This document provides information about Lisfrac injuries, which occur at the tarsometatarsal (TMT) joint. It describes the anatomy of the TMT joint and the mechanisms of injury, which commonly include direct crush injuries or indirect injuries from axial loading of the plantar flexed foot. Diagnosis involves examining for pain, swelling, inability to bear weight, and radiographic findings like widening of the TMT transition zone. Treatment may involve non-operative casting or operative approaches like closed or open reduction and fixation with screws or plates if realignment cannot be achieved non-operatively. Complications can include infection, delayed healing, arthritis, and stiffness.
This document discusses the treatment of Galeazzi fractures, which involve a break in the distal third of the radius bone along with dislocation of the distal radio-ulnar joint. It outlines the evaluation, surgical approaches, techniques for open reduction and internal fixation using plates or pins, post-operative care, and potential complications. The prognosis depends on factors like the timing of surgery and whether the radius fracture and joint dislocation are properly reduced.
An olecranon fracture is a break of the proximal end of the ulna bone where it forms part of the elbow joint. It most often occurs from a fall on an outstretched arm. Diagnosis is made through physical exam finding tenderness and a gap at the fracture site as well as x-rays. Treatment depends on the severity of the break, with minor fractures treated by casting and more severe displaced fractures requiring surgical fixation such as screws, plates or wires to stabilize the bone fragments. Complications can include stiffness, non-healing of the fracture and arthritis if not properly treated.
This document discusses the management of humerus shaft fractures. It begins with an introduction and anatomy section. It then covers the mechanisms of injury, examination findings, imaging, classification systems, and indications for conservative versus operative management. Conservative management techniques like slings and bracing are outlined. Surgical approaches, fixation options like plating and nailing, challenges, post-operative care, complications, and prognosis are reviewed. Key points are radial nerve palsy often recovers spontaneously and plate fixation achieves good results for most humerus shaft fractures.
This document discusses various types of elbow fractures that can occur in children, including medial epicondyle apophysis fractures, pulled elbow syndrome, lateral condylar fractures, capitellar fractures, and medial condylar fractures. It provides details on the mechanisms of injury, classification systems, stages of displacement, and treatment approaches for each type of fracture. Key facts covered include that lateral condylar fractures can cross the physis or extend into the trochlear cartilage, and medial condylar fractures have both an intra-articular and extra-articular component. Classification systems such as those proposed by Milch and Weiss are described.
This document reports on a case of non-union of an odontoid fracture in a 24-year-old male patient. The patient initially presented with neck pain after a fall and was found to have a type II odontoid fracture with minimal displacement. He was treated conservatively with a cervical collar. After 4 months, he developed neurological deficits. Surgery was performed to achieve posterior C1-C2 fusion with instrumentation. The document then reviews literature finding that non-union of odontoid fractures is multifactorial but not due to compromised blood supply, and is more common when there is less bone density, trabeculae, and surface area at the fracture site.
This document discusses fractures of the olecranon bone. It begins with the epidemiology, noting these fractures have a bimodal distribution in younger individuals due to high-energy trauma and older individuals due to simple falls. The anatomy section outlines the subcutaneous position of the olecranon making it vulnerable to trauma, as well as its articulation with the elbow joint. Clinical presentation, evaluation, classification systems, treatment objectives, nonoperative and operative treatment options including various surgical techniques are then covered in detail.
This document summarizes the epidemiology, anatomy, mechanisms of injury, classification, treatment approaches, and complications for radial head fractures. Some key points:
- Radial head fractures account for 4% of all fractures and 30% of elbow fractures. They are rare in children.
- The radial head provides stability to the elbow joint and transmits 50-60% of the load across the elbow.
- Fractures are typically classified using the Mason classification system based on displacement.
- Treatment depends on fracture type but may include non-operative management, open reduction and internal fixation, radial head replacement, or radial head excision.
- Complications can include nerve injuries, stiffness, hardware issues, and recurrent
This document provides information about Lisfrac injuries, which occur at the tarsometatarsal (TMT) joint. It describes the anatomy of the TMT joint and the mechanisms of injury, which commonly include direct crush injuries or indirect injuries from axial loading of the plantar flexed foot. Diagnosis involves examining for pain, swelling, inability to bear weight, and radiographic findings like widening of the TMT transition zone. Treatment may involve non-operative casting or operative approaches like closed or open reduction and fixation with screws or plates if realignment cannot be achieved non-operatively. Complications can include infection, delayed healing, arthritis, and stiffness.
This document discusses the treatment of Galeazzi fractures, which involve a break in the distal third of the radius bone along with dislocation of the distal radio-ulnar joint. It outlines the evaluation, surgical approaches, techniques for open reduction and internal fixation using plates or pins, post-operative care, and potential complications. The prognosis depends on factors like the timing of surgery and whether the radius fracture and joint dislocation are properly reduced.
An olecranon fracture is a break of the proximal end of the ulna bone where it forms part of the elbow joint. It most often occurs from a fall on an outstretched arm. Diagnosis is made through physical exam finding tenderness and a gap at the fracture site as well as x-rays. Treatment depends on the severity of the break, with minor fractures treated by casting and more severe displaced fractures requiring surgical fixation such as screws, plates or wires to stabilize the bone fragments. Complications can include stiffness, non-healing of the fracture and arthritis if not properly treated.
