Telecon ext.
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A 38-year-old Thai man was brought to the hospital after falling off his motorcycle. He had swelling and limited range of motion in his right foot. X-rays showed a Lisfranc injury and fracture of the base of the fifth metatarsal bone in his right foot. He underwent surgery to repair the injuries using screws and K-wires. Lisfranc injuries occur when bones in the midfoot are displaced and can lead to long-term disability if not properly treated. Surgical fixation is usually required for unstable or displaced fractures.
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Ankle fracture-by-rgjel
1. A 43-year-old female patient fell down stairs 3.5 hours prior to arriving at the hospital. On examination, she had significant swelling and tenderness of the left ankle with limited range of motion due to pain.
2. X-rays showed a closed bimalleolar fracture of the left ankle. She was placed in a short leg cast and admitted to the ward for pain control and waiting for surgery to undergo an open reduction and internal fixation.
3. Bimalleolar ankle fractures are unstable injuries involving fractures of two malleoli. Surgical treatment with open reduction and internal fixation is usually required for anatomical reduction and stabilization to allow early mobilization.
Cubital Tunnel Syndrome EBP
Cubital tunnel syndrome involves compression or irritation of the ulnar nerve as it passes through the cubital tunnel under the elbow. The main causes are idiopathic subluxation of the ulnar nerve or trauma/arthrosis leading to delayed paresis. Symptoms include numbness and weakness in the fourth and fifth digits. Conservative treatment involves splinting, exercises, and anti-inflammatory medication, while surgery may be considered for persistent or progressive symptoms.
ulnar Entrapment Neuropathy and double crush syndrome
Nerve entrapment occurs when a nerve becomes compressed as it travels through tight spaces in the body. The ulnar nerve is commonly entrapped at the elbow, where it passes through the cubital tunnel, or at the wrist in Guyon's canal. Symptoms include numbness, tingling, and weakness. Treatment involves modifying activities that cause compression, splinting, and sometimes surgery to decompress the nerve. The double crush syndrome can occur when a nerve is compressed at multiple sites, worsening symptoms.
Cubital tunnel syndrome ( final)
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Interesting case pimpitcha
- A 52-year-old Thai man presented with right knee and shoulder pain after falling off his motorcycle while wearing a helmet.
- X-rays showed closed fractures of the right patella and greater tuberosity of the right humerus.
- Treatment for the patellar fracture includes either non-operative management with long leg casting or operative treatment with open reduction and internal fixation using tension band wiring or screws, depending on the degree of displacement and integrity of the extensor mechanism.
Extern conference-sani
1. The document describes a 43-year-old Thai woman who presented to the hospital after slipping and injuring her right elbow.
2. Physical examination revealed tenderness and limited range of motion of the right elbow due to pain and mild swelling. X-rays showed a fracture of the right radial neck.
3. The patient was diagnosed with a complex right elbow dislocation with a radial neck fracture. She underwent closed reduction with placement in a posterior long arm splint.
Extern orthopedics-conference
1) The patient is a 60-year-old Thai male who presented to the hospital with left hip pain after being hit by a motorcycle 14 hours prior.
2) Physical examination revealed localized tenderness and limited range of motion of the left hip. X-rays showed a closed fracture of the left intertrochanteric region.
3) Intertrochanteric fractures occur between the greater and lesser trochanters. Surgical treatment with an intramedullary hip screw is usually recommended for unstable patterns to stabilize the fracture.
Galeazzi fx saraj pcm
- 64-year-old Thai man was in a motorcycle accident where he fell and used his left arm to brace himself, injuring his left forearm.
- Physical exam and x-rays showed a fracture of the midshaft to distal radius with dislocation of the distal radioulnar joint (Galeazzi fracture).
- Treatment involves open reduction and internal fixation of the radius fracture with a plate to restore anatomy and function, along with splinting the forearm in full supination for 6 weeks to maintain stability of the distal radioulnar joint.
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Ankle fracture-by-rgjel
1. A 43-year-old female patient fell down stairs 3.5 hours prior to arriving at the hospital. On examination, she had significant swelling and tenderness of the left ankle with limited range of motion due to pain.
2. X-rays showed a closed bimalleolar fracture of the left ankle. She was placed in a short leg cast and admitted to the ward for pain control and waiting for surgery to undergo an open reduction and internal fixation.
