilt > 10 degree
• Volar tilt > 20 degree
• Articular step off or gap >2mm
• Open fracture
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