Orthofaipun
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This document summarizes the case of a 49-year-old Thai female patient who presented with left hip pain for 5 hours after falling from her motorcycle. Examination revealed tenderness and limited range of motion of the left hip with shortening and external rotation of the left leg. X-rays showed a displaced Garden IV femoral neck fracture. The document then reviews femoral neck fracture epidemiology, anatomy, signs and symptoms, investigations, classification systems, management options including fixation versus arthroplasty depending on patient age and fracture characteristics, and potential complications.
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Ortho..
- 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.
Ortho
This document summarizes a case of a 9 year old female who presented with right leg pain for 2 hours after a bicycle accident. On examination, she had deformity, swelling and tenderness of the right ankle with limited range of motion due to pain. X-rays showed close transverse fractures of the right distal tibia and fibula with minimal displacement. The diagnosis was close fractures of both bones of the right leg. Management included pain control, possible closed reduction, application of a long leg posterior splint, and monitoring for compartment syndrome. The document then reviews general knowledge of tibia and fibula fractures including mechanisms of injury, signs and symptoms, radiological findings, and treatment options such as cast immobilization or surgery.
Extern conference ortho
This document describes the case of a 69-year-old Thai man who presented to the emergency department with right thigh pain after falling 1.5 meters from the roof of his house. On examination, he had swelling and tenderness of the left thigh with limited range of motion. Radiographs revealed an intertrochanteric fracture of the left femur. Intertrochanteric fractures occur between the greater and lesser trochanters and are common in elderly patients, often resulting from low-energy falls. Treatment depends on the stability of the fracture but may involve internal fixation with screws or cephalomedullary nails. Complications can include malunion, nonunion, and loss of fixation.
Extern conference may
- An 11-year-old Thai girl presented with left elbow pain and swelling after being knocked over by a dog at home. She had limited range of motion of her left elbow due to pain.
- X-rays showed a closed fracture of the left supracondylar humerus, classified as a Gartland type II.
- Supracondylar fractures are the most common elbow fractures in children and usually result from a fall onto an outstretched hand. They can cause deformity, swelling, and nerve injuries depending on the type and severity of the fracture.
- Treatment options include casting or surgery depending on the fracture type and degree of displacement. The goal is to restore the elbow
Ortho conf
A 68-year-old Thai male was in a motorcycle accident and suffered injuries including an open fracture of the right tibia and fibula and a closed fracture of the right distal femur. At the emergency room, he received pain control, antibiotics, tetanus vaccination, and external fixation of the tibial fracture. He was then admitted to the trauma surgery ward to monitor for vascular injury before being transferred to orthopedics. He will require further treatment including definitive fixation of the fractures and management of open fractures according to Gustilo-Anderson classification. Complications of "floating knee" injuries which involve both femur and tibia fractures can include ligament injuries, neurovascular problems, and infection.
Ortho con supra copy
The document summarizes an orthopedic case of a child who fell from a table and injured his left arm. On physical examination, the child's left elbow was swollen and deformed with limited range of motion due to pain. X-rays revealed a complete transverse fracture at the supracondylar region of the left humerus with total posterior-medial displacement, classified as a Gartland Type III injury. The child underwent closed reduction and percutaneous pinning of the fractured elbow. Post-operatively, the child will need elevation, pain control, range of motion exercises, and pin removal after 3-4 weeks once the fracture has healed. Complications of this type of injury can include nerve damage,
Noon conference hangman
A 35-year-old man fell and hit the back of his head on the ground after drinking alcohol. He was brought to the emergency room 4 hours later with pain in his head and neck. On examination, he had a 2 cm laceration on the back of his skull but was neurologically intact. Imaging showed a hangman's fracture. He was placed in a hard cervical collar, the wound was sutured, and he was started on skull traction and a Philadelphia collar for the hangman's fracture.
.Ortho.
An 81-year-old Thai woman presented to the hospital with left hip pain after falling three days prior. Imaging revealed a Garden type 3 fracture of the left femoral neck. She was diagnosed with a displaced left femoral neck fracture. Her treatment plan included pain control, skin traction of the left leg, and a left bipolar hemiarthroplasty surgery. Femoral neck fractures typically result from low-energy falls in older patients and require prompt surgical management to reduce complications.
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Ortho..
- 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.
Ortho
This document summarizes a case of a 9 year old female who presented with right leg pain for 2 hours after a bicycle accident. On examination, she had deformity, swelling and tenderness of the right ankle with limited range of motion due to pain. X-rays showed close transverse fractures of the right distal tibia and fibula with minimal displacement. The diagnosis was close fractures of both bones of the right leg. Management included pain control, possible closed reduction, application of a long leg posterior splint, and monitoring for compartment syndrome. The document then reviews general knowledge of tibia and fibula fractures including mechanisms of injury, signs and symptoms, radiological findings, and treatment options such as cast immobilization or surgery.
Extern conference ortho
This document describes the case of a 69-year-old Thai man who presented to the emergency department with right thigh pain after falling 1.5 meters from the roof of his house. On examination, he had swelling and tenderness of the left thigh with limited range of motion. Radiographs revealed an intertrochanteric fracture of the left femur. Intertrochanteric fractures occur between the greater and lesser trochanters and are common in elderly patients, often resulting from low-energy falls. Treatment depends on the stability of the fracture but may involve internal fixation with screws or cephalomedullary nails. Complications can include malunion, nonunion, and loss of fixation.