This document discusses the management of humerus shaft fractures. It begins with an introduction and anatomy section. It then covers the mechanisms of injury, examination findings, imaging, classification systems, and indications for conservative versus operative management. Conservative management techniques like slings and bracing are outlined. Surgical approaches, fixation options like plating and nailing, challenges, post-operative care, complications, and prognosis are reviewed. Key points are radial nerve palsy often recovers spontaneously and plate fixation achieves good results for most humerus shaft fractures.
This document discusses various types of elbow fractures that can occur in children, including medial epicondyle apophysis fractures, pulled elbow syndrome, lateral condylar fractures, capitellar fractures, and medial condylar fractures. It provides details on the mechanisms of injury, classification systems, stages of displacement, and treatment approaches for each type of fracture. Key facts covered include that lateral condylar fractures can cross the physis or extend into the trochlear cartilage, and medial condylar fractures have both an intra-articular and extra-articular component. Classification systems such as those proposed by Milch and Weiss are described.
This document reports on a case of non-union of an odontoid fracture in a 24-year-old male patient. The patient initially presented with neck pain after a fall and was found to have a type II odontoid fracture with minimal displacement. He was treated conservatively with a cervical collar. After 4 months, he developed neurological deficits. Surgery was performed to achieve posterior C1-C2 fusion with instrumentation. The document then reviews literature finding that non-union of odontoid fractures is multifactorial but not due to compromised blood supply, and is more common when there is less bone density, trabeculae, and surface area at the fracture site.
This document discusses fractures of the olecranon bone. It begins with the epidemiology, noting these fractures have a bimodal distribution in younger individuals due to high-energy trauma and older individuals due to simple falls. The anatomy section outlines the subcutaneous position of the olecranon making it vulnerable to trauma, as well as its articulation with the elbow joint. Clinical presentation, evaluation, classification systems, treatment objectives, nonoperative and operative treatment options including various surgical techniques are then covered in detail.
This document summarizes the epidemiology, anatomy, mechanisms of injury, classification, treatment approaches, and complications for radial head fractures. Some key points:
- Radial head fractures account for 4% of all fractures and 30% of elbow fractures. They are rare in children.
- The radial head provides stability to the elbow joint and transmits 50-60% of the load across the elbow.
- Fractures are typically classified using the Mason classification system based on displacement.
- Treatment depends on fracture type but may include non-operative management, open reduction and internal fixation, radial head replacement, or radial head excision.
- Complications can include nerve injuries, stiffness, hardware issues, and recurrent
Lateral condyle fractures of the elbow are common in children between ages 6-10 years. They occur when a varus force is applied to an extended elbow. These fractures are prone to displacement and nonunion due to pull from forearm extensors and being bathed in synovial fluid. Treatment depends on the amount of displacement, with undisplaced fractures often treated non-operatively and displaced fractures requiring closed or open reduction and internal fixation. Complications can include ulnar nerve palsy, osteonecrosis, nonunion, and cubitus deformities.
This document discusses supracondylar humeral fractures in children. It notes that these are the most common pediatric fractures, usually occurring from falls onto an outstretched hand in children ages 5-7. The fractures are classified into 4 types based on displacement and angulation. Type I are undisplaced while types II-IV are increasingly displaced, with type III being completely displaced. Treatment depends on type, with undisplaced or mildly angulated fractures treated with splinting while more severe fractures require closed or open reduction and percutaneous pinning under imaging guidance.
This document provides information on fractures of the radius and ulna shaft. It discusses the anatomy of the forearm bones and the deforming forces that can occur with certain fracture locations. Types of fractures covered include isolated radius or ulna shaft fractures, both bone fractures, Monteggia fractures, Galeazzi fractures, and reverse Galeazzi fractures. Treatment options including nonoperative management with casting or operative management with open reduction and internal fixation are described. Postoperative rehabilitation and potential complications are also summarized.
This document discusses fractures of the calcaneus bone, also known as the heel bone. It begins with an introduction stating that calcaneus fractures make up approximately 2% of all fractures and are most common in males aged 21-45. The document then covers the anatomy and mechanisms of injury, describing how these fractures usually occur from high-energy impacts like falls from heights. It classifies fractures as either extra-articular or intra-articular and discusses the clinical features, imaging, treatment, and complications associated with calcaneus fractures.
An 92 year old male presented to the emergency department after a mechanical fall at a nursing home with neck pain. Imaging showed a type II odontoid fracture. He was placed in a rigid cervical collar and referred to spine surgery for further management which may include halo vest immobilization or surgical fixation.
Talus fractures involve the second largest tarsal bone. Hawkins classification system categorizes talus neck fractures into 4 types based on displacement and disruption of blood supply. Type 1 fractures are undisplaced while type 4 have the worst prognosis. Treatment depends on fracture type but generally involves anatomical reduction, stable fixation, and avoiding complications like avascular necrosis. Surgical approaches may be needed for types 2-4 to achieve and maintain reduction.
