Quick review of orthopaedics part -1 BY DR. D. P. SWAMI
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quick review of orthopaedics basic science including joint pathologies, metabolic disorders, hip/knee/shoulder/elbow disorders,
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Quick review of orthopaedics part 2
TRAUMATOLOGY OF LOWER LIMB WITH MECHANISM OF INJURY, CLASSIFICATION, RADIOLOGY, NON OPERATIVE/ OPERATIVE TREATMENT, POTENTIAL PROBLEMS AND PREVENTIVE MEASURES
Fat grafting in Plastic Surgery
Fat grafting involves harvesting fat from areas like the abdomen through liposuction and refining it to separate viable fat cells from other components. The purified fat is then reinjected into areas like the face and breasts through microdroplet injections between skin layers to augment volume. Potential complications include irregular contours, necrosis of grafted fat, and infection. However, stem cells found in fat tissue are also being researched for uses like wound healing, skin engineering, and repairing various organs. Fat grafting is a popular aesthetic procedure that has been improved through techniques preserving high viability of transplanted fat cells.
Scalp defects
Scalp defects can arise as a result of trauma including burns, following tumor resection, infections, iatrogenic and so on
Perforasome
This document summarizes a journal meeting discussing perforator flaps. It covers:
1) The evolution of flap reconstruction and goal of optimal tissue replacement with minimal donor site impact leading to perforator flaps.
2) Research on 217 flaps from 40 cadavers identifying over 350 perforators, each with its own vascular territory called a perforasome.
3) Dynamic 4D-CT imaging showing direct linking vessels between perforasomes and directional flow within perforasomes.
Free Functional Muscle Transfer
The document discusses free functional muscle transfers (FFMT) as a technique for reconstructing upper extremity function lost due to various injuries and conditions. FFMT involves transplanting a donor muscle with its blood supply and nerve innervation to provide motor function. The gracilis muscle is commonly used as it has a long strap-like shape and dual blood supply that allows it to be transferred for functions like elbow flexion or finger movements. The document outlines the surgical technique, considerations for patient positioning and donor/recipient sites, and potential complications to help maximize outcomes of this complex microsurgical procedure.
Lower leg defect reconstruction
this presentation of continuous medical education in al wasity teaching hospital for plastic and reconstructive surgery 2017
Anterior approach to shoulder
This document provides an overview of the anterior approach to the shoulder, also known as the deltopectoral approach. It indicates the approach gives access to the anterior, medial, and lateral aspects of the shoulder and can extend distally to include the anterior humerus. Common indications for the approach include shoulder arthroplasty, proximal humerus fractures, recurrent dislocation reconstruction, and biceps or tumor procedures. The document describes relevant anatomy, patient positioning, landmarks, surgical steps including incision, exposure, and potential dangers like nerve injury.
Amputation dr. harsh
The document discusses amputation, including:
1. It describes amputation as the surgical removal of a limb or part of a limb through bone or a joint. The most ancient of surgical procedures, it was originally done crudely without anesthesia.
2. Common causes of amputation include injury, peripheral vascular disease, infection, malignancy, and congenital anomalies. The leading indication in younger patients is trauma, while in older patients it is typically peripheral vascular disease.
3. Key principles for amputation include maintaining the greatest possible skin and muscle length, transecting nerves and blood vessels separately, and removing bony prominences to provide a smooth stump.
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Quick review of orthopaedics part 2
TRAUMATOLOGY OF LOWER LIMB WITH MECHANISM OF INJURY, CLASSIFICATION, RADIOLOGY, NON OPERATIVE/ OPERATIVE TREATMENT, POTENTIAL PROBLEMS AND PREVENTIVE MEASURES
Fat grafting in Plastic Surgery
Fat grafting involves harvesting fat from areas like the abdomen through liposuction and refining it to separate viable fat cells from other components. The purified fat is then reinjected into areas like the face and breasts through microdroplet injections between skin layers to augment volume. Potential complications include irregular contours, necrosis of grafted fat, and infection. However, stem cells found in fat tissue are also being researched for uses like wound healing, skin engineering, and repairing various organs. Fat grafting is a popular aesthetic procedure that has been improved through techniques preserving high viability of transplanted fat cells.
