Pre op
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X-rays are the basic investigation used in orthopedics, especially for fractured bones, pre-operative and post-operative assessments, and checking for bone tumors. During surgery, the patient is monitored and stabilized hemodynamically, with oxygen levels, ECG, blood pressure, and CO2 monitored. Blood or saline may be transfused if needed, and antibiotics and temperature control are provided. Post-operative complications can include shock, DVT, tetanus, gas gangrene, fever, fat embolism, delirium tremors, blisters, bed sores, torn muscle fibers, tissue atrophy, tendon tears, nerve compression, vascular injuries, bleeding, compartment syndrome, infections, malun
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The document discusses amputation, including definitions, history, indications, types, postoperative care, complications, and special procedures. It notes that amputation involves surgical removal of part or all of a limb through bone or joints. The main indications are trauma, peripheral vascular disease, infection, tumors, and congenital anomalies. Postoperative goals are prompt healing, edema control, pain management, and early rehabilitation and prosthesis training. Complications can include wound issues, infection, phantom pain, and psychological impacts.
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amputation
The document provides an overview of general principles and techniques for amputation. It discusses:
1. The definition of amputation and its historical development from ancient times to modern antiseptic techniques.
2. The common indications for amputation including peripheral vascular disease, trauma, infections, and tumors.
3. Surgical principles such as ideal stump shape and length, techniques for blood vessels, nerves, muscles and bone, and postoperative care including rigid dressings.
4. Potential complications like hematoma, infection, wound necrosis, contractures and phantom limb pain.
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This document discusses various imaging modalities used to evaluate knee injuries, including plain X-rays, CT scans, MRI, and angiography. Plain X-rays can show abnormal joint space, subluxation, and associated fractures. CT angiography provides detail on avulsions and fractures. MRI is indicated for all multiligament knee injuries as it can identify ligament, meniscal, cartilage, and tendon injuries. It also helps determine treatment plans by identifying the type and location of injuries. Vascular investigations include assessing pulses, temperature, color, and ankle-brachial indices to evaluate arterial flow and determine if further arterial studies are needed.
Presentation1 radiological imaging of carpal tunnel syndrome.
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- Ultrasound and MRI are useful imaging modalities. Ultrasound can show bowing of the flexor retinaculum, flattening and swelling of the median nerve. MRI also demonstrates these findings and can detect additional causes like masses or arthritic changes.
- Various pathologies can cause carpal tunnel syndrome by decreasing the size of the tunnel or enlarging its contents, compressing the median nerve. Imaging allows visualization
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The document discusses various indications for amputation including peripheral vascular disease, trauma, burns, frostbite, infections and tumors. It provides details on evaluating each condition and determining whether amputation is necessary. For example, it states that for peripheral vascular disease, a vascular consultation is recommended to assess revascularization options before amputating. For trauma, scoring systems can help predict limb salvageability. Infection is another common reason, and different infectious etiologies require specific antibiotic and surgical treatments. Overall, the document offers guidance on the management and decision making for various conditions that may require amputation.
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- Tarsal tunnel syndrome refers to entrapment of the posterior tibial nerve as it passes through the tarsal tunnel in the ankle. Common symptoms include pain, numbness and tingling in the foot.
- Causes of tarsal tunnel syndrome include ganglion cysts, bone deformities, varicose veins, space-occupying lesions, and muscle or structural abnormalities that compress the nerve.
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Case Study 2
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Dynamic study
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Amputation
Amputation involves the surgical removal of a limb or part of a limb. It is one of the oldest surgical procedures, historically performed without anesthesia to control bleeding from traumatic injuries or as treatment for gangrene, tumors, or other conditions. The goals of amputation are to remove dead, dangerous, or dysfunctional tissue while preserving maximum limb length and function. It requires consideration of various factors like the level of injury, adequate tissue margins, circulation, soft tissues, and infection control. Various techniques and postoperative management aim to provide a healed stump that can accommodate a prosthesis and restore mobility. Complications can include bleeding, wound healing issues, infections, phantom limb sensations and pain.
