Intertrochanteric fractures occur between the greater and lesser trochanters of the femur. They are common in elderly osteoporotic patients, especially women, and are usually caused by a fall. Early internal fixation is the standard treatment to restore anatomy and allow early mobilization. Complications can include malunion, nonunion, and hardware failure due to poor bone quality. Subtrochanteric fractures below the lesser trochanter involve a greater blood supply and may extend into the intertrochanteric region, posing unique challenges for fixation and restoration of alignment.
The document discusses intertrochanteric fractures and subtrochanteric fractures of the femur. Intertrochanteric fractures most commonly occur in elderly osteoporotic women and usually involve a fall directly on the hip. They often heal easily without complications. Subtrochanteric fractures below the lesser trochanter typically result from high-energy trauma and can be difficult to heal due to the dense cortical bone in that region. Surgical treatment with internal fixation is now preferred for most intertrochanteric and subtrochanteric fractures to allow early mobilization and reduce complications compared to previous nonsurgical approaches.
1) Subtrochanteric Fracture
Subtrochanteric typically defined as area from lesser trochanter to 5cm distal fractures with an associated intertrochanteric component may be called peritrochanteric fracture.
*Unique Aspect
Blood loss is greater than with femoral neck or trochanteric fractures – covered with anastomosing branches of the medial and lateral circumflex femoral arteries branch of profunda femoris trunk.
2) Femoral Shaft Fracture
Femoral shaft fracture is defined as a fracture of the diaphysis occurring between 5 cm distal to the lesser trochanter and 5 cm proximal to the adductor tubercle
The femoral shaft is padded with large muscles.
- reduction can be difficult as muscle contraction displaces the fracture
- healing potential is improved by having this well-vascularized
*Age
-usually a fracture of young adults and results from a high energy injury
-elderly patients should be considered ‘pathological’ until proved otherwise
-children under 4 years the suspected possibility of physical abuse
*FRACTURES ASSOCIATED WITH VASCULAR INJURY
Warning signs of an associated vascular injury are
(1) excessive bleeding or haematoma formation; and
(2) paraesthesia, pallor or pulselessness in the leg and foot.
~Warm ischemia in 2-3H
~If > 6H – salvage not possible
*‘FLOATING KNEE’
Ipsilateral fractures of the femur and tibia may leave the knee joint ‘floating’
3) Distal Femoral Fracture
Defined as fractures from articular surface to 5cm above metaphyseal flare
*clinical feature
The knee is swollen because of a haemarthrosis – this can be severe enough to cause blistering later
Movement is too painful to be attempted
The tibial pulses should always be checked to ensure the popliteal artery was not injured in the fracture.
Reference: Apley's System of Orthopaedic and Fracture (9th edition)
Fractures of the proximal humerus are common injuries, usually occurring in older osteoporotic patients after falls. The Neer classification system divides fractures into 1, 2, 3, or 4-part patterns based on the number of displaced bone fragments. Treatment depends on the fracture type and patient factors. Minimally displaced fractures are treated non-operatively with rest and rehabilitation. More displaced fractures may require operative fixation using techniques like percutaneous pins, plates, or nails to stabilize the fragments. Complications can include avascular necrosis, nerve injuries, stiffness, and malunion.
1) The document discusses different types of femoral fractures including femoral head, neck, intertrochanteric, subtrochanteric, shaft, and distal fractures.
2) Subtrochanteric fractures are defined as occurring within 5cm below the lesser trochanter. Fielding classification categorizes subtrochanteric fractures based on their location relative to the lesser trochanter.
3) Treatment options depend on the type and stability of the fracture, and may include traction, plating, intramedullary nailing, or hip screws.
Intertrochentric femur fracture by DR.NAVEEN RATHORDR.Naveen Rathor
The document discusses intertrochanteric hip fractures, which occur between the greater and lesser trochanters of the proximal femur. It describes the anatomy, mechanisms of injury, classification systems used, treatment options including internal fixation with devices like the sliding hip screw or intramedullary nails, and postoperative management. Complications of treatment like fixation failure, nonunion, and avascular necrosis are also mentioned.