Cervical spine fractures, especially those involving C1 and C2, were discussed. Key points included that 10% of cervical fractures involve C1, with 56% being isolated fractures and 44% combined fractures. 20% involve C2. Types of C1 fractures described were Type 1 stable fractures at the posterior arch-lateral mass junction, Type 2 burst fractures, and Type 3 lateral mass fractures. Types of C2 fractures included odontoid fractures classified using Anderson and D'Alonzo's system, Hangman's fractures classified using Levine or Francis systems, and other miscellaneous fractures. Management depended on fracture type but often involved external immobilization though surgery may be indicated for unstable fractures or those with displacement,
This document provides information on Galeazzi fractures, which involve a fracture of the radial shaft with a dislocation of the distal radioulnar joint. It describes the mechanism of injury as a fall on a hyperpronated forearm, discusses associated injuries, signs on imaging, and classifications. Surgical management is the preferred treatment, involving plate fixation of the radial shaft fracture and possible pinning or open repair of the distal radioulnar joint if unstable. Postoperative immobilization and rehabilitation are also outlined.
Dr. ms goud management of forearm fracturesvaruntandra
The document discusses the anatomy, biomechanics, classification systems, treatment options, and complications of forearm fractures. It provides details on the bones, joints, ligaments, and muscles of the forearm. Furthermore, it examines various forearm fracture patterns and treatments such as plating, intramedullary nailing, and external fixation. Proper treatment aims to restore alignment, length, rotation, and blood supply to promote healing.
This document provides information on fractures of the radius and ulna shafts (forearm fractures). It discusses the epidemiology, anatomy, classification systems, clinical evaluation, imaging, and management including both closed and open reduction techniques. Surgical indications include displaced fractures of both bones, isolated fractures with over 10 degrees of angulation or rotation, and fracture dislocations. Acceptable postoperative alignment is discussed as well as postoperative care involving splinting and rehabilitation. Specific fracture patterns like Monteggia and Galeazzi fractures are also summarized.
This document describes the surgical procedure for repairing a Type 2 radial head fracture. It involves making a skin incision over the radial head, exposing the fracture, reducing the fracture anatomically with tools like elevators and k-wires, and fixing it with a Herbert screw placed under the articular surface. Range of motion is checked after fixation to ensure stability before closing.
This document provides information on apophyseal injuries of the distal humerus, including fractures of the medial and lateral epicondyles and intercondylar fractures.
For medial epicondyle fractures, the fragment is often displaced distally and may become incarcerated in the joint. They are typically treated nonoperatively with immobilization, while operative treatment is required for irreducible fragments. Lateral epicondyle fractures involve avulsion of the extensor tendon origin and are also usually treated nonoperatively.
Intercondylar fractures involve displacement of articular fragments and rotation of the condyles. Treatment depends on the degree of displacement and comminution, ranging from nonoperative immobilization to open reduction
This document summarizes surgical management of acetabular fractures. It discusses the goals of operative management as anatomic reduction and different surgical approaches for specific fracture patterns. The Kocher-Langenbeck approach is indicated for posterior wall, column and transverse fractures involving the posterior region. The ilioinguinal approach is used for anterior wall, column and transverse fractures involving the anterior region. Perfect anatomic reduction is important for excellent outcomes, and timing of surgery within 2 weeks can improve chances of anatomic reduction. Complications of each approach are discussed.
Pearls and pitfalls with im nailing of proximal tibia fracturesBipulBorthakur
This document discusses the challenges of intramedullary (IM) nailing of proximal tibia fractures. It notes a reported malalignment rate of 44-84% with IM implants. Key points include recognizing troublesome fracture patterns, the importance of preoperative planning and imaging, starting point selection, and use of adjunctive techniques like clamps, blocking wires/screws, and unicortical plates to help maintain reduction during nailing. Proper application of reduction principles can help reduce risk of angular deformities, the most common complication.
This document discusses Bennett's fracture, which is an intra-articular fracture at the base of the first metacarpal. It occurs due to an axial blow to a partially flexed thumb. The anatomy and mechanism of injury are described. Treatment options include closed reduction, closed reduction with internal fixation using K-wires, and open reduction with internal fixation using screws if there is joint incongruity. Gamekeeper's thumb, which is a ulnar collateral ligament injury of the thumb metacarpophalangeal joint, and its treatment are also summarized.
This document discusses the anatomy, classification, and management of fractures of the talus bone. It describes the different types of talar fractures including neck, body, lateral and posterior process, and head fractures. It outlines the mechanisms of injury, investigations, treatment options including casting, open reduction internal fixation, and excision depending on the fracture type and degree of displacement. Complications of the different fracture types such as avascular necrosis, osteoarthritis, and malunion are also summarized.
The document discusses fracture of the femoral shaft, including classifications of femoral shaft fractures and the significance of the third fragment. It also discusses the anatomical and mechanical axes of the femur, approaches to the femoral shaft, advantages and disadvantages of different surgical techniques like closed antegrade nailing, and key steps in the surgical procedure like patient positioning, preparation of the femur, and reaming.
Fractures around elbow lateral condyle and intercondylar fracturesSiddhartha Sinha
Fractures around the elbow include lateral condyle fractures and intercondylar fractures. Lateral condyle fractures involve the lateral epicondyle and account for 17% of distal humeral fractures in children. They often result in less satisfactory outcomes than supracondylar fractures due to missed diagnoses and loss of motion. Intercondylar fractures involve a T or Y-shaped fracture line through the two humeral condyles and comminution is common. Both fracture types are typically treated operatively with open reduction and internal fixation to restore the joint surface and columns. Complications can include post-traumatic arthritis, failure of fixation, loss of motion, and neurologic injury.
