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Rolando Melendez protocols for surgery when you need foot and/or ankle surgery? post operative period
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hallux valgus & hallux rigidus
Hallux valgus is a lateral deviation of the great toe with medial deviation of the first metatarsal. It is often accompanied by lesser toe deformities and is more common in women. Risk factors include genetic predisposition and shoes that are too narrow. Pathologically, the deforming forces cause changes to the joint capsule and sesamoid complex.
Presentation includes pain with shoe wear and prominence over the first MTP joint. Exam evaluates the first ray and associated deformities. Radiographs measure angles to guide treatment and assess for degenerative changes.
Management begins conservatively with shoe modifications. Surgical options range from soft tissue procedures for mild cases to osteotomies or fusions for more severe
Hallux Valgus - A Detailed Outline
This document summarizes a seminar on hallux valgus (bunions). It provides details on the relevant anatomy, biomechanics, causes, symptoms, physical exam findings, radiographic assessment, classification, and treatment options for hallux valgus. Conservative treatments include footwear modifications and stretching exercises. Surgical treatments aim to correct the structural deformities and include soft tissue procedures, distal and proximal metatarsal osteotomies, phalangeal osteotomies, fusions, and resection arthroplasty. The Mitchell and Chevron osteotomies are described as common distal metatarsal osteotomy techniques.
Lecture 25 shah flat foot conservative
This document discusses tibialis posterior tendon dysfunction and acquired flatfoot deformity. It provides information on the anatomy and biomechanics of the tibialis posterior tendon and how dysfunction can lead to flatfoot deformity. It describes the clinical stages of tibialis posterior tendon dysfunction from tendinopathy to fixed deformity. Diagnostic tests like x-rays and MRI are discussed. Conservative treatment is recommended for early stages, while later stages with deformity may require surgery. The document concludes by announcing an upcoming conference on foot and ankle orthopaedics to be held in August 2015.
Hallux valgus
This document discusses hallux valgus, a deformity of the big toe. It begins by describing the clinical presentation and anatomy involved, including lateral deviation of the big toe, overriding of the other toes, and bunion formation. Radiographic findings like increased intermetatarsal angle are also detailed. Non-surgical treatments are outlined first, followed by indications for various surgical procedures to correct the deformity. Common procedures discussed include bunionectomy techniques like the McBride method as well as different osteotomies of the first metatarsal bone. Complications of recurrence and hallux varus are also mentioned.
Disorders of hallux
The document discusses hallux valgus, also known as a bunion deformity. It is characterized by lateral deviation of the great toe and medial deviation of the first metatarsal. Risk factors include hereditary factors and wearing narrow, high-heeled shoes. Treatment involves conservative options like orthotics or wider shoes initially. For more severe cases, surgical options aim to correct the deformity and relieve pain, such as soft tissue procedures, osteotomies to realign the bone, or fusing joints in advanced cases. Post-operative care focuses on reducing swelling and maintaining correction of the deformity.
Hallux valgus
Hallux valgus is a deformity of the big toe characterized by lateral deviation of the toe and medial deviation of the first metatarsal. It is caused by both intrinsic and extrinsic factors and can cause pain, difficulty wearing shoes, and cosmetic issues. Treatment involves conservative measures like wider shoes initially, with surgical correction considered for more severe or symptomatic cases. Surgery aims to correct angles, realign the joint, and restore normal mechanics, and may involve soft tissue procedures, osteotomies, or arthrodesis in severe cases. Proper patient selection and technique are important for achieving good outcomes.
Upper limb splinting workshop
This document provides guidance on splinting for common upper limb injuries. It outlines safe splinting positions and options for various injuries including hand fractures and dislocations, flexor tendon injuries, mallet finger, skier's thumb, and wrist fractures. The principles of splinting are to provide early stabilization, manage swelling, allow for protected motion to prevent stiffness, and protect joints from risky positions. Early referral within one week is advised if injury is unstable or movement is not possible. The goal is early diagnosis, treatment and return to function.
Excision of the trapezium presentation
Excision of the trapezium bone is a surgical treatment for carpometacarpal arthritis of the thumb. The document summarizes the results of excising the trapezium bone in 26 wrists. It found that excision provided good relief from pain and hand function, though some patients had reduced grip strength. Arthrography showed the metacarpophalangeal joint space was distinct initially but became irregular and smaller within 6 months of surgery in most patients. One patient experienced late deterioration from pseudoarthrosis. Overall, trapezium excision effectively treated carpometacarpal arthritis symptoms in most patients.
Recommended
hallux valgus & hallux rigidus
Hallux valgus is a lateral deviation of the great toe with medial deviation of the first metatarsal. It is often accompanied by lesser toe deformities and is more common in women. Risk factors include genetic predisposition and shoes that are too narrow. Pathologically, the deforming forces cause changes to the joint capsule and sesamoid complex.
