Tillaux Fracture
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A 13-year-old male presented with ankle pain after twisting his foot while hiking. On examination, he had limited range of motion in his right ankle with marked swelling and tenderness. Radiographs revealed a Salter Harris III fracture involving avulsion of the anterolateral tibial epiphysis. He was treated with pain control, orthopedic consultation for possible open reduction and internal fixation, and stabilization in a long leg cast or splint with orthopedic follow-up.
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A 15-year-old male presents to the emergency department after jumping off a merry-go-round and landing on his right foot, experiencing achy pain and swelling. On examination, he has dorsal swelling and tenderness over the foot and malleolus, and pain with ankle movement. This suggests a triplane fracture, which involves the tibial growth plate and metaphysis, occurring through multiple planes. Treatment involves splinting nondisplaced fractures and closed or open reduction for displaced fractures.
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Presentation includes pain with shoe wear and prominence over the first MTP joint. Exam evaluates the first ray and associated deformities. Radiographs measure angles to guide treatment and assess for degenerative changes.
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This document provides an overview of hallux valgus, including its etiology, pathogenesis, clinical features, evaluation, classification systems, non-operative and operative treatment options. Key points include:
- Hallux valgus is a common foot deformity involving the big toe. Its prevalence increases with age and it is more common in females.
- Causes include biomechanical instability, arthritic/metabolic conditions, and trauma. The deformity progresses as the abductor hallucis muscle becomes unopposed.
- Evaluation involves assessing angles on weight-bearing radiographs and classifying severity.
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This document discusses hallux valgus, also known as a bunion. It begins by defining the deformity and listing associated symptoms. It then discusses causes, classifications based on x-ray measurements, conservative and surgical treatment options. For surgery, it explains various procedures that can be used to correct deformities ranging from mild to severe, including soft tissue releases, osteotomies of the metatarsal and phalanx bones, and arthrodesis or fusion procedures. Potential complications of surgery are also outlined.
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The document discusses hallux valgus, also known as a bunion deformity. It is characterized by lateral deviation of the great toe and medial deviation of the first metatarsal. Risk factors include hereditary factors and wearing narrow, high-heeled shoes. Treatment involves conservative options like orthotics or wider shoes initially. For more severe cases, surgical options aim to correct the deformity and relieve pain, such as soft tissue procedures, osteotomies to realign the bone, or fusing joints in advanced cases. Post-operative care focuses on reducing swelling and maintaining correction of the deformity.
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1. The document discusses various surgical procedures for correcting hallux valgus deformity, including distal soft tissue procedures, osteotomies of the first metatarsal, and phalangeal osteotomies.
2. Common procedures described are the modified McBride bunionectomy, Mitchell osteotomy, Chevron osteotomy, and Ludloff osteotomy.
3. Patient factors like age, severity of deformity, and joint arthritis help determine which procedure is most appropriate. Soft tissue procedures are preferred for milder cases while more severe deformities may require metatarsal osteotomies.
Luxatio Erecta Inferior Shoulder Dislocation
A 20-year-old male presented with right shoulder pain after being involved in a wrestling move on a trampoline that involved having his arm held out and then being jumped on at the top of the shoulder. On examination, he was holding his right arm abducted and elevated above his head due to pain and inability to move the shoulder. He was diagnosed with an anterior shoulder dislocation based on the mechanism of injury and physical exam findings.
Hallux valgus.pptx
This document provides an overview of hallux valgus, including its anatomy, causes, symptoms, diagnosis, and treatment options. Key points include:
- Hallux valgus is a lateral deviation of the great toe and medial deviation of the first metatarsal. It can cause pain over the bunion.
- Risk factors include heredity, footwear, ligament laxity, and pes planus. Diagnosis involves examining range of motion, deformity, and taking x-rays to measure angles.
- Treatment progresses from footwear modifications and stretching to various surgical procedures depending on severity, including distal soft tissue procedures, osteotomies, and joint fusion or replacement in severe cases.