Scalp defects
Scalp defects can arise as a result of trauma including burns, following tumor resection, infections, iatrogenic and so on
Perforasome
This document summarizes a journal meeting discussing perforator flaps. It covers:
1) The evolution of flap reconstruction and goal of optimal tissue replacement with minimal donor site impact leading to perforator flaps.
2) Research on 217 flaps from 40 cadavers identifying over 350 perforators, each with its own vascular territory called a perforasome.
3) Dynamic 4D-CT imaging showing direct linking vessels between perforasomes and directional flow within perforasomes.
Free Functional Muscle Transfer
The document discusses free functional muscle transfers (FFMT) as a technique for reconstructing upper extremity function lost due to various injuries and conditions. FFMT involves transplanting a donor muscle with its blood supply and nerve innervation to provide motor function. The gracilis muscle is commonly used as it has a long strap-like shape and dual blood supply that allows it to be transferred for functions like elbow flexion or finger movements. The document outlines the surgical technique, considerations for patient positioning and donor/recipient sites, and potential complications to help maximize outcomes of this complex microsurgical procedure.
Lower leg defect reconstruction
this presentation of continuous medical education in al wasity teaching hospital for plastic and reconstructive surgery 2017
Anterior approach to shoulder
This document provides an overview of the anterior approach to the shoulder, also known as the deltopectoral approach. It indicates the approach gives access to the anterior, medial, and lateral aspects of the shoulder and can extend distally to include the anterior humerus. Common indications for the approach include shoulder arthroplasty, proximal humerus fractures, recurrent dislocation reconstruction, and biceps or tumor procedures. The document describes relevant anatomy, patient positioning, landmarks, surgical steps including incision, exposure, and potential dangers like nerve injury.
Amputation dr. harsh
The document discusses amputation, including:
1. It describes amputation as the surgical removal of a limb or part of a limb through bone or a joint. The most ancient of surgical procedures, it was originally done crudely without anesthesia.
2. Common causes of amputation include injury, peripheral vascular disease, infection, malignancy, and congenital anomalies. The leading indication in younger patients is trauma, while in older patients it is typically peripheral vascular disease.
3. Key principles for amputation include maintaining the greatest possible skin and muscle length, transecting nerves and blood vessels separately, and removing bony prominences to provide a smooth stump.
Superficial circumflex iliac artery perforator flap
1) The document discusses the superficial circumflex iliac artery (SCIA) and its use in the superficial circumflex iliac artery perforator (SCIP) flap for reconstructive surgery.
2) The SCIP flap is based on perforators from the SCIA and can be used to reconstruct soft tissue defects of the hand, fingers, and other areas with thin, pliable skin and reliable blood supply.
3) Case studies demonstrate the use of the SCIP flap to reconstruct defects on the leg, foot, and oral cavity after tumor resection. The flap allows for primary closure of the donor site in the groin region.
Algorithm to approach the lower extremity defect and to select appropriate fl...
1. The document provides an algorithm for selecting appropriate flaps to reconstruct lower extremity defects, discussing various options from primary closure to free flaps.
2. It begins by covering primary and secondary wound closure, then skin grafts including split-thickness and full-thickness grafts.
3. Next it discusses flaps in general and provides classifications. It then details various local, regional, and free flap options for reconstruction, including musculocutaneous flaps like the gastrocnemius and latissimus dorsi flaps.
Nasalreconstructiongrandrounds043009
The document discusses various techniques for reconstructing nasal defects, including:
1) Local flaps like bilobed flaps are well-suited for small defects, while larger defects require recruitment of distant tissue like paramedian forehead or cheek flaps.
2) Adequate reconstruction of skin cover, structural support, and intranasal lining layers is crucial to prevent contracture and stenosis.
3) Cartilage grafts from septum or conchal shell are often used to recreate nasal structure and support reconstructed skin.
Benign bone tumours
mainly discussion on bone forming tumors and cartillage forming benign tumors of bone ,
priority given to imaging
Scalp reconstruction
1. The scalp and forehead have a complex anatomy consisting of layers of skin, subcutaneous tissue, fascia, and muscle overlying the skull. The scalp receives its blood supply from branches of the external carotid artery and drains venously into a network that connects to the internal jugular vein.