3. Bimalleolar ankle fractures are unstable injuries involving fractures of two malleoli. Surgical treatment with open reduction and internal fixation is usually required for anatomical reduction and stabilization to allow early mobilization.
Cubital Tunnel Syndrome EBP
Cubital tunnel syndrome involves compression or irritation of the ulnar nerve as it passes through the cubital tunnel under the elbow. The main causes are idiopathic subluxation of the ulnar nerve or trauma/arthrosis leading to delayed paresis. Symptoms include numbness and weakness in the fourth and fifth digits. Conservative treatment involves splinting, exercises, and anti-inflammatory medication, while surgery may be considered for persistent or progressive symptoms.
ulnar Entrapment Neuropathy and double crush syndrome
Nerve entrapment occurs when a nerve becomes compressed as it travels through tight spaces in the body. The ulnar nerve is commonly entrapped at the elbow, where it passes through the cubital tunnel, or at the wrist in Guyon's canal. Symptoms include numbness, tingling, and weakness. Treatment involves modifying activities that cause compression, splinting, and sometimes surgery to decompress the nerve. The double crush syndrome can occur when a nerve is compressed at multiple sites, worsening symptoms.
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- A 52-year-old Thai man presented with right knee and shoulder pain after falling off his motorcycle while wearing a helmet.
- X-rays showed closed fractures of the right patella and greater tuberosity of the right humerus.
- Treatment for the patellar fracture includes either non-operative management with long leg casting or operative treatment with open reduction and internal fixation using tension band wiring or screws, depending on the degree of displacement and integrity of the extensor mechanism.
Extern conference-sani
1. The document describes a 43-year-old Thai woman who presented to the hospital after slipping and injuring her right elbow.
2. Physical examination revealed tenderness and limited range of motion of the right elbow due to pain and mild swelling. X-rays showed a fracture of the right radial neck.
3. The patient was diagnosed with a complex right elbow dislocation with a radial neck fracture. She underwent closed reduction with placement in a posterior long arm splint.
Extern orthopedics-conference
1) The patient is a 60-year-old Thai male who presented to the hospital with left hip pain after being hit by a motorcycle 14 hours prior.
2) Physical examination revealed localized tenderness and limited range of motion of the left hip. X-rays showed a closed fracture of the left intertrochanteric region.
3) Intertrochanteric fractures occur between the greater and lesser trochanters. Surgical treatment with an intramedullary hip screw is usually recommended for unstable patterns to stabilize the fracture.
Galeazzi fx saraj pcm
- 64-year-old Thai man was in a motorcycle accident where he fell and used his left arm to brace himself, injuring his left forearm.
- Physical exam and x-rays showed a fracture of the midshaft to distal radius with dislocation of the distal radioulnar joint (Galeazzi fracture).
- Treatment involves open reduction and internal fixation of the radius fracture with a plate to restore anatomy and function, along with splinting the forearm in full supination for 6 weeks to maintain stability of the distal radioulnar joint.
Extern conference ortho
1. A 17-year-old Thai male presented to the emergency department with an abrasion wound on his left face and left shoulder following a motorcycle accident 5 hours prior.
2. Imaging revealed a T3-T4 fracture-dislocation with spinal cord compression. He was diagnosed with a spinal cord injury and underwent treatment including methylprednisolone and surgical stabilization of his spine.
3. His injury resulted in lower extremity weakness and loss of sensation. He will require long-term rehabilitation for his spinal cord injury.
Ac sep
- A 37-year-old Thai man presented to the emergency department with left shoulder pain after a motorcycle accident. He was not wearing a helmet when a dog cut in front of his motorcycle, causing him to crash and land on his left shoulder.
- Radiographs showed a type V AC separation with disruption of both the AC and CC ligaments. The patient was admitted and taken to the operating room for open reduction and internal fixation with tightrope fixation to restore the coracoclavicular interval.
- AC separations are commonly caused by direct blows to the shoulder. They are classified based on the degree of ligament disruption and bone displacement. Nonoperative treatment is usually indicated for low-grade injuries while
Conference
This case conference discusses a 45-year-old Thai male who was in a motor vehicle accident where he sustained a left humerus fracture. On physical examination, his left arm was tender and swollen with limited range of motion due to pain. X-rays confirmed a closed midshaft left humerus fracture. Treatment options for humerus fractures include non-operative management with a hanging arm cast or functional brace, or operative management with plate fixation or intramedullary nails depending on the fracture pattern and patient factors. Complications can include radial nerve palsy.
ACL INJURY
This document presents the case of a 17-year-old Thai woman who experienced left knee pain for 3 months following a motorcycle accident. On examination, she was found to have an anterior cruciate ligament injury and lateral collateral ligament injury in her left knee. MRI findings confirmed a grade 3 ACL avulsion fracture as well as a grade 1 medial meniscal tear. The document then reviews ACL anatomy, mechanisms of injury, clinical assessment tools, imaging modalities, treatment options including reconstruction surgery and rehabilitation.
Clavicle fracture
1. The patient is a 75-year-old Thai man who fell off his bicycle 6 hours prior, injuring his left elbow and clavicle.
2. Radiographs show a fracture of the left shaft of the clavicle.
3. Clavicle fractures are commonly classified using the Allman or Neer classifications to determine appropriate treatment. Non-displaced or stable fractures are typically treated non-operatively while displaced or unstable fractures often require surgical fixation.
Extern conference ortho
This document describes the case of a 69-year-old Thai man who presented to the emergency department with right thigh pain after falling 1.5 meters from the roof of his house. On examination, he had swelling and tenderness of the left thigh with limited range of motion. Radiographs revealed an intertrochanteric fracture of the left femur. Intertrochanteric fractures occur between the greater and lesser trochanters and are common in elderly patients, often resulting from low-energy falls. Treatment depends on the stability of the fracture but may involve internal fixation with screws or cephalomedullary nails. Complications can include malunion, nonunion, and loss of fixation.
Ant.shoulder dislocation
This document summarizes an orthopedic case of a 42-year-old Thai male who presented to the emergency room with left shoulder pain after hearing a popping sound while lifting roof tiles. On examination, he was found to have deformity and tenderness of the left shoulder with the humeral head palpable in the anterior shoulder, indicating an anterior shoulder dislocation. X-rays confirmed an anterior shoulder dislocation with an associated greater tuberosity fracture. The patient was taken to the operating room for closed reduction of the dislocation and rehabilitation.
Floating shoulder
1. A 65-year-old Thai man presented to the emergency department after a motorcycle accident where he was sideswiped by a pickup truck.
2. He suffered a closed fracture of the middle third of his left clavicle and a closed fracture of the neck of his left scapula (floating shoulder injury).
3. He was admitted to the hospital for an open reduction and internal fixation surgery.
Burst fracture
1. The patient is a 57-year-old Thai man who fell from a mango tree approximately 3 meters while picking mangoes. He experienced back and left foot pain after the incident and could not walk, having to crawl for help.
2. Examination found mild lumbar tenderness and moderate ankle tenderness with limited range of motion due to pain. Imaging showed a burst fracture of L1 with retropulsion into the spinal canal and a comminuted fracture of the left calcaneus.
3. The patient was diagnosed with a burst fracture of L1 and a closed fracture of the left calcaneus. He underwent pedicle screw fixation from T12 to L2 to stabilize the spinal fracture
Teleconferences 22.2.18
A 36-year-old Thai man presented to the hospital after a motorcycle accident where he collided with a dog and fell off his bike 3 hours prior. He complains of left shoulder and chest pain. Imaging shows a closed fracture of the mid-shaft left clavicle with a left scapula neck fracture. The patient is admitted and managed conservatively with sling immobilization.
.Ortho.
An 81-year-old Thai woman presented to the hospital with left hip pain after falling three days prior. Imaging revealed a Garden type 3 fracture of the left femoral neck. She was diagnosed with a displaced left femoral neck fracture. Her treatment plan included pain control, skin traction of the left leg, and a left bipolar hemiarthroplasty surgery. Femoral neck fractures typically result from low-energy falls in older patients and require prompt surgical management to reduce complications.
C5 C6 dislocation
This document summarizes the medical history, physical examination, investigations, diagnosis, and treatment for a 43-year-old male who presented with neck pain and weakness in his extremities after a motor vehicle accident. Physical examination revealed neck tenderness and decreased sensation below C6. Imaging showed a C5-C6 unilateral facet dislocation with complete spinal cord injury. The patient received high-dose steroids and was placed in skull traction. He was diagnosed with an incomplete spinal cord injury and underwent operative treatment including closed reduction and stabilization.
