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Introduction to Orthopaedics

Introduction to Orthopaedics. Munir Saadeddin,FRCSEd Associate Professor & Consultant College of Medicine King Saud University. Objectives of this lecture. To explain what is Orthopedic and what conditions will be discussed during this course. Explain what do we mean by Red Flags.

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Introduction to Orthopaedics

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  1. Introduction to Orthopaedics Munir Saadeddin,FRCSEd Associate Professor & Consultant College of Medicine King Saud University

  2. Objectives of this lecture To explain what is Orthopedic and what conditions will be discussed during this course. Explain what do we mean by Red Flags. List the different causes of Orthopedic disease. Describe some of clinical examination tests. Introduce titles of Clinical Skills which will be taught during this course.

  3. What is the meaning of: Orthopedics ORTHO = Straight , Upright , Correct Paios = Child First used by Nicolas Andry; a French doctor(1841) in a book titled: Orthopedia : the art to correct and prevent deformities in children

  4. Orthopedic Associations Emblem: the British

  5. Saudi Orthopedic Association Emblem

  6. Orthopedic Surgery = Not only Bone Surgery Orthopedic specialty is the branch of medicine which manage trauma and disease of Musculoskeletal system. It includes : bones, muscles, tendons, ligaments, joints, peripheral nerves, vertebral column and spinal cord and its nerves.

  7. Orthopedic Specialty Also Known as : Trauma and Orthopedic Surgery. Sub-Specialties in orthopedic include : Pediatric Orthopedic, Sport and Reconstructive Orthopedic, Orthopedic Trauma, Arthroplasty, Spinal Surgery , Foot and Ankle surgery and Orthopedic Oncology.

  8. Red Flags

  9. Red Flags Red Flag = Warning Symptom or Sign. Red flags should always be looked for and remembered. Presence of a red flag means the necessity for urgent or different action/intervention.

  10. Examples of Red Flags Open Fractures : more serious and very high possibility of infection and complications Complicated Fractures : fracture with injury to major blood vessel, nerve or nearby structure Compartment Syndrome : increase in intra-compartment pressure which endangers the blood circulation of the limb and may affect nerve supply Acute joint Dislocations : requires urgent reduction or may cause serious complications

  11. Examples of Red Flags Multiple Trauma or Pelvic Injury: more than one fracture or injury sustained at the same time ; consider massive blood loss and associated injuries. CaudaEquina Syndrome : compression of the nerve roots of the CaudaEquