1) The document discusses various types of upper limb trauma including fractures and dislocations of the shoulder, elbow, forearm, wrist and hand.
2) Signs and symptoms, mechanisms of injury, clinical evaluation including relevant tests and imaging, complications and treatment options are described for conditions like shoulder dislocation, humeral fractures, supracondylar humerus fractures, forearm fractures and wrist fractures.
3) Common fractures discussed include Colles fracture of distal radius, supracondylar humerus fractures in children, lateral condyle humerus fracture and Bennett's and Rolando fractures of the thumb.
4) Different types of splints used for immobilization like K wire splint,
Hoffa's Fracture: Diagnosis, management & New Classification System by BAGARI...Vaibhav Bagaria
Hoffa's Fracture - coronal split fracture of distal femur, its diagnosis, management strategy, a new classification and tips and tricks of management. First described Hoffa, a new classification system by Bagaria et al helps plan the surgery for these tricky fracture. The most crucial step is not to miss these fractures in ER.
Posterolateral corner injuries of knee joint Samir Dwidmuthe
Missed posterolateral corner injuries of knee joint is a common cause for failure of ACL and PCL reconstruction only next to malpositioned tunnels.
Isolated PLC injuries are uncommon, making up <2% of all acute knee ligamentous injuries. Covey JBJS 2001
Incidence of PLC injuries associated with concomitant ACL and PCL disruptions are much more common (43% to 80%). Ranawat JAAOS 2008
A recent (MRI) analysis of surgical tibialplateau fractures demonstrated an incidence of PLC injuries in 68% of cases. Gardner JOT 2005
Take home message
PLC injuries to be ruled out in every case of ACL& PCL rupture.
Neurovascular integrity to be checked in every case.
Grade I & II can be managed conservatively.
Grade III Acute- Repair.
Grade III Chronic- Anatomic PLC recon.
Beware of varus knee alignment.
describing the decision making process in deciding which implant to use for trochanteric fractures and its complications - done for Basic AO course in Bengbu, China
Hoffa's Fracture: Diagnosis, management & New Classification System by BAGARI...Vaibhav Bagaria
Hoffa's Fracture - coronal split fracture of distal femur, its diagnosis, management strategy, a new classification and tips and tricks of management. First described Hoffa, a new classification system by Bagaria et al helps plan the surgery for these tricky fracture. The most crucial step is not to miss these fractures in ER.
Posterolateral corner injuries of knee joint Samir Dwidmuthe
Missed posterolateral corner injuries of knee joint is a common cause for failure of ACL and PCL reconstruction only next to malpositioned tunnels.
Isolated PLC injuries are uncommon, making up <2% of all acute knee ligamentous injuries. Covey JBJS 2001
Incidence of PLC injuries associated with concomitant ACL and PCL disruptions are much more common (43% to 80%). Ranawat JAAOS 2008
A recent (MRI) analysis of surgical tibialplateau fractures demonstrated an incidence of PLC injuries in 68% of cases. Gardner JOT 2005
Take home message
PLC injuries to be ruled out in every case of ACL& PCL rupture.
Neurovascular integrity to be checked in every case.
Grade I & II can be managed conservatively.
Grade III Acute- Repair.
Grade III Chronic- Anatomic PLC recon.
Beware of varus knee alignment.
describing the decision making process in deciding which implant to use for trochanteric fractures and its complications - done for Basic AO course in Bengbu, China
this ppt is based on clinical anatomy related with upper limb which will help all medical students to understand the upper limb related clinical situations for the diagnostic purposes.
JOINT DISLOCATION of hip knee and shoulder PART-2.pptxrammmramm000
JOINT DISLOCATION of hip knee and shoulder
JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder
JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder
JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder
JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder
JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder
JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip knee and shoulder JOINT DISLOCATION of hip kn
Supracondylar humerus fracture & complication for MBBS studentsYash Oza
Fracture classification, xray, complication, reduction method, surgery, cast, vascular injury, nerve injury, all the Undergraduate students should know is included
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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
- 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
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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 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
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.
