Patella and tibial condyle fractures are injuries to the knee. The patella is a triangular bone that articulates with the femur and protects the knee joint. Tibial condyle fractures involve breaks in the end of the tibia. Risk factors include trauma, osteoporosis, and falls. Treatment depends on the type and severity of the fracture, and may involve rest, casting, surgery such as open reduction and internal fixation, or external fixation for severe injuries. The goals of treatment are to restore alignment and joint stability to allow functional recovery of the knee.
Please find the power point on Fracture of Talus with well diagrammatic explanation from very reliable sources. If you need such a power point on different topics related with MBBS then please write it on comment section. Thank you
Madelung deformity is an abnormality of the palmar ulnar part of the distal radial physis in which progressive ulnar and volar tilt develops at the distal radial articular surface, with dorsal subluxation of the distal ulna.
A fracture is a medical term used to describe a broken bone. While most fractures can be treated with immobilization and conservative measures, some fractures can lead to complications, especially if they are not treated promptly or appropriately. The following are some common complications of fractures:
Delayed union: Delayed union is a condition where the fractured bone takes longer than usual to heal. This can occur due to several factors, including inadequate blood supply to the bone, poor nutrition, or a lack of stability at the fracture site.
Malunion: Malunion is a condition where the fractured bone heals in an abnormal position, resulting in deformity or misalignment. This can occur due to inadequate reduction (alignment) of the fracture, inadequate immobilization, or other factors.
Nonunion: Nonunion is a condition where the fractured bone fails to heal even after an extended period of time. This can occur due to several factors, including poor blood supply, infection, or inadequate immobilization.
Infection: Fractures can also lead to infections, particularly if the bone is exposed or there is an open wound at the fracture site. This can lead to complications such as osteomyelitis, a serious bone infection that can require long-term antibiotics or surgery to treat.
Compartment syndrome: Compartment syndrome is a condition where increased pressure within a muscle compartment causes reduced blood flow and tissue damage. This can occur after a fracture, particularly if there is significant swelling or bleeding in the affected area.
Nerve damage: Fractures can also lead to nerve damage, particularly if the fracture is near a nerve. This can lead to symptoms such as numbness, tingling, or weakness in the affected area.
Blood vessel damage: Fractures can also cause damage to blood vessels, leading to bleeding or reduced blood flow to the affected area.
It is important to seek prompt medical attention if you suspect a fracture, to ensure appropriate diagnosis and treatment and to minimize the risk of complications.
Please find the power point on Fracture of Talus with well diagrammatic explanation from very reliable sources. If you need such a power point on different topics related with MBBS then please write it on comment section. Thank you
Madelung deformity is an abnormality of the palmar ulnar part of the distal radial physis in which progressive ulnar and volar tilt develops at the distal radial articular surface, with dorsal subluxation of the distal ulna.
A fracture is a medical term used to describe a broken bone. While most fractures can be treated with immobilization and conservative measures, some fractures can lead to complications, especially if they are not treated promptly or appropriately. The following are some common complications of fractures:
Delayed union: Delayed union is a condition where the fractured bone takes longer than usual to heal. This can occur due to several factors, including inadequate blood supply to the bone, poor nutrition, or a lack of stability at the fracture site.
Malunion: Malunion is a condition where the fractured bone heals in an abnormal position, resulting in deformity or misalignment. This can occur due to inadequate reduction (alignment) of the fracture, inadequate immobilization, or other factors.
Nonunion: Nonunion is a condition where the fractured bone fails to heal even after an extended period of time. This can occur due to several factors, including poor blood supply, infection, or inadequate immobilization.
Infection: Fractures can also lead to infections, particularly if the bone is exposed or there is an open wound at the fracture site. This can lead to complications such as osteomyelitis, a serious bone infection that can require long-term antibiotics or surgery to treat.
Compartment syndrome: Compartment syndrome is a condition where increased pressure within a muscle compartment causes reduced blood flow and tissue damage. This can occur after a fracture, particularly if there is significant swelling or bleeding in the affected area.
Nerve damage: Fractures can also lead to nerve damage, particularly if the fracture is near a nerve. This can lead to symptoms such as numbness, tingling, or weakness in the affected area.
Blood vessel damage: Fractures can also cause damage to blood vessels, leading to bleeding or reduced blood flow to the affected area.