Extern conference may
- An 11-year-old Thai girl presented with left elbow pain and swelling after being knocked over by a dog at home. She had limited range of motion of her left elbow due to pain.
- X-rays showed a closed fracture of the left supracondylar humerus, classified as a Gartland type II.
- Supracondylar fractures are the most common elbow fractures in children and usually result from a fall onto an outstretched hand. They can cause deformity, swelling, and nerve injuries depending on the type and severity of the fracture.
- Treatment options include casting or surgery depending on the fracture type and degree of displacement. The goal is to restore the elbow
Ortho conf
A 68-year-old Thai male was in a motorcycle accident and suffered injuries including an open fracture of the right tibia and fibula and a closed fracture of the right distal femur. At the emergency room, he received pain control, antibiotics, tetanus vaccination, and external fixation of the tibial fracture. He was then admitted to the trauma surgery ward to monitor for vascular injury before being transferred to orthopedics. He will require further treatment including definitive fixation of the fractures and management of open fractures according to Gustilo-Anderson classification. Complications of "floating knee" injuries which involve both femur and tibia fractures can include ligament injuries, neurovascular problems, and infection.
Ortho con supra copy
The document summarizes an orthopedic case of a child who fell from a table and injured his left arm. On physical examination, the child's left elbow was swollen and deformed with limited range of motion due to pain. X-rays revealed a complete transverse fracture at the supracondylar region of the left humerus with total posterior-medial displacement, classified as a Gartland Type III injury. The child underwent closed reduction and percutaneous pinning of the fractured elbow. Post-operatively, the child will need elevation, pain control, range of motion exercises, and pin removal after 3-4 weeks once the fracture has healed. Complications of this type of injury can include nerve damage,
Noon conference hangman
A 35-year-old man fell and hit the back of his head on the ground after drinking alcohol. He was brought to the emergency room 4 hours later with pain in his head and neck. On examination, he had a 2 cm laceration on the back of his skull but was neurologically intact. Imaging showed a hangman's fracture. He was placed in a hard cervical collar, the wound was sutured, and he was started on skull traction and a Philadelphia collar for the hangman's fracture.
.Ortho.
An 81-year-old Thai woman presented to the hospital with left hip pain after falling three days prior. Imaging revealed a Garden type 3 fracture of the left femoral neck. She was diagnosed with a displaced left femoral neck fracture. Her treatment plan included pain control, skin traction of the left leg, and a left bipolar hemiarthroplasty surgery. Femoral neck fractures typically result from low-energy falls in older patients and require prompt surgical management to reduce complications.
Extern conference ortho
1. A 41-year-old Thai man fell from a 10-wheel truck while unloading goods and his right leg struck the ground.
2. His right leg was deformed, swollen, and painful around the shin and he could not bear weight. There were no other injuries.
3. X-rays showed a fracture of the right tibia shaft.
The document describes a case of a 41-year-old man who fell from a truck, injuring his right leg. His leg was swollen, deformed and painful around the shin. X-rays confirmed a fracture of the right tibia shaft. The document then provides information on tibia shaft fractures, including mechanisms of injury
Extern conference praparat
This document describes a case of a 61-year-old Thai man who presented to the emergency department with left hip pain after falling 1.5 meters from a tree while working. On physical examination, he had tenderness and deformity of the left hip with limited range of motion due to pain. X-rays showed a posterior dislocation of the left hip. He underwent closed reduction of the hip dislocation under general anesthesia. Post-reduction x-rays confirmed an acceptable reduction.
Patellar fx 5502004
This document discusses a case of a 51-year-old Thai man who was injured in a motorcycle accident, falling and striking his right knee on the ground. On examination, he had swelling and abrasions on his right knee with limited range of motion. Imaging showed a patellar fracture. The document then reviews anatomy of the patella, mechanisms of patellar injury, signs and symptoms of patellar fractures, imaging studies for diagnosis, classifications of patellar fractures, and treatment options which include non-operative management, open reduction and internal fixation, partial or complete patellectomy.
Scaphoid fx
- A 64-year-old Thai female presented with right wrist pain after falling and catching herself with her right hand in the bathroom.
- Examination found swelling and tenderness over the right wrist and pain with grip and wrist movement.
- X-rays showed a non-displaced fracture of the right scaphoid bone.
- She was placed in a thumb spica cast to immobilize the fracture.
Floating shoulder
1. A 65-year-old Thai man presented to the emergency department after a motorcycle accident where he was sideswiped by a pickup truck.
2. He suffered a closed fracture of the middle third of his left clavicle and a closed fracture of the neck of his left scapula (floating shoulder injury).
3. He was admitted to the hospital for an open reduction and internal fixation surgery.
Oooopoppooo
A 35-year-old Thai woman presented to the hospital with right foot pain and swelling after her right foot struck the gas pedal during a motor vehicle accident 6 hours prior. On physical examination, she had swelling and tenderness over the lateral malleolus with limited range of motion due to pain. X-rays showed a fracture of the right calcaneus bone. The diagnosis was an intra-articular fracture of the right calcaneus based on the Sanders classification system. Treatment options discussed included cast immobilization for non-operative cases or surgical options such as open reduction internal fixation or primary subtalar arthrodesis.
Acinjury chitphisut-chennisata
- The patient is a 38-year-old Thai man who was in a motorcycle accident while intoxicated. He hit a footpath and was thrown from the motorcycle, landing on his right shoulder on the road without a helmet.