Ext.conference..
1. An 82-year-old Thai man presented to the emergency room with right knee pain for 3 hours after tripping and falling on his right knee.
2. Examination found marked swelling and tenderness of the right knee with a palpable patella defect and joint effusion. X-rays showed a closed comminuted fracture of the right patella.
3. The patient was diagnosed with a closed comminuted fracture of the right patella. His treatment plan included immobilization with a cylindrical slab and observation for compartment syndrome, with plans for open reduction and internal fixation using a tension band construct.
Scaphoid fx
- A 26-year-old Thai man presented to the emergency department with right wrist pain after falling 1 meter from a motorcycle 10 hours prior.
- Examination and x-rays revealed a non-displaced distal fracture of the right scaphoid bone. The patient was placed in a thumb spica cast and instructed to follow-up in 1 week.
- Scaphoid fractures are common injuries of the wrist, often occurring from falls onto an outstretched hand. Proper diagnosis requires standard x-ray views of the wrist due to the potential for missed or delayed fractures. Nondisplaced fractures are usually treated conservatively with casting while displaced or unstable fractures often require surgical fixation.
Case discussion ortho jeen
This document discusses the case of a 6-year-old Thai boy who fell from a half-meter height at school, landing on his outstretched right arm and elbow. On examination, he had swelling and deformity of the right elbow with limited range of motion due to pain. X-rays revealed a Gartland Type III closed supracondylar fracture of the left humerus. The boy underwent closed reduction with pinning under fluoroscopy and was placed in a posterior long arm slab for 4 weeks. Supracondylar fractures are common elbow fractures in children aged 5-10 years old and usually result from a fall onto an outstretched hand.
Closed fracture at the humeral shaft
This document discusses the case of a 41-year-old Thai woman who experienced a humerus shaft fracture after falling from a motorbike. On examination, she had deformity and swelling of the right forearm with an abrasion on the elbow but intact motor and sensory function. X-rays showed a fracture of the right humerus. The document summarizes treatment approaches for humerus shaft fractures, including non-operative management with a brace or operative fixation with plates or nails, depending on the fracture pattern and patient factors. Complications like radial nerve palsy are also addressed.
Ortho..
- The patient is a 38-year-old Thai man who was in a motorcycle accident after drinking alcohol. He complains of left knee pain for 3 hours.
- Radiographs show a fracture of the left tibial plateau and left fibula. Physical examination reveals tenderness over the left knee with limited range of motion due to pain.
- The diagnoses are a fracture of the left tibial plateau, a fracture of the left fibula, and a mild head injury. The patient is placed in a long leg splint and advised to remain non-weightbearing on the left leg. Close monitoring is needed for compartment syndrome or neurological changes.
Compartment syndrome
Compartment syndrome is an elevated pressure within a closed muscle compartment that restricts blood flow. It can be acute, caused by injury, or chronic from exertion. Symptoms include pain, numbness, and weakness. Diagnosis involves measuring compartment pressure. If pressure is over 30mmHg, fasciotomy surgery is required to cut fascial layers and release pressure to prevent muscle and nerve damage. Without release of pressure, complications like contractures can occur.
Femoral shaft-fractures
1) A female patient was brought to the hospital after a motorcycle accident where she collided with a car 1 hour prior and lost consciousness. On examination, she had an abrasion on her right thigh and was unable to walk but could move her toes.
2) X-rays showed a fracture of the right femur. She was given pain medication and placed in skeletal traction awaiting surgery.
3) Surgical fixation with a plate and screws was planned to treat the femoral shaft fracture.
Carpal tunnel Syndrom Wesam Aljabali -1.pdf
Carpal tunnel syndrome occurs when the median nerve becomes compressed at the wrist, causing numbness, tingling, and weakness in the hand. It is often caused by repetitive wrist motions combined with anatomical factors. Diagnosis involves physical exams and electrodiagnostic tests, with severity graded on nerve conduction studies. Initial treatment involves splinting and medications, while surgery is considered if symptoms persist. The most common surgical technique is endoscopic carpal tunnel release, with rehabilitation focusing on scar management, range of motion exercises, and strengthening. Full recovery can take 3-6 months as the nerve heals.