It is important to seek prompt medical attention if you suspect a fracture, to ensure appropriate diagnosis and treatment and to minimize the risk of complications.
Knee injuries for MBBS (undergraduate students). This presentation deals with injuries to the bones and ligaments around the knee as well as gives a brief overview on the dislocations of the knee and patella.
Distal femur fractures are traumatic injuries involving the region extending from the distal metaphyseal-diaphyseal junction to the articular surface of the femoral condyles.
Diagnosis is made radiographically with CT studies often required to assess for intra-articular extension.
Treatment is generally operative with ORIF, intramedullary nail, or distal femur replacement depending on available bone stock, age of patient, and patient activity demands.
Patella Fractures are traumatic knee injuries caused by direct trauma or rapid contracture of the quadriceps with a flexed knee that can lead to loss of the extensor mechanism.
Diagnosis can be made clinically with the inability to perform a straight leg raise and confirmed with radiographs of the knee.
Treatment is either immobilization or surgical fixation depending on fracture displacement and integrity of the extensor mechanism.
Proximal third tibia fractures are relatively common fractures of the proximal tibial shaft that are associated with high rates of soft tissue compromise and malunion (valgus and procurvatum).
Diagnosis is made with orthogonal radiographs of the tibia with CT scan often required to assess for intra-articular extension.
Treatment generally consists of surgical open reduction and internal fixation (ORIF) versus intramedullary nail fixation.
Objectives:
-Recognize the anatomy of the proximal tibia
-Describe initial evaluation and management
-Identify common fracture patterns
-Apply treatment principles and strategies for Partial articular fractures and Complete articular fractures
-Discuss rehabilitation and complications
-Learn Management in selected tibial plateau case scenarios
In the elderly osteoporotic fractures although the principles are the same but some special considerations in management of the soft tissues and the bony injuries are considered.
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 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
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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.
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
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.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
- 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
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
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
2. ANATOMY
• Largest sesamoid bone
• Plays an important role in the biomechanics of
the knee.
• Very hard & triangular-shaped bone
3. • Situated in an exposed position in front
of the knee joint
• separated from the skin by subcutaneous
bursa.
• Patella Surfaces
• Ant.
• Post
• Lat. & med.
4. • Patella borders
- Base
- Med and Lat.
- Apex
• Articulation
• Post. surface central portion, is covered
with a layer of hyaline cartilage.
• • Articular cartilage of the patella is the
thickest in the body (up to 7-mm thick).
5. PATELLAR ALIGNMENT
• Q-angle is the angle formed by two
intersecting lines.
• A normal Q-angle, women >men, is 10 to
15.
8. SIGNS AND SYMPTOMS
• Localized pain aggravated by movement
• Muscle guarding with passive movement
• Decreased function of the part
• Swelling, deformity, abnormal movement
• Sharp, localized tenderness at the site
9. CLINICAL MANIFESTATIONS
• Pain in the affected knee.
• Lacerations
• Intra-articular effusion
• Palpable defect at the fracture site.
• Hemarthrosis
• Unable to perform a straight leg raise
• Inability to extend the knee against gravity
10. ETIOLOGY
• Subcutaneous location of the patella makes it prone to
injury.
• Fractures occur as a result of a compressive force such as a
direct blow, a sudden tensile force as occurs with
hyperflexion of the knee, or from a combination of these.
11. TESTS AND DIAGNOSTIC PROCEDURES
• X-rays
• Aspiration of a hemarthrosis followed by instillation of intra-articular lidocaine
12. TREATMENT: NON-SURGICAL
• Rest
• gentle motion,
• muscle-setting exercises in pain-free positions.
• Casts or splints
• Crutches
13. TREATMENT: SURGICAL
• Timing of surgery
• If the skin around your fracture has not been broken may recommend waiting until
any abrasions have healed before having surgery.
• Open fractures, however, expose the fracture site to the environment urgently need
to be cleansed and require immediate surgery.
14. • TENSION BAND WIRING(TBW)
• Canulated lag-screw with tension band
• Partialpatellectomy
• Total patellectomy
15. TBW
• This is a surgical procedure to treat transverse patellar fractures, transverse patellar
fracture may be non-displaced or displaced
• In non-displaced or minimally transverse fracture the patient is able to do extend
the knee with full extension.In this condition simply “knee immobiliser” or “knee
brace” is applied to treat the fracture.