- On examination, he had pain and limited movement in his right shoulder. Imaging showed a grade V injury of the right acromioclavicular joint with disruption of the acromioclavicular and coracoclavicular ligaments.
- He underwent open reduction and internal fixation surgery with tightrope fixation of the right acromioclavicular joint.
Extern case
The document summarizes the case of a 19-year-old Thai man who presented to the emergency department after being assaulted with a knife. He sustained a large laceration and open fracture of both the radius and ulna in his right forearm. Physical examination revealed the injuries as well as decreased sensation and inability to extend his wrist and fingers. X-rays confirmed the open, oblique fractures of both forearm bones. The patient was taken to the operating room for wound debridement, tendon repair, and application of a splint.
Pelvic fx
1. The patient is a 56-year-old Thai male who fell from a tree approximately 4 meters, landing on his left hip. He experienced worsening left hip pain after the fall and could no longer stand or move his left leg.
2. Imaging studies including CT scan revealed a vertical fracture of the sacrum and fractures of the left superior and inferior pubic rami. The SI joints and pubic symphysis were intact.
3. The diagnosis was a left pelvic fracture. The patient was admitted for bed rest and planned for an open reduction and internal fixation of the pelvis.
Case conference extern ortho ed1
This case conference discusses a 48-year-old Thai man who presented to the hospital after falling and injuring his right hip. On examination, he had tenderness and swelling of the right hip and thigh with limited range of motion due to pain. X-rays revealed a closed fracture of the right femoral neck. The attending physician provided a provisional diagnosis and treatment plan involving admission, skin traction, pain medication, and monitoring. The discussion then reviewed femoral neck fractures, including risk factors, mechanisms of injury, imaging, classifications, complications, and treatment options such as internal fixation, hemiarthroplasty, or total hip arthroplasty.
Externconference sirakit
- 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.
Orthopaedics
1) A 55yo male fell down stairs and has left knee pain and swelling. Imaging shows a tibial plateau fracture which often requires open reduction and internal fixation surgery.
2) A 19yo male injured his right foot in a waterskiing accident and has pain and inability to bear weight. Imaging shows a widening of the Lisfranc ligament at the base of the first and second metatarsals, likely requiring open reduction with screws.
3) An 89yo female fell and has left hip pain, possibly indicating an occult hip fracture requiring MRI for diagnosis due to its sensitivity and ability to define anatomy compared to other imaging options.
bbfx_orthomhr
This document summarizes the case of a 14-year-old Thai male who presented to the hospital with right arm pain after falling while playing football. On examination, he was found to have swelling and deformity of the right forearm with limited range of motion due to pain. X-rays revealed greenstick fractures of both the radius and ulna of the right forearm. The diagnosis was closed fractures of both bones of the right forearm. Treatment options discussed included non-operative management with closed reduction and casting or surgical options like percutaneous or open reduction with internal fixation.
Noon extern (1)
This document describes the case of a 19-year-old Thai female who was in a motorcycle accident where she injured her left arm. She was found to have a spiral fracture of the distal third of her left humerus. Humeral shaft fractures most commonly occur in young patients from high-energy trauma or elderly patients from low-energy injuries. Treatment options include splinting or surgery depending on the severity of the injury. Complications can include nonunion, malunion, or radial nerve palsy.
Ortho conference
This orthopedic case conference discusses a 10-year-old Thai girl who injured her right forearm after falling while running and catching herself with her right hand. Physical examination revealed swelling and deformity of the right forearm with marked tenderness and limited range of motion due to pain. Radiographs showed a closed fracture of both bones in the right forearm. Initial management involved pain medication, closed reduction, and splinting, but closed reduction failed. Due to the failed closed reduction, surgery was planned to perform an open reduction and internal fixation with a plate and screws.
Caseortho ext.bodin
- An 8-year-old Thai boy presented with right arm pain for 1 hour after falling while playing and landing on his outstretched right arm.
- X-rays showed a proximal 1/3 ulnar fracture of the right forearm with associated radial head dislocation.
- The diagnosis was a Monteggia fracture of the right forearm. For pediatric patients, treatment is typically closed reduction of the ulna and radial head fractures with long arm casting. Operative treatment is indicated for unstable or open fractures.
Ortho ext. สิทธิณัฐ
- A 51-year-old Thai farmer presented to the emergency department after cutting the back of his left hand with a knife while trimming grass 3 hours prior.
- On examination, he had a 3cm laceration on the back of his second middle finger with loss of active extension of the second MCP joint and visible extensor tendon tear.
- An x-ray showed no fractures. The impression was a tear of the extensor tendon zone V of the second finger. The patient was taken to the operating room for debridement and repair of the tendon.
Bb fx forearm
An elderly Thai female presented with a closed fracture of both bones of the right forearm after falling and bracing her fall with her right arm. On examination, she had deformity, swelling, and limited range of motion of the right forearm. X-rays confirmed a closed fracture of both the radius and ulna. She was splinted externally initially and then referred to the hospital, where she was admitted and placed in a long arm splint. She was scheduled for an operation to place a plate and screws to fixate the fractures.
