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پستهای کانال
■ Posterior hip dislocation: Shortened, internally rotated leg.
■ Anterior hip dislocation:
Lengthened, externally rotated leg .
■ Hip fracture: Shortened, externally rotated leg.
| 2 | 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) | 1 |
| 3 | 🌸 Volkman's ischemic contracture involves the most commonly Flexor digitorum profundus👌 | 1 |
| 4 | 🌸 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 🤗 | 1 |
| 5 |  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 | 292 |
| 6 | 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 | 256 |
| 7 | 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 | 210 |
| 8 | 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 | 198 |
| 9 | 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. | 177 |
| 10 | Support the forearm with elbow in slight flexion method of conservative tx in elbow dislocation | 167 |
| 11 | 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 | 162 |
| 12 | 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 | 161 |
| 13 | X-ray of tibia and fibula
No name ,no age ,no sex
Ab view shows external fixation for fracture in diphysis tibia and fibula
indications:
1.Fractures associated with sever soft tissue damage.
2.Fractures associated with sever nerve or vessels damage
3.Severely comminuted and unstable fractures.
4.Ununited fractures
5.Pelvic fractures
6.Infected fractures.
7.Sever multiple injuries
Complications
1.Damage to soft – tissue structures if the transfixing pins injure the nerves or vessels
Or may tether ligaments or muscl
2.Over distraction
3.Pin – tract infection. | 163 |
| 14 | No name , no age, no sex
X-ray of femurs bone AP view show
Internal fixation (screw and plate)
of dyphsis of the femur
Advantages:
1.hold fractures securely so allow early movement and prevent stiffness, and edema.
2.allow early leaving of hospital.
3.accurate reduction as in intraarticular fractures.
indications:
1.failure of closed method.
2.unstable fractures
3.fractures that unite poorly or slowly as in fracture neck femur
4.pathological fractures.
5.multiple fractures.
6.in patient with nursing difficulties as in paraplegics , and multiple injuries.
Complications:
1.Infection
2.Non – union
3.Implant failure
4.Refracture | 169 |
| 15 | Cast splintage(pop)
complication //
1.stiffness of the joints
2.tight cast or limbs swelling The patient complain from diffuse pain, or compartment syndrome
3.pressure sores
4.skin abrasion or laceration
5.lose cast this after swelling subside, so should be replaced | 166 |
| 16 | "
Points to be remembered 👇
** Shoulder fracture :
* Most commonly damaged is Supraspinatus
* Most common early complication of anterior dislocation of shoulder is nerve injury
*Most commonly injured nerve in anterior dislocation of shoulder is circumflex branch of axillary nerve . The injury to nerve is usually neuropraxia.
*Inferior dislocation also axillary nerve involvement is commonest.
*Shoulder is weakest inferiorly but dislocates anteriorly because
it is the direction of force that decides the dislocation
$ Recurrent dislocation is most common in shoulder joint, accounting for nearly 50% of all dislocations.
-Most commonly it is subcoracoid type.
-Second common joint for recurrent dislocation is patella and rarest joint to dislocate is ankle:
*Most authors agree that the Bankart lesion is the most commonly observed pathological lesion in recurrent subluxation or dislocation of the shoulder
* most common lesion àss é recurrent ant dislocation is tear in the anterior part
" Bankart lesion "
* hill-Sachs lesion is a defect in the posterolateral aspect of the humeral
head.
* Reverse hill sachs :
-Anterior part of humeral head
-Medial part of humeral head
- Posterior dislocation of shoulder
* Painful arc syndrome is caused by impingement of Rotator cuff tendon
* Lift off test is done for subscapularis
*Rotator interval is between supraspinatus and subscapularis
*Weakest portion of shoulder joint capsule is inferior
* luxatio erecta :
Inferior (Downward/subglenoid) dislocation of shoulder
*posterior dislocation :
- most commonly during a fit, convulsion or an electric shock .
-the classical clinical feature is arm is held in medial rotation. | 196 |
| 17 | Hallux valgus = deviations of big toe away from midline at metatarsopharengal joint
Common in women 💅
Cause = congenital or narrow pointed shoes
Ttt = wide shoes and insert wedge of plastic b/w 1st , 2ed toe | 192 |
| 18 | بدون متن... | 252 |
| 19 | بدون متن... | 242 |
| 20 | بدون متن... | 232 |