2. Injuries or defects of the scalp and forehead can often be reconstructed using local flaps such as rotation, transposition, or advancement flaps. For larger defects, regional flaps from the temporal region, glabella, or forehead can be mobilized.
3. Microsurgical reconstruction with free flaps or face transplantation are options for very large scalp or forehead defects that cannot
Uper n middle third leg defects
This presentation atalks about the various reconstructive options in upper and middle third leg defects.
Skeletal manifestations of eosinophilic granuloma (eg)
short notes about Skeletal manifestations of eosinophilic granuloma (EG) summarized by Dr laith fadhel / radiologist
6 bubbly lesions of bone
This document contains radiographic images and descriptions of various bubbly or lytic bone lesions. It shows examples of lesions caused by conditions such as fibrous dysplasia, giant cell tumor, aneurysmal bone cyst, enchondroma, central chondrosarcoma, plasmacytoma, renal cell carcinoma metastases, lymphoma, Langerhans cell histiocytosis, osteoblastoma, chondroblastoma, intraosseous ganglion cyst, coccidioidomycosis, hemophilia, hemangioendothelioma, cystic angiomatosis, sarcoidosis, and pigmented villonodular synovitis. The images demonstrate the location, appearance,
Forehead flap
This document discusses the forehead flap procedure. It provides background on the history and anatomy of the forehead flap, which is based on the superficial temporal artery and its branches. The forehead flap can be used to reconstruct large defects in the nose, eyelids, cheeks, mouth, chin, and tongue. The technique involves outlining the flap based on the eyebrows and behind the ear. A tunnel is constructed to pass the flap to the defect site, either directly through the cheek or deep to the zygomatic arch. The donor site is closed primarily while the flap is monitored, with a second surgery needed to divide and close the bridge of the flap. Complications are rare given the rich blood supply but include infection, nerve injury, and
Distally-Based Sural Flap
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Local Flaps For Lower Limb Reconstruction Version1
This document discusses various anatomical principles and commonly used local flaps for reconstruction in the lower leg. It describes several options for flaps based on specific vascular structures in the posterior calf, gastrocnemius, soleus, and surrounding the lesser saphenous vein. Perforator flaps involving the peroneal, anterior tibial, and posterior tibial arteries are also mentioned. The use of these flaps depends on the specific part of the leg needing reconstruction.
Spine presentation
Potts spine , tuberculosis of spine , Potts paraplegia, spinal tumor syndrome, treatment of spinal tuberculosis, exposure for tuberculosis spine
La névralgie cervico-brachiale
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MACS Facelift
MACS-Facelift (Minimal Access Cranial Suspension) is a procedure that leaves you looking fresher and youthful. People may not notice that you have had surgery, just that you look refreshed. The MACS-Lift helps to remove excessive jowling around the chin, deep creases that appear between your nose and mouth, and restores the outline of the jaw. The MACS-Lift is less invasive than other facelift procedures and leaves a shorter scar. This type of facelift will lift and hold up sagging tissues in the neck, cheeks, chin, or near the nose with suspension sutures in the deeper tissues. This operation is done on an outpatient basis while you are under local anesthesia.MACS FaceLift provides natural rejuvenation with shorter operative time, quicker recovery, and less potential for complications compared with traditional face lifts. Fat grafting and Blepharoplasty can enhance the final result.
Nerve substitutes and advances in nerve reconstruction
Overcoming nerve gaps can be done through early repair, mobilization, transposition, bone shortening, or nerve grafts and conduits. For nerve transections, autografts are the gold standard but conduits and allografts are alternatives that avoid donor site morbidity. Evidence shows synthetic conduits have mixed results for major nerves but good outcomes for short digital nerve gaps, while vein and nerve allografts can achieve equivalent results to autografts for gaps under 3cm. Nerve wraps following repair protect the site from adhesion.
Compartment syndrome
Compartment syndrome is a condition caused by increased pressure within a compartment, compromising circulation and causing tissue damage. It can be acute or chronic. Acute compartment syndrome risks necrosis within 6 hours and requires urgent fasciotomy. Chronic exertional compartment syndrome causes pain with exercise that resolves with rest. Without treatment, acute compartment syndrome can lead to Volkmann's ischemic contracture, causing rigid muscle contractures. Diagnosis is clinical but measurements can confirm. Fasciotomy decompresses the compartment to prevent permanent damage. Prognosis depends on timely diagnosis and treatment.