Surgery 6th year, Tutorial (Dr. Aso Omar)
The kidneys can be injured by blunt or penetrating trauma, requiring timely medical evaluation. The kidneys are normally protected by back muscles but can be damaged by severe impacts or objects piercing the skin. Blunt trauma may cause bruising while penetrating injuries like gunshots can enter elsewhere and travel to the kidneys. Most kidney injuries are minor but evaluation with imaging tests like ultrasound or CT scans helps classify the injury and guide management, which may include rest, antibiotics, surgery, or nephrectomy in more severe cases.
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This document discusses various types of toe and partial foot amputations. It begins by explaining how amputations alter ambulation depending on the amount and location of tissue removed. It then describes the anatomy of the foot and toes. The main types of amputations discussed are phalangeal, transmetatarsal, and various partial foot amputations. For each type, the document explains the procedure and important anatomical and functional considerations.
Amputations of extremity
AMPUTATION: Cutting of the extremity or part of the extremity through the bone
While ………..
DISARTICULATION: Cutting of the extremity or part of the extremity through the joint
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This document provides details on MRI imaging of the knee and ankle, including:
- Muscles and ligaments relevant to the knee and ankle
- Imaging modalities used including MRI sequences and technical considerations
- Anatomy and normal appearances of structures like the menisci, ACL, PCL, MCL, LCL
- Descriptions and diagrams of MRI slices in the sagittal, coronal, and axial planes
- Checklist for evaluating ankle MRI focusing on bones, joints, ligaments, and tendons
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This document discusses the medical history and treatment of a patient, T.M.O., who has sickle cell anemia. It describes how he underwent a hip replacement surgery using bone from his other hip to rebuild the acetabular roof. After a month of traction, the prosthesis could be inserted. Years later, he presented with a painful right hip and infection after an accident, showing a perforated femoral stem on x-ray. The doctor recommends a two-stage revision surgery to remove the stem, treat the infection, and later insert a new revision stem.
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This document discusses amputation of the lower extremities for ischemia. It begins by outlining general considerations for operative planning, including selecting the appropriate amputation level based on a patient's ambulatory status and vascular exam findings. It then describes techniques for specific amputations, including:
1) Toe amputations, which can be either transphalangeal or ray (transmetatarsal). Proper technique and hemostasis are emphasized to prevent complications.
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amputation
The document provides an overview of general principles and techniques for amputation. It discusses:
1. The definition of amputation and its historical development from ancient times to modern antiseptic techniques.
2. The common indications for amputation including peripheral vascular disease, trauma, infections, and tumors.
3. Surgical principles such as ideal stump shape and length, techniques for blood vessels, nerves, muscles and bone, and postoperative care including rigid dressings.
4. Potential complications like hematoma, infection, wound necrosis, contractures and phantom limb pain.
4. knee investigations
This document discusses various imaging modalities used to evaluate knee injuries, including plain X-rays, CT scans, MRI, and angiography. Plain X-rays can show abnormal joint space, subluxation, and associated fractures. CT angiography provides detail on avulsions and fractures. MRI is indicated for all multiligament knee injuries as it can identify ligament, meniscal, cartilage, and tendon injuries. It also helps determine treatment plans by identifying the type and location of injuries. Vascular investigations include assessing pulses, temperature, color, and ankle-brachial indices to evaluate arterial flow and determine if further arterial studies are needed.
Presentation1 radiological imaging of carpal tunnel syndrome.
- Carpal tunnel syndrome results from compression of the median nerve as it passes through the carpal tunnel in the wrist. It commonly occurs between ages 36-60 and is more frequent in women. Symptoms include pain, numbness, and tingling in the hand.
- Ultrasound and MRI are useful imaging modalities. Ultrasound can show bowing of the flexor retinaculum, flattening and swelling of the median nerve. MRI also demonstrates these findings and can detect additional causes like masses or arthritic changes.