Presentation includes pain with shoe wear and prominence over the first MTP joint. Exam evaluates the first ray and associated deformities. Radiographs measure angles to guide treatment and assess for degenerative changes.
Management begins conservatively with shoe modifications. Surgical options range from soft tissue procedures for mild cases to osteotomies or fusions for more severe
Hallux Valgus - A Detailed Outline
This document summarizes a seminar on hallux valgus (bunions). It provides details on the relevant anatomy, biomechanics, causes, symptoms, physical exam findings, radiographic assessment, classification, and treatment options for hallux valgus. Conservative treatments include footwear modifications and stretching exercises. Surgical treatments aim to correct the structural deformities and include soft tissue procedures, distal and proximal metatarsal osteotomies, phalangeal osteotomies, fusions, and resection arthroplasty. The Mitchell and Chevron osteotomies are described as common distal metatarsal osteotomy techniques.
Lecture 25 shah flat foot conservative
This document discusses tibialis posterior tendon dysfunction and acquired flatfoot deformity. It provides information on the anatomy and biomechanics of the tibialis posterior tendon and how dysfunction can lead to flatfoot deformity. It describes the clinical stages of tibialis posterior tendon dysfunction from tendinopathy to fixed deformity. Diagnostic tests like x-rays and MRI are discussed. Conservative treatment is recommended for early stages, while later stages with deformity may require surgery. The document concludes by announcing an upcoming conference on foot and ankle orthopaedics to be held in August 2015.
Hallux valgus
This document discusses hallux valgus, a deformity of the big toe. It begins by describing the clinical presentation and anatomy involved, including lateral deviation of the big toe, overriding of the other toes, and bunion formation. Radiographic findings like increased intermetatarsal angle are also detailed. Non-surgical treatments are outlined first, followed by indications for various surgical procedures to correct the deformity. Common procedures discussed include bunionectomy techniques like the McBride method as well as different osteotomies of the first metatarsal bone. Complications of recurrence and hallux varus are also mentioned.
Disorders of hallux
The document discusses hallux valgus, also known as a bunion deformity. It is characterized by lateral deviation of the great toe and medial deviation of the first metatarsal. Risk factors include hereditary factors and wearing narrow, high-heeled shoes. Treatment involves conservative options like orthotics or wider shoes initially. For more severe cases, surgical options aim to correct the deformity and relieve pain, such as soft tissue procedures, osteotomies to realign the bone, or fusing joints in advanced cases. Post-operative care focuses on reducing swelling and maintaining correction of the deformity.
Hallux valgus
Hallux valgus is a deformity of the big toe characterized by lateral deviation of the toe and medial deviation of the first metatarsal. It is caused by both intrinsic and extrinsic factors and can cause pain, difficulty wearing shoes, and cosmetic issues. Treatment involves conservative measures like wider shoes initially, with surgical correction considered for more severe or symptomatic cases. Surgery aims to correct angles, realign the joint, and restore normal mechanics, and may involve soft tissue procedures, osteotomies, or arthrodesis in severe cases. Proper patient selection and technique are important for achieving good outcomes.
Upper limb splinting workshop
This document provides guidance on splinting for common upper limb injuries. It outlines safe splinting positions and options for various injuries including hand fractures and dislocations, flexor tendon injuries, mallet finger, skier's thumb, and wrist fractures. The principles of splinting are to provide early stabilization, manage swelling, allow for protected motion to prevent stiffness, and protect joints from risky positions. Early referral within one week is advised if injury is unstable or movement is not possible. The goal is early diagnosis, treatment and return to function.
Excision of the trapezium presentation
Excision of the trapezium bone is a surgical treatment for carpometacarpal arthritis of the thumb. The document summarizes the results of excising the trapezium bone in 26 wrists. It found that excision provided good relief from pain and hand function, though some patients had reduced grip strength. Arthrography showed the metacarpophalangeal joint space was distinct initially but became irregular and smaller within 6 months of surgery in most patients. One patient experienced late deterioration from pseudoarthrosis. Overall, trapezium excision effectively treated carpometacarpal arthritis symptoms in most patients.
AHSS Registrar Review Course. Scaphoid and carpal fractures
- Scaphoid fractures occur most commonly in young males due to falls on an outstretched hand. Location and degree of displacement affect stability and union rates.
- CT imaging with parasagittal views of the scaphoid aids in determining fracture stability and configuration to guide treatment.
- Treatment options include casting for undisplaced fractures or open reduction and internal fixation using a variable-pitch screw for displaced fractures to restore alignment and compression.
- Other carpal bone fractures have specific mechanisms of injury and surgical treatment is indicated for displaced or unstable fractures to address carpal instability or restore joint congruity.
Hammer toe
Hammer toe is caused by tight shoes that force the toe into a flexed position, shortening the muscles and tendons. It most commonly affects the second toe, causing it to rotate downward into a claw-like position. Mild cases in children can be treated with foot manipulation and splinting, while wearing properly fitting shoes can help prevent worsening. For more severe cases, podiatrists may recommend straightening devices, exercises, or surgery to straighten the joint.