A 16-year-old boy was admitted to the hospital after a traffic accident where he fell from a motorcycle. He reported pain in his left thigh. Examination found deformity, hematoma, and swelling of the left femur region with tenderness. X-rays showed a closed fracture of the middle third of the left femur. He was diagnosed and treated with open reduction internal fixation surgery.
Intertrochanteric fractures occur between the greater and lesser trochanters of the femur. They are common in elderly osteoporotic patients, especially women, and are usually caused by a fall. Early internal fixation is the standard treatment to restore anatomy and allow early mobilization. Complications can include malunion, nonunion, and hardware failure due to poor bone quality. Subtrochanteric fractures below the lesser trochanter involve a greater blood supply and may extend into the intertrochanteric region, posing unique challenges for fixation and restoration of alignment.
The document discusses intertrochanteric fractures and subtrochanteric fractures of the femur. Intertrochanteric fractures most commonly occur in elderly osteoporotic women and usually involve a fall directly on the hip. They often heal easily without complications. Subtrochanteric fractures below the lesser trochanter typically result from high-energy trauma and can be difficult to heal due to the dense cortical bone in that region. Surgical treatment with internal fixation is now preferred for most intertrochanteric and subtrochanteric fractures to allow early mobilization and reduce complications compared to previous nonsurgical approaches.
1) Subtrochanteric Fracture
Subtrochanteric typically defined as area from lesser trochanter to 5cm distal fractures with an associated intertrochanteric component may be called peritrochanteric fracture.
*Unique Aspect
Blood loss is greater than with femoral neck or trochanteric fractures – covered with anastomosing branches of the medial and lateral circumflex femoral arteries branch of profunda femoris trunk.
2) Femoral Shaft Fracture
Femoral shaft fracture is defined as a fracture of the diaphysis occurring between 5 cm distal to the lesser trochanter and 5 cm proximal to the adductor tubercle
The femoral shaft is padded with large muscles.
- reduction can be difficult as muscle contraction displaces the fracture
- healing potential is improved by having this well-vascularized
*Age
-usually a fracture of young adults and results from a high energy injury
-elderly patients should be considered ‘pathological’ until proved otherwise
-children under 4 years the suspected possibility of physical abuse
*FRACTURES ASSOCIATED WITH VASCULAR INJURY
Warning signs of an associated vascular injury are
(1) excessive bleeding or haematoma formation; and
(2) paraesthesia, pallor or pulselessness in the leg and foot.
~Warm ischemia in 2-3H
~If > 6H – salvage not possible
*‘FLOATING KNEE’
Ipsilateral fractures of the femur and tibia may leave the knee joint ‘floating’
3) Distal Femoral Fracture
Defined as fractures from articular surface to 5cm above metaphyseal flare
*clinical feature
The knee is swollen because of a haemarthrosis – this can be severe enough to cause blistering later
Movement is too painful to be attempted
The tibial pulses should always be checked to ensure the popliteal artery was not injured in the fracture.
Reference: Apley's System of Orthopaedic and Fracture (9th edition)
Fractures of the proximal humerus are common injuries, usually occurring in older osteoporotic patients after falls. The Neer classification system divides fractures into 1, 2, 3, or 4-part patterns based on the number of displaced bone fragments. Treatment depends on the fracture type and patient factors. Minimally displaced fractures are treated non-operatively with rest and rehabilitation. More displaced fractures may require operative fixation using techniques like percutaneous pins, plates, or nails to stabilize the fragments. Complications can include avascular necrosis, nerve injuries, stiffness, and malunion.
1) The document discusses different types of femoral fractures including femoral head, neck, intertrochanteric, subtrochanteric, shaft, and distal fractures.
2) Subtrochanteric fractures are defined as occurring within 5cm below the lesser trochanter. Fielding classification categorizes subtrochanteric fractures based on their location relative to the lesser trochanter.