Tb spine
This article talks about TB spine and its management. Also given are the management options of various kyphotic deformities that can occur.
Basic Principles Of Local Flap In Plastic Surgery
1) The document discusses principles of local flaps in plastic surgery, including definitions, classifications, and history. Local flaps are classified based on location, blood supply, movement, and tissue composition.
2) Key classifications include random pattern flaps which rely on subdermal plexus, and axial pattern flaps named after a source artery. Advancement, pivot, and interpolation flaps are classified by their movement.
3) The history outlines early descriptions of cutaneous territories and vascular anatomy from the 16th century to present. Delaying flaps was also described as enhancing vascularity through various mechanisms.
Anterolateral thigh flap
The document summarizes the anterolateral thigh (ALT) flap, which has become a popular reconstructive option. It describes the history and indications of the ALT flap, including head and neck and extremity reconstruction. The key aspects of evaluating patients, raising the flap, and post-operative care and complications are covered. The advantages include a long vascular pedicle and ability to harvest a large skin paddle, while disadvantages include a bulky flap and potential donor site morbidity. Variations in anatomy are also discussed.
Deformities around elbow and management
Deformities around elbow and management: Clinico-radiological evaluation, decision making and surgical options
Systematic interpretation of shoulder MRI: DR. D. P. SWAMI
This document provides an overview of shoulder MRI interpretation and anatomy. It discusses the stabilizing structures of the shoulder joint including muscles like the rotator cuff and ligaments like the glenohumeral ligaments. Common injuries like rotator cuff tears, labral tears, and biceps tendon pathology are described. MRI techniques for imaging the shoulder in different planes are also outlined. The goal is to understand the anatomy and recognize abnormalities that can be seen on shoulder MRI.
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2) The SCIP flap is based on perforators from the SCIA and can be used to reconstruct soft tissue defects of the hand, fingers, and other areas with thin, pliable skin and reliable blood supply.
3) Case studies demonstrate the use of the SCIP flap to reconstruct defects on the leg, foot, and oral cavity after tumor resection. The flap allows for primary closure of the donor site in the groin region.
Algorithm to approach the lower extremity defect and to select appropriate fl...
1. The document provides an algorithm for selecting appropriate flaps to reconstruct lower extremity defects, discussing various options from primary closure to free flaps.
2. It begins by covering primary and secondary wound closure, then skin grafts including split-thickness and full-thickness grafts.
3. Next it discusses flaps in general and provides classifications. It then details various local, regional, and free flap options for reconstruction, including musculocutaneous flaps like the gastrocnemius and latissimus dorsi flaps.
Nasalreconstructiongrandrounds043009
The document discusses various techniques for reconstructing nasal defects, including:
1) Local flaps like bilobed flaps are well-suited for small defects, while larger defects require recruitment of distant tissue like paramedian forehead or cheek flaps.
2) Adequate reconstruction of skin cover, structural support, and intranasal lining layers is crucial to prevent contracture and stenosis.
3) Cartilage grafts from septum or conchal shell are often used to recreate nasal structure and support reconstructed skin.
Benign bone tumours
mainly discussion on bone forming tumors and cartillage forming benign tumors of bone ,
priority given to imaging
Scalp reconstruction
1. The scalp and forehead have a complex anatomy consisting of layers of skin, subcutaneous tissue, fascia, and muscle overlying the skull. The scalp receives its blood supply from branches of the external carotid artery and drains venously into a network that connects to the internal jugular vein.
2. Injuries or defects of the scalp and forehead can often be reconstructed using local flaps such as rotation, transposition, or advancement flaps. For larger defects, regional flaps from the temporal region, glabella, or forehead can be mobilized.
3. Microsurgical reconstruction with free flaps or face transplantation are options for very large scalp or forehead defects that cannot
Uper n middle third leg defects
This presentation atalks about the various reconstructive options in upper and middle third leg defects.