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.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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
4. Head of Humerus loses its articulation from
the Glenoid:
• Anterior dislocation >95% (Preglenoid;
Subcoracoid; Subclavicular)
• Posterior dislocation <5%
• Inferior dislocation (Luxatio erecta)
<1%(Subglenoid)
5. Anterior Dislocation
Causes: Frequently seen in younger patients after trauma such as in RTA or sports.
Posterior Dislocation
Causes: Usually the result of discoordinated rotator cuff muscle contraction seen in Electric shock,
Seizures, etc.
Examination: Humeral head is prominent, asymmetry, reduced ROM.
Assess neurovascular status. Commonly the axillary nerve is affected, check for numbness
over the regimental patch (Skin over deltoid insertion) or deltoid muscle paralysis is seen.
6. Clinical Tests
• Dugas’ test
• Hamilton ruler test
Radiographic Evaluation
• True AP shoulder: Head of humerus can be seen lying beneath coracoid
• Axillary view: Head of humerus lying anterior or posterior to glenoid
9. Complications of Shoulder Dislocation
• Recurrent dislocation; common in patients <20 years of age.
• Rotator cuff injury; common in middle aged and elderly.
• Greater tuberosity fractures.
• Axillary nerve injuries; deltoid paralysis and loss of sensation over regimental badge area.
• Shoulder stiffness
14. Epidemiology
• Clavicle fractures are one of the most common injuries of upper limb
• Account for 5-10% of all fractures
• Easy to diagnose
• Majority unite uneventfully
• Can happen during childbirth
15. ›History›: Age is often Elderly with a H/O Trauma or Fall.
C/O: Pain, Swelling & inability to lift the upper limb.
O/E: Always compare both sides.
• Limitation of motion
• Bruising, tenderness, crepitus, deformity
• Arm usually held across the chest with the opposite limb supporting it
• Look for associated injuries such as Neurovascular deficit,
pneumothorax, etc.
Diagnosis
16. • AP Xray
- evaluate superior inferior displacement
• 45degree cephalic tilt view
- evaluate AP displacement
• CT-scan
Radiographs
20. • Fracture of diaphysis of the humerus
• Causes: Usual cause is direct trauma/Fall on an outstretched hand
• Fracture pattern depends on the stress applied.
• Symptoms: Pain, swelling, decreased ROM
• Examination: Assess Neurovascular status. Most commonly the radial nerve is affected
(Supplies motor innervation to the wrist extensors causing wrist drop)
21.
22. Holstein-Lewis Fracture
• Distal 1/3 fracture of Shaft of Humerus
• May entrap or lacerate radial nerve as the
fracture passes through the intermuscular
septum
23. Clinical evaluation
• Thorough history and physical
• Patients typically present with pain, swelling,
and deformity of the upper arm
• Careful NV exam important as the radial nerve
is in close proximity to the humerus and can be
injured
24. Treatment
- Closed reduction and immobilisation
• U-Slab
• Hanging cast
• Chest arm bandage
- Open reduction and internal fixation
26. Types
It depends upon the displacement of the distal fragment.
• Extension type (80%)
• Flexion type (20%)
Presentation
• Pain, swelling, deformity and inability to move the affected elbow.
• Unusual posterior prominence of the elbow because of backward tilt of
distal fragment.
• 3 bony points relationship is maintained.
31. Lateral Condyle Humerus Fracture
• 2nd most common fracture of the elbow in children
• Age group; 4-10 years
32. Clinical Presentation
• Pain
• Swelling
• Restriction of movement
• Skin changes or wound
• Bony crepitus
Mechanism of injury
• Fall on the extended upper extremity with
axial load transmission causing radial
head to impinge on lateral condyle (Push
off theory)
• Avulsion injury due to pull of strong wrist
extensors (Pull-off theory)
34. Complications
• Nonunion, leading to Cubitus valgus deformity
• Tardy Ulnar Nerve palsy; late complication of
progressive cubitus valgus
• Malunion
• Growth Arrest
• Lateral spurring
37. • Radial shaft fracture at junction of
middle and distal thirds with
disruption of distal radio-ulnar joint.