- Various pathologies can cause carpal tunnel syndrome by decreasing the size of the tunnel or enlarging its contents, compressing the median nerve. Imaging allows visualization
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The document discusses various indications for amputation including peripheral vascular disease, trauma, burns, frostbite, infections and tumors. It provides details on evaluating each condition and determining whether amputation is necessary. For example, it states that for peripheral vascular disease, a vascular consultation is recommended to assess revascularization options before amputating. For trauma, scoring systems can help predict limb salvageability. Infection is another common reason, and different infectious etiologies require specific antibiotic and surgical treatments. Overall, the document offers guidance on the management and decision making for various conditions that may require amputation.
Traumatic amputations
This document discusses the management of traumatic amputations in the emergency department. It provides details on initial assessment, handling of amputated parts, criteria for replantation versus amputation, and various scoring systems used to predict outcomes. Key points include controlling bleeding, administering antibiotics and tetanus prophylaxis, placing amputated parts in saline-moistened bags on ice, and consulting plastic/vascular surgeons for possible replantation depending on the level of injury and time since amputation. Scoring systems aim to guide the decision for limb salvage versus amputation based on factors like soft tissue, bone, nerve and vascular injuries.
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Presentation1 radiological imaging of tarsal tunnel syndrome.
- Tarsal tunnel syndrome refers to entrapment of the posterior tibial nerve as it passes through the tarsal tunnel in the ankle. Common symptoms include pain, numbness and tingling in the foot.
- Causes of tarsal tunnel syndrome include ganglion cysts, bone deformities, varicose veins, space-occupying lesions, and muscle or structural abnormalities that compress the nerve.
- Radiological imaging techniques like ultrasound and MRI can identify potential compressive elements, assess nerve damage, and help determine appropriate treatment which may be conservative therapy or surgery.
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Case Study 2
Knee OA with persistent lateral pain and painful limitation of the flexion,
Dynamic study
probe is placed transverse over lateral femoral condyle
at 90 degrees flexion the iliotibial band impinges between 2 osteophytes leading to severe pain and limitation of flexion,with extension the iliotibial band moves anterior and lateral away from the osteophytes with relief of pain.
Charcot foot
This document discusses Charcot foot, also known as neuropathic foot, which is a condition where repetitive stress causes destruction of bones and joints in the foot. It primarily affects those with nerve damage from conditions like diabetes, syphilis, tabes dorsalis, and leprosy. Charcot foot was first described by Jean-Martin Charcot in 1868. Physical findings include swelling, deformity, warmth, and bone resorption. Treatment involves immobilization in the acute phase to reduce stress, and bracing or surgery in the post-acute phase depending on the location and severity of damage. The document also briefly discusses the risks and management of diabetic foot complications.
MRI of Knee joint-- hossam massoud
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Presentation1 radiological imaging of carpal tunnel syndrome.
Presentation1 radiological imaging of carpal tunnel syndrome.
Presentation1 radiological imaging of tarsal tunnel syndrome.
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Use of PRP-HA for the Treatment of Articular and Peri-Articular Diseases By ...
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1. The document discusses the evaluation and management of patients presenting to the emergency department with trauma or acute diseases.
2. It outlines the clinical examination, laboratory tests, radiology imaging and procedures used for trauma and acute care patients.
3. Specific radiological evaluations are described for trauma patients, including cervical spine, chest and pelvis x-rays, and CT scans of the brain, chest, abdomen and pelvis depending on the mechanism and sites of injury.
TUBERCULOSIS OF SPINE.pptx
Hello students.
It's a lecture prepared from maheshwari with pictures attached. This is sufficient for for answering a question in examination at mbbs level.