Ortho con supra copy
The document summarizes an orthopedic case of a child who fell from a table and injured his left arm. On physical examination, the child's left elbow was swollen and deformed with limited range of motion due to pain. X-rays revealed a complete transverse fracture at the supracondylar region of the left humerus with total posterior-medial displacement, classified as a Gartland Type III injury. The child underwent closed reduction and percutaneous pinning of the fractured elbow. Post-operatively, the child will need elevation, pain control, range of motion exercises, and pin removal after 3-4 weeks once the fracture has healed. Complications of this type of injury can include nerve damage,
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Extern conference ortho
1. A 17-year-old Thai male presented to the emergency department with an abrasion wound on his left face and left shoulder following a motorcycle accident 5 hours prior.
2. Imaging revealed a T3-T4 fracture-dislocation with spinal cord compression. He was diagnosed with a spinal cord injury and underwent treatment including methylprednisolone and surgical stabilization of his spine.
3. His injury resulted in lower extremity weakness and loss of sensation. He will require long-term rehabilitation for his spinal cord injury.
Ac sep
- A 37-year-old Thai man presented to the emergency department with left shoulder pain after a motorcycle accident. He was not wearing a helmet when a dog cut in front of his motorcycle, causing him to crash and land on his left shoulder.
- Radiographs showed a type V AC separation with disruption of both the AC and CC ligaments. The patient was admitted and taken to the operating room for open reduction and internal fixation with tightrope fixation to restore the coracoclavicular interval.
- AC separations are commonly caused by direct blows to the shoulder. They are classified based on the degree of ligament disruption and bone displacement. Nonoperative treatment is usually indicated for low-grade injuries while
Conference
This case conference discusses a 45-year-old Thai male who was in a motor vehicle accident where he sustained a left humerus fracture. On physical examination, his left arm was tender and swollen with limited range of motion due to pain. X-rays confirmed a closed midshaft left humerus fracture. Treatment options for humerus fractures include non-operative management with a hanging arm cast or functional brace, or operative management with plate fixation or intramedullary nails depending on the fracture pattern and patient factors. Complications can include radial nerve palsy.
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This document presents the case of a 17-year-old Thai woman who experienced left knee pain for 3 months following a motorcycle accident. On examination, she was found to have an anterior cruciate ligament injury and lateral collateral ligament injury in her left knee. MRI findings confirmed a grade 3 ACL avulsion fracture as well as a grade 1 medial meniscal tear. The document then reviews ACL anatomy, mechanisms of injury, clinical assessment tools, imaging modalities, treatment options including reconstruction surgery and rehabilitation.
Clavicle fracture
1. The patient is a 75-year-old Thai man who fell off his bicycle 6 hours prior, injuring his left elbow and clavicle.
2. Radiographs show a fracture of the left shaft of the clavicle.
3. Clavicle fractures are commonly classified using the Allman or Neer classifications to determine appropriate treatment. Non-displaced or stable fractures are typically treated non-operatively while displaced or unstable fractures often require surgical fixation.
Extern conference ortho
This document describes the case of a 69-year-old Thai man who presented to the emergency department with right thigh pain after falling 1.5 meters from the roof of his house. On examination, he had swelling and tenderness of the left thigh with limited range of motion. Radiographs revealed an intertrochanteric fracture of the left femur. Intertrochanteric fractures occur between the greater and lesser trochanters and are common in elderly patients, often resulting from low-energy falls. Treatment depends on the stability of the fracture but may involve internal fixation with screws or cephalomedullary nails. Complications can include malunion, nonunion, and loss of fixation.
Ant.shoulder dislocation
This document summarizes an orthopedic case of a 42-year-old Thai male who presented to the emergency room with left shoulder pain after hearing a popping sound while lifting roof tiles. On examination, he was found to have deformity and tenderness of the left shoulder with the humeral head palpable in the anterior shoulder, indicating an anterior shoulder dislocation. X-rays confirmed an anterior shoulder dislocation with an associated greater tuberosity fracture. The patient was taken to the operating room for closed reduction of the dislocation and rehabilitation.
Floating shoulder
1. A 65-year-old Thai man presented to the emergency department after a motorcycle accident where he was sideswiped by a pickup truck.
2. He suffered a closed fracture of the middle third of his left clavicle and a closed fracture of the neck of his left scapula (floating shoulder injury).