1) Bennett's fracture is an intra-articular fracture of the thumb metacarpal that causes disruption of the carpometacarpal joint. It occurs due to an axial blow against the partially flexed metacarpal.
2) Rolando's fracture is another type of rare, intra-articular fracture of the thumb metacarpal that results in a Y- or T-shaped fracture pattern. It has a poor prognosis.
3) Extra-articular fractures of the thumb metacarpal are the most common and usually do not require surgery. They can be treated with closed manipulation and casting.
Children have tendency to fall frequently. and most commony got injured around elbow joint.presenting you injuries around elbow and treatment modalities
Lateral condyle fractures of the elbow are common in children between ages 6-10 years. They occur when a varus force is applied to an extended elbow. These fractures are prone to displacement and nonunion due to pull from forearm extensors and being bathed in synovial fluid. Treatment depends on the amount of displacement, with undisplaced fractures often treated non-operatively and displaced fractures requiring closed or open reduction and internal fixation. Complications can include ulnar nerve palsy, osteonecrosis, nonunion, and cubitus deformities.
This document discusses supracondylar humeral fractures in children. It notes that these are the most common pediatric fractures, usually occurring from falls onto an outstretched hand in children ages 5-7. The fractures are classified into 4 types based on displacement and angulation. Type I are undisplaced while types II-IV are increasingly displaced, with type III being completely displaced. Treatment depends on type, with undisplaced or mildly angulated fractures treated with splinting while more severe fractures require closed or open reduction and percutaneous pinning under imaging guidance.
This document provides information on fractures of the radius and ulna shaft. It discusses the anatomy of the forearm bones and the deforming forces that can occur with certain fracture locations. Types of fractures covered include isolated radius or ulna shaft fractures, both bone fractures, Monteggia fractures, Galeazzi fractures, and reverse Galeazzi fractures. Treatment options including nonoperative management with casting or operative management with open reduction and internal fixation are described. Postoperative rehabilitation and potential complications are also summarized.
This document discusses fractures of the calcaneus bone, also known as the heel bone. It begins with an introduction stating that calcaneus fractures make up approximately 2% of all fractures and are most common in males aged 21-45. The document then covers the anatomy and mechanisms of injury, describing how these fractures usually occur from high-energy impacts like falls from heights. It classifies fractures as either extra-articular or intra-articular and discusses the clinical features, imaging, treatment, and complications associated with calcaneus fractures.
An 92 year old male presented to the emergency department after a mechanical fall at a nursing home with neck pain. Imaging showed a type II odontoid fracture. He was placed in a rigid cervical collar and referred to spine surgery for further management which may include halo vest immobilization or surgical fixation.
Talus fractures involve the second largest tarsal bone. Hawkins classification system categorizes talus neck fractures into 4 types based on displacement and disruption of blood supply. Type 1 fractures are undisplaced while type 4 have the worst prognosis. Treatment depends on fracture type but generally involves anatomical reduction, stable fixation, and avoiding complications like avascular necrosis. Surgical approaches may be needed for types 2-4 to achieve and maintain reduction.
Cervical spine fractures, especially those involving C1 and C2, were discussed. Key points included that 10% of cervical fractures involve C1, with 56% being isolated fractures and 44% combined fractures. 20% involve C2. Types of C1 fractures described were Type 1 stable fractures at the posterior arch-lateral mass junction, Type 2 burst fractures, and Type 3 lateral mass fractures. Types of C2 fractures included odontoid fractures classified using Anderson and D'Alonzo's system, Hangman's fractures classified using Levine or Francis systems, and other miscellaneous fractures. Management depended on fracture type but often involved external immobilization though surgery may be indicated for unstable fractures or those with displacement,
This document provides information on Galeazzi fractures, which involve a fracture of the radial shaft with a dislocation of the distal radioulnar joint. It describes the mechanism of injury as a fall on a hyperpronated forearm, discusses associated injuries, signs on imaging, and classifications. Surgical management is the preferred treatment, involving plate fixation of the radial shaft fracture and possible pinning or open repair of the distal radioulnar joint if unstable. Postoperative immobilization and rehabilitation are also outlined.
Dr. ms goud management of forearm fracturesvaruntandra
The document discusses the anatomy, biomechanics, classification systems, treatment options, and complications of forearm fractures. It provides details on the bones, joints, ligaments, and muscles of the forearm. Furthermore, it examines various forearm fracture patterns and treatments such as plating, intramedullary nailing, and external fixation. Proper treatment aims to restore alignment, length, rotation, and blood supply to promote healing.
This document provides information on fractures of the radius and ulna shafts (forearm fractures). It discusses the epidemiology, anatomy, classification systems, clinical evaluation, imaging, and management including both closed and open reduction techniques. Surgical indications include displaced fractures of both bones, isolated fractures with over 10 degrees of angulation or rotation, and fracture dislocations. Acceptable postoperative alignment is discussed as well as postoperative care involving splinting and rehabilitation. Specific fracture patterns like Monteggia and Galeazzi fractures are also summarized.
This document describes the surgical procedure for repairing a Type 2 radial head fracture. It involves making a skin incision over the radial head, exposing the fracture, reducing the fracture anatomically with tools like elevators and k-wires, and fixing it with a Herbert screw placed under the articular surface. Range of motion is checked after fixation to ensure stability before closing.
This document provides information on apophyseal injuries of the distal humerus, including fractures of the medial and lateral epicondyles and intercondylar fractures.