Interesting case orthokorat clavical fracture
This document summarizes a case report of a 27-year-old man who presented with right shoulder pain and limited range of motion after falling off his motorcycle without a helmet. Physical examination revealed tenderness and limited range of motion of the right shoulder. X-rays showed a fracture of the middle third of the right clavicle. The diagnosis was a closed fracture of the right clavicle. Treatment involved figure-of-eight splint immobilization and pain medication. The patient was advised to keep the splint on until his follow-up appointment in one week.
Conference
This case conference discusses a 45-year-old Thai male who was in a motor vehicle accident where he sustained a left humerus fracture. On physical examination, his left arm was tender and swollen with limited range of motion due to pain. X-rays confirmed a closed midshaft left humerus fracture. Treatment options for humerus fractures include non-operative management with a hanging arm cast or functional brace, or operative management with plate fixation or intramedullary nails depending on the fracture pattern and patient factors. Complications can include radial nerve palsy.
Extern conference cfx tibia
This document summarizes the case of a 35-year-old Thai man who was in a motorcycle accident and experienced left leg pain, swelling, and abrasions. On examination, he had limited range of motion in his left leg due to pain but no neurological deficits. X-rays showed a closed fracture of the left tibia. He was placed in a posterior long leg splint and diagnosed with a closed tibia fracture and mild head injury.
Ortho discuss-spine fx
This document discusses the case of a 43-year-old Thai female patient who fell from a tree approximately 4 meters 2 hours prior. On primary and secondary survey, she had tenderness in her lower back but intact motor and sensory functions. Imaging showed a burst fracture of her L1 vertebra. She was diagnosed with a burst fracture of L1 and underwent percutaneous pedicle screw fixation from T12 to L2.
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Extern conference ortho
1. A 41-year-old Thai man fell from a 10-wheel truck while unloading goods and his right leg struck the ground.
2. His right leg was deformed, swollen, and painful around the shin and he could not bear weight. There were no other injuries.
3. X-rays showed a fracture of the right tibia shaft.
The document describes a case of a 41-year-old man who fell from a truck, injuring his right leg. His leg was swollen, deformed and painful around the shin. X-rays confirmed a fracture of the right tibia shaft. The document then provides information on tibia shaft fractures, including mechanisms of injury
Extern conference praparat
This document describes a case of a 61-year-old Thai man who presented to the emergency department with left hip pain after falling 1.5 meters from a tree while working. On physical examination, he had tenderness and deformity of the left hip with limited range of motion due to pain. X-rays showed a posterior dislocation of the left hip. He underwent closed reduction of the hip dislocation under general anesthesia. Post-reduction x-rays confirmed an acceptable reduction.
Patellar fx 5502004
This document discusses a case of a 51-year-old Thai man who was injured in a motorcycle accident, falling and striking his right knee on the ground. On examination, he had swelling and abrasions on his right knee with limited range of motion. Imaging showed a patellar fracture. The document then reviews anatomy of the patella, mechanisms of patellar injury, signs and symptoms of patellar fractures, imaging studies for diagnosis, classifications of patellar fractures, and treatment options which include non-operative management, open reduction and internal fixation, partial or complete patellectomy.
Scaphoid fx
- A 64-year-old Thai female presented with right wrist pain after falling and catching herself with her right hand in the bathroom.
- Examination found swelling and tenderness over the right wrist and pain with grip and wrist movement.
- X-rays showed a non-displaced fracture of the right scaphoid bone.
- She was placed in a thumb spica cast to immobilize the fracture.
Floating shoulder
1. A 65-year-old Thai man presented to the emergency department after a motorcycle accident where he was sideswiped by a pickup truck.
2. He suffered a closed fracture of the middle third of his left clavicle and a closed fracture of the neck of his left scapula (floating shoulder injury).
3. He was admitted to the hospital for an open reduction and internal fixation surgery.
Oooopoppooo
A 35-year-old Thai woman presented to the hospital with right foot pain and swelling after her right foot struck the gas pedal during a motor vehicle accident 6 hours prior. On physical examination, she had swelling and tenderness over the lateral malleolus with limited range of motion due to pain. X-rays showed a fracture of the right calcaneus bone. The diagnosis was an intra-articular fracture of the right calcaneus based on the Sanders classification system. Treatment options discussed included cast immobilization for non-operative cases or surgical options such as open reduction internal fixation or primary subtalar arthrodesis.
Acinjury chitphisut-chennisata
- The patient is a 38-year-old Thai man who was in a motorcycle accident while intoxicated. He hit a footpath and was thrown from the motorcycle, landing on his right shoulder on the road without a helmet.
- On examination, he had pain and limited movement in his right shoulder. Imaging showed a grade V injury of the right acromioclavicular joint with disruption of the acromioclavicular and coracoclavicular ligaments.
- He underwent open reduction and internal fixation surgery with tightrope fixation of the right acromioclavicular joint.
Extern case
The document summarizes the case of a 19-year-old Thai man who presented to the emergency department after being assaulted with a knife. He sustained a large laceration and open fracture of both the radius and ulna in his right forearm. Physical examination revealed the injuries as well as decreased sensation and inability to extend his wrist and fingers. X-rays confirmed the open, oblique fractures of both forearm bones. The patient was taken to the operating room for wound debridement, tendon repair, and application of a splint.
Pelvic fx
1. The patient is a 56-year-old Thai male who fell from a tree approximately 4 meters, landing on his left hip. He experienced worsening left hip pain after the fall and could no longer stand or move his left leg.
2. Imaging studies including CT scan revealed a vertical fracture of the sacrum and fractures of the left superior and inferior pubic rami. The SI joints and pubic symphysis were intact.