3. He was admitted to the hospital for an open reduction and internal fixation surgery.
Burst fracture
1. The patient is a 57-year-old Thai man who fell from a mango tree approximately 3 meters while picking mangoes. He experienced back and left foot pain after the incident and could not walk, having to crawl for help.
2. Examination found mild lumbar tenderness and moderate ankle tenderness with limited range of motion due to pain. Imaging showed a burst fracture of L1 with retropulsion into the spinal canal and a comminuted fracture of the left calcaneus.
3. The patient was diagnosed with a burst fracture of L1 and a closed fracture of the left calcaneus. He underwent pedicle screw fixation from T12 to L2 to stabilize the spinal fracture
Teleconferences 22.2.18
A 36-year-old Thai man presented to the hospital after a motorcycle accident where he collided with a dog and fell off his bike 3 hours prior. He complains of left shoulder and chest pain. Imaging shows a closed fracture of the mid-shaft left clavicle with a left scapula neck fracture. The patient is admitted and managed conservatively with sling immobilization.
.Ortho.
An 81-year-old Thai woman presented to the hospital with left hip pain after falling three days prior. Imaging revealed a Garden type 3 fracture of the left femoral neck. She was diagnosed with a displaced left femoral neck fracture. Her treatment plan included pain control, skin traction of the left leg, and a left bipolar hemiarthroplasty surgery. Femoral neck fractures typically result from low-energy falls in older patients and require prompt surgical management to reduce complications.
C5 C6 dislocation
This document summarizes the medical history, physical examination, investigations, diagnosis, and treatment for a 43-year-old male who presented with neck pain and weakness in his extremities after a motor vehicle accident. Physical examination revealed neck tenderness and decreased sensation below C6. Imaging showed a C5-C6 unilateral facet dislocation with complete spinal cord injury. The patient received high-dose steroids and was placed in skull traction. He was diagnosed with an incomplete spinal cord injury and underwent operative treatment including closed reduction and stabilization.
Ext.conference..
1. An 82-year-old Thai man presented to the emergency room with right knee pain for 3 hours after tripping and falling on his right knee.
2. Examination found marked swelling and tenderness of the right knee with a palpable patella defect and joint effusion. X-rays showed a closed comminuted fracture of the right patella.
3. The patient was diagnosed with a closed comminuted fracture of the right patella. His treatment plan included immobilization with a cylindrical slab and observation for compartment syndrome, with plans for open reduction and internal fixation using a tension band construct.
Scaphoid fx
- A 26-year-old Thai man presented to the emergency department with right wrist pain after falling 1 meter from a motorcycle 10 hours prior.
- Examination and x-rays revealed a non-displaced distal fracture of the right scaphoid bone. The patient was placed in a thumb spica cast and instructed to follow-up in 1 week.
- Scaphoid fractures are common injuries of the wrist, often occurring from falls onto an outstretched hand. Proper diagnosis requires standard x-ray views of the wrist due to the potential for missed or delayed fractures. Nondisplaced fractures are usually treated conservatively with casting while displaced or unstable fractures often require surgical fixation.
Case discussion ortho jeen
This document discusses the case of a 6-year-old Thai boy who fell from a half-meter height at school, landing on his outstretched right arm and elbow. On examination, he had swelling and deformity of the right elbow with limited range of motion due to pain. X-rays revealed a Gartland Type III closed supracondylar fracture of the left humerus. The boy underwent closed reduction with pinning under fluoroscopy and was placed in a posterior long arm slab for 4 weeks. Supracondylar fractures are common elbow fractures in children aged 5-10 years old and usually result from a fall onto an outstretched hand.
Closed fracture at the humeral shaft
This document discusses the case of a 41-year-old Thai woman who experienced a humerus shaft fracture after falling from a motorbike. On examination, she had deformity and swelling of the right forearm with an abrasion on the elbow but intact motor and sensory function. X-rays showed a fracture of the right humerus. The document summarizes treatment approaches for humerus shaft fractures, including non-operative management with a brace or operative fixation with plates or nails, depending on the fracture pattern and patient factors. Complications like radial nerve palsy are also addressed.
Ortho..
- The patient is a 38-year-old Thai man who was in a motorcycle accident after drinking alcohol. He complains of left knee pain for 3 hours.
- Radiographs show a fracture of the left tibial plateau and left fibula. Physical examination reveals tenderness over the left knee with limited range of motion due to pain.