For medial epicondyle fractures, the fragment is often displaced distally and may become incarcerated in the joint. They are typically treated nonoperatively with immobilization, while operative treatment is required for irreducible fragments. Lateral epicondyle fractures involve avulsion of the extensor tendon origin and are also usually treated nonoperatively.
Intercondylar fractures involve displacement of articular fragments and rotation of the condyles. Treatment depends on the degree of displacement and comminution, ranging from nonoperative immobilization to open reduction
This document summarizes surgical management of acetabular fractures. It discusses the goals of operative management as anatomic reduction and different surgical approaches for specific fracture patterns. The Kocher-Langenbeck approach is indicated for posterior wall, column and transverse fractures involving the posterior region. The ilioinguinal approach is used for anterior wall, column and transverse fractures involving the anterior region. Perfect anatomic reduction is important for excellent outcomes, and timing of surgery within 2 weeks can improve chances of anatomic reduction. Complications of each approach are discussed.
Pearls and pitfalls with im nailing of proximal tibia fracturesBipulBorthakur
This document discusses the challenges of intramedullary (IM) nailing of proximal tibia fractures. It notes a reported malalignment rate of 44-84% with IM implants. Key points include recognizing troublesome fracture patterns, the importance of preoperative planning and imaging, starting point selection, and use of adjunctive techniques like clamps, blocking wires/screws, and unicortical plates to help maintain reduction during nailing. Proper application of reduction principles can help reduce risk of angular deformities, the most common complication.
This document discusses Bennett's fracture, which is an intra-articular fracture at the base of the first metacarpal. It occurs due to an axial blow to a partially flexed thumb. The anatomy and mechanism of injury are described. Treatment options include closed reduction, closed reduction with internal fixation using K-wires, and open reduction with internal fixation using screws if there is joint incongruity. Gamekeeper's thumb, which is a ulnar collateral ligament injury of the thumb metacarpophalangeal joint, and its treatment are also summarized.
This document discusses the anatomy, classification, and management of fractures of the talus bone. It describes the different types of talar fractures including neck, body, lateral and posterior process, and head fractures. It outlines the mechanisms of injury, investigations, treatment options including casting, open reduction internal fixation, and excision depending on the fracture type and degree of displacement. Complications of the different fracture types such as avascular necrosis, osteoarthritis, and malunion are also summarized.
The document discusses fracture of the femoral shaft, including classifications of femoral shaft fractures and the significance of the third fragment. It also discusses the anatomical and mechanical axes of the femur, approaches to the femoral shaft, advantages and disadvantages of different surgical techniques like closed antegrade nailing, and key steps in the surgical procedure like patient positioning, preparation of the femur, and reaming.
Fractures around elbow lateral condyle and intercondylar fracturesSiddhartha Sinha
Fractures around the elbow include lateral condyle fractures and intercondylar fractures. Lateral condyle fractures involve the lateral epicondyle and account for 17% of distal humeral fractures in children. They often result in less satisfactory outcomes than supracondylar fractures due to missed diagnoses and loss of motion. Intercondylar fractures involve a T or Y-shaped fracture line through the two humeral condyles and comminution is common. Both fracture types are typically treated operatively with open reduction and internal fixation to restore the joint surface and columns. Complications can include post-traumatic arthritis, failure of fixation, loss of motion, and neurologic injury.
1) Bennett's fracture is an intra-articular fracture of the thumb metacarpal that causes disruption of the carpometacarpal joint. It occurs due to an axial blow against the partially flexed metacarpal.
2) Rolando's fracture is another type of rare, intra-articular fracture of the thumb metacarpal that results in a Y- or T-shaped fracture pattern. It has a poor prognosis.
3) Extra-articular fractures of the thumb metacarpal are the most common and usually do not require surgery. They can be treated with closed manipulation and casting.
Children have tendency to fall frequently. and most commony got injured around elbow joint.presenting you injuries around elbow and treatment modalities
Radiographs for placement of Dental Implant is essential. It is required before, after and during dental implant placement.
Oral Rehabilitaion : wide range of options
available
Implant : nearly 3rd set of teeth.
OBJECTIVES OF IMPLANT IMAGING
To decide if implant treatment is appropriate for the
patient
To detect any possible pathological conditions
To ascertain height, buccolingual width, and angulation
of alveolar process
To identify the location of vital anatomical stuctures such
as the inferior alveolar nerve and maxillary sinus
To ascertain bone quantity
To decide the length and width of implant to be placed
This document discusses various orthopaedic instruments and implants used in bone healing and surgery. It begins with describing instruments such as bone hooks, elevators, levers, holders, curettes, forceps, nibblers, osteotomes, chisels, gouges, and mallets. It then discusses implants like K-wires, pins, clamps, rods, external fixators, intramedullary nails, plates, and screws. The document concludes by mentioning prosthetics like the Austin-Moore, Thompson's, and bipolar prostheses, as well as total hip and knee replacements.
This document discusses painful arc syndrome, also known as impingement syndrome. It begins with a brief history, noting early descriptions in the 1800s and contributions in the 1970s by Neer, who characterized it as impingement of the rotator cuff tendons against the acromion. It then describes the four main types of impingement and their causes. Treatment options discussed include non-operative treatments like anti-inflammatories and physiotherapy, as well as surgical options like arthroscopic acromioplasty to remove bone and relieve impingement. Potential complications of surgery are also outlined.