Kn ee pain
This document provides guidance on evaluating and diagnosing knee pain. It outlines questions to ask the patient regarding their symptoms and medical history. Potential causes of knee pain and related symptoms are described. The document then details the process of physically examining the knee to detect injuries, including tests of range of motion, joint stability, and meniscal function. Guidance is provided on further tests that may be needed like x-rays or MRI if the condition cannot be diagnosed based on the physical exam alone. Non-surgical treatment options like yoga poses and breathing exercises are also mentioned.
Ctev
This document discusses idiopathic clubfoot, including its classification, causes, epidemiology, and treatment options. It focuses on the Ponseti method of manipulation and serial casting as the preferred treatment for idiopathic clubfoot. The Ponseti method involves specific techniques to correct cavus, adductus, varus, and equinus deformities through non-surgical manipulation and casting, sometimes including a percutaneous tenotomy of the Achilles tendon. Compliance with brace wear after treatment is critical to prevent recurrence of the deformity. The document also addresses evaluation methods, examples of clinical cases, common errors in technique, and strategies for managing clubfoot at the public health
ANALYSIS OF TIBIAL CONDYLE FRACTURES TREATED BY MINIMALLY INVASIVE PLATE OST...
ANALYSIS OF TIBIAL CONDYLE FRACTURES TREATED BY MINIMALLY INVASIVE PLATE OST...Dr Naveen Thiyagu Bashingam
To analyse the functional outcome of the tibial condyle fractures treated with Minimally Invasive Plate Osteosynthesis (MIPO)Ankle articular cartilage paste graft
This document discusses the evaluation and treatment of ankle arthritis. It covers evaluating patients through history, physical exam, imaging like x-rays and MRI, and assessing their response to physical therapy treatments. Surgical considerations for ankle arthritis include debridement, chondroplasty, cartilage grafting, and addressing hardware pain or impingement. Post-surgical rehabilitation involves initial non-weight bearing, use of a CPM machine, soft tissue mobilization, regaining full range of motion, and a long-term physical therapy and fitness program.
Lecture 42 shah calcaneal malunions
This document discusses the diagnosis and treatment of calcaneus malunions by Dr. Rajiv Shah. It describes evaluating patients through history, physical exam, and radiology to identify pain generators and the degree of injury. Classification systems are discussed but found lacking, as each case requires understanding all reasons for pain. Treatment options include conservative care, revision fixation, realignment through osteotomy with or without fusion, joint sacrificing procedures like arthrodesis with osteotomy, and arthrodesis. Surgical planning considers multiple factors, and late or complex cases may require multiple extensive procedures to address pain, impingements, deformities and arthritis. The document emphasizes addressing injuries early through surgery to reduce difficulties of late salvage procedures.
Basal joint arthritis presentation
This document discusses basal joint arthritis of the thumb, also known as trapeziometacarpal arthritis. It covers the ligamentous anatomy, epidemiology, etiology, clinical evaluation, radiographic evaluation, classification systems, treatment options including conservative and surgical management, postoperative care, complications, and cost analysis. The key points are that it is a common source of hand pain, especially in post-menopausal women, and treatment ranges from splinting and injections for mild cases to various surgical procedures like ligament reconstruction and tendon interposition or prosthetic arthroplasty for more advanced stages of arthritis.
Knee osteoarthritis basics to reconstruction to replacement dr.sandeep c agr...
Knee osteoarthritis basics to reconstruction to replacement dr.sandeep c agr...AGRASEN Fracture Arthritis Hospital, Ganesh Nagar,Gondia,Maharashtra,INDIA
Knee Osteoarthritis, a common cause of knee pain and treatment ranges from exercises,tablets,arthroscopy,deformity correction to total knee replacement (TKR).
Complications after surgery can even be corrected if occurs by proper evaluation,planning and execution of the Revision Surgery.
Knee osteoarthritis basics to reconstruction to replacement dr.sandeep c agrawal agraesn hospital gondia indiaABI Research Forum 2014 Poster
The document presents a statistical shape model of the carpometacarpal (CMC) joint of the thumb. The model was created using manual segmentations of 50 CMC joints from CT scans. Principal component analysis identified the main modes of morphological variation, with the first 10 modes describing over 90% of the variation with 0.3 mm accuracy. The first mode, describing joint size, showed a very strong correlation with sex, suggesting size differences may account for the higher rate of osteoarthritis in women. The shape model will enable automated segmentation and analysis of larger cohorts.
Lecture 45 shah hallux rigidus
Hallux Rigidus is a painful condition of the big toe joint characterized by restricted motion, especially in dorsiflexion, and proliferative bone formation around the joint. It is most commonly caused by repetitive microtraumas or acute injury to the joint. Conservative management includes medications like NSAIDs, joint manipulation, orthotics to stiffen the forefoot and reduce motion at the big toe joint, and footwear modifications. Surgical options like cheilectomy or joint fusion are considered if conservative care fails to provide relief from pain and stiffness.