- The diagnoses are a fracture of the left tibial plateau, a fracture of the left fibula, and a mild head injury. The patient is placed in a long leg splint and advised to remain non-weightbearing on the left leg. Close monitoring is needed for compartment syndrome or neurological changes.
Compartment syndrome
Compartment syndrome is an elevated pressure within a closed muscle compartment that restricts blood flow. It can be acute, caused by injury, or chronic from exertion. Symptoms include pain, numbness, and weakness. Diagnosis involves measuring compartment pressure. If pressure is over 30mmHg, fasciotomy surgery is required to cut fascial layers and release pressure to prevent muscle and nerve damage. Without release of pressure, complications like contractures can occur.
Femoral shaft-fractures
1) A female patient was brought to the hospital after a motorcycle accident where she collided with a car 1 hour prior and lost consciousness. On examination, she had an abrasion on her right thigh and was unable to walk but could move her toes.
2) X-rays showed a fracture of the right femur. She was given pain medication and placed in skeletal traction awaiting surgery.
3) Surgical fixation with a plate and screws was planned to treat the femoral shaft fracture.
Carpal tunnel Syndrom Wesam Aljabali -1.pdf
Carpal tunnel syndrome occurs when the median nerve becomes compressed at the wrist, causing numbness, tingling, and weakness in the hand. It is often caused by repetitive wrist motions combined with anatomical factors. Diagnosis involves physical exams and electrodiagnostic tests, with severity graded on nerve conduction studies. Initial treatment involves splinting and medications, while surgery is considered if symptoms persist. The most common surgical technique is endoscopic carpal tunnel release, with rehabilitation focusing on scar management, range of motion exercises, and strengthening. Full recovery can take 3-6 months as the nerve heals.
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The document summarizes an orthopedic case of a child who fell from a table and injured his left arm. On physical examination, the child's left elbow was swollen and deformed with limited range of motion due to pain. X-rays revealed a complete transverse fracture at the supracondylar region of the left humerus with total posterior-medial displacement, classified as a Gartland Type III injury. The child underwent closed reduction and percutaneous pinning of the fractured elbow. Post-operatively, the child will need elevation, pain control, range of motion exercises, and pin removal after 3-4 weeks once the fracture has healed. Complications of this type of injury can include nerve damage,
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Extern.con.anklefx.chaipat
- 17-year-old Thai female presented to the hospital with right ankle pain and swelling after twisting her ankle 3 hours prior while playing football.
- Physical examination revealed swelling and tenderness of the right ankle which was held in plantarflexion. X-rays showed a bimalleolar fracture of the right ankle.
- Bimalleolar fractures involve fractures of both the medial and lateral malleoli. Non-displaced fractures are typically treated conservatively with immobilization while displaced or unstable fractures require open reduction and internal fixation surgery followed by non-weightbearing and rehabilitation.
Noon conference hangman
A 35-year-old man fell and hit the back of his head on the ground after drinking alcohol. He was brought to the emergency room 4 hours later with pain in his head and neck. On examination, he had a 2 cm laceration on the back of his skull but was neurologically intact. Imaging showed a hangman's fracture. He was placed in a hard cervical collar, the wound was sutured, and he was started on skull traction and a Philadelphia collar for the hangman's fracture.
Ortho con
1) A 14-year-old boy was in a motorcycle accident where his left hip hit the ground, causing left hip pain and deformity.
2) Examination and x-rays revealed a posterior dislocation of the left hip.
3) The patient was taken to the operating room for closed reduction of the hip dislocation under general anesthesia with skeletal traction.
Scaphoid fx
- A 64-year-old Thai female presented with right wrist pain after falling and catching herself with her right hand in the bathroom.
- Examination found swelling and tenderness over the right wrist and pain with grip and wrist movement.
- X-rays showed a non-displaced fracture of the right scaphoid bone.
- She was placed in a thumb spica cast to immobilize the fracture.
Patella fx
This patient is a 34-year-old Thai man who presented with knee pain and swelling after falling and hitting his right knee 3 days ago. On examination, his right knee was tender and swollen with limited range of motion due to pain. X-rays showed a patella fracture. Patella fractures typically occur from direct impact or forceful knee flexion against the contracted quadriceps muscle. Treatment depends on the fracture pattern and degree of displacement, ranging from immobilization to surgery to repair the extensor mechanism or address displaced fragments.