Skeletal manifestations of eosinophilic granuloma (eg)
short notes about Skeletal manifestations of eosinophilic granuloma (EG) summarized by Dr laith fadhel / radiologist
6 bubbly lesions of bone
This document contains radiographic images and descriptions of various bubbly or lytic bone lesions. It shows examples of lesions caused by conditions such as fibrous dysplasia, giant cell tumor, aneurysmal bone cyst, enchondroma, central chondrosarcoma, plasmacytoma, renal cell carcinoma metastases, lymphoma, Langerhans cell histiocytosis, osteoblastoma, chondroblastoma, intraosseous ganglion cyst, coccidioidomycosis, hemophilia, hemangioendothelioma, cystic angiomatosis, sarcoidosis, and pigmented villonodular synovitis. The images demonstrate the location, appearance,
Forehead flap
This document discusses the forehead flap procedure. It provides background on the history and anatomy of the forehead flap, which is based on the superficial temporal artery and its branches. The forehead flap can be used to reconstruct large defects in the nose, eyelids, cheeks, mouth, chin, and tongue. The technique involves outlining the flap based on the eyebrows and behind the ear. A tunnel is constructed to pass the flap to the defect site, either directly through the cheek or deep to the zygomatic arch. The donor site is closed primarily while the flap is monitored, with a second surgery needed to divide and close the bridge of the flap. Complications are rare given the rich blood supply but include infection, nerve injury, and
Distally-Based Sural Flap
Step-by-step approach for general orthopedist
Presenting in "Regional Hand Meeting 2015" at Ubon Ratchathani, THAILAND
Local Flaps For Lower Limb Reconstruction Version1
This document discusses various anatomical principles and commonly used local flaps for reconstruction in the lower leg. It describes several options for flaps based on specific vascular structures in the posterior calf, gastrocnemius, soleus, and surrounding the lesser saphenous vein. Perforator flaps involving the peroneal, anterior tibial, and posterior tibial arteries are also mentioned. The use of these flaps depends on the specific part of the leg needing reconstruction.
Spine presentation
Potts spine , tuberculosis of spine , Potts paraplegia, spinal tumor syndrome, treatment of spinal tuberculosis, exposure for tuberculosis spine
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MACS Facelift
MACS-Facelift (Minimal Access Cranial Suspension) is a procedure that leaves you looking fresher and youthful. People may not notice that you have had surgery, just that you look refreshed. The MACS-Lift helps to remove excessive jowling around the chin, deep creases that appear between your nose and mouth, and restores the outline of the jaw. The MACS-Lift is less invasive than other facelift procedures and leaves a shorter scar. This type of facelift will lift and hold up sagging tissues in the neck, cheeks, chin, or near the nose with suspension sutures in the deeper tissues. This operation is done on an outpatient basis while you are under local anesthesia.MACS FaceLift provides natural rejuvenation with shorter operative time, quicker recovery, and less potential for complications compared with traditional face lifts. Fat grafting and Blepharoplasty can enhance the final result.
Nerve substitutes and advances in nerve reconstruction
Overcoming nerve gaps can be done through early repair, mobilization, transposition, bone shortening, or nerve grafts and conduits. For nerve transections, autografts are the gold standard but conduits and allografts are alternatives that avoid donor site morbidity. Evidence shows synthetic conduits have mixed results for major nerves but good outcomes for short digital nerve gaps, while vein and nerve allografts can achieve equivalent results to autografts for gaps under 3cm. Nerve wraps following repair protect the site from adhesion.
Compartment syndrome
Compartment syndrome is a condition caused by increased pressure within a compartment, compromising circulation and causing tissue damage. It can be acute or chronic. Acute compartment syndrome risks necrosis within 6 hours and requires urgent fasciotomy. Chronic exertional compartment syndrome causes pain with exercise that resolves with rest. Without treatment, acute compartment syndrome can lead to Volkmann's ischemic contracture, causing rigid muscle contractures. Diagnosis is clinical but measurements can confirm. Fasciotomy decompresses the compartment to prevent permanent damage. Prognosis depends on timely diagnosis and treatment.
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This article talks about TB spine and its management. Also given are the management options of various kyphotic deformities that can occur.
Basic Principles Of Local Flap In Plastic Surgery
1) The document discusses principles of local flaps in plastic surgery, including definitions, classifications, and history. Local flaps are classified based on location, blood supply, movement, and tissue composition.
