🟥 ORTHOPEDIC_2ndBATCH
قناة خاصة بقسم طب التجبير في التدريب السريري تتبع اللجنة العلمية | الدفعة الثانية "2017" https://t.me/DOCMARK21 تحتوي على كل مايخص قسم طب التجبير من : #أخبار #جداول #تدوينات #محاضرات #آخر_الأنباء #تسجيلات
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🌸 Volkman's ischemic contracture involves the most commonly Flexor digitorum profundus👌
■ Posterior hip dislocation: Shortened, internally rotated leg.
■ Anterior hip dislocation:
Lengthened, externally rotated leg .
■ Hip fracture: Shortened, externally rotated leg.
Clinical Features of Volkman’s Ischemic Contracture (VIC)
•• Pain out of proportion to physical examination findings.
•• Pain on passive stretching: 1st sign
•• Pressure increased
•• Pallor/may also be pink
•• Pulselessness
•• Paresthesia
•• Paralysis
(Pulselessness is a late sign and is unreliable for diagnosis of compartment syndrome)
🌸 Named fracture of the upper limb
🌹 Colles-fracture of the distal radius with dorsal angulation of the distal bone fragment
🌹 Smiths fracture-reverse Colles fracture.fractures of the distal one third of the radius with palmar displacement
🌹 Galeazzi fracture dislocation-fracture of the lower third of the radius and subluxation of the distal radio ulnar joint.
🌹 Monteggia fracture dislocation
fracture of the shaft of ulna with dislocation of proximal radio ulnar joint.
🌹 Barton’s fracture - intra-articular fracture of distal radius
🌹 Rolando fracture:
intraarticular comminuted fracture of the base of the first metacarpal with a t or Y configuration
🌹 Chauffeurs fracture-fracture of the radial styloid
🌹 Essex lopresti - fracture of the radial head with disruption of the interosseous membrane and distal radial ulnar joint ligament
🌹 Nightstick fracture: isolated fracture of the radial or ulnar bone
🌹 Bennet’s fracture: It is an oblique fracture of the base of 1st metacarpal.It is intra-articular and may be associated with subluxation or dislocation of metacarpal.
🌹 Boxer’s fracture : It is fracture of neck of metacarpal, and most commonly involves neck of 5th metacarpal.
اهم شيء اول اربعه 🤗
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Xray of knee joint
No name no age no sex
AP&lateral view show total knee replacement
The main indication
1-pain with deformity
2-instability
Complication
1.DVT
2.Infection
3.lossening
4.Patellar problems
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Median nerve injery..carpal tunnel syndrome
1_loss sensation in radial three and half digit
2_pointing sign
3_pinch defect
Treatment
_If the nerve is divided , suturing or nerve grafting should always be attempted
_Postoperatively the wrist is splinted in flexion to avoid tension.
_Late lesions are sometimes seen, if there has been no recovery , tendon transfer can be done
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Ulnar nerve
1_numbness in ulner one and half finger
2_claw hand deformity in low lesions
Treatment
_Exploration and suturing of a divided nerve , anterior transposition at the elbow permits closure of gap up to 5cm.
_while recovery is awaited , the skin should be protected from burn, passive physiotherapy keeps the hands supple and useful
_If there is no recovery after nerve repair , tendon transfer can be done
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anterior shoulder dislocation
1-flattening of lateral aspect of the shoulder
2-hold the affected arm with another
3-prominence acromion
4-head of humer is present
Complications:
Anterior Dislocation
1_Early
*Axillary nerve damage
*Unreduced dislocation
2_Late
* Recurrent dislocation
*Traumatic osteoarthritis
*Shoulder stiffnes
Posterior Dislocation
Early
*Unreduced dislocation
Late
* Recurrent dislocation
*Traumatic osteoarthritis
*Shoulder stiffnes
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Radial nerve injury
a_high lesion wrist drop
b_loss sensation around anatomical snuffbox
Treatment :
_Open injuries should be explored and the nerve is repaired or grafted
_Closed injuries are usually first or second degree lesions , and function eventually returns
_If the palsy is present on admission , one can wait for 6 weeks to see if it starts to recovers.
If it does not , then EMG should be performed , if this show denervation potentials , then the nerve should explored.
_While recovery is awaited , the small joints of the hand must be put through a full range of passive movements
_If recovery does not occur , the disability can be largely overcome by tendon transverse.
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S _deformity of the elbow in supracondylar fracture (extention type)
Classification:gartland’s
Type1/undisplaced fr
2/ angulated fr with the posterior cortex still in continuity
3/completely displaced fr
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