3) Treatment options depend on the type and stability of the fracture, and may include traction, plating, intramedullary nailing, or hip screws.
Intertrochentric femur fracture by DR.NAVEEN RATHORDR.Naveen Rathor
The document discusses intertrochanteric hip fractures, which occur between the greater and lesser trochanters of the proximal femur. It describes the anatomy, mechanisms of injury, classification systems used, treatment options including internal fixation with devices like the sliding hip screw or intramedullary nails, and postoperative management. Complications of treatment like fixation failure, nonunion, and avascular necrosis are also mentioned.
A 16-year-old boy was admitted to the hospital after a traffic accident where he fell from a motorcycle. He reported pain in his left thigh. Examination found deformity, hematoma, and swelling of the left femur region with tenderness. X-rays showed a closed fracture of the middle third of the left femur. He was diagnosed and treated with open reduction internal fixation surgery.
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.
This document describes various fractures of the lower limbs, including: femur (femoral neck, shaft, distal end), tibia and fibula, patella, ankle (Weber classification), calcaneus (Sanders classification), and metatarsals. Key details are provided on classifications of femoral neck fractures (Garden, Pauwels), tibial plateau fractures, and calcaneal fractures. Common fracture patterns such as supracondylar femoral fractures and lateral malleolar fractures are also outlined.
fracture and dislocation ppt . Almas khan. khorfakkhan hospital dubaialmasmkm
This document discusses fractures and dislocations, including:
- Signs and symptoms of fractures like pain, deformity, and loss of function
- Types of fractures such as complete, incomplete, open, comminuted, spiral, and stress fractures
- Emergency care for fractures including splinting, immobilization, and controlling bleeding
- Diagnosis using x-rays, CT scans, or MRIs to identify fracture type and location
- Treatment options like casting, internal fixation surgery, traction, and exercise
- Factors that can delay or prevent fracture healing like infection, movement, and poor blood supply
- The role of the radiographer in obtaining quality images to aid in diagnosis and monitoring healing
Dislocation of the knee joint can be a serious injury, especially if there is damage to blood vessels which can lead to limb loss if missed. The knee can dislocate in various positions such as anteriorly, posteriorly, or medially/laterally. Over half of dislocations are anterior or posterior, which have a high risk of popliteal artery injury. Knee dislocations require reduction and splinting, followed by examination and imaging to check for injuries to ligaments, blood vessels, and nerves.
Hip fractures are common injuries that can occur in the femoral neck, intertrochanteric region, or femoral shaft. Posterior dislocations of the hip are the most common type of hip dislocation. Treatment for hip fractures involves closed or open reduction and internal fixation or arthroplasty depending on the type and displacement of the fracture.
Nailing it hip fractures short versus long; locked versus non lockedLove2jaipal
This document discusses the treatment of intertrochanteric hip fractures with intramedullary nails. It provides an overview of short versus long nails and locked versus nonlocked nails. The document covers fracture classifications, mechanisms of injury, surgical techniques, advantages of cephalomedullary nails over other methods like plates or sliding hip screws, and factors in determining fracture stability and implant choice.
The document discusses fractures of the talus bone. It provides a brief history of studies on talus injuries from 1919 to 1970. It then describes the anatomy of the talus bone and its limited blood supply. Different classification systems for talus fractures are mentioned. Treatment depends on fracture type but generally involves closed or open reduction and internal fixation to restore alignment and blood flow. Complications like osteonecrosis can occur depending on displacement and are challenging to treat.
The document discusses fracture of the femoral shaft, including classifications of femoral shaft fractures and the significance of the third fragment. It also discusses the anatomical and mechanical axes of the femur, approaches to the femoral shaft, advantages and disadvantages of different surgical techniques like closed antegrade nailing, and key steps in the surgical procedure like patient positioning, preparation of the femur, and reaming.