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Hallux valgus is a deformity of the big toe characterized by lateral deviation of the toe and medial deviation of the first metatarsal. It is caused by both intrinsic and extrinsic factors and can cause pain, difficulty wearing shoes, and cosmetic issues. Treatment involves conservative measures like wider shoes initially, with surgical correction considered for more severe or symptomatic cases. Surgery aims to correct angles, realign the joint, and restore normal mechanics, and may involve soft tissue procedures, osteotomies, or arthrodesis in severe cases. Proper patient selection and technique are important for achieving good outcomes.
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Hallux valgus, also known as a bunion, is a progressive foot deformity where the first metatarsophalangeal joint is affected, causing the big toe to deviate laterally away from the second toe. This is often accompanied by pain and functional impairment. Non-surgical treatments include footwear modifications and orthotics to reduce pressure and pain. Surgical options vary based on severity, from osteotomies like the Chevron procedure for mild cases to joint fusions for severe deformities. Post-operative management focuses on gradually restoring range of motion and strengthening through physical therapy exercises.
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This document summarizes a seminar on hallux valgus (bunions). It provides details on the relevant anatomy, biomechanics, causes, symptoms, physical exam findings, radiographic assessment, classification, and treatment options for hallux valgus. Conservative treatments include footwear modifications and stretching exercises. Surgical treatments aim to correct the structural deformities and include soft tissue procedures, distal and proximal metatarsal osteotomies, phalangeal osteotomies, fusions, and resection arthroplasty. The Mitchell and Chevron osteotomies are described as common distal metatarsal osteotomy techniques.
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This document discusses hallux valgus, a deformity of the foot where the big toe points away from the midline of the body. It covers relevant anatomy, biomechanics, etiology, signs and symptoms, physical exam findings, pathological changes, and radiographic assessment. Key factors that contribute to hallux valgus include heredity, flat feet, ligament laxity, and wearing narrow shoes with high heels. Physical exam assesses deformities, joint motion, and gait. Radiographs are important to evaluate bone and joint alignment as well as arthritis.
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A 21-year-old female presented to the emergency department after a motor vehicle collision with left arm pain from striking the steering wheel without restraints. Examination revealed a swollen and deformed left upper extremity without open fracture. The arm was reduced and splinted, with the radial head gently repositioned anteriorly and the ulnar shaft reduced by manual pressure. Orthopedics was contacted to discuss urgent operative repair for a Monteggia fracture dislocation of the left forearm.
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This document describes a case of a 50-year-old female who presented with left leg deformity and swelling after being involved in a motor vehicle accident where she hit a pole 6 hours prior. On examination, she had swelling and bruising of her left leg, with marked tenderness over the left knee. X-rays revealed a fracture of the left tibial plateau. The document then discusses tibial plateau fractures, including their mechanisms of injury, classification systems like Schatzker classification, associated injuries, and treatment options like non-operative management with bracing or operative fixation depending on the fracture pattern and stability.
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Hallux valgus is a lateral deviation of the great toe with medial deviation of the first metatarsal. It is often accompanied by lesser toe deformities and is more common in women. Risk factors include genetic predisposition and shoes that are too narrow. Pathologically, the deforming forces cause changes to the joint capsule and sesamoid complex.
Presentation includes pain with shoe wear and prominence over the first MTP joint. Exam evaluates the first ray and associated deformities. Radiographs measure angles to guide treatment and assess for degenerative changes.
Management begins conservatively with shoe modifications. Surgical options range from soft tissue procedures for mild cases to osteotomies or fusions for more severe
Hammer toes
Hammer toes is a condition where the toe is bent at the middle joint, causing it to resemble a hammer. There are two types - flexible and rigid. Risk factors include genetics and wearing tight shoes. Symptoms are pain at the bent joint from corns. Causes include tight shoes putting pressure on the toe tendon. Treatment depends on whether the toe is flexible or rigid - orthotics for flexible toes and surgery for rigid toes.
