Colles fracture is the fracture at the distal end of radius, at its
cortico cancellous junction(about 2cm from the distal articular
surface).
It is not just the fracture of distal radius but the fracture
dislocation of the inferior radio-ulnar joint.
Seminar presentation by 4th year medical student of Lincoln University College, supervised by HRPZ Orthopedic's specialist.
Reference were from reliable medical websites and also from texttbook; Apley and Solomon's Concise System of Orthopaedics and Trauma, 4th Ed.
Colles fracture is the fracture at the distal end of radius, at its
cortico cancellous junction(about 2cm from the distal articular
surface).
It is not just the fracture of distal radius but the fracture
dislocation of the inferior radio-ulnar joint.
Seminar presentation by 4th year medical student of Lincoln University College, supervised by HRPZ Orthopedic's specialist.
Reference were from reliable medical websites and also from texttbook; Apley and Solomon's Concise System of Orthopaedics and Trauma, 4th Ed.
This presentation deals with the causes, signs, symptoms and management of compartment syndrome. It also briefly deals with abdominal comaprtment syndrome
This presentation deals with the causes, signs, symptoms and management of compartment syndrome. It also briefly deals with abdominal comaprtment syndrome
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
2. What is a compartment?
Closed area of muscles
group, nerves & blood
vessels surrounded by
fascia
Pressure: 5-15 mmhg
3. Definition:
An increased pressure within enclosed
osteofascial space that reduces capillary
perfusion below level necessary for
tissue viability;
the underlying mechanism is:
- increased volume within space
- decreased space for contents
- combination of both
4. What is a compartment
syndrome?
intra comp. pressure
(35-40 mmhg)
capillaries collapse
Blood flow to muscles
and nerves
Bl.Vs collapse
20. SYMPTOMS
Burning of the affected limb
Tight muscle(rigid)tightness feeling
Numbness: bad sign
21. SIGNS & DIAGNOSIS
Passive stretching of fingers or toes (muscle
stretch)will lead to severe pain (diagnostic sign)
Never wait for signs of ischemia (5 Ps):irreversible
damage
22. STRECH TEST
It is possible to strech
the affected muscles by
passively moving the
joints in direction
opposite to that of the
damaged muscles,s
action (( e.g. ::: passive
extension of fingers
produces pain in flexor
compartment of forearm
28. Management
Non surgical management:
Remove any tight bandage, tubigrip or soaked
dressing
Cast should be removed completely
Elevation
29. •management
Surgical management:
(FASCIOTOMY)
Open skin and fascia
down to a compartment
It is a surgical procedure
where the fascia is cut to
relieve tension or
pressure commonly to
treat the resulting loss of
circulation to the tissue
30. Fasciotomy Principles
Make early diagnosis
Long extensile incisions
Release all fascial compartments
Preserve neurovascular structures
Debride necrotic tissues
Coverage within 7-10 days
31. Compartment Syndrome
Indications for Fasciotomy
Unequivocal clinical findings
Pressure within 15-20 mm hg of DBP
Rising tissue pressure
Significant tissue injury or high risk pt
> 6 hours of total limb ischemia
Injury at high risk of compartment syndrome
CONTRAINDICATION -
Missed compartment syndrome (>24-48
hrs)
39. Wound Management
Wound is not closed at initial surgery
Second look debridement with consideration for
coverage after 48-72 hrs
Limb should not be at risk for further swelling
Pt should be adequately stabilized
Usually requires skin graft
DPC possible if residual swelling is minimal
Flap coverage needed if nerves, vessels, or bone
exposed
Goal is to obtain definitive coverage within 7-10
days
40. Wound Management
After the fasciotomy, a bulky compression dressing and
a splint are applied.
“VAC” (Vacuum Assisted Closure) can be used
Foot should be placed in neutral to prevent equinus
contracture.
Incision for the fasciotomy usually can be closed after
three to five days
41. Complications Related to
Fasciotomies
Altered sensation within the margins of the wound (77%)
Dry, scaly skin (40%)
Pruritus (33%)
Discolored wounds (30%)
Swollen limbs (25%)
Tethered scars (26%)
Recurrent ulceration (13%)
Muscle herniation (13%)
Pain related to the wound (10%)
Tethered tendons (7%)
Fitzgerald, McQueen Br J Plast Surg 2000
42. Compartment syndrome is a serious syndrome, Which needs
to be diagnosed early.
Palpable pulse doesn’t exclude compartment syndrome
If diagnosis and fasciotomy were done within 24 hrs, the
prognosis is good.
If delayed, complications will develop.
The earlier you diagnose, the safer you are
Editor's Notes
Seven P’s:
Pain- pain in excess of the presenting injury
Pressure- affected compartment may be tense to palpation
Pain with passive stretch- pain increases with passive ROM
Paresthesia- Numbness over the cutaneus distribution of the nerve that runs through the affected compartment
Paresis/Paralysis- Ischemia or necrosis of the nerves or muscles develops within the affected compartment
Pulses- could be absent but frequently palpable
Pallor- skin discoloration may be visible due to impaired venous drainage
Co-Morbidities include:
Mild:
~ mm weakness
~fatigue
~ Myositis ossificans
Severe
~ Severe life threatening vascular compromise
~ decreased arteriovenous gradient
**To Remember**
~ Do not elevate limb above hear because it decreases the arteriovenous gradient therefore decreasing blood flow
~ Instead limb should be elevated at heart level to maintain arteriovenous gradient and assist with venous drainage
~ Remove any compression casts or dressings
These are indications for surgical decompression. A missed CS > 24-48 hours should not be opened. (see Rockwood and Green 5th edition and Campbell’s 10 th edition) The damage cannot be reversed and there is a significant infection rate when the dead tissue is exposed to the hospital environment. The surgeon must deal with the residual contractures of the ischemic muscle and not risk the chance of infection. Some have suggested that the scarred ant tib muscle can serve as a check rein and limit foot drop sequelae.
Volar approach use Henry Approach to release superficial and deep flexors flexors followed by the pronators and supinator. The dorsal approach is centered over the proximal forearm and can be used to release the Mobile Wad (BR, ECRL,ECRB). It is important to remember when treating and electrical injury with a compartment syndrome, the most damage is deep along the bone (i.e. the Pro and Sup muscles) and may require debridement at the initial surgery…Do not miss this!