Fracture of fmur
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The document discusses the management of femoral shaft fractures in children. Femoral shaft fractures represent less than 2% of fractures in children and are difficult to manage clinically, socially, and economically. They occur most commonly in boys and are usually caused by falls or sporting/vehicle collisions. Emergency management involves exclusion of other injuries, immobilization, and imaging. Treatment depends on the child's age and weight, and may involve non-operative methods like casting or traction for younger children, or operative methods like intramedullary nailing for older children.
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Developmental dysplasia of hip 1
Developmental dysplasia of the hip (DDH) refers to a spectrum of abnormalities where the femoral head is not properly seated in the acetabulum. DDH can range from mild dysplasia to complete dislocation. Predisposing factors include breech positioning, female sex, and family history. Diagnosis involves clinical examination of the Ortolani and Barlow signs in infants as well as ultrasound and x-rays. Treatment goals are reduction and maintenance of reduction to allow joint development. For infants under 6 months, the Pavlik harness is most commonly used and aims to maintain flexion and abduction of the hip. Success rates are high if used full-time for 6 months, monitoring progress regularly with examination and ultrasound.
Developmental dysplasia of hip 1
Developmental dysplasia of the hip (DDH) refers to a spectrum of abnormalities where the femoral head is not properly seated in the acetabulum. In newborns, DDH ranges from mild dysplasia to severe dislocation. The goals of treatment are to reduce the hip and maintain the reduction to allow for normal development of the femoral head and acetabulum. Treatment may involve use of a Pavlik harness or splint for young infants or closed or open reduction for older children. Early diagnosis and treatment are important to achieve an optimal outcome, while late or untreated DDH can lead to secondary problems like limp length inequality.
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Perthes disease is a condition that affects the blood supply to the femoral head, causing bone death. It most commonly affects children between 4-8 years old. While the exact cause is unknown, it is believed to be due to problems with the blood vessels supplying the femoral head. Symptoms include limping and hip pain. Diagnosis is made through x-rays which can stage the progression of the disease from early to late stages. Treatment aims to contain the hip through non-operative or operative methods like casts or osteotomies, with the goal of relieving symptoms and restoring hip function. Outcomes depend on factors like age of onset and how much of the femoral head is involved.
Developmental dysplasiahip
Developmental dysplasia of the hip (DDH) is a spectrum of hip disorders that can include dislocation, subluxation, or dysplasia. It was previously known as congenital hip dislocation. Risk factors include breech presentation, family history, ligament laxity, female sex, and nursing position. Clinical diagnosis involves the Ortolani and Barlow tests. Ultrasound screening can identify dysplastic or dislocated hips and monitor treatment. Treatment for infants under 6 months aims to reduce the femoral head using a Pavlik harness to stimulate acetabular development. Without treatment, instability often leads to degenerative joint disease in adulthood.
Fracture Neck Of Femur
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Fracture of fmur
- 1. A PROJECT WORK ON FRACTURE OF FEMUR BY PRABHAT KUMAR KESHAV 5TH YEAR ,4TH GROUP
- 2. âĸ FEMORAL SHAFT FRACTURE âĸ FEMORAL SHAFT FRACTURE REPRESENTS LESS THAN 2% of fracture in childhood but difficult to manaage,clinically,socially,and economically.they present in a bionomal distribution,with fracture occuring in early childhood,due to the relatives weakmess in cortical strength at the age,and the later in in the mid-adolescence,due to high energy associated with road traffic accidents.at all ages ,femoral shaft fracture are most comman in boys with overall ratio of male to female is 2:6:1. âĸ Other important causes of femoral shaft fracture includes non-accidental injury and pathological fractures.nai has ben shown to account for up to 50% OF femoral fracture presenting below the age of 4 and should be actively ruled out if a child is below the age 4.
- 3. EMERGENCY DPARTMENT MANAGEMENT âĸ The history is commenly of a full from a height, or a sporting or vehicle collisiion.other injuries must be excluded by formal primary and secondary durvey and appropriate fluid resuscitation should be started. âĸ The thigh will be deformed o swollen. âĸ A carefull neurovascular assesment is requiered. âĸ IMMOBILIZATION âĸ Reduce any gross deformety with splintage or traction under procedural sedation and analgesia prior to obtaining imaging.
- 4. Radiological feature âĸ AP and lateral view of the femur:plain radiograph should be taken ,including the hip and the knee joint. âĸ Hip or knee series :if a proxiamal or dstal extention is suspected, viewed centre over the affected joint will help to identify periphysial or intra-articular involvement. âĸ MRI:if pathological fracture is suspected then mri is needed.
- 5. ORTHOPEDIC MANAGEMENT âĸ The management stratgy for a prediabetic femoral shaft fracture is largely based on the childs age and weight.however it will also tke cosideration the wishes and social circumstances of the family,locla expertiseand equipment,and the potential drawbacks of prongled hospitalization versus the complications associated with surgery. âĸ NON-OPERATIVE âĸ Children upto age 5 year is managed non-operatively.
- 6. table âĸ Pavllic harness âĸ Gallow traction âĸ Balanced traction âĸ Spica casts âĸ OPERATIVE âĸ Flexible intramedullary nailing âĸ Plating âĸ Intramedullary nailing âĸ External fixation
- 7. SURGICAL TECHNIQUE âĸ THIS IS SUITABLE FOR PATIENTS >45 YEARS OF AGE. âĸ RETROGRADE TECHNIQUE âĸ ANTEGRADE TECHNIQUE âĸ POST OPERATIVE MANAGEMENT âĸ Apply light dressing for 3-4 days. âĸ Encourage range of motion exercise for the hip and knee plus isometric muscles rehabillation as soon as the patient is comfotable.touch weight bearing is allowed initially unless it is a length unstable fracture. âĸ Progess to full weight bearning when callus is seen.