16. • Reduction of fracture is done with
reduction clamp.
• K-wires are placed perpendicular
to the fracture.
• Figure of 8 tension band wire is
applied for compression of the
fracture.
• The wire convert anterior
distractive forces to compressive
forces at the articular surface
during the knee flexion and
extension.
17. Canulated lag-screw with tension band
• Wires passes through the screws and across the patella in figure of 8
tension band.
18. PARTIAL PATELLECTOMY
• Usually involving the distal pole,smaller fragments are excised.
• The patellar tendon is attached anteriorly with sutures.
19. TOTAL PATELLECTOMY
• Indicated for comminuted and displaced fractures that cannot be reconstructed.
• Bone fragments are excised before reattachment of the patellar tendon.
21. Mechanism of injury
• Varus or valgus force with axial
loading in fully extended or
partially flexed knee.
• A result of high energy trauma
in adults.
• A result of tivial fall in
osteopenic elderly.
22. Symptoms and sign
• Pain
• Swelling & Haemarthroses knee
• Inability to bear weight
• Restricted mobility
• Instability
• Deformity Around the Knee
• Pale, Cool Foot
23. Associated injuries
• Neurovascular injury
• Compartment syndrome
• DVT
• Contussion & crush injury with open wounds.
• Ligamentous injury – more with # dislocation pattern (60%) as compared to pure #
pattern (4-33%)
24. Radiological assessment
• X-rays
• Antero posterior
• Lateral
• Oblique
• Beam at a 10 degree angle caudally
• Computed tomography.
• Magnetic Resonance Imaging.
27. Schatzkers classification
• Type -1 › 4-6%. Valgus force + Axial loading
• Type–2 › 60-75% Valgus force
• Type–3 Very rare. Pure compression
• Type–4. 7-10% High energy varus force +/- Axial loading
• Type–5 › 2-3% High energy complex varus and valgus force
• Type–6 › 16-20% High energy complex varus and valgus force
30. Surgical treatment
• Indications
• Unstable # + ligament injury + articular
• displacement: a) Instability - > 10 degrees of varus or valgus
b) Depression or displacement > 10 mm
• Open #
• # with compartment syndrome › # with vascular injury
31. Treatment modalities
• Percutaneous screw fixation
• › Indications - Nondisplaced type I fractures
• › Advantages - Simple technique with minimal soft-tissue injury.
• › Disadvantages - Not applicable for other patterns of fracture.
32. • Percutaneous elevation and screw fixation
• Indications - Type II and III fractures in osteoporotic bone.
• Advantages - Simple technique with minimal soft-tissue
injury.
• Disadvantages - Not useful for high-energy fractures with
ligamentous and meniscal injuries.
33. • Arthroscopic-assisted elevation and screw fixation
• Indications - Types I, II, III, and IV fractures with ligamentous and meniscal
injuries.
• Advantages –
• Minimal soft-tissue injury.
• Helps to diagnose and treat intra-articular injuries.
• Aids in reduction of depressed articular fractures.
• Allows for joint lavage.
• Disadvantages - Not useful in high-energy fractures
34. • Open reduction and internal fixation with or without bone grafting
• Indications - Types II,III, IV, V, and VI fractures without soft-tissue injury.
• Advantages –
• Allows anatomic reduction.
• rigid internal fixation and bone grafting.
• facilitates joint exploration and treatment of intra-articular injuries.
• Disadvantages –
• Should not be performed in the acute setting in the presence of soft-tissue injury.
35. • External fixators - Half-pin fixator, ring fixator, hybrid fixator
• Indications – Open injuries and high-energy (types IV, V,
• and VI) fractures with soft-tissue injury.
• Fractures with vascular injury with or without compartment syndrome and polytrauma patients
• Advantages –
• Minimal soft-tissue injury.
• Disadvantages –
• Nonrigid fixation.
• Difficult to achieve anatomic fracture reduction.
• Joint stiffness.
• Pin-tract infections.
• Septic arthritis.
36. Follow up
• Non – weight-bearing precautions generally continue
for 12 weeks.
• Active flexion and passive extension are encouraged
for 6 weeks, after which active knee extension is
started.