Subtrochanteric fractures occur in the region of the femur between the lesser trochanter and 5 cm distal to it. They are challenging injuries to treat due to strong muscle forces and high stresses in this region. Surgical stabilization with an intramedullary nail is usually recommended to provide rigid fixation while minimizing stress on the implant. Care must be taken to achieve and maintain an anatomical reduction to prevent complications like malunion and nonunion. Long-term bisphosphonate use may be associated with an increased risk of subtrochanteric fractures with a characteristic radiographic appearance.
Common lower limb injuries include fractures, dislocations, and subluxations of bones or joints. Posterior hip dislocations are the most common type of hip dislocation, often caused by an axial load on the flexed and adducted hip. They are diagnosed via x-ray and treated initially with closed reduction and immobilization. Complications can include avascular necrosis, stiffness, and late onset osteoarthritis. Femoral neck fractures are also common in the elderly and are classified using the Garden system to determine appropriate treatment.
Fractures of the lower limb can result from high-energy trauma or osteoporosis in the elderly. Common fractures include the femur, patella, tibia, fibula, ankle, and bones of the foot. Treatment depends on the type and location of the fracture, ranging from closed reduction and casting to open reduction with internal fixation using plates, screws, or intramedullary nails. Pelvic fractures may also require surgical fixation depending on the forces involved and stability of the injury.
Complications of total hip replacement finalHumayun Israr
This document discusses potential complications of total hip replacement surgery. It describes complications that can occur related to anesthesia, during surgery such as nerve injuries, fat embolism, leg length discrepancy and vascular injuries. Post-operative complications discussed include dislocation, infection, DVT, hematoma formation, heterotopic ossification, aseptic loosening, fractures, and osteolysis. Prevention and management strategies are provided for many of the complications.
1. Supracondylar fractures of the femur usually occur due to low-energy trauma in elderly patients or high-energy trauma in young patients near the knee.
2. Fractures of the knee region include patellar fractures from direct blows, femoral condyle fractures from axial loading with twisting forces, and tibial plateau fractures most commonly from falls.
3. Treatment depends on the type and severity of the fracture, ranging from bracing for nondisplaced fractures to open reduction and internal fixation for displaced or unstable fractures.
Maxillofacial fractures usually occur as the result of massive facial trauma and can include fractures of the mandible, nasal bones, maxilla, and zygomatic bones. Cervical spine fractures include fractures of C1-C2 as well as burst, compression, and teardrop fractures of the lower cervical vertebrae. Humerus fractures are classified as one, two, three, or four-part fractures. Distal radius fractures include Colles', Smith's, Barton's, and Galeazzi fractures. Hip fractures are classified as femoral neck, intertrochanteric, or subtrochanteric fractures. Common foot fractures are Lisfranc fractures and fractures of the metatarsals
1. Amputation involves removing part of a limb, while disarticulation separates bones at a joint. Common indications are gangrene, trauma, burns, infections, and tumors.
2. Types of amputation include provisional, guillotine, and formal amputations. Formal amputations create flaps to cover the bone and form an ideal stump.
3. Complications can be early like hemorrhage and infection, or late like pain, ulceration, neuromas, and phantom limb sensation. Proper technique and postoperative care can help reduce complications.
The document discusses ankle fractures, providing information on ankle anatomy, classification systems, clinical features, imaging, treatment, and complications. It describes the ankle joint as composed of the tibia, fibula, and talus bones. Two common classification systems are described - the Weber system categorizes fractures by the location of the fibular fracture in relation to the syndesmosis, while the Lauge-Hansen system depends on the mechanism of injury. Clinical features may include pain, swelling, limited movement, and neurovascular issues. Imaging includes x-rays and sometimes CT or MRI to evaluate bone and soft tissue injuries. Treatment involves initial stabilization followed by casting or surgery to restore anatomy, with goals of preventing post-traumatic arthritis
This document provides an overview of lower limb fractures, focusing on the hip, femur, knee, tibia, and ankle. It describes the epidemiology, classification systems, clinical evaluation, imaging, and treatment options for various fractures in these areas. Key points covered include the types and management of femoral neck, intertrochanteric hip, tibial plateau and pilon fractures. Evaluation involves history, exam, and radiographs, while treatment may involve fixation, arthroplasty or non-operative management depending on the fracture pattern and patient factors. Complications are also discussed for several injuries.