• Fall on outstretched hand.
• Suspect if tenderness at distal radius
and distal radial ulnar joint (DRUJ)
disruption
Galeazzi’s Fracture
38. • Transverse or oblique fracture at junction
of middle and distal thirds seen on AP
view
• Widening of DRUJ on AP view
• Radial shortening >5mm
• Dislocation of radius relative to ulna on
lat view
Radiographic Evaluation
Treatment
• Open reduction and internal fixation
with anatomic reduction.
39. • Fracture of proximal 1/3rd of ulnar shaft with
dislocation of radial head
• Fall on outstretched, extended, and pronated
elbow is usual mechanism
• Radial head may be palpated in antecubital
fossa
• Posterior Interosseus nerve injury.
Monteggia’s Fracture
41. • Most common fracture of the distal radius
(Cortico-cancellous junction)
• Results from a fall on an outstretched hand
(FOOSH)
Examination
• Dorsal swelling
• Ecchymosis
• “Silver fork” deformity of the hand and wrist
Colles’ Fracture
43. Radiographs
• AP & Lateral views
• Fracture line prominent at portico-cancellous
junction of distal radius
• Dorsal tilt is most characteristic displacement
• Typically occurs within 2cm of distal radius articular
surface
44. Treatment
• Closed reduction and plaster immobilisation
• Closed reduction with K wire fixation
• Open reduction and internal fixation using plates
46. • Less common fracture of distal radius
• Unstable fracture
• Fall on the flexed wrist with forearm fixed in supination
• Distal fragment is displaced volarly and proximally (apex
dorsal)
• Direct blow to dorsum of the wrist
• Treatment is generally done by open reduction and
internal fixation due to unstability
Smith’s Fracture
49. Epidemiology
• The most frequent fractured bone of the wrist
• 10-15% of all hand and wrist fractures
• 60-80% of carpal fractures
• Waist 65%
• 1/3 distal 10%
• 1/3 proximal 15%
50. Mechanism
• Axial load over hyperextended and radially
deviated wrist
Examination
• Wrist pain
• Swelling
• Tenderness in the anatomic snuffbox
54. • Intra articular fracture through the base of 1st metacarpal
• Disruption of 1st CMC Joint
Mechanism of injury
• Axial blow directed against the partially flexed metacarpal
• Commonly sustained in fistfights
55. Radiograph:
• Treatment by fixation with K-wires & immobilisation with thumb spica cast
• Generally Closed reduction is enough but sometimes Open reduction is needed
56. Rolando Fracture
• T or Y shaped intra articular fracture involving the
base of 1st metacarpal
• Does not cause diaphyseal displacement of the shaft
as seen with Bennet’s fracture
• Treatment by fixation with K-wires & immobilisation
with thumb spica cast
57. • Any material which is used to support a fracture is called a splint.
• Splints are used for immobilizing fractures either temporarily during transportation or for
definitive treatment.
• Rule of splintage is to immobilize a joint one above and one below the fracture.
SPLINTS
58. Krammer Wire Splint
• Used for temporary quick splintage of a limb for
transport.
• Two thick parallel wires with ladder like thin
wires.
• Malleable, can easily be bent to the contour of
limb.
59. Triangular sling
• Used when there are injuries to the upper limb and
for some chest injuries.
• It holds the arm in adduction & forearm across the
chest.
• Used as first aid and is a temporary measure.
60. Buddy Strapping of fingers
• Buddy strapping is used for undisplaced proximal
or middle shaft phalynx fractures or sprains.
• It refers to the practice of bandaging an injured
finger to an uninjured one.
• The uninjured digit acts as a sort of splint, and
helps to support, protect, and realign the injured
finger.
61. Above Elbow Slab
• Used for forearm fractures and
fractures around the elbow.
• Proximally; at insertion of deltoid
muscle
• Distally; proximal to metacarpo-
phalangeal joint
62. Below Elbow Slab
• Used for metacarpal and wrist fractures.
• Proximally; below the elbow joint
• Distally; proximal to metacarpo-
phalangeal joint.