This document discusses various types of splints and tractions used in orthopaedics. It describes different wooden, metallic, and plaster splints used to immobilize parts of the body like the leg, arm, and spine. It also discusses types of skeletal traction used to reduce fractures or dislocations, including femoral, tibial, and calcaneal traction. Complications of splints and traction like pressure sores, nerve injuries, and infections are also outlined.
The document discusses the assessment and management of extremity trauma and compartment syndrome in the emergency room. It describes a case of a 25-year-old male who was in a motorcycle accident and presented with pain in his left leg, right shoulder, and bleeding from his right foot. The document then outlines various types of extremity injuries commonly seen in the ER, including fractures, dislocations, open wounds, and compartment syndrome. It provides guidance on history taking, clinical examination, imaging, and immobilization techniques for different types of fractures, emphasizing the importance of managing ABCs first if life-threatening injuries are present.
The document discusses orthopedic trauma and fracture treatment. It defines trauma, orthopedic trauma, and types of fractures. It covers fracture classification systems, examination, imaging, primary and secondary surveys. Treatment principles are described including reduction, immobilization methods like casting, traction, and fixation options like plates, screws and nails. Complications of fractures are outlined for both early and late stages.
This document provides information about bone plates, including their function, history, types, and uses. It discusses:
- Bone plates act as internal splints, holding fractured bone ends together and transmitting force across fracture sites.
- Plating technology has evolved from standard round-hole plates in 1958 to currently used locking compression plates.
- Plate types include dynamic compression plates (DCP), locking compression plates (LCP), and reconstruction plates.
- Plates are also classified based on shape, width, screw hole design, surface characteristics, and intended application site.
- Key principles of plating include compression, neutralization, buttress fixation, and tension band techniques.
- Locking plates provide angular
This document summarizes the anatomy of the female pelvis. It describes the false pelvis and true pelvis, as well as the three planes - inlet, midpelvis, and outlet. It details the diameters and landmarks of the pelvic inlet, midpelvis, and outlet. Signs of midpelvis contraction are provided. Finally, pelvic shapes based on Caldwell-Moloy classification are briefly introduced.
This document discusses various surgical procedures for glaucoma management. It provides details on laser trabeculoplasty, incisional surgery such as filtering procedures, laser iridotomy, glaucoma drainage devices, and cyclodestructive procedures. Laser trabeculoplasty involves applying laser energy to the trabecular meshwork to lower intraocular pressure. Filtering surgery involves creating a fistula to allow aqueous humor to drain from the anterior chamber. Laser iridotomy is used to treat pupillary block glaucoma by creating an iridotomy. Glaucoma drainage devices provide an alternative drainage pathway through a tube. Cyclodestructive procedures aim to reduce aqueous production by ablating the ciliary body. The
This document discusses several mechanical complications that can arise from coronary artery disease, including left ventricular aneurysm, ventricular septal defect, left ventricular free wall rupture, and ischemic mitral regurgitation. It provides details on the causes, presentations, diagnoses, and surgical treatments for each complication. Surgical techniques like linear repair, patch repair, and infarct exclusion are described for repairing left ventricular aneurysms and ventricular septal defects. The importance of addressing these complications through early surgical intervention is emphasized.
This document describes three posterior surgical approaches to the humerus:
1) The posterior approach to the proximal humerus, which exposes the bone between the lateral head of the triceps and deltoid muscles. Key structures include the axillary nerve and posterior circumflex humeral artery proximally and the radial nerve distally.
2) The posterolateral approach to the distal humeral shaft, which is a modified lateral approach between the brachioradialis and triceps muscles.
3) The posterior approach for the middle two-thirds of the humerus described by Henry, which splits the triceps muscle to access tumors.
1. Varicose veins result from increased pressure in the superficial veins due to gravity and malfunctioning valves. The document discusses various surgical procedures to treat varicose veins including stripping, ligation, and newer minimally invasive techniques like radiofrequency ablation, foam sclerotherapy, and endovenous laser therapy.
2. Precautions are discussed for different patient conditions and potential surgical complications include bruising, infection, nerve damage, and deep vein thrombosis. Proper pre-op evaluation and post-op compression are important to reduce risks.
3. Surgical techniques aim to eliminate reflux by ligating vein sources and removing incompetent veins like the long saphenous vein during stripping procedures or closing veins end
This document discusses the classification, clinical features, investigation, management, and complications of zygomatic bone fractures. It describes 8 types of zygomatic bone fractures classified by Row and Killey or Knight and Northwood. Clinical features include midface deformities, ocular symptoms like diplopia, neurological symptoms, oral symptoms like trismus, and nasal symptoms like epistaxis. Management involves surgical approaches like bicoronal or Gillies temporal to reduce the fracture using indirect or direct methods, then fixing with miniplates in 1-4 points. Complications can include infraorbital numbness, enophthalmos, diplopia, or superior orbital fissure syndrome.
