Scaphoid Fractures_UTSAV
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This document discusses the anatomy, classification, clinical presentation, diagnosis, and treatment of scaphoid fractures. Some key points: - The scaphoid bone has a boat or cashew shape and accounts for 70% of carpal fractures. - Scaphoid fractures are commonly caused by a fall on an outstretched hand and result from forced dorsiflexion. - Diagnosis involves history, clinical exam, and imaging like X-rays, MRI, or bone scans. - Fractures are classified by the Herbert and Fisher system into stable or unstable acute fractures, delayed unions, and nonunions. - Treatment depends on the type but may include casting
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Scaphoid fractures
Scaphoid fractures are the most common carpal bone fractures, often occurring in young adults from falls on an outstretched hand. The scaphoid has a tenuous blood supply and is prone to non-union, especially for proximal pole fractures. Treatment depends on fracture type and stability, ranging from casting to operative fixation with screws. Complications include malunion, delayed union, non-union and avascular necrosis, requiring further procedures like bone grafting or carpal fusion.
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Clavicle fracture
1. The clavicle is the only long bone that lies horizontally in the body and connects the thorax to the shoulder girdle.
2. Clavicle fractures are classified based on their location as medial, middle, or lateral thirds. Common causes are falls on an outstretched hand or lateral shoulder.
3. Treatment depends on the fracture type and patient factors, ranging from sling immobilization to surgical fixation with plates or screws.
Terrible triad - elbow
The "terrible triad" refers to an elbow dislocation with fractures of the coronoid process and radial head. This is an extremely unstable injury that often leads to recurrent instability, stiffness, and arthritis. Surgical treatment aims to address all fractures, repair ligaments, and restore stability through techniques like internal fixation, replacement, and external fixation. Postoperative rehabilitation focuses on early range of motion while protecting the repair.
Clavicle fracture and its management
1) The clavicle is the most commonly fractured bone in the shoulder girdle.
2) Clavicle fractures are usually caused by a direct blow to the shoulder or falling on an outstretched hand.
3) Clavicle fractures are classified using the Allman classification system, which divides fractures into 3 types based on location along the clavicle.
Distal femur fractures what makes it complex ,dr mohamed ashraf,hod orthopae...
distal femur fractures are notorious for post operative complications due to malreduction and improper fixation.unless plan and execute a sound and stable fixation,this injury will lead to undesirable results.dr mohamed ashraf HOD orthopaedics govt TD medical college is presenting how to avoid complications in surgical management of these fractures..
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2. Primary repair within 12-24 hours of injury provides the best functional outcomes while delayed or secondary repairs have higher risks of adhesion formation.
3. Flexor tendon repair techniques aim to accurately approximate the tendon ends with core sutures while minimizing handling and restoring the normal gliding relationship between tendons. Postoperative rehabilitation is crucial.
4. Flexor tendon grafting is indicated for injuries with segment
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Length
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The document discusses scaphoid fractures, which constitute 60-70% of carpal bone fractures. The scaphoid is important for wrist mechanics and links the proximal and distal carpal rows. Scaphoid fractures are often caused by falls on an outstretched hand and result from compression or bending forces. Diagnosis involves history, clinical exam including provocative tests, and imaging like x-rays, CT, MRI. Treatment depends on fracture displacement and chronicity, ranging from cast immobilization to surgical fixation with screws or plates. Complications include non-union, malunion, and avascular necrosis.
Recurrent shoulder dislocation and management
This document provides an overview of recurrent shoulder dislocations. It discusses the anatomy of the shoulder joint and its stabilizers. The glenohumeral ligaments, labrum, rotator cuff muscles, and negative intra-articular pressure provide static stability, while dynamic stability comes from the rotator cuff and scapulo-thoracic motion. Younger age, returning to collision sports, and bone defects increase risk of recurrence. Evaluation involves assessing range of motion, translation, and special tests like the anterior drawer and sulcus sign. History and physical exam help determine treatment which may include rehabilitation or surgery to address labral tears or bone loss.
Scaphoid fractures
This document provides information on scaphoid fractures, including anatomy, biomechanics, classification, diagnosis, treatment and complications. Scaphoid fractures make up 60-70% of carpal bone fractures and often result from falls on an outstretched hand. Treatment depends on factors like location, displacement and time since injury. Options include cast immobilization for nondisplaced fractures or surgery like open reduction and internal fixation for displaced fractures. Complications can include nonunion, malunion and osteoarthritis if not treated properly.