3. The diagnosis was a left pelvic fracture. The patient was admitted for bed rest and planned for an open reduction and internal fixation of the pelvis.
Case conference extern ortho ed1
This case conference discusses a 48-year-old Thai man who presented to the hospital after falling and injuring his right hip. On examination, he had tenderness and swelling of the right hip and thigh with limited range of motion due to pain. X-rays revealed a closed fracture of the right femoral neck. The attending physician provided a provisional diagnosis and treatment plan involving admission, skin traction, pain medication, and monitoring. The discussion then reviewed femoral neck fractures, including risk factors, mechanisms of injury, imaging, classifications, complications, and treatment options such as internal fixation, hemiarthroplasty, or total hip arthroplasty.
Externconference sirakit
- 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.
Orthopaedics
1) A 55yo male fell down stairs and has left knee pain and swelling. Imaging shows a tibial plateau fracture which often requires open reduction and internal fixation surgery.
2) A 19yo male injured his right foot in a waterskiing accident and has pain and inability to bear weight. Imaging shows a widening of the Lisfranc ligament at the base of the first and second metatarsals, likely requiring open reduction with screws.
3) An 89yo female fell and has left hip pain, possibly indicating an occult hip fracture requiring MRI for diagnosis due to its sensitivity and ability to define anatomy compared to other imaging options.
bbfx_orthomhr
This document summarizes the case of a 14-year-old Thai male who presented to the hospital with right arm pain after falling while playing football. On examination, he was found to have swelling and deformity of the right forearm with limited range of motion due to pain. X-rays revealed greenstick fractures of both the radius and ulna of the right forearm. The diagnosis was closed fractures of both bones of the right forearm. Treatment options discussed included non-operative management with closed reduction and casting or surgical options like percutaneous or open reduction with internal fixation.
Noon extern (1)
This document describes the case of a 19-year-old Thai female who was in a motorcycle accident where she injured her left arm. She was found to have a spiral fracture of the distal third of her left humerus. Humeral shaft fractures most commonly occur in young patients from high-energy trauma or elderly patients from low-energy injuries. Treatment options include splinting or surgery depending on the severity of the injury. Complications can include nonunion, malunion, or radial nerve palsy.
Ortho conference
This orthopedic case conference discusses a 10-year-old Thai girl who injured her right forearm after falling while running and catching herself with her right hand. Physical examination revealed swelling and deformity of the right forearm with marked tenderness and limited range of motion due to pain. Radiographs showed a closed fracture of both bones in the right forearm. Initial management involved pain medication, closed reduction, and splinting, but closed reduction failed. Due to the failed closed reduction, surgery was planned to perform an open reduction and internal fixation with a plate and screws.
Caseortho ext.bodin
- An 8-year-old Thai boy presented with right arm pain for 1 hour after falling while playing and landing on his outstretched right arm.
- X-rays showed a proximal 1/3 ulnar fracture of the right forearm with associated radial head dislocation.
- The diagnosis was a Monteggia fracture of the right forearm. For pediatric patients, treatment is typically closed reduction of the ulna and radial head fractures with long arm casting. Operative treatment is indicated for unstable or open fractures.
Ortho ext. สิทธิณัฐ
- A 51-year-old Thai farmer presented to the emergency department after cutting the back of his left hand with a knife while trimming grass 3 hours prior.
- On examination, he had a 3cm laceration on the back of his second middle finger with loss of active extension of the second MCP joint and visible extensor tendon tear.
- An x-ray showed no fractures. The impression was a tear of the extensor tendon zone V of the second finger. The patient was taken to the operating room for debridement and repair of the tendon.
Bb fx forearm
An elderly Thai female presented with a closed fracture of both bones of the right forearm after falling and bracing her fall with her right arm. On examination, she had deformity, swelling, and limited range of motion of the right forearm. X-rays confirmed a closed fracture of both the radius and ulna. She was splinted externally initially and then referred to the hospital, where she was admitted and placed in a long arm splint. She was scheduled for an operation to place a plate and screws to fixate the fractures.
Interesting case orthokorat clavical fracture
This document summarizes a case report of a 27-year-old man who presented with right shoulder pain and limited range of motion after falling off his motorcycle without a helmet. Physical examination revealed tenderness and limited range of motion of the right shoulder. X-rays showed a fracture of the middle third of the right clavicle. The diagnosis was a closed fracture of the right clavicle. Treatment involved figure-of-eight splint immobilization and pain medication. The patient was advised to keep the splint on until his follow-up appointment in one week.
Conference
This case conference discusses a 45-year-old Thai male who was in a motor vehicle accident where he sustained a left humerus fracture. On physical examination, his left arm was tender and swollen with limited range of motion due to pain. X-rays confirmed a closed midshaft left humerus fracture. Treatment options for humerus fractures include non-operative management with a hanging arm cast or functional brace, or operative management with plate fixation or intramedullary nails depending on the fracture pattern and patient factors. Complications can include radial nerve palsy.
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Similar to Orthofaipun
Extern conference cfx tibia
This document summarizes the case of a 35-year-old Thai man who was in a motorcycle accident and experienced left leg pain, swelling, and abrasions. On examination, he had limited range of motion in his left leg due to pain but no neurological deficits. X-rays showed a closed fracture of the left tibia. He was placed in a posterior long leg splint and diagnosed with a closed tibia fracture and mild head injury.