2) Key classifications include random pattern flaps which rely on subdermal plexus, and axial pattern flaps named after a source artery. Advancement, pivot, and interpolation flaps are classified by their movement.
3) The history outlines early descriptions of cutaneous territories and vascular anatomy from the 16th century to present. Delaying flaps was also described as enhancing vascularity through various mechanisms.
Anterolateral thigh flap
The document summarizes the anterolateral thigh (ALT) flap, which has become a popular reconstructive option. It describes the history and indications of the ALT flap, including head and neck and extremity reconstruction. The key aspects of evaluating patients, raising the flap, and post-operative care and complications are covered. The advantages include a long vascular pedicle and ability to harvest a large skin paddle, while disadvantages include a bulky flap and potential donor site morbidity. Variations in anatomy are also discussed.
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Systematic interpretation of shoulder MRI: DR. D. P. SWAMI
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Radiological evaluation of TKR by Dr. D. P. Swami
(1) Pre-operative radiological assessment of the knee for total knee replacement includes AP, lateral, skyline, and full leg radiographs to evaluate alignment, joint spacing, patellar height, and leg length discrepancies.
(2) MRI may also be used pre-operatively to assess the integrity of menisci and ligaments.
(3) Post-operative assessment methods were not discussed in detail in the document.
Ilizarov ring fixator
The document provides an overview of the Ilizarov ring fixator, including its history, principles, instrumentation, operative techniques, and post-operative management. Some key points:
- The Ilizarov ring fixator was developed in the 1950s in Russia by Gavril Abramovich Ilizarov to treat difficult bone fractures and deformities. It uses a circular external fixator frame connected to bone with wires.
- The fixator works based on the principle of distraction osteogenesis, where bone segments are gradually separated and new bone grows in between.
- Key components of the fixator include rings, wires, rods, nuts, and other connectors. Proper positioning and tensioning of components
Kite String Injury Causing a Complete Tear of the Tendoachilles
A 62-year-old man sustained a complete tear of his tendoachilles from a kite string injury while walking. His foot got entangled in the barely visible kite string coated with glass powder as a bicycle passed by. He underwent surgical repair of the tendon using the Krackow technique. At one-year follow-up, he had good strength in plantar flexion and normal ankle range of motion. This case report highlights the rare but serious potential injuries that can occur from kite strings, and the need to increase awareness of risks and consider regulations.
CTEV basics
Club foot, or congenital talipes equinus varus, is a complex three-dimensional deformity of the foot with four main components: equinus, varus, adductus, and cavus. It has an incidence of about 1 in 1,000 live births. Treatment involves serial manipulation and casting, most commonly using the Ponseti method, with the goal of correcting all deformity components to achieve a functional, plantigrade foot. Maintenance treatment with a foot abduction brace is also required to prevent recurrence of the deformity. Surgery may be needed for resistant, relapsed, or neglected clubfoot cases and involves soft tissue releases to address all pathological structures.
Spine trauma basics
1. Spinal injuries can range from stable compression fractures to unstable fracture-dislocations that involve failure of multiple spinal columns. A thorough history, physical exam, and imaging are needed to classify the injury and spinal stability.
2. Key considerations in management include immobilization to prevent further injury, intravenous fluids, medications like corticosteroids, and prompt referral to a spinal specialist. Complications can include neurological deficits, pressure sores, DVT, and respiratory issues.
3. Complete injuries result in total loss of motor and sensory function below the level of injury, while incomplete injuries involve a mixed or partial neurological picture. Grading systems like ASIA are used to document deficits and guide prognosis.
Principles of splints and casts in orthopaedics by Dr. D. P. Swami
Principles of splints/slabs and casts in orthopaedics. historical perspective, technique of slab/cast application, indications/ contraindications, care of slab/cast
Tribology in-orthopaedics
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Principles of external fixator
External fixation is used for definitive or temporary treatment of fractures. It has advantages of being minimally invasive and flexible, but disadvantages include potential pin site infections, inadequate immobilization, and soft tissue complications. Key components are pins, clamps, and connecting rods or rings. Pins must be carefully placed to avoid neurovascular injury and ensure stability. Frame construction and pin placement principles maximize stability and load sharing to promote fracture healing. Conversion to internal fixation is generally safe if done within 2-3 weeks to prevent pin track infections from compromising outcomes.
Damage control orthopaedics (dco)
Damage control orthopaedics (DCO) is a strategy that focuses on temporary stabilization of major orthopaedic injuries in polytrauma patients who are physiologically unstable. The goals of DCO are to control haemorrhage, provisionally stabilize fractures, and minimize surgical insult. This is achieved through early external fixation followed by delayed definitive treatment once the patient is resuscitated. While early total care aimed for early definitive fixation, studies found this increased complications in unstable patients. DCO follows a staged approach using minimal fixation initially to stabilize the patient, allowing resuscitation before further treatment.
Orthopaedics: historical perspective
This document provides an overview of the history and development of orthopedics. It discusses how the field originated from treating bone and joint disorders in ancient civilizations. Key events and figures mentioned include Hippocrates describing fracture treatments in ancient Greece, advances during the Roman era, and developments during the Middle Ages. The modern era saw major breakthroughs in surgery, devices, and treatment of infections. Important orthopedic pioneers highlighted are Hugh Owen Thomas, regarded as the Father of Orthopedic Surgery in Britain, and Robert Jones, considered the Father of Modern Orthopedic Surgery. The document also reviews orthopedic subspecialties and orthopedic terminology.
Knee mri: systematic interpretation by dr. d. p. swami
This document discusses the systematic interpretation of MRI of the knee. It recommends that T1-weighted or proton density images should be performed in the sagittal and coronal planes to assess anatomy, while T2-weighted images using fat saturation or STIR techniques should be used to evaluate pathology. Direct signs of ACL disruption on MRI include discontinuity of fibers, abnormal slope, or nonvisualization of the ligament. Indirect signs include bone contusions, a deep sulcus sign on the lateral femoral condyle, and a Segond fracture of the lateral tibial plateau. The document provides additional details on interpreting MRI findings for various structures of the knee.
Triage
1. The document discusses different types and purposes of triage. Triage is used to prioritize patient treatment during mass casualty events based on urgency of conditions. It aims to allocate patients to the most appropriate care provider and area to maximize lives saved.
2. Primary triage is done in the field to classify patients into categories of urgent need. Secondary triage in the ED further evaluates patients and assigns color codes. Tertiary triage by specialists determines who needs emergency surgery or ICU care.
3. The triage process involves classifying patients into categories of red (most urgent), yellow, green, or black (deceased) based on injury severity and prognosis to direct patients to the right level
Quick review of orthopaedics part 4
FRACTURES OF SPINE AND PELVIS, MECHANISM OF INJURY, RADIO LOGICAL ANALYSIS OF TRAUMA, CLASSIFICATIONS, TREATMENT OPTIONS, PITFALLS AND SOLUTIONS
Quick review of orthopaedics part 3
FRACTURES OF UPPER LIMB, MECHANISM OF INJURY, FRACTURE CLASSIFICATIONS, RADIOLOGY,MANAGEMENT, PROBLEMS IN TREATMENT AND SOLUTIONS
Basics of knee arthroscopy by dr. d. p. swami
basics of knee arthroscopy, clinical anatomy, interpretation of MRI, INSTRUMENTS AND THEIR USE, diagnostic steps, troubleshooting, PICTORIAL DEPICTION
Basics of total hip replacement by DR. D. P. SWAMI
BASICS OF THR WITH CLINICAL ANATOMY, BIO-MECHANICS, INSTRUMENTS, IMPLANTS ANS SURGICAL TECHNIQUE WITH POST OPERATIVE RADIOLOGICAL EVALUATION
Ulnar nerve examination
The document discusses examination of the ulnar nerve, including its course through the brachial plexus and forearm, the muscles it supplies, and clinical tests to evaluate it. It describes checking for signs of ulnar nerve damage like clawing, wasting of hypothenar muscles, and sensory loss. Tests mentioned include Froment's sign, Egawa test, and Andre-Thomas sign. Management is said to involve a comprehensive approach determining impaired function and responsible muscles to select appropriate options for deformities.
BASICS OF TKR BY DR. D. P. SWAMI
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Kite String Injury Causing a Complete Tear of the Tendoachilles
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
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We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.Top Effective Soaps for Fungal Skin Infections in India
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