A case of unicameral bone cyst with pathological fracture
This document describes a case study of a 22-year-old male patient who suffered a pathological intertrochanteric fracture of the right femur due to a unicameral bone cyst after a fall. The patient underwent an open biopsy and curettage of the cyst, which was diagnosed as a unicameral bone cyst. A definitive surgery was performed where the cyst was filled with bone graft and the fracture was fixed with a proximal femoral nail. Post-operatively, the patient underwent rehabilitation and follow-ups showed healing of the fracture with full range of motion and no pain or disability.
Lumps, bumps, tingles in the night gp education
This document provides an overview of common lumps, bumps, and nerve entrapment conditions in the hand and wrist. It discusses the presentation, diagnosis, and treatment options for various conditions including mucous cysts, ganglia, Heberdon's nodes, nerve compressions, and others. The goal is to help practitioners identify these issues, understand management approaches, and determine appropriate referral timing to specialists like the author, a hand surgeon.
Carpometacarpal ( C)
Carpometacarpal (CMC) arthritis most commonly affects the thumb joint, causing pain and loss of motion. It involves wear and tearing of cartilage at the saddle joint between the thumb metacarpal and trapezium bones. Non-surgical treatments include splinting and injections, while surgical options range from joint preserving procedures like osteotomy to joint replacement or fusion depending on severity. Outcomes of different procedures include reduced pain and improved function.
Banda de Tensión
This document discusses various types of fractures including patella fractures, ankle fractures, and olecranon fractures. For patella fractures, it describes treatment options such as tension band wiring, screws, and partial or full patellectomy. For ankle fractures, it covers K-wire fixation and aftercare involving compression dressing, splinting, and progressive weight bearing. For olecranon fractures, it provides indications and contraindications for K-wire fixation as well as advantages and disadvantages of the technique.
Basal Joint Arthritis Of The Thumb
Basal joint arthritis, or arthritis of the thumb carpometacarpal joint, is a common condition affecting women in particular. It has multiple treatment options depending on the stage of arthritis. For early stage arthritis with instability, volar ligament reconstruction is recommended. For more advanced arthritis, options include ligament reconstruction with tendon interposition, trapezium excision with tendon interposition, or arthrodesis (fusion) of the joint, with the choice depending on patient age, demands, and severity of arthritis. Surgical treatment aims to relieve pain while maintaining function and stability.
Treatment of patellar fracture
This document discusses surgical techniques for treating transverse patellar fractures, including tension band wiring (TBW) and the Himawari method. TBW involves using K-wires and a figure-of-8 tension band wire to compress a displaced transverse fracture. The Himawari method was developed in Japan for comminuted fractures and uses self-locking pin sleeves and cables passed through the sleeves to provide rigid fixation of all fragments. Partial or total patellectomy may be required for comminuted fractures that cannot be reconstructed.
Patella fractures and extensor mechanism injuries
The document summarizes patella fractures and extensor mechanism injuries. It begins by discussing the history of surgical treatment and advances in fixation techniques. It then covers mechanisms of injury, physical exam findings, imaging studies, fracture classification, and treatment approaches. Fractures are classified as displaced or nondisplaced, and treatment depends on factors like fragment separation, articular displacement, and integrity of the extensor mechanism. Nondisplaced fractures are typically treated nonoperatively while displaced fractures often require open reduction and internal fixation techniques like tension band wiring.
Ponceti techniqe
This document provides an overview of the Ponseti technique for treating clubfoot. It discusses the pathophysiology and classification of clubfoot, as well as the key steps of the Ponseti method including serial casting, Achilles tenotomy, and foot abduction bracing. The Ponseti technique uses gentle manipulation and serial casting to gradually correct the deformity, with a tenotomy sometimes needed to achieve full correction. Proper bracing is essential to maintain correction long-term. Recurrence rates are low (under 10%) when the Ponseti method is followed correctly. Surgery is rarely needed when this technique is used.
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.
Osteo-arthritis Knee, strategies for management
Strategies for management of Osteo-arthritis of knee. A talk given by Dr.A.K.Venkatachalam at the Joint Replacement conclave in Mumbai.
Osteotomies for blounts
This document discusses Blount's disease, a disorder affecting growth of the proximal tibia. It describes the different types and stages of the disease. Surgical treatment involves various osteotomy techniques to correct deformities, including at the metaphysis, epiphysis, or intra-epiphyseal levels. Osteotomies are generally recommended for children over 3 years old or if non-operative treatment has failed. Complications can include nerve palsy, vascular injury, or recurrence of the deformity.
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AHSS Registrar Review Course. Scaphoid and carpal fractures
- Scaphoid fractures occur most commonly in young males due to falls on an outstretched hand. Location and degree of displacement affect stability and union rates.