Ortho discuss-spine fx
This document discusses the case of a 43-year-old Thai female patient who fell from a tree approximately 4 meters 2 hours prior. On primary and secondary survey, she had tenderness in her lower back but intact motor and sensory functions. Imaging showed a burst fracture of her L1 vertebra. She was diagnosed with a burst fracture of L1 and underwent percutaneous pedicle screw fixation from T12 to L2.
Clavicle fracture
1. The patient is a 75-year-old Thai man who fell off his bicycle 6 hours prior, injuring his left elbow and clavicle.
2. Radiographs show a fracture of the left shaft of the clavicle.
3. Clavicle fractures are commonly classified using the Allman or Neer classifications to determine appropriate treatment. Non-displaced or stable fractures are typically treated non-operatively while displaced or unstable fractures often require surgical fixation.
Nithit case discussion
1. The patient is a 58-year-old Thai woman who fell and injured her left shoulder 3 days ago.
2. Physical examination revealed tenderness and mild swelling of the left shoulder with limited range of motion due to pain.
3. X-rays of the left shoulder showed a fracture of the proximal humerus.
The document describes a case of a 58-year-old Thai woman who presented with a fractured left shoulder after a fall. Physical examination and x-rays confirmed a fracture of the proximal humerus. Non-displaced fractures can be treated conservatively while displaced fractures require orthopedic referral.
Extern conference ortho
1. A 17-year-old Thai male presented to the emergency department with an abrasion wound on his left face and left shoulder following a motorcycle accident 5 hours prior.
2. Imaging revealed a T3-T4 fracture-dislocation with spinal cord compression. He was diagnosed with a spinal cord injury and underwent treatment including methylprednisolone and surgical stabilization of his spine.
3. His injury resulted in lower extremity weakness and loss of sensation. He will require long-term rehabilitation for his spinal cord injury.
Noon conference
- The patient is a 54-year-old female who was in a motorcycle accident 4 hours prior where her motorcycle was hit on the side causing her to fall and injure her left leg.
- On examination, she had swelling and deformity of her left knee and thigh with tenderness and limited range of motion. X-rays showed a posterolateral dislocation of the left knee.
- She underwent closed reduction of the knee dislocation. A CTA showed no evidence of vascular injury. She was diagnosed with a posterolateral left knee dislocation and given splinting and pain management.
Afternoon ortho
This document summarizes the presentation and medical case of a 57-year-old Thai female patient who was hit by a pickup truck 30 minutes prior. Upon examination, she had left knee tenderness and positive valgus and anterior drawer tests. Radiographs did not show any fractures. The impression was MCL and ACL injuries of the left knee. She was given pain medication and discharged with follow up in 2 weeks. The presentation also reviewed knee anatomy, approach to traumatic knee pain, ligament injuries including MCL, ACL, PCL injuries and treatment.
Closed fracture at the humeral shaft
This document discusses the case of a 41-year-old Thai woman who experienced a humerus shaft fracture after falling from a motorbike. On examination, she had deformity and swelling of the right forearm with an abrasion on the elbow but intact motor and sensory function. X-rays showed a fracture of the right humerus. The document summarizes treatment approaches for humerus shaft fractures, including non-operative management with a brace or operative fixation with plates or nails, depending on the fracture pattern and patient factors. Complications like radial nerve palsy are also addressed.
Interesting case orthopedic ภัชชา
1. The patient is a 6 year old Thai boy who was run over by a motorcycle 3 hours ago, suffering pain and swelling in his left thigh.
2. X-rays revealed a complete oblique fracture of the left femur shaft with angulation and 2-3cm of shortening.
3. Treatment options depend on the patient's age and fracture pattern, ranging from casting or traction for younger children, to flexible nails, plates or external fixation for older children, with the goals of restoring length, alignment and rotation while avoiding complications like osteonecrosis.
Interesting case orthopedic ภัชชา
1. The patient is a 6 year old Thai boy who was run over by a motorcycle 3 hours ago, suffering pain and swelling in his left thigh.
2. X-rays revealed a complete oblique fracture of the left femur shaft with angulation and 2-3cm of shortening.
3. Treatment options depend on the patient's age and fracture pattern, ranging from casting or traction for younger children, to flexible nails, plates or external fixation for older children, with the goals of restoring length, alignment and rotation while avoiding complications like osteonecrosis.
Proximal humerus fracture
This document summarizes the key points about a proximal humerus fracture case. It describes a 30-year-old female patient who was brought to the emergency room after falling off her motorcycle. Her injuries included a proximal humerus fracture on her right arm. The document reviews the epidemiology, anatomy, classification, evaluation, treatment options and rehabilitation for proximal humerus fractures. It provides details on the patient's case, management in the emergency room, and anticipated treatment plan.
Galeazzi fracture
- 44-year-old Thai female patient fell and injured her left arm, presenting with a deformity and swelling of the left wrist with limited range of motion due to pain.
- X-rays revealed a Galeazzi fracture of the left forearm, which is a fracture of the distal radial shaft with disruption of the distal radioulnar joint.
- She underwent an open reduction and internal fixation procedure to stabilize the radius fracture and distal radioulnar joint.