The document discusses various types of cervical spine trauma and injuries that can occur. It describes fractures of the atlas including Jefferson's fracture and posterior arch fractures. Hangman's fractures and teardrop fractures of the axis are also summarized. Odontoid fractures are divided into Types I-III. Vertebral body compression fractures like wedge fractures and burst fractures are mentioned. The document also briefly summarizes clay shoveler's fractures and lamina and transverse process fractures of the cervical spine. Various imaging modalities for evaluating cervical spine injuries are also discussed.
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.
This document describes various fractures of the lower limbs, including: femur (femoral neck, shaft, distal end), tibia and fibula, patella, ankle (Weber classification), calcaneus (Sanders classification), and metatarsals. Key details are provided on classifications of femoral neck fractures (Garden, Pauwels), tibial plateau fractures, and calcaneal fractures. Common fracture patterns such as supracondylar femoral fractures and lateral malleolar fractures are also outlined.
fracture and dislocation ppt . Almas khan. khorfakkhan hospital dubaialmasmkm
This document discusses fractures and dislocations, including:
- Signs and symptoms of fractures like pain, deformity, and loss of function
- Types of fractures such as complete, incomplete, open, comminuted, spiral, and stress fractures
- Emergency care for fractures including splinting, immobilization, and controlling bleeding
- Diagnosis using x-rays, CT scans, or MRIs to identify fracture type and location
- Treatment options like casting, internal fixation surgery, traction, and exercise
- Factors that can delay or prevent fracture healing like infection, movement, and poor blood supply
- The role of the radiographer in obtaining quality images to aid in diagnosis and monitoring healing
Dislocation of the knee joint can be a serious injury, especially if there is damage to blood vessels which can lead to limb loss if missed. The knee can dislocate in various positions such as anteriorly, posteriorly, or medially/laterally. Over half of dislocations are anterior or posterior, which have a high risk of popliteal artery injury. Knee dislocations require reduction and splinting, followed by examination and imaging to check for injuries to ligaments, blood vessels, and nerves.
Hip fractures are common injuries that can occur in the femoral neck, intertrochanteric region, or femoral shaft. Posterior dislocations of the hip are the most common type of hip dislocation. Treatment for hip fractures involves closed or open reduction and internal fixation or arthroplasty depending on the type and displacement of the fracture.
Nailing it hip fractures short versus long; locked versus non lockedLove2jaipal
This document discusses the treatment of intertrochanteric hip fractures with intramedullary nails. It provides an overview of short versus long nails and locked versus nonlocked nails. The document covers fracture classifications, mechanisms of injury, surgical techniques, advantages of cephalomedullary nails over other methods like plates or sliding hip screws, and factors in determining fracture stability and implant choice.
The document discusses fractures of the talus bone. It provides a brief history of studies on talus injuries from 1919 to 1970. It then describes the anatomy of the talus bone and its limited blood supply. Different classification systems for talus fractures are mentioned. Treatment depends on fracture type but generally involves closed or open reduction and internal fixation to restore alignment and blood flow. Complications like osteonecrosis can occur depending on displacement and are challenging to treat.
The document discusses fracture of the femoral shaft, including classifications of femoral shaft fractures and the significance of the third fragment. It also discusses the anatomical and mechanical axes of the femur, approaches to the femoral shaft, advantages and disadvantages of different surgical techniques like closed antegrade nailing, and key steps in the surgical procedure like patient positioning, preparation of the femur, and reaming.
