1. General Principles of Fractures discusses the different types of fractures including closed/simple, open/compound, incomplete, complete, displaced, undisplaced, linear, comminuted, and atypical fractures.
2. Fractures are classified based on their extent and fracture pattern. Clinical features include pain, swelling, deformity, and inability to use the affected part. Investigations include radiography and CT/MRI scans.
3. Management of fractures includes closed reduction techniques like casting or open reduction with internal fixation using plates, screws, nails or wires depending on the fracture type. The goal is to restore normal anatomy and prevent long-term disability.
Colles fracture is the fracture at the distal end of radius, at its
cortico cancellous junction(about 2cm from the distal articular
surface).
It is not just the fracture of distal radius but the fracture
dislocation of the inferior radio-ulnar joint.
The presentation is for the use of Physiotherapy students. It covers a brief introduction, classification, clinical features and general principles of management.
Colles fracture is the fracture at the distal end of radius, at its
cortico cancellous junction(about 2cm from the distal articular
surface).
It is not just the fracture of distal radius but the fracture
dislocation of the inferior radio-ulnar joint.
The presentation is for the use of Physiotherapy students. It covers a brief introduction, classification, clinical features and general principles of management.
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Amputation is of the common surgical procedure done in the ER. This is also common in various routine cases. This presentation covers various aspects of amputation including steps of below knee amputation. The background has been changed from the previous one to hide the brutality of this procedure.
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 presentation was Shown on a community gathering in Gulshan Club Dhaka on the eve of the World Osteoporosis Day, 2010.
Prof. Shahiduzzaman was the key note speaker.
New zeland Dairy Milk was the organiser of this Seminar.
1. General Principles of Fractures Muhammad Shahiduzzaman Professor and Head Department of Orthopaedic Surgery Dhaka Medical College
2. Definition Break in the continuity of bone. It is basically a soft tissue trauma where the bone happens to be broken.
3. Types of Fractures Simple or Closed Bone can break within its soft tissue envelope and may not communicate to the exterior. Compound or Open When the fracture haematoma communicates with the exterior.
5. Types of fracture Based on extent of fracture line: Incomplete Fracture Complete Fracture – Displaced, Undisplaced Based on fracture pattern : Linear fractures- Transverse, oblique, spiral Comminuted Fractures. Segmental fractures
10. Remember Greenstick fracture-occurs in children. Stress fracture- common in athletes. Fatigue fracture- in occupation like police Pathological fractures-usually seen in elderly.
11. Approach to Orthopaedic injury History Age: Birth, early childhood, Late childhood Adult, Elderly. Sex Mechanism of injury
12. Clinical Features Symptoms: Pain, Swelling, deformity, inability to use the affected part. O/E Look – Deformity, swelling, Shortening Feel: Tenderness, Move : Abnormal mobility, Crepitus
13. Remember Clinical manifestation in a fracture is due to : Fracture per se ,Its complications or both Impendening vascular damage is detected by five ‘P’ Pain, Pallor, Paraesthesia, Pulselessness, Paralysis
14. Investigations in Orthotrauma Radiography- most important diagnostic tool for fractures. Minimum two views (AP and Lateral) are required. Sometimes an oblique and other special views are required. CT Scan and MRI – both are noninvasive and extremely useful in detecting both soft tissue and bony injury.
15. Remember the rules in X-ray Better no X-ray than one view X-ray X-ray is a shadow. It conceals and distorts so Interpret x-ray with caution. A joint above andjoint below should be included with the fracture under study. Read x-ray holding it in anatomical position. Exposure should be adequate.
16. Management of Fracture The goal of fracture management is to restore the anatomy back to its normal or near to normal as possible. The responsibility of the doctor is to ensure that there is no functional disability to the patient following the treatment of fracture.
17. Management of fractures Can be discussed under the following : Management of closed uncomplicated fracture Management of open fracture Management of complicated fracture.
18. Management of closed fracture Managed by conservative or operative methods. Conservative methods : For undisplaced #,incomplete #,Impacted # : Collar and cuff sling, Strapping, plaster slab, For displaced fracture : the aim is to restore anatomy as near as possible by either closed or open reduction.
20. Management of # by closed reduction Resuscitation, Reduction Retention Rehabilitation
21. Fracture management by open reduction Where closed reduction fails Displaced intra articular fractures Type III and IV epiphyseal injuries Major avulsion fracture Nonunion Multiple fractures
22. Retention after open reduction Fracture fragments invariably needs to be fixed by various implants. Choice of implants K-wire Intramedullary nails Plate and screw Interlocking nail Hip implants, Spine implants, Steel wires