This document discusses varicose veins and their treatment options. It begins by describing the anatomy of varicose veins and their branches. It then discusses various surgical treatment options for varicose veins including stripping, endovenous laser therapy (EVLT), sclerotherapy, and hook phlebectomy. It provides details on the procedures, risks, post-operative care, and complications. In summary, it provides an overview of varicose vein anatomy and treatments through both invasive and non-invasive surgical procedures.
different type of lower limb amputation with indication, peri-operative care, surgical steps, post op care complication and different type of prosthesis
This document provides an overview of anterior cruciate ligament (ACL) injuries, including the anatomy of the knee ligaments, mechanisms of ACL injury, examination and diagnostic tests, imaging, surgical reconstruction techniques, grafts, complications, and rehabilitation. It describes the ligamentous anatomy of the knee, mechanisms of ACL injury, physical examination maneuvers to evaluate the ACL, imaging like X-ray and MRI, surgical reconstruction using grafts like hamstring tendons, fixation techniques, post-operative rehabilitation, and potential complications.
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11. INLET VIEW
• INTERNAL OR EXTERNAL RETOATION OF
HEMIPELVIS
• OPENING OF SI JOINT
• IMPACTION # OF SACRAL ALA
• AP DISPLACEMENT OF POSTERIOR RING
OUTLET VIEW
• SACRAL FRACTURES WITH RESPECT TO
FORAMINA.
14. CT
• CT SCAN CAN AID IN THE RECOGNITION OF MANY OF THESE INJURIES
THAT GO UNDETECTED ON PLAIN RADIOGRAPHS
• THE 3D AND OTHER RECONSTRUCTED IMAGES CAN ASSIST IN
DETERMINATION OF THE SURGICAL APPROACH
STRESS VIEWS : TAKEN UNDER ANEASTHESIA MAY REVEAL
SOME INSTABILITY WHICH IS NOT SEEN IN NORMAL XRAYS
18. LATERAL COMPRESSION (LC I)
ANTERIOR INJURY: PUBIC RAMI #
POST INJURY: SACRAL # ON SIDE
OF IMAPACT
19. LATERAL COMPRESSION - II
ANTERIOR INJURY: RAMI #
POSTERIOR INJURY:
CRESCENT# (FRACTURE
DISLOCATION OF ILIUM
THROUGH SI JOINT)
20. LATERAL COMPRESSION III (WIND SWEPT PELVIS)
TYPE I OR II INJURY ON SIDE OF IMPACT +
CONTRALATERAL OPEN BOOK INJURY
21.
22.
23. ANTERO POSTERIOR COMPRESSION (APC I)
[ANTERIOR INJURY= SYMPHYSIS DIASTASIS/ RAMI #]
MODE OF INJURY: SEVERE EXTERNAL
ROTATION OF ONE HEMIPELVIS
ANTERIOR INJURY: PUBIC DIASTASIS < 2.5 CM
POSTERIOR INJURY: MILD ANTERIOR
OPENING OF SI JOINT
24. APC II ANT. INJURY: PUBIC DIASTSIS >2.5 CM
POST. INJURY:OPENING OF ANTERIOR SI
JOINT, INACT POSTERIOR SI
LIGAMENTS,RUPTURE OF ANTERIOR SI
LIGAMENTS
(SACROTUBEROUS,
SACROSPINOUS,ANTERIOR SACROILIAC)
25. APC III – COMPLETE SI JOINT DISRUPTION
DISRUPTION OF
INTRAARTICULAR AND
POSTERIOR SI LIGAMENTS .
26. VERTICAL SHEAR
• PRIMARY FORCE VECTOR IS DIRECTED CEPHALAD.
• HEMI PELVIS SHIFTED VERTICALLY
• AVULSION # OF L5 INDICATES UNSTABLE # (ILIO LUMBAR LIGAMENT DISRUPTION)
28. DENIS CLASSIFICATION OF SACRAL FRACTURES
• BASED ON FRACTURE LINE IN RELATION WITH
SACRAL FORAMINA
• ZONE I – FRACTURE LINE LATERAL TO FORAMINA
• ZONE II – FRACTURE LINE THROUGH THE
FORAMINA, HIGH CHANCE OF SACRAL NERVE
INJURY
• ZONE III – FRACTURE MEDIAL TO FORAMINA, HIGH
RISK OF INJURY TO SPINAL CANAL
29.
30. MANAGEMENT
NON OPERATIVE TRATMENT: INDICATIONS :-
• STABLE PELVIC RING INJURIES (LC – I)
• STABLE SACRAL INJURIES. (RISK OF LATE DISPLACEMENT)
• COMORBIDITIES PRECLUDING SURGICAL INTERVENTION
• POOR BONE QUALITY WHERE SCREW PURCHASE MAY BE
PROBLEMATIC
• THE LOW-ENERGY OSTEOPOROTIC PELVIC RING FRACTURE
31. OPERATIVE MANAGEMENT - GENERAL PRINCIPLES:
• POSTERIOR INJURY IS REGARDED AS THE MORE CRITICAL ONE REQUIRING AN
ACCURATE REDUCTION AND STABLE FIXATION.