Subtrochanteric fractures occur in the region of the femur between the lesser trochanter and 5 cm distal to it. They are challenging injuries to treat due to strong muscle forces and high stresses in this region. Surgical stabilization with an intramedullary nail is usually recommended to provide rigid fixation while minimizing stress on the implant. Care must be taken to achieve and maintain an anatomical reduction to prevent complications like malunion and nonunion. Long-term bisphosphonate use may be associated with an increased risk of subtrochanteric fractures with a characteristic radiographic appearance.
Common lower limb injuries include fractures, dislocations, and subluxations of bones or joints. Posterior hip dislocations are the most common type of hip dislocation, often caused by an axial load on the flexed and adducted hip. They are diagnosed via x-ray and treated initially with closed reduction and immobilization. Complications can include avascular necrosis, stiffness, and late onset osteoarthritis. Femoral neck fractures are also common in the elderly and are classified using the Garden system to determine appropriate treatment.
Fractures of the lower limb can result from high-energy trauma or osteoporosis in the elderly. Common fractures include the femur, patella, tibia, fibula, ankle, and bones of the foot. Treatment depends on the type and location of the fracture, ranging from closed reduction and casting to open reduction with internal fixation using plates, screws, or intramedullary nails. Pelvic fractures may also require surgical fixation depending on the forces involved and stability of the injury.
Complications of total hip replacement finalHumayun Israr
This document discusses potential complications of total hip replacement surgery. It describes complications that can occur related to anesthesia, during surgery such as nerve injuries, fat embolism, leg length discrepancy and vascular injuries. Post-operative complications discussed include dislocation, infection, DVT, hematoma formation, heterotopic ossification, aseptic loosening, fractures, and osteolysis. Prevention and management strategies are provided for many of the complications.
1. Supracondylar fractures of the femur usually occur due to low-energy trauma in elderly patients or high-energy trauma in young patients near the knee.
2. Fractures of the knee region include patellar fractures from direct blows, femoral condyle fractures from axial loading with twisting forces, and tibial plateau fractures most commonly from falls.
3. Treatment depends on the type and severity of the fracture, ranging from bracing for nondisplaced fractures to open reduction and internal fixation for displaced or unstable fractures.
Maxillofacial fractures usually occur as the result of massive facial trauma and can include fractures of the mandible, nasal bones, maxilla, and zygomatic bones. Cervical spine fractures include fractures of C1-C2 as well as burst, compression, and teardrop fractures of the lower cervical vertebrae. Humerus fractures are classified as one, two, three, or four-part fractures. Distal radius fractures include Colles', Smith's, Barton's, and Galeazzi fractures. Hip fractures are classified as femoral neck, intertrochanteric, or subtrochanteric fractures. Common foot fractures are Lisfranc fractures and fractures of the metatarsals
1. Amputation involves removing part of a limb, while disarticulation separates bones at a joint. Common indications are gangrene, trauma, burns, infections, and tumors.
2. Types of amputation include provisional, guillotine, and formal amputations. Formal amputations create flaps to cover the bone and form an ideal stump.
3. Complications can be early like hemorrhage and infection, or late like pain, ulceration, neuromas, and phantom limb sensation. Proper technique and postoperative care can help reduce complications.
The document discusses ankle fractures, providing information on ankle anatomy, classification systems, clinical features, imaging, treatment, and complications. It describes the ankle joint as composed of the tibia, fibula, and talus bones. Two common classification systems are described - the Weber system categorizes fractures by the location of the fibular fracture in relation to the syndesmosis, while the Lauge-Hansen system depends on the mechanism of injury. Clinical features may include pain, swelling, limited movement, and neurovascular issues. Imaging includes x-rays and sometimes CT or MRI to evaluate bone and soft tissue injuries. Treatment involves initial stabilization followed by casting or surgery to restore anatomy, with goals of preventing post-traumatic arthritis
This document provides an overview of lower limb fractures, focusing on the hip, femur, knee, tibia, and ankle. It describes the epidemiology, classification systems, clinical evaluation, imaging, and treatment options for various fractures in these areas. Key points covered include the types and management of femoral neck, intertrochanteric hip, tibial plateau and pilon fractures. Evaluation involves history, exam, and radiographs, while treatment may involve fixation, arthroplasty or non-operative management depending on the fracture pattern and patient factors. Complications are also discussed for several injuries.