- CT imaging with parasagittal views of the scaphoid aids in determining fracture stability and configuration to guide treatment.
- Treatment options include casting for undisplaced fractures or open reduction and internal fixation using a variable-pitch screw for displaced fractures to restore alignment and compression.
- Other carpal bone fractures have specific mechanisms of injury and surgical treatment is indicated for displaced or unstable fractures to address carpal instability or restore joint congruity.
Hammer toe
Hammer toe is caused by tight shoes that force the toe into a flexed position, shortening the muscles and tendons. It most commonly affects the second toe, causing it to rotate downward into a claw-like position. Mild cases in children can be treated with foot manipulation and splinting, while wearing properly fitting shoes can help prevent worsening. For more severe cases, podiatrists may recommend straightening devices, exercises, or surgery to straighten the joint.
Kn ee pain
This document provides guidance on evaluating and diagnosing knee pain. It outlines questions to ask the patient regarding their symptoms and medical history. Potential causes of knee pain and related symptoms are described. The document then details the process of physically examining the knee to detect injuries, including tests of range of motion, joint stability, and meniscal function. Guidance is provided on further tests that may be needed like x-rays or MRI if the condition cannot be diagnosed based on the physical exam alone. Non-surgical treatment options like yoga poses and breathing exercises are also mentioned.
Ctev
This document discusses idiopathic clubfoot, including its classification, causes, epidemiology, and treatment options. It focuses on the Ponseti method of manipulation and serial casting as the preferred treatment for idiopathic clubfoot. The Ponseti method involves specific techniques to correct cavus, adductus, varus, and equinus deformities through non-surgical manipulation and casting, sometimes including a percutaneous tenotomy of the Achilles tendon. Compliance with brace wear after treatment is critical to prevent recurrence of the deformity. The document also addresses evaluation methods, examples of clinical cases, common errors in technique, and strategies for managing clubfoot at the public health
ANALYSIS OF TIBIAL CONDYLE FRACTURES TREATED BY MINIMALLY INVASIVE PLATE OST...
ANALYSIS OF TIBIAL CONDYLE FRACTURES TREATED BY MINIMALLY INVASIVE PLATE OST...Dr Naveen Thiyagu Bashingam
To analyse the functional outcome of the tibial condyle fractures treated with Minimally Invasive Plate Osteosynthesis (MIPO)Ankle articular cartilage paste graft
This document discusses the evaluation and treatment of ankle arthritis. It covers evaluating patients through history, physical exam, imaging like x-rays and MRI, and assessing their response to physical therapy treatments. Surgical considerations for ankle arthritis include debridement, chondroplasty, cartilage grafting, and addressing hardware pain or impingement. Post-surgical rehabilitation involves initial non-weight bearing, use of a CPM machine, soft tissue mobilization, regaining full range of motion, and a long-term physical therapy and fitness program.
Lecture 42 shah calcaneal malunions
This document discusses the diagnosis and treatment of calcaneus malunions by Dr. Rajiv Shah. It describes evaluating patients through history, physical exam, and radiology to identify pain generators and the degree of injury. Classification systems are discussed but found lacking, as each case requires understanding all reasons for pain. Treatment options include conservative care, revision fixation, realignment through osteotomy with or without fusion, joint sacrificing procedures like arthrodesis with osteotomy, and arthrodesis. Surgical planning considers multiple factors, and late or complex cases may require multiple extensive procedures to address pain, impingements, deformities and arthritis. The document emphasizes addressing injuries early through surgery to reduce difficulties of late salvage procedures.
Basal joint arthritis presentation
This document discusses basal joint arthritis of the thumb, also known as trapeziometacarpal arthritis. It covers the ligamentous anatomy, epidemiology, etiology, clinical evaluation, radiographic evaluation, classification systems, treatment options including conservative and surgical management, postoperative care, complications, and cost analysis. The key points are that it is a common source of hand pain, especially in post-menopausal women, and treatment ranges from splinting and injections for mild cases to various surgical procedures like ligament reconstruction and tendon interposition or prosthetic arthroplasty for more advanced stages of arthritis.
Knee osteoarthritis basics to reconstruction to replacement dr.sandeep c agr...
Knee osteoarthritis basics to reconstruction to replacement dr.sandeep c agr...AGRASEN Fracture Arthritis Hospital, Ganesh Nagar,Gondia,Maharashtra,INDIA
Knee Osteoarthritis, a common cause of knee pain and treatment ranges from exercises,tablets,arthroscopy,deformity correction to total knee replacement (TKR).
Complications after surgery can even be corrected if occurs by proper evaluation,planning and execution of the Revision Surgery.
Knee osteoarthritis basics to reconstruction to replacement dr.sandeep c agrawal agraesn hospital gondia indiaABI Research Forum 2014 Poster
The document presents a statistical shape model of the carpometacarpal (CMC) joint of the thumb. The model was created using manual segmentations of 50 CMC joints from CT scans. Principal component analysis identified the main modes of morphological variation, with the first 10 modes describing over 90% of the variation with 0.3 mm accuracy. The first mode, describing joint size, showed a very strong correlation with sex, suggesting size differences may account for the higher rate of osteoarthritis in women. The shape model will enable automated segmentation and analysis of larger cohorts.