Teleconference
This document contains a case summary for a 57-year-old Thai woman who slipped on a banana leaf and fell, twisting her right ankle. On physical examination, her right ankle was bruised, swollen, and painful to move. X-rays showed a bimalleolar fracture of the right ankle. The diagnosis was a right bimalleolar fracture, which was treated surgically with an open reduction and internal fixation using plates and screws. The document also reviews ankle fracture classifications, treatment indications, and orthopedic examination techniques.
Galeazzi fx saraj pcm
- 64-year-old Thai man was in a motorcycle accident where he fell and used his left arm to brace himself, injuring his left forearm.
- Physical exam and x-rays showed a fracture of the midshaft to distal radius with dislocation of the distal radioulnar joint (Galeazzi fracture).
- Treatment involves open reduction and internal fixation of the radius fracture with a plate to restore anatomy and function, along with splinting the forearm in full supination for 6 weeks to maintain stability of the distal radioulnar joint.
Case conference: Natthanit Sae-lee
This case conference discusses a 63-year-old Thai female patient who presented with right thigh pain for 7 hours. She reported being tied by a rope to a water buffalo that fell on her right leg, causing inability to stand or move the right leg and severe pain. Physical examination found swelling, tenderness, and rotation of the right thigh with shortening of the right leg. Radiographs revealed a closed fracture of the right femoral shaft. She was given pain medication and placed in skeletal traction while waiting for surgery for open reduction and internal fixation with plate and screws.
Presentation2
A 18-year-old Thai male presented to the hospital complaining of left wrist pain for 4 hours after falling while playing football. Imaging showed a closed fracture at the distal end of the radius. The fracture was treated with a short arm cast. Distal radius fractures are common orthopedic injuries that can be classified in several ways. Treatment may involve closed reduction and casting or surgical fixation depending on the type and displacement of the fracture. Complications can include nerve issues, tendon problems, malunion, and arthritis.
Shoulderdislocation
- A 67-year-old Thai female presented to the emergency department with left shoulder pain after falling from a motorcycle accident.
- X-rays revealed an anterior dislocation of the left shoulder with a greater tuberosity fracture.
- She underwent closed reduction under sedation and analgesia, followed by immobilization of the left arm in a sling.
Tharinee anterior-hip-dislocation
1. A 9-year-old boy presented to the emergency room with a dislocated right hip after falling from a height of about 2 meters while trying to jump onto a basketball hoop.
2. Physical examination revealed an anterior dislocation of the right hip with external rotation, abduction and flexion.
3. The patient underwent closed reduction of the right hip dislocation under general anesthesia using traction and counter-traction maneuvers. Post-reduction x-rays confirmed an acceptable reduction with no fractures seen.
Knee dislocation ext ณัฐ
This document summarizes a patient's presentation with a right knee dislocation. A 60-year-old Thai man was in a motorcycle accident 4 hours prior and presented with right knee pain and deformity. Examination found swelling and deformity of the right knee with positive ligament tests. X-rays confirmed a knee dislocation. The knee was closed reduced in the ER and immobilized. The patient was admitted for vascular monitoring and potential ligament reconstruction surgery.
Ankle fracture-by-rgjel
1. A 43-year-old female patient fell down stairs 3.5 hours prior to arriving at the hospital. On examination, she had significant swelling and tenderness of the left ankle with limited range of motion due to pain.
2. X-rays showed a closed bimalleolar fracture of the left ankle. She was placed in a short leg cast and admitted to the ward for pain control and waiting for surgery to undergo an open reduction and internal fixation.
3. Bimalleolar ankle fractures are unstable injuries involving fractures of two malleoli. Surgical treatment with open reduction and internal fixation is usually required for anatomical reduction and stabilization to allow early mobilization.
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Ortho
A 19-year-old Thai male presented to the emergency room after his motorcycle was hit by a car. He reported left knee pain for 30 minutes. On examination, he had a 4x6cm laceration wound on his left knee with exposed bone and active bleeding. Imaging showed an open left patellar fracture. He was diagnosed with an open left patellar fracture and treated empirically with antibiotics. He underwent debridement and tension band wiring in the operating room.
Nearly amputation extern conference
This document describes the case of a 13-year-old Thai boy who was in a motorcycle accident, resulting in a near amputation of his left index finger. Upon initial examination, he was conscious and coherent with a laceration on his left eyebrow and active bleeding from his injured left index finger. X-rays showed no fractures. He was referred to another hospital, where he underwent surgery to close the stump of his amputated left index finger. The document then provides definitions, classifications, and management guidelines for traumatic finger amputations.
Extern.con.anklefx.chaipat
- 17-year-old Thai female presented to the hospital with right ankle pain and swelling after twisting her ankle 3 hours prior while playing football.
- Physical examination revealed swelling and tenderness of the right ankle which was held in plantarflexion. X-rays showed a bimalleolar fracture of the right ankle.
- Bimalleolar fractures involve fractures of both the medial and lateral malleoli. Non-displaced fractures are typically treated conservatively with immobilization while displaced or unstable fractures require open reduction and internal fixation surgery followed by non-weightbearing and rehabilitation.
Ext.conference..
1. An 82-year-old Thai man presented to the emergency room with right knee pain for 3 hours after tripping and falling on his right knee.
2. Examination found marked swelling and tenderness of the right knee with a palpable patella defect and joint effusion. X-rays showed a closed comminuted fracture of the right patella.
3. The patient was diagnosed with a closed comminuted fracture of the right patella. His treatment plan included immobilization with a cylindrical slab and observation for compartment syndrome, with plans for open reduction and internal fixation using a tension band construct.