Hallux valgus
This document provides an overview of hallux valgus, including its etiology, pathogenesis, clinical features, evaluation, classification systems, non-operative and operative treatment options. Key points include:
- Hallux valgus is a common foot deformity involving the big toe. Its prevalence increases with age and it is more common in females.
- Causes include biomechanical instability, arthritic/metabolic conditions, and trauma. The deformity progresses as the abductor hallucis muscle becomes unopposed.
- Evaluation involves assessing angles on weight-bearing radiographs and classifying severity.
- Treatment ranges from footwear modifications and orthoses to various osteotomy procedures depending on deform
Hallux valgus
This document discusses hallux valgus, also known as a bunion. It begins by defining the deformity and listing associated symptoms. It then discusses causes, classifications based on x-ray measurements, conservative and surgical treatment options. For surgery, it explains various procedures that can be used to correct deformities ranging from mild to severe, including soft tissue releases, osteotomies of the metatarsal and phalanx bones, and arthrodesis or fusion procedures. Potential complications of surgery are also outlined.
Disorders of hallux
The document discusses hallux valgus, also known as a bunion deformity. It is characterized by lateral deviation of the great toe and medial deviation of the first metatarsal. Risk factors include hereditary factors and wearing narrow, high-heeled shoes. Treatment involves conservative options like orthotics or wider shoes initially. For more severe cases, surgical options aim to correct the deformity and relieve pain, such as soft tissue procedures, osteotomies to realign the bone, or fusing joints in advanced cases. Post-operative care focuses on reducing swelling and maintaining correction of the deformity.
Hallux Varus
Hallux varus is a deformity of the great toe characterized by three key radiographic findings: a negative hallux abductus angle, negative IM 1-2 angle, and tibial sesamoid peaking. Patients typically present with pain, difficulty with shoes, and decreased push off ability. Treatment begins with orthotics and splinting but often requires surgery involving medial soft tissue release and lateral tightening, with tendon transfers used to correct deformity and maintain correction. Classification systems aim to guide surgical decision making by considering joint flexibility and deforming forces at work.
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A 44-year-old man presented with acute onset left leg pain, numbness, and weakness. On examination, his left lower limb was pale, cold, pulseless with reduced sensation. Imaging showed a thrombus in his aorta and left iliac and femoral arteries. He was diagnosed with acute limb ischemia and underwent aortic endarterectomy, femoral embolectomy and patch angioplasty, and fasciotomy to restore blood flow and prevent compartment syndrome. Post-operatively, he required monitoring for reperfusion injuries and long-term anticoagulation to prevent recurrence.
Acute Limb Ischemia
Acute limb ischemia is a sudden decrease in blood flow to a limb that threatens viability. It requires urgent evaluation and management to determine if the limb is viable, threatened, or irreversibly damaged. Prompt diagnosis and revascularization through catheter-based thrombolysis, thrombectomy, or surgery can reduce limb loss risk. Treatment approaches depend on the severity of ischemia and limb threat.
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The ankle is a three bone joint composed of the tibia, fibula, and talus. The talus articulates superiorly with the tibial plafond and posteriorly and medially with the posterior and medial malleoli. Laterally, it articulates with the fibular malleolus. The ankle joint is saddle-shaped and wider anteriorly than posteriorly. During dorsiflexion, the fibula rotates externally through the tibiofibular syndesmosis to accommodate the widened anterior surface of the talar dome. Displacement of the talus within the ankle mortise by only 1 mm decreases the contact area by 42%.
9. dela cruz cleidocranial dysplasia
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This document summarizes common lower limb fractures, including fractures of the femur (hip), tibia, fibula, patella, ankle, calcaneus, and metatarsals. It describes the location and classification of these fractures, along with examples of X-ray images demonstrating various fracture patterns such as femoral neck, tibial plateau, lateral malleolus, and Jones fractures of the 5th metatarsal. Classification systems are outlined for femoral neck, ankle, and calcaneal fractures based on their location and degree of displacement.
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2. They are indicated for paralyzed muscles due to nerve injury, neurological disease, or nerve repair with early transfer. They are also used for injured tendons or muscles.