Lecture 45 shah hallux rigidus
Hallux Rigidus is a painful condition of the big toe joint characterized by restricted motion, especially in dorsiflexion, and proliferative bone formation around the joint. It is most commonly caused by repetitive microtraumas or acute injury to the joint. Conservative management includes medications like NSAIDs, joint manipulation, orthotics to stiffen the forefoot and reduce motion at the big toe joint, and footwear modifications. Surgical options like cheilectomy or joint fusion are considered if conservative care fails to provide relief from pain and stiffness.
A case of unicameral bone cyst with pathological fracture
This document describes a case study of a 22-year-old male patient who suffered a pathological intertrochanteric fracture of the right femur due to a unicameral bone cyst after a fall. The patient underwent an open biopsy and curettage of the cyst, which was diagnosed as a unicameral bone cyst. A definitive surgery was performed where the cyst was filled with bone graft and the fracture was fixed with a proximal femoral nail. Post-operatively, the patient underwent rehabilitation and follow-ups showed healing of the fracture with full range of motion and no pain or disability.
Lumps, bumps, tingles in the night gp education
This document provides an overview of common lumps, bumps, and nerve entrapment conditions in the hand and wrist. It discusses the presentation, diagnosis, and treatment options for various conditions including mucous cysts, ganglia, Heberdon's nodes, nerve compressions, and others. The goal is to help practitioners identify these issues, understand management approaches, and determine appropriate referral timing to specialists like the author, a hand surgeon.
Carpometacarpal ( C)
Carpometacarpal (CMC) arthritis most commonly affects the thumb joint, causing pain and loss of motion. It involves wear and tearing of cartilage at the saddle joint between the thumb metacarpal and trapezium bones. Non-surgical treatments include splinting and injections, while surgical options range from joint preserving procedures like osteotomy to joint replacement or fusion depending on severity. Outcomes of different procedures include reduced pain and improved function.
Banda de Tensión
This document discusses various types of fractures including patella fractures, ankle fractures, and olecranon fractures. For patella fractures, it describes treatment options such as tension band wiring, screws, and partial or full patellectomy. For ankle fractures, it covers K-wire fixation and aftercare involving compression dressing, splinting, and progressive weight bearing. For olecranon fractures, it provides indications and contraindications for K-wire fixation as well as advantages and disadvantages of the technique.
Basal Joint Arthritis Of The Thumb
Basal joint arthritis, or arthritis of the thumb carpometacarpal joint, is a common condition affecting women in particular. It has multiple treatment options depending on the stage of arthritis. For early stage arthritis with instability, volar ligament reconstruction is recommended. For more advanced arthritis, options include ligament reconstruction with tendon interposition, trapezium excision with tendon interposition, or arthrodesis (fusion) of the joint, with the choice depending on patient age, demands, and severity of arthritis. Surgical treatment aims to relieve pain while maintaining function and stability.
Treatment of patellar fracture
This document discusses surgical techniques for treating transverse patellar fractures, including tension band wiring (TBW) and the Himawari method. TBW involves using K-wires and a figure-of-8 tension band wire to compress a displaced transverse fracture. The Himawari method was developed in Japan for comminuted fractures and uses self-locking pin sleeves and cables passed through the sleeves to provide rigid fixation of all fragments. Partial or total patellectomy may be required for comminuted fractures that cannot be reconstructed.
Patella fractures and extensor mechanism injuries
The document summarizes patella fractures and extensor mechanism injuries. It begins by discussing the history of surgical treatment and advances in fixation techniques. It then covers mechanisms of injury, physical exam findings, imaging studies, fracture classification, and treatment approaches. Fractures are classified as displaced or nondisplaced, and treatment depends on factors like fragment separation, articular displacement, and integrity of the extensor mechanism. Nondisplaced fractures are typically treated nonoperatively while displaced fractures often require open reduction and internal fixation techniques like tension band wiring.
Ponceti techniqe
This document provides an overview of the Ponseti technique for treating clubfoot. It discusses the pathophysiology and classification of clubfoot, as well as the key steps of the Ponseti method including serial casting, Achilles tenotomy, and foot abduction bracing. The Ponseti technique uses gentle manipulation and serial casting to gradually correct the deformity, with a tenotomy sometimes needed to achieve full correction. Proper bracing is essential to maintain correction long-term. Recurrence rates are low (under 10%) when the Ponseti method is followed correctly. Surgery is rarely needed when this technique is used.
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.
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AHSS Registrar Review Course. Scaphoid and carpal fractures
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ANALYSIS OF TIBIAL CONDYLE FRACTURES TREATED BY MINIMALLY INVASIVE PLATE OST...