The document discusses various types of cervical spine trauma and injuries that can occur. It describes fractures of the atlas including Jefferson's fracture and posterior arch fractures. Hangman's fractures and teardrop fractures of the axis are also summarized. Odontoid fractures are divided into Types I-III. Vertebral body compression fractures like wedge fractures and burst fractures are mentioned. The document also briefly summarizes clay shoveler's fractures and lamina and transverse process fractures of the cervical spine. Various imaging modalities for evaluating cervical spine injuries are also discussed.
This document outlines the management cycle for community-based rehabilitation (CBR) programs, which consists of four stages: situation analysis, planning and design, implementation and monitoring, and evaluation. The situation analysis stage involves collecting data about the community to understand the current situation and needs of people with disabilities. This includes facts about demographics, living conditions, health, education, economics, culture, and more. Key stakeholders are also identified and analyzed. The planning stage then uses this situation analysis to decide what the CBR program should do to address the issues. The implementation stage carries out the program with monitoring, and the evaluation stage measures the outcomes and impact.
The Motor Relearning Programme (MRP) is a task-oriented approach developed by Australian physiotherapists to improve motor control through relearning daily activities. It focuses on neuroplasticity and eliminating unnecessary muscle activity. The MRP involves analyzing tasks, practicing missing components, practicing the full task with progression, and transferring learning to daily life. Some techniques include stimulating appropriate muscles, providing feedback, and addressing common compensatory strategies through specific exercises. The goal is to help patients progress from cognitive control of movement to automatic performance of motor tasks.
This document discusses acute respiratory infections (ARI), including their causes, transmission, clinical assessment, classification, treatment, and prevention. It notes that ARI can be classified as either upper or lower respiratory infections depending on the site of inflammation. Common bacterial and viral agents that cause ARI are described. Clinical assessment of ARI involves examining factors like breathing rate, chest indrawing, wheezing and malnutrition. Treatment depends on illness classification and may involve antibiotics, symptomatic relief or referral. Immunization and improved living conditions are emphasized for prevention.
The document discusses various types of health indicators and how they are used. It defines health indicators as variables that can be directly measured to reflect the health status of a community. It then describes how indicators help measure program objectives and targets, compare health statuses of countries, assess health needs, and monitor/evaluate health services. The document provides examples of common indicators like infant mortality rate and life expectancy. It also discusses characteristics important for indicators such as being valid, reliable, and relevant.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
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).
2. Intertrochanteric fracture
Definition :
These fractures are ‘ extracapsular ’ and occur in the
wide metaphyseal region between the two
trochanters of the femur.
Why such fractures tend to unite without difficulty and
seldom cause avascular necrosis?
Because the blood supply to the fracture is
adequate.
6. Intertrochanteric fracture
They are common in
Elderly, osteoporotic people; most of the patients
are women in the 8th decade.
Risk factors
-Age (>70 years)
-Sex (female>male)
-Rheumatoid arthritis
-Pathologic fractures may occur in the presence
of tumor or metastatic bone lesions.
7. Intertrochanteric fracture
Mechanism of injury
The fracture is caused either by a fall
directly onto the greater trochanter or by
an indirect twisting injury.
The crack runs up between the lesser and
greater trochanter and the proximal
fragment tends to displace in varus.
10. Intertrochanteric fracture
X-ray
Undisplaced, stable fractures
may show no more than a
thin crack along the
intertrochanteric line;
indeed,there is often
doubt as to whether
the bone is fractured
and the diagnosis may
have to be confirmed by MRI.