Amputation class
Amputation is the complete removal of an injured or deformed body part. It is performed to treat conditions such as peripheral vascular disease, trauma, infection, tumors, and congenital anomalies. The goals of amputation are to remove diseased tissue, reduce morbidity and mortality from severe conditions, and allow for reconstruction to produce a functional end organ. Various techniques are used depending on the condition and location of the amputation. Postoperative management focuses on wound healing, pain management, rehabilitation, and prevention of complications.
compartment syndrome
The document discusses compartment syndrome and crush injury. Compartment syndrome occurs when increased pressure within a compartment reduces blood flow, and presents with pain, paresthesia, pallor and paralysis. Treatment requires immediate fasciotomy to decompress the compartment. Crush injury results from direct muscle crushing and causes metabolic derangements as muscle contents are released. Management involves aggressive fluid resuscitation, monitoring and treating for hyperkalemia, acidosis and renal failure, with hemodialysis as needed.
Spine examination-Part 2
Clinical examination of the spine/back covering: NEUROLOGICAL EXAMINATION -
-MOTOR
-SENSORY
-REFLEXES
-AUTONOMOUS
-BOWEL AND BLADDER
(Upper and Lower Limbs)
Covering separately:
The Vertebral level
The pathological process : Extradural or Intradural
The extent of deficit: The Neurological level
The type of deficit: UMN or LMN
UPPER & LOWER LIMBS
Heterotrophic ossification
Heterotopic ossification (HO) is the formation of bone in soft tissues near a joint. It commonly occurs after injuries like traumatic brain or spinal cord injuries. Risk factors include older age, complete neurological lesions, male gender, and spasticity. While the exact cause is unknown, damage to sympathetic nerves may increase blood flow and promote HO. Diagnosis involves imaging like bone scans and x-rays. Treatment includes NSAIDs, bisphosphonates, radiation, surgery if limiting range of motion, and physical therapy to preserve joint mobility. Rehabilitation follows phases focusing on edema control, range of motion, and returning to prior activity levels.
Compartment syndrome
Compartment syndrome and crush injury are serious conditions that require prompt treatment. Compartment syndrome occurs when increased pressure within a muscle compartment impairs blood flow, and symptoms include pain, paresthesia, pallor and paralysis if left untreated. Crush injury results from direct muscle crushing and can cause metabolic derangements like hyperkalemia and rhabdomyolysis. Early fluid resuscitation and fasciotomy or hemodialysis may be needed to manage the conditions and prevent further muscle and organ damage.
Introduction to Bone Scan: Techniques and Diagnosis
This document provides an overview of nuclear medicine imaging techniques like bone scans. It discusses how nuclear medicine shows physiological functioning rather than anatomy. Bone scans specifically involve injecting radioactive tracers that are absorbed by bone and then imaging their distribution to identify abnormalities. The document reviews normal scan findings, uses of bone scans to detect conditions like metastases and fractures, and presents several case examples to illustrate bone scan interpretations for conditions like osteomyelitis, bone metastases, and trauma.
Tourniquet
A tourniquet is a device that controls blood flow to an extremity by applying circumferential pressure. It is used medically to create a bloodless surgical field or stop traumatic bleeding. The earliest known usage was by Romans in 199 BC during amputations. Modern tourniquets are used widely in orthopedic and plastic surgery. Complications can include post-tourniquet syndrome if applied for too long or at insufficient pressure, especially in patients with vascular issues. Proper application and monitoring can prevent complications.
THROMBO ANGITIS OBLITERENS2-1.pptx
This document provides information on thromboangitis obliterans (TAO), including characteristics, clinical findings, investigations, and treatment options. TAO most commonly affects young males who smoke and presents with pain, ulcers, and discoloration of the lower limbs. Diagnosis involves clinical examination, Doppler/duplex ultrasound, angiography and meeting Shionoya criteria. Treatment includes lifestyle changes, medications like antiplatelets, and surgical options like amputation or sympathectomy depending on severity and location of obstruction. The goal of treatment is to relieve symptoms, promote healing, and preserve limb function.
Paraganglioma in head and neck
Paragangliomas are neuroendocrine tumors that arise from paraganglia outside the adrenal gland. In the head and neck region, the most common locations are the carotid body, jugular foramen (jugulotympanic tumors), and vagus nerve (vagal paraganglioma). Carotid body tumors typically present as asymptomatic neck masses while jugulotympanic tumors can cause pulsatile tinnitus and hearing loss. Complete surgical resection remains the primary treatment for head and neck paragangliomas when possible due to the risk of cranial nerve deficits and malignant transformation with incomplete removal or observation alone.
