- The patient is a 38-year-old Thai man who was in a motorcycle accident after drinking alcohol. He complains of left knee pain for 3 hours.
- Radiographs show a fracture of the left tibial plateau and left fibula. Physical examination reveals tenderness over the left knee with limited range of motion due to pain.
- The diagnoses are a fracture of the left tibial plateau, a fracture of the left fibula, and a mild head injury. The patient is placed in a long leg splint and advised to remain non-weightbearing on the left leg. Close monitoring is needed for compartment syndrome or neurological changes.
the slide describes femoral fracture with case presentations as well as rediological diagnosis ,when opened and closed .the management from emergency period and through to stabilization
Spine and extremity injuries are common among people of all ages and can have a significant impact on mobility and quality of life. This PowerPoint presentation provides a comprehensive overview of spine and extremity injuries, including the causes, symptoms, and treatment options.
Through powerful images and personal stories, we showcase the impact of spine and extremity injuries on individuals, families, and communities. We highlight the challenges of accessing healthcare and rehabilitation services, particularly in low-resource settings, and the importance of early intervention and treatment.
The presentation provides detailed information about the various types of spine and extremity injuries, including fractures, dislocations, and soft tissue injuries. We also discuss the diagnostic procedures, including imaging tests and physical exams, and the treatment options, such as surgery, physical therapy, and pain management.
In addition, we explore the efforts being made to prevent and manage spine and extremity injuries. We highlight the importance of safety precautions, such as proper equipment use and ergonomic work practices, and the role of rehabilitation services in promoting recovery and restoring function.
Through this PowerPoint presentation, we aim to raise awareness about spine and extremity injuries and the importance of early diagnosis and treatment. We showcase the latest research and innovations in injury prevention and treatment, and the importance of collaboration and partnership to address the disease.
We urge the audience to take action in the fight against spine and extremity injuries, whether it be through spreading awareness, supporting organizations working on the ground, or advocating for policy change. Let us come together to create a world where everyone has access to the care and support they need to recover from spine and extremity injuries and live healthy, fulfilling lives.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
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.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
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?
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
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It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
4. Primary survay
A : can talk ,not tender along c-spine
B : normal breath sound ,equal breath sound ,CCT negative
C : BP 108/58 ,P 90, no active bleeding
D : E4M6V5 pupil 2 mm RTLBE
E : at picture
9. Diagnosis
• Cfx left tibial plateau
• AC ligament injury
• Mild head injury ( moderate risk)
10. Secondary survey
A ปฏิเสธแพ้ยาแพ้อาหาร
M no
P ปฏิเสธโรคประจาตัว
เคยประสบอุบัติเหตุMCล้มแขนซ้ายหักประมาณ1ปีก่อน
ได้รับการผ่าตัดซ่อมเส้นประสาทมือซ้ายอ่อนแรงอยู่เดิม
Chronic alcohol drinking
No smoking
L ประมาณ 18.00 น. ( 4 ชั่วโมงก่อนมารพ)
E ดื่มสุราขับMC ชนราวกั้นถนน
11. PHYSICAL EXAMINATION
Vital sign : BT 37.0, PR 90 bpm, RR20 /min, BP108/58
HEENT : not pale ,no jaundice , abrasion wound at lower lip 3 cm
Heart : normal S1 S2 , no murmur
Lung : Clear , equal breath sound ,CCT negative
Abdomen : soft ,not tender
Neuro : E4M6V5 pupil 2 mm RTLBE motor power gr 5 all escape
left hand gr 4 left leg limit due to pain , sensory intact
Extremity : tender at Right shoulder full ROM
left ulnar claw hand with old surgical scar
tender at left knee , Valgus and Varus Stress Test negative
mild swelling of left knee and leg
limit ROM due to pain ,DPA 2 + both leg
contusion at right leg ,mild tender
20. Overview
20
- Fractures of tibial plateau involve the articular surface
of the proximal tibia.
- Assessing associated soft tissue injuries around the
knee is critically important.
- Treatment conceps based on restoring or preserving
limb alignment
- Represent approximately 1% in adults.
- Fractures in men occur at a younger age and tend to be
the result of high energy trauma; women have
increasing incidence with advancing age.
THO Ch - of Tib#
Instable type Groans
Tmnt.
-
=
-
-
-
21. Assessment
21
- Mechanism of injury :
- In middle aged or elderly patients, simple falls
lead most commonly to lateral side.
- Higher speed injuries in younger patients from
sports can cause split fractures or rim avulsion fractures
associated with knee ligament injury.
- The energy of fracture results from a combination
of axially loading forces and angular forces
- Associated Injuries :
- Ligament and meniscal injury
- Soft Tissue Envelope
22. Assessment
22
- Physical examination:
- Knee Physical examination,
- special test can examine only in stable type.
- Neurovascular examination
- Communicating open wounds
- Compartment syndrome evaluation
- Radiograph
- Film knee AP/Lat
- CT
- MRI
joslignmeut
,
attenderpointt.ba/otterut
→ Distal pulses
-
-
'
b
Ttgligtsotltissuinjyyig
27. Outcome
25
- The factors that most predictably lead to favorable
outcome include patient factors, injury factors, and
factors involved with treatment.
- In general, tibial plateau fractures have favorable
outcomes if knee alignment is maintained and
complications are avoided.
- In comparing outcomes and arthrosis rates, the
articular surface of the proximal tibia appears to be
more tolerant to fractures than the ankle or hip
28. Treatment Options
26
- Nonoperative Treatment
- Cast immobilization up to 6 wks.
- Non weight bearing during the
initial weeks after injury, typically 4-8 wks.
- Operative Treatment
- Plates and Screw Fixation
- External Fixation IT
a
29. 27
- Operative Treatments indicated for displaced unstable
tibial plateau fractures.
- In young healthy patients, this will include almost all
bicondylar and shaft dissociated patterns, and all but
minimally displaced medial plateau fractures and lateral
plateau fracture patterns where valgus alignment will
occur.
- For the lateral patterns, the presence of a split fragment,
a depression affecting over half of the lateral articular
surface, a fibular head fracture, valgus alignment on
injury radiographs, and clinical valgus alignment on
exam are all strong indications for surgery.
Treatment Options
30.
31. Post Operative Care
28
- Non weight bearing or minimal weight bearing 6-12 wks.
- Early mobilizing the knee postoperatively.
- The early motion was much more important after operative
treatment, because knees immobilized for longer than 2 wks
tended to be stiff
he