11. Intertrochanteric fracture
Treatment
Intertrochanteric fractures are almost always
treated by early internal fixation
not because they fail to unite with conservative
treatment but
(a) to obtain the best possible position and
(b) to get the patient up and walking as soon as
possible and there by reduce the complications
associated with prolonged lying down
12. Intertrochanteric fracture
Treatment
Fracture reduction at
surgery is performed
on a fracture
table that provides slight
traction and internal
rotation;the position is checked by
x-ray and the fracture is fixed with an angle device
preferably a sliding screw in conjunction with a plate or
intramedullary nail.
13. Intertrochanteric fracture
Treatment
Positioning the screw is
important if it is to be
Prevented from cutting
out of the osteoporotic
bone.
It should pass up the
femoral neck to end
within the centre
of the femoral head,
with the tip resting
about 5 mm
from the subchondral
bone plate.
14. Intertrochanteric fracture
Treatment
Non-operative treatment may be appropriate for a
small group who are too ill to undergo anaesthesia;
traction in bed until there is sufficient reduction of
pain to allow mobilization can yield reasonable results
but much depends on the quality of nursing care and
physical therapy.
15. Intertrochanteric fracture
PRIMARY PROSTHETIC REPLACEMENT
Peritrochanteric fractures in the presence of severe
arthritis of the hip, especially if the hip is stiff
Pathologic fractures in which the bone stock
preclude internal fixation
Unstable, severely comminuted fractures in the
very elderly, whose bone is so osteoporotic that
internal fixation, even with cement augmentation,
is expected to fail
17. Intertrochanteric fracture
Complications
LATE
1-Failed fixation Screws may cut out of the osteoporotic bone
if reduction is poor or if the fixation device is incorrectly
positioned
2-Malunion Varus and external rotation deformities are
common. Fortunately they are seldom severe and rarely
interfere with function.
3-Non-union Intertrochanteric fractures seldom fail to unite
19. SUBTROCHANTERIC FRACTURE
These are proximal femur fractures located
within 5cm of the lesser trochanter that may
occur in low energy (elderly) or high energy
(young patients) mechanisms.
20. Subtrochanteric Fracture
They are common in
In elderly patient with osteoporosis,
osteomalacia, paget’s disease or secondary
deposit
Blood loss is greater than with femoral neck
or trochanteric fracture
21. Subtrochanteric Fracture
29.18 Subtrochanteric fractures of the femur –
warning signs on the X-ray findings that should
caution the surgeon: (a) comminution, with extension into
the piriform fossa; (b) displacement of a medial fragment
including the lesser trochanter and, (c) lytic lesions in the
femur.
(a) (b) (c)
22. Subtrochanteric Fracture
Subtrochanteric fractures have several features
which make them interesting (and challenging to
treat):
1. Blood loss is greater than with femoral neck or
trochanteric fractures – the region is covered with
anastomosing branches of the medial and lateral
circumflex femoral arteries which come off the
profunda femoris trunk
23. Subtrochanteric Fracture
2.There may be subtle extensions of the fracture
into the intertrochanteric region, which may
influence the manner in which internal fixation
can be performed.
3.The proximal part is abducted and externally
rotated by the gluteal muscles, and flexed by the
psoas.The shaft of the femur has to be brought
into a position to match the proximal part or else
a malunion is created by internal fixation
25. Subtrochanteric Fracture
X-ray
The fracture is through or below the lesser trochanter.
It may be transverse, oblique or spiral, and is frequently
comminuted.The upper fragment is flexed
and appears deceptively short; the shaft is adducted
and is displaced proximally
26. Subtrochanteric Fracture
Open reduction and internal fixation is the treatment
of choice
Two main types of implant are used for fracture
fixation:
(a ) an intramedullary nail with aproximal interlocking
screw.
(b) a 95 degree hip screw-and-plate device.
28. Subtrochanteric Fracture
Treatment
Traction may help to reduce blood loss and pain. It is
an interim measure until the patient, especially if elderly
and with multiple medical problems, is stabilized
and prepared for surgery
29. COMPLICATION
Malunion :Is Fairly common and may need
operative correction
Non-union This occurs in about 5 per cent of cases; it
will require operative correction of any deformity,
renewed fixation and bone grafting