ANALYSIS OF TIBIAL CONDYLE FRACTURES TREATED BY MINIMALLY INVASIVE PLATE OST...
Knee osteoarthritis basics to reconstruction to replacement dr.sandeep c agr...
Knee osteoarthritis basics to reconstruction to replacement dr.sandeep c agr...
A case of unicameral bone cyst with pathological fracture
A case of unicameral bone cyst with pathological fracture
Similar to Protocols
Osteo-arthritis Knee, strategies for management
Strategies for management of Osteo-arthritis of knee. A talk given by Dr.A.K.Venkatachalam at the Joint Replacement conclave in Mumbai.
Osteotomies for blounts
This document discusses Blount's disease, a disorder affecting growth of the proximal tibia. It describes the different types and stages of the disease. Surgical treatment involves various osteotomy techniques to correct deformities, including at the metaphysis, epiphysis, or intra-epiphyseal levels. Osteotomies are generally recommended for children over 3 years old or if non-operative treatment has failed. Complications can include nerve palsy, vascular injury, or recurrence of the deformity.
TalipesEquinoVarus.pptx
This document discusses soft tissue procedures for treating talipes equinovarus (clubfoot deformity). It describes the typical components and presentation of clubfoot as well as conservative and surgical treatment options. Initial treatment involves serial casting while older, more rigid cases may require soft tissue releases and bony corrections like talectomy. The document provides details on specific soft tissue and bone procedures and references studies on outcomes of talectomy and fixation methods for tibiocalcaneal fusion.
Hallux valgus Deformity
Hallux valgus, also known as a bunion, is a progressive foot deformity where the first metatarsophalangeal joint is affected, causing the big toe to deviate laterally away from the second toe. This is often accompanied by pain and functional impairment. Non-surgical treatments include footwear modifications and orthotics to reduce pressure and pain. Surgical options vary based on severity, from osteotomies like the Chevron procedure for mild cases to joint fusions for severe deformities. Post-operative management focuses on gradually restoring range of motion and strengthening through physical therapy exercises.
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This document provides an overview of common ligamentous and tendon injuries around the ankle. It describes the anatomy of the ankle joint and surrounding ligaments. It then discusses the evaluation and treatment of lateral and medial ankle sprains, syndesmotic injuries, ankle dislocations, Achilles tendon ruptures, and peroneal tendon dislocations. For each injury, the document outlines the typical mechanism, clinical findings, imaging evaluation, classification systems, and non-surgical and surgical management approaches.
Jess
This document discusses Dr. B.B. Joshi's External Stabilization System (JESS) for treating clubfoot, also known as congenital talipes equinovarus (CTEV). It provides details on the causes of clubfoot relapse, assessment methods, the basic anatomy derangements in clubfoot, and the principles and components of the JESS fixator system. The JESS system uses gradual distraction with differential rates to correct the deformity while preventing tissue damage. It has advantages over surgery or other external fixators in allowing correction without shortening and minimizing scarring.
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MCE 2016, semester ii, foot deformities, Benha University Orthopaedic Depart...
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Following References were used to prepare this powerpoint presentation which makes the slides accurate and relaible for studying purpose; Therapeutic Exrercise – Carolyn Kisner
Orthopaedic Physical Assessment – Magee
Orthopaedic Medicine – L. Ombregt
Campbell’s Operative Orthopaedics
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DEFINITION
TYPES
ORTHOPAEDIC ASSESSMENT
MEDICAL MANAGGEMENT
PHYSIOTHERAPY MANAGEMENT
SURGICAL MANAGEMENT
Jess in ctev
This document provides information on Dr. Imran Jan's Joshi's External Stabilization System (JESS) for the treatment of clubfoot, or congenital talipes equinovarus (CTEV). JESS uses the principles of fractional distraction developed by Ilizarov to gradually correct clubfoot deformities in multiple planes. It involves the insertion of wires and connecting rods under the skin to form fixation points in the tibia, calcaneus, and metatarsals. Graduated distraction between these points over weeks can fully correct clubfoot without surgery in many cases. Studies show JESS achieves excellent results in over 75% of CTEV cases.
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congenital pseudoarthrosis of tibia or anterolateral bowing of tibia is cause of major morbidity in children with no definitive or curative management.