Superior Shoulder Suspensory Complex injuries (SSSC)
This document discusses zonal CME conducted at GSLMC on the superior shoulder suspensory complex (SSSC). It defines the SSSC as a bony and soft tissue ring structure that maintains the stable relationship between the scapula and axial skeleton. Injuries to two structures in the SSSC can cause instability known as the "floating shoulder". Treatment depends on the amount of displacement, with conservative management used for displacements under 5mm and no caudal displacement of the glenoid. Surgical stabilization is recommended for larger displacements or malalignment.
Periprosthetic fracture
1. Periprosthetic fractures are fractures that occur near a joint replacement prosthesis. They can occur in the femur, patella, or tibia.
2. Risk factors include increasing age, female sex, osteoporosis, revision arthroplasty, rheumatoid arthritis, steroid use, and neurological diseases.
3. Surgical treatment depends on the fracture classification and stability of the prosthesis. Options include open reduction internal fixation with a locking plate, intramedullary nailing, or revision arthroplasty.
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Distal femur fractures what makes it complex ,dr mohamed ashraf,hod orthopae...
Distal femur fractures what makes it complex ,dr mohamed ashraf,hod orthopae...
Superior Shoulder Suspensory Complex injuries (SSSC)
Superior Shoulder Suspensory Complex injuries (SSSC)
Modified sauve kapandji procedure for patients with old fractures
Modified sauve kapandji procedure for patients with old fractures
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Supracondylar fractures in_children
1. The document discusses radiographic anatomy and classification of supracondylar fractures in children, which are most commonly caused by a fall on an outstretched hand and involve extension of the elbow.
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This document summarizes a seminar on scaphoid and lunate fractures presented by Dr. Hari Krishna Bachu. It discusses the anatomy, blood supply, biomechanics, classification systems, clinical presentation, diagnosis, and management of scaphoid fractures. Key points include that scaphoid fractures most commonly occur at the waist, can be difficult to diagnose, and require careful immobilization to heal properly. Imaging options like CT, MRI and bone scans can help in diagnosis. Treatment depends on factors like stability, chronicity and location of the fracture. Nonunions may require surgical intervention like bone grafting.
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Scaphoid - Tips to fix Scaphoid fractures & Non union management
This document discusses scaphoid fractures, including:
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Scaphoid fractures are the most common carpal bone fractures, often occurring in young adults from falls on an outstretched hand. The scaphoid has a tenuous blood supply and is prone to non-union, especially for proximal pole fractures. Treatment depends on fracture type and stability, ranging from casting to operative fixation with screws. Complications include malunion, delayed union, non-union and avascular necrosis, requiring further procedures like bone grafting or carpal fusion.
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Distal radius fractures can be extra-articular or intra-articular. They are commonly classified based on location, configuration, displacement, involvement of the ulna, and stability. Treatment depends on factors like age, fracture pattern, and degree of displacement. Options include closed reduction with casting or surgical fixation to restore anatomy and allow early mobility. Complications can include malunion, arthritis, and nerve injuries if not properly treated.
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The document discusses scaphoid fractures, including:
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The document discusses fractures of the humerus bone, which has three parts - proximal, mid shaft, and distal. Shaft fractures of the humerus are common in adults from falls and in children. Distal humerus fractures are rare and occur after age 40 from force through the flexed elbow. Treatment depends on the type and location of the fracture, ranging from splinting, casting, and bracing for nondisplaced fractures to open reduction and internal fixation for displaced fractures. Complications can include nerve and blood vessel injuries as well as joint stiffness.
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This document discusses Colles' fracture, which is a fracture of the distal radius near the wrist. It most commonly occurs in post-menopausal women after a fall on an outstretched hand. The fracture causes dorsal displacement of the distal radius fragment. Treatment involves closed manipulation and casting the forearm in pronation, palmar flexion, and ulnar deviation. Complications can include nerve injuries, complex regional pain syndrome, malunion from improper treatment, and secondary osteoarthritis in more severe fractures.
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ScaPHOID #
The scaphoid bone is located in the wrist and is vulnerable to injury due to its position. It has a tenuous blood supply and reduced healing capacity. Scaphoid fractures are difficult to diagnose on initial imaging and occur most commonly at the waist of the bone. Treatment depends on fracture pattern and stability, with nondisplaced fractures typically treated non-operatively with casting and displaced or unstable fractures often requiring surgical fixation. While casting results in immobilization, surgical treatment allows for earlier rehabilitation and return to activity.