3. General principles include only restoring functional hand motion, considering patient factors, ensuring the recipient site is suitable, matching the donor muscle properties to the function being replaced, and properly tensioning and positioning the transfer.
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Mucopolysaccharidoses
definition ,types,causes,presentations,most common types,diagnosis ,differential diagnosis ,treatment ,prevention
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Congenital syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum transmitted from mother to fetus. It can cause symptoms in the fetus and newborn ranging from rash, fever, bone abnormalities to long term complications affecting eyes, teeth, bones and nervous system if untreated. Diagnosis involves tests for syphilis in the mother and treatment with intravenous penicillin can prevent transmission if given before 18 weeks of pregnancy.
Ankle Foot Orthosis
Ankle-foot orthoses (AFOs) are external devices that attach to the lower leg and foot to improve function by controlling motion and providing support. The main components are a calf band, medial and lateral bars that articulate with ankle joints, and a stirrup that anchors to the shoe. There are 5 types of artificial ankle joints prescribed according to muscle strength: free ankle, dorsiflexion stop, plantarflexion stop, fixed dorsiflexion stop, and fixed hinge. AFOs are used to treat drop foot and other conditions involving muscle weakness, deformities, or instability by maintaining proper foot and ankle positioning during gait.
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A 34-year-old man presents with sharp chest pain for 2 hours following crack cocaine use. He has no other symptoms. On examination, he has a heart rate of 148, blood pressure of 98.7/105, respiratory rate of 18, and clear lungs. Chest x-ray shows pneumomediastinum. The patient is admitted for observation and treatment with oxygen and IV fluids.
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Tuberculosis Power Point
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Lobar pneumonia Power Point
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A 10-year-old boy presented with an obvious deformity to his right wrist following a football injury. X-rays showed a Salter Harris Type II fracture extending from the growth plate through the bone with part of the bone broken off. The boy's wrist was splinted and he was referred to orthopedics for follow-up.
Pitcher's Elbow Power Point
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A 9 year old female presented to the emergency department after falling from a horse at summer camp and injuring her right wrist. She complained of pain with palpation and movement of the wrist. Examination revealed mild swelling and tenderness over the wrist, but plain films did not show any obvious abnormalities. Due to the possibility of a Salter Harris I fracture that may not be visible on initial x-rays, the patient was splinted and advised to follow up with orthopedics in 7-10 days for repeat films to check for any delayed findings.
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Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
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Chapter 6
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1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
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Tillaux Fracture
- 2. 13YOM presents with the complaint of ankle pain. The patient was hiking with friends and family when his foot got caught and he “twisted” his ankle. He has been unable to bear weight and is complaining of marked swelling. T 98.7 P 98 BP 126/84 O2 99% Gen: WDWN, obvious pain CV: RRR, no m/r/g Pulm: Lungs CTA bilat Musc: Limited active and passive ROM R ankle; marked swelling and TTP of anterior R ankle; no TTP over medial and lateral malleolus
- 4. Red arrow: Salter Harris III fracture involving avulsion of anterolateral tibial epiphysis
- 5. Pain control Orthopedic Consultation for possible ORIF Displacement of >2mm requires ORIF Stabilization/Closed Reduction Internal rotation of ankle and supination of the foot with pressure on fracture fragment Stabilization in long leg cast or stirrup splint with posterior slab Prompt orthopedic follow-up
- 6. Fracture occurs in adolescents w/ relatively mature growth plates; therefore, there is minimal potential for deformity due to growth plate injury Needs to be differentiated from a triplane fracture, which is a salter harris IV fracture that extends through the epiphysis, physis, and metaphysis
- 8. http://www.radpod.org/2007/07/20/tillaux-fracture/ http://radiologyschools.com/Radiology- Courses/ext/8ankle/33.html http://www.wheelessonline.com/ortho/tillaux_fractur e http://www.joint-pain-expert.net/tillaux-fracture.html Pediatric Emergency Medicine. Chapter 38 Injuries of the Pelvis and Lower Extremities