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Mipo
Minimally invasive plate osteosynthesis is a new technics in Bangladesh. This presentation is for Annual BOSCON Conference, 2011
Ctev
Congenital talipes equinovarus, or clubfoot, is a birth defect affecting the foot and ankle. It occurs in approximately 1 in 1000 live births. The deformity involves equinus (plantar flexion) of the ankle, varus and inversion of the heel, and adduction and supination of the forefoot. Non-surgical treatment involves serial casting and manipulation based on the Ponseti method. This involves weekly cast changes to gradually correct the deformity, often including a percutaneous Achilles tenotomy. Surgical treatment is reserved for resistant cases and involves soft tissue releases and occasionally bony procedures. Proper bracing after correction is critical to prevent relapse of the deformity. With appropriate treatment
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Protocols
- 1. Forefoot procedure: 1st-3rd week: limited and protected WB with a surgical shoe, (coach-bathroom-bed), Rest, elevate, ice (20min in, 20min out), anti-inflammatory 4th week: Begin ROM exercises 3rd-6th week: active WB, transfer to tennis shoe progressively 4th week : return to sitting job, 5-6th week: return to walking job Rearfoot procedure 1st week: Non weight bearing with a posterior splint 2nd-3rd week: Non weight bearing with a cast 4th-6th week: Weight bearing on a CAM boot 4th week: begin PT 6th-8th week: transfer to a tennis shoe progressively Amputation Indication: treatment of gangrene, acute and chronic infections, (Digital amputation): treatment of severe painful hammertoe on compromise patients Post-op: digital amputation: 3 week limited and protected WB with a surgical shoe, return to job 6th week proximal amputation 3-4weeks NWB patient will require a especial molded shoes by the 4th week Hammertoe repair Indication: flexible and rigit painful digital deformities, Deformities that can be ulcer prone in DM Procedure: o In-office tenotomy: flexible deformity on compromise patients o PIPJ fusion with K-wire: 2-4 digits o PIPIJ arthroplasty: 4-5 digits o Skin plasty w arthroplasty: 5th digit o MPJ capsule balancing: MPJ contracture, pre-dislocation, capsulitis Risk: swollen digit, dorsal scar, numbness (up to 12mo) Management of bone/joint infection: Procedure: amputation, incision and drainage, staged procedures, use of antibiotic beads Management of bone tumor: Indication: prevention of malignancy spread or becoming malignant, pathological fracture Procedure: biopsy, debridement of tumor and packed with bone chips, amputation Metatarsal osteotomy (Weil, Jacoby): Indication: painful IPK, pre-dislocation MPJ Risk: transfer lesion
- 2. ORIF digital, metatarsal fractures: Indication: dislocated fractures affecting the foot’s parabola Procedure: close reduction, screw or k-wire fixation, 5th met will require 4.0-6.5 intramedullary screw, elder patient treatment can begin with a CAM boot if this fail after 4 weeks surgical treatment should be considered Post-op: aggressive tx on atletes and young patients with PT on 3-4th week, Ostectomy/exostectomies: Indication: painful interdigital exostosis, subungual exostosis, dorsal midfoot Procedure: percutaneous exostectomies Risk: recurrence, swelling, numbness, nail change, nerve adhesions Revision surgery: Indication: recurrence bunion and hammertoe deformities, non-union fractures, painful joints Risk: longer recovery, incision complications Post-op: longer NWB than original surgery, bone stimulator can be requiere Bunionectomy: Indication: painful bunion deformity in adult, progressive and severe pediatric bunion deformity Procedure: adult IM 12-15: Austin or Kalish, IM more than 15: base procedure, phalanx osteotomy (Akin) Post-op: Head procedure: : 3 week limited and protected WB with a surgical shoe, return to sitting job on 4th week, return to walking job on 6th week, PT on the 4th week Base procedure and Lapidus: 2 weeks on a cast, 3-4th limited CAM boot, 4-5th week sitting jobs with CAM walker, ,6th week sitting jobs with CAM walker, PT on 4th week Hallux limitus: painful 1st MPJ Procedure: Painful joint: Chelectomy: painful joint no xray changes End stage chronic painful joint: Implant for older patient or non-active patients Fusion: active, young patient, athlete Sesamoidectomy: Indication: non healing sesamoid fracture, chronic sesamoiditis Procedure: excision of sesamoid Risk: hallux valgus, hallux varus Tailors bunion: Indication: Painful deformity, painful plantarflexed 5th met head Procedure: head osteotomy, head excision Risk: transfer lesion, swelling, numbness
- 3. Metatarsal adduction: Procedure: multiple metatarsal osteotomies, midfoot osteotomies Flat foot: Procedures: Johnson strom 1: PTT repair, TAL Johnson strom 2: Kidner, calcaneal osteotomy, Evans, Cotton Johnson strom 3: isolated fusion Johnson strom 4: triple arthrodesis or pan-talar fusion Post-op: 1st week posterior splint, 2-3rd NWB cast, 4-6th limited walking CAM walker, 68th progressive walking CAM walker Plantar fasciitis Indication: recalcitrant heel pain Procedure: Topaz, EPF, Cobiguard, Open plantar fasciitis Post-op: percutaneous procedure same postop as a forefoot surgery, open plantar fasciitis requires longer post op recovery Achilles tendonitis Procedure: retrocalcaneal exostectomy, Hagland deformity excision, repair of Achilles tendon tear (procedures require an 2-3 anchors) Risk: dehiscence, re-rupture, tendon adhesions, nerve entrapment Post-op: like rearfoot procedures, important physical therapy