Head & Neck Radiology ppt
This document discusses imaging modalities used for head and neck cancers including radiography, ultrasound, CT, MRI, nuclear scans and PET CT/PET MR. It describes the anatomy visualized by each modality and indications for their use. Key points covered include ultrasound criteria for evaluating lymph nodes, advantages and disadvantages of CT and MRI, and basics of interpreting various tissue types on imaging studies. The neck is divided into spaces and triangles and relevant anatomy of each area is outlined.
thoracic outlet syndrome
This document provides information on thoracic outlet syndrome (TOS). It begins with a brief history and defines TOS as abnormal compression of the neurovascular bundle in the thoracic outlet. It describes the relevant anatomy and compartments of the thoracic outlet. The document discusses the causes, types, symptoms, and diagnostic approaches for the neurogenic, venous, and arterial forms of TOS. It provides details on conservative and surgical treatment options.
Elective spine surgeries
This document discusses the anaesthetic considerations and challenges for major spinal surgeries. It covers preoperative evaluation of the patient's airway, pulmonary, cardiac, neurological and haematological status. Intraoperative monitoring including neurophysiological monitoring is important. Positioning the patient prone can cause various complications which need to be mitigated. The anaesthetic technique aims to allow for monitoring while maintaining a stable depth. Criteria for extubation and postoperative concerns are outlined.
Ewing sarcoma
Ewing's sarcoma is a rare cancer that affects bones or soft tissue. It is characterized by small, round cancer cells and commonly affects children and young adults. Treatment involves induction chemotherapy, followed by local therapy with surgery or radiation if possible, along with additional maintenance chemotherapy. The multimodal approach has improved survival rates in recent decades, though long-term outcomes remain challenging due to the risk of recurrence or secondary cancers.
Ewings sarcoma - Dr. Vandana
Identified in 1921 by James Ewing
2nd most common bone tumor in children
Ewing’s Sarcoma Family of tumors:
Ewing’s sarcoma (Bone –87%)
Extraosseous Ewing’s sarcoma (8%)
Peripheral PNET(5%)
Askin’s tumor
Entrapment Syndromes of Lower Limb.pptx
This presentation contains information about the various Entrapment syndromes of Lower limb in descending order of topography. It also contains information about etiology, clinical features and management of each of these entrapment syndromes with special emphasis on electrodiagnostic confirmation.
Gct radius
gct distal radiusntrreated by extended curettage.newer modalities of treatment as per the literature.recent advsncses un ythe fiewld.bone c2wment,graft and ghelfoam were used to reconstruct the defect
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Wound healing PPT
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
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Pre op
- 12. x-ray, the basic investigation of every department. Without x-ray we cannot proceed further (especially in ORTHOPEDICS) x-ray of fractured bones. x-ray pre-op and post-op. x-ray of chest for operation (FOR GA FITNESS) USG, CT AND MRI IF NEEDED(FOR BONE TUMOURS)
- 28. MAIN AIM: to keep stabilize the pt. haemodynamically. Monitoring (O2 saturation,ECG,BP,CO2 levels) Transfusion of blood or RL during operation if required. ANTIBIOIC COVER CONTROL HTN in hypertensive pt. CONTROL THE TEMPERATURE of the pt, as well of the OT.
- 43. SHOCK DVT TETANUS GAS GANGRENE FEVER FAT EMBOLISM DELERIUM TREMORS
- 44. SKIN = BLISTER .BED SORE MUSCLE =TORN MUSLE FIBER.TISSUE ATROPHY TENDON =TEARS.AVULSION TENDINITIS NERVE =COMPRESSION NEURITIS VASCULAR=INJURY .BLEEDING. COMPARTMENT SYNDROME BONE COMPLICATION=INFECTION .MALUNION .NON UNION CONTRACTURES