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- 2. ผู้ป่วยชายไทยโสด อายุ 38 ปี อาชีพรับจ้าง ภูมิลาเนาจังหวัดนครราชสีมา ขับมอเตอร์ไซค์ล้มเอง 1 ชั่วโมง ก่อนมาโรงพยาบาล
- 4. A : can talk clearly, no stridor ,no posterior neck tenderness
- 5. ❄B : no trachea shift , no subcutaneous emphysematous , normal breath sound , equal both lung , CCT : negative
- 6. C : Vital sign stable ( BP 120/76 mmHg, pulse rate 68 bpm ), abdomen soft,not tender,no guarding , PCT : negative
- 7. D : E4V5M6 pupil 3 mm RTLBE
- 8. E : swelling at right foot with limit ROM due to pain
- 11. A M P L E
- 12. No food and drug allergy
- 15. Last meal 19.00 (4 hr ก่อนมา รพ)
- 16. ดื่มสุรา แล้วขับ MC ล้มเอง ไม่สลบ ไม่มีศีรษะ กระแทก จาเหตุการณ์ได้หลังล้มปวดเท้าขวามาก
- 17. ❄HEENT : no pale conjunctivae, anicteric sclerae ❄CVS : full and regular pulse, normal s1 s2 ,no murmur ❄LUNG : equal breath sound ,clear both lungs ❄ABDOMEN : soft ,not tender ,no guarding ❄NEURO : good consciousness,motor power grade V all except right foot , sensory intact ❄EXTREMITIES : Rt foot swelling ,limit ROM due to pain , no pain on passive stretching , no paresthesia , capillary refill <2 sec Marked tender
- 21. ❄ Lisfranc injury Rt foot ❄ Closed fracture base of 5th MTB Rt foot
- 22. ❄At ER : on posterior short leg slab ❄Set OR for ORIF with Screw with K-wire
- 24. Intraoperative finding : • Lisfranc joint injury Rt foot ( Myerson BII ) • Closed fracture Rt 5th MTB • Tarsometatarsal joint injury 3rd,4th and 5th Rt foot ORIF with Screw with K-wire
- 25. Lisfranc Injury
- 26. • Diagnosis is missed in about 20% - 30% • If Lisfranc injury is not diagnosed and treated properly, it can lead to an altered gait, midfoot arthritis, and long term disability ( foot deformity, chronic pain and dysfunction) • Associated with compartment syndrome
- 28. Large oblique ligament extend from the plantar aspect of the medial cuneiform to the base of 2nd metatarsal bone Stabilize the 2nd metatarsal and maintains the midfoot arch
- 29. Medial : 1st tarsometatarsal joints -> 6 mobility Middle : 2nd , 3rd tarsometatarsal joint -> Rigid Lateral : 4th , 5th tarsometatarsal joint -> Mobile
- 30. The dorsalis pedis artery and the deep peroneal nerve both run between the 1st and 2nd metatarsal bases
- 32. ❄Severe pain at the midfoot and unable to bear weight ❄Swelling in the midfoot dorsally ❄Tenderness over the tarsometatarsal joint ❄Plantar bruising may be present, especially medially
- 33. • Medial border of the second metatarsal should line up with the medial border of the middle cuneiform on both the AP and Oblique view • Check for fractures, especially at the base of the 2nd metatarsal, navicular and cuboid
- 34. • Check for widening between the first and second ray (more than 2 mm is an indication for surgery)
- 36. • In the lateral view, check the dorsal displacement or subluxation of a metatarsal
- 38. • Check for the FLECK sign (bony fragment) • Avulsion fragment of the lisfranc ligament form the base of the 2nd metatarsal
- 39. • The medial side of the fourth metatarsal should line up with the medial side of the cuboid
- 41. Non-operative : Cast immobilization for 6-8 weeks indications • no displacement on weight-bearing and stress radiographs and no evidence of bony injury on CT ( usually dorsal sprains ) • certain nonoperative candidates
- 42. Operative : open reduction and rigid internal fixation indications • any evidence of instability (> 2mm shift) • favored in bony fracture dislocations as opposed to purely ligamentous injuries
- 43. Skin incision at medial + lateral + dorsal of Rt.foot and release hematome