Ortho con
1) A 14-year-old boy was in a motorcycle accident where his left hip hit the ground, causing left hip pain and deformity.
2) Examination and x-rays revealed a posterior dislocation of the left hip.
3) The patient was taken to the operating room for closed reduction of the hip dislocation under general anesthesia with skeletal traction.
Patella fx
This patient is a 34-year-old Thai man who presented with knee pain and swelling after falling and hitting his right knee 3 days ago. On examination, his right knee was tender and swollen with limited range of motion due to pain. X-rays showed a patella fracture. Patella fractures typically occur from direct impact or forceful knee flexion against the contracted quadriceps muscle. Treatment depends on the fracture pattern and degree of displacement, ranging from immobilization to surgery to repair the extensor mechanism or address displaced fragments.
Conference der
- A 50-year-old Thai man presented to the emergency department with right wrist pain and swelling for 6 hours after a motorcycle accident.
- On examination, he had swelling, tenderness, and deformity of the right wrist with limited range of motion. X-rays showed a closed fracture of the distal end of the right radius with intra-articular involvement.
- He underwent hematoma block and closed reduction with placement in a short arm splint. Post-procedure x-rays confirmed acceptable reduction of the fracture based on measurements of volar tilt, radial shortening, and radial angle.
Septic arthritis
A 61-year-old Thai woman presented with left knee pain and fever for 2 days. She had a known diabetic ulcer on her left foot. On examination, she had swelling and tenderness around her left ankle with redness and warmth. Joint fluid analysis found white blood cells of 54,000/ml with 92% polymorphonuclear cells and gram-positive cocci. She was diagnosed with septic arthritis of the left knee and taken to the operating room for arthrotomy and antibiotics.
Posteriorhipdislocation
This document summarizes the case of a 41-year-old man who was in a car accident where he hit a tree with his console but did not hit his head. He reported right hip pain after the accident and could not walk or move his right leg. On examination, he had marked tenderness over his right hip with limited and painful range of motion. He was taken to the OR for closed reduction of a posterior hip dislocation under general anesthesia. Potential complications of posterior hip dislocations include osteonecrosis, osteoarthritis, and sciatic nerve injury.
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Orthofaipun
- 2. History • Patient Profile: ผู้ป่วยหญิงไทย อายุ 49ปี • Chief Complaint: ปวดสะโพกซ้าย 5ชั่วโมง • Present Illness: – 5ชั่วโมง PTA ขับMCล้ม สะโพกซ้ายกระแทกพื้น จากนั้นปวดสะโพกซ้าย เดินไม่ได้ ไม่มีศีรษะกระแทกพื้น ไม่สลบ จาเหตุการณ์ได้
- 3. Primary Survey • A – can speak, not tender C-spine, full ROM • B – clear, equal both lungs, CCT negative • C – BP 125/80mmHg, PR90bpm, no active bleeding • D – E4V5M6, pupils 2mm RTLBE
- 4. Primary Survey • E – Lt hip: Tender and limit ROM due to pain, Abrasion wound 5x5cm – Lt leg: Shotening and external rotation, motor gr.V, sensory intact – Lt PTA, DPA 2+
- 5. Secondary Survey • A – no drug allergy • M – no current medication • P – no U/D • L – 5hr PTA • E – ขับMCล้มเอง
- 6. Investigation: Film hip AP, Lateral
- 9. Diagnosis • Closed fracture Lt neck of femur Garden class IV, Pauwels type II
- 11. Introduction • Epidemiology – Common in eldery – Women > Men • Mechanism – High energy in young patients – Low energy falls in older patients • Pathophisiology – Femoral neck is intracapsular, bathed in synovial fluid – Callus formation limited, which affects healing
- 12. Anatomy
- 13. Sign & Symptom • Impacted fracture (nondisplaced) – Slightly pain in the groin or pain referred along the medial side of the thigh and knee – No obvious clinical deformity – Minor discomfort with active or passive ROM – Pain with percussion over greater trochanter • Displaced fracture – Pain in the entire hip region – Leg in external rotation and abduction with shortening – Limit ROM
- 14. Investigation • Film: – Both hip AP – Lateral cross-table • CT: if doubtful
- 16. Simplified Garden Classification • Nondisplaced: Garden I and II • Displaced: Garden III and IV
- 18. Pauwels Classification • Type I – Multiple screw • Type II, III – Dynamic hip screw
- 19. Management • Surgery if possible – Conservative: bedridden, infection, DVT/PE • Surgical choices: – Fixation vs Arthroplasty
- 20. Femoral neck Fx Displaced Age < 60 Undisplaced Fixation in all age groups Displaced Age > 60
- 21. Displaced Age < 60 -Age < 60 and no risk for osteoporosis or - Some risk but age < 40 -Age 40-60 and risk for osteoporosis -Age 40-60 and alcohol abuse Reduction and fixation Bipolar hemiarthroplasty THR probably best option
- 22. Displaced Age > 60 Independently mobile, no cognitive impairment, no comorbidities Independently mobile, No/mild cognitive impairment, Limit to house or short distance Cognitive impairment, Poor function Major comorbidities Total hip arthroplasty Unipolar hemiarthroplasty Bipolar hemiarthroplasty
- 23. Complication • Osteonecrosis – 10-45% – Increased risk with initial diaplacement • Delay-union and nonunion
- 26. Thank you for your attention