• ANTERIOR FIXATION CAN NEITHER MAINTAIN POSTERIOR REDUCTION NOR
RESTORE STABILITY
• IN CEPHALAD DISPLACEMENT OF THE HEMIPELVIS WITH COMPLETE INSTABILITY
OF THE POSTERIOR RING, POSTERIOR FIXATION SHOULD ALWAYS BE
SUPPLEMENTED WITH ANTERIOR STABILIZATION
• POSTERIOR PELVIC RING SHOULD BE REDUCED AND STABILIZED FIRST, FOLLOWED
BY ANTERIOR PELVIC RING
32. ANTERIOR RING
• EXTERNAL FIXATION
• PUBIC SYMPHYSIS
PLATING
• PUBIC RAMI PLATING
• PUBIC RAMI PC SCREW
FIXATION
POSTERIOR RING
• SACROILIAC SCREW
FIXATION
• SI JOINT PLATING
• ILIAC WING PLATE/SREW
33. EXTERNAL FIXATION:
INDICATIONS:
• AS AN EMERGENCY PROCEDURE
• TO REDUCE THE POSTERIOR LESION PRIOR TO POSTERIOR
STABILIZATION.
• DEFINITIVE FIXATION: WHEN INTERNAL FIXATION CANNOT BE DONE
( WOUNDS, SPC, TO AVOID MORBIDITY OF OPEN PROCEDURE)
• COMMUNITED FRACTURES
37. DRILLING THE FIRST CORTEX ADVANCING THE PIN BETWEEN TWO TABLES OF ILIAC BONE
38. GUIDING PIN WHICH INSERTED
BETWEEN THE ILIACUS AND
INNER TABLE
ILIAC CREST PIN
39. SUPRA ACETABULAR PIN TECHNIQUE:
• BIOMECHANICALLY STRONGER.
• PATIENT CAN SIT.
• FLUROSCOPY DEPENDENT
• SITE: 4-6 CM INFERIOR, 3-4 CM MEDIAL TO ASIS.
• STARTING POINT: AIIS .
• PIN DIRECTION: 10-20 CRANIALLY, 20-30 MEDIALLY. TOWARDS PIIS
• SECOND PIN: 2CM SUPERIOR
40.
41.
42. PELVIC INFIX
• DONE BY ADAPTING SPINAL INSTRUMENTS TO PELVIS
• INSERTION OF PEDICLE SCREW AS SUPRA ACETABULAR PIN
• SPINAL ROD CONTURED, CUT AND PASSED BETWEEN ABDOMINAL
FAT LAYER AND RECTUS.
43.
44. INTERNAL FIXATION TECHNIQUES
ANTERIOR FIXATION:
INDICATIONS:
• PUBIC DIASTASIS >2.5 CM
• AUGMENTATION OF POSTERIOR FIXATION IN UNSTABLE PELVIC RING
INJURIES
• SIGNIFICANTLY DISPLACED RAMI FRACTURES
• LOCKED SYMPHYSIS
• STRADDLE FRACTURES (BILATERAL SUPERIOR AND INFERIOR RAMI
FRACTURES)
• PAIN AND INABILITY TO MOBILIZE (RELATIVE INDICATION)
45. CONTRAINDICATIONS:
• BLADDER RUPTURE
• COLOSTOMY
• SUPRAPUBIC CATHETER
• APPROACHES:STOPPA APPROACH
PFANNENSTIEL INCISION
SKIN INCISION WITH EXPOSED FASCIA
50. FIXATION OF RAMI FRACTURES
• MANY FRACTURES CAN BE TREATED CONSERVATIVELY
• USED FOR GROSSLY DISPLACED RAMI # OR AUGMENT POSTERIOR
FIXATION
• APPROACH: EXTENSION OF STOPPA OR ILIOINGUINAL APPROACH
51.
52. PERCUTANEOUS SCREW FIXATION
• AVOIDS EXTENSIVE DISSECTION OF OPEN REDUCTION.
ANTEROGRADE SCREW (RIGHT)
• THE STARTING POIN MIDPOINT ON A
LINE BETWEEN THE TIP OF THE
GREATER TROCHANTER AND A SPOT
ABOUT 4 CM POSTERIOR TO THE ASIS
RETROGRADE SCREW (LEFT)
• ENTER JUST LATERAL TO PUBIC
TUBERCLE
55. PERCUTANEOUS VS OPEN
OPEN SI JOINT REDUCTION
• COMBINED ACETABULUM FRACTURE
• PERCUTANEOUS REDUCTION NOT
ADEQUATE
• NO LINEAR REDUCTION VECTOR
PERCUTANEOUS
• LESS INVASIVE
• AVOID WOUND COMPLICATIONS
• LINEAR REDUCTION VECTOR AVAILABLE
56.
57. ILIOSACRAL SCREW FIXATION
• INDICATIONS: SI JOINT
DISLOCATIONS, CRESCENT
FRACTURE,SACRAL BODY
FRACTURE
• POSITION : SUPINE/ PRONE
• SITE: INTRSECTION OF LINE
DRAWN FROM GT AND ASIS
• STARTING POINT:
66. ZONE I – SACROILIAC SCREW, PARTIALLY THREADED
ZONE II – 1)UNDISPLACED,NON COMMUNITED-
PARTIALLY THREADED SCREW
2)COMMUNITED FRACTURE- FULLY THREADED
3)WITH NERVE INJURY – OPEN REDUCTION
AND DECOMPRESSION
ZONE III – UNDISPLACED – SI SCREW PARTIALLY
THREADED
67. CRESCENT FRACTURES
TYPE I – TREATED LIKE ILIAC WING
FRACTURE
ANTERIOR APPROACH
LAG SCREWS
TYPE II – POSTERIOR APPROACH
LAG SCREW FIXATION
TYPE III – POSTERIOR APPPROACH
LAG SCREW/ SI SCREW