Calcaneal Fractures
Calcaneal fractures can involve the subtalar joint or be extra-articular. Intra-articular fractures make up 75% of cases and often have poor outcomes without surgery. Surgical treatment, including open reduction and internal fixation, aims to restore the posterior facet joint, calcaneal height and width, and alignment. While closed treatment is generally recommended for non-displaced or minimally displaced fractures, surgical intervention provides the best chance of an anatomical reconstruction for significantly displaced intra-articular fractures.
Clavicular fracture & acj injury
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- Treatment depends on fracture type and displacement, with non-displaced fractures typically treated non-operatively and displaced/unstable fractures often requiring surgery.
- AC joint injuries use the Rockwood classification, with Types I-III usually treated non-operatively and Types IV-VI requiring surgery.
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Monteggia fracture & galeazzi fracture
A Monteggia fracture involves a break in the proximal ulna shaft combined with dislocation of the radial head. It most commonly occurs in children following a fall on an outstretched hand. Treatment involves closed or open reduction of the radial head and restoration of the ulna length, with casting or plating depending on patient age. Complications can include nerve injuries or radial head instability.
A Galeazzi fracture is a break of the radius near the middle-distal junction with disruption of the distal radio-ulnar joint. It typically results from a fall onto an outstretched, pronated forearm. Treatment is always surgical via open reduction and internal fixation of the radius and potential K-wiring or
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Scaphoid Fractures_UTSAV
- 2. Derived from greek word ‘scaphos’ meaning boat Boat or cashew shaped bone Rule of 70 for scaphoid – Accounts for 70% of carpal fractures Of these 70% occur at waist 70% of scaphoid fractures unite 70% of vascular supply is through dorsal branch of radial artery
- 3. Boat or cashew shaped 80% of bone covered by articular surface expect tubercle Located in a 45° plane to horizontal and vertical axes •
- 8. Common in young adults Fall on outstretched hand Mechanism – Bending with compression dorsally and tension on palmar surface owing to forced dorsiflexion
- 9. Proper history about mechanism of injury Clinical examination Radiographic evaluation – X-ray – PA view, lateral, Radial oblique, ulnar oblique, Scaphoid view MRI – 100% sensitivity even in 48 hrs Tc 99 bone scans also have high sensitivity in occult fractures
- 13. 80 % 15% 5% Time to union – 4-6 weeks Time to union – 10- 12 weeks Time to union – 12- 20 weeks
- 14. Type A Stable Acute fracture A1 : Fracture through tuberosity A2 : Incomplete fracture through waist HERBERT AND FISHER CLASSIFICATION
- 15. Type B Unstable Acute Fractures Type B1: Distal Oblique Fracture Type B2: Complete Fracture of Waist Type B3: Proximal Pole Fracture Type B4: Transscaphoid- Perilunate Fracture-Dislocation of Carpus Type B5: Comminuted Fractures
- 16. Type C Delayed Union Type D Established Nonunuion Type D1: Fibrous Union Type D2: Pseudarthrosis
- 18. Type 1 – Tuberosity fracture Type 2 - Distal intra- articular fracture Type 3 – Osteochondral fracture
- 19. Occult Fractures – Colles cast for 4-6 weeks Type A1 – Colles cast cast for 4-6 weeks Type A2 – Below elbow cast in neutral position cast c ast for 6-12 weeks in low demand patients in other patients percutaneous screw fixation A displaced fracture is defined as one with more than 1 mm of step-off or more than 60 degrees of SL or 15 degrees of lunato-capitate angulation as observed on either plain radiographs or CT scans.
- 21. Type B2 – Percutaneous screw fixation - in case reduction cannot be achieved, open reduction and internal fixation - Cast required in case of asso. ligamentous injury In case of hump-back deformity, bone-grafting may be required Hump-back deformity
- 22. Type B3 - closed or open reduction and screw fixation through dorsal approach
- 23. VOLAR APPROACH
- 31. Type D1 – Open reduction and screw fixation with bone gafting- either from distal radius or iliac crest Success – 60-95% Type D2 – Open reduction and internal fixation with bone graft or vascularised bone graft – pronator quadratus
- 33. Patial radial styloidectomy and pronator quadratus bone graft
- 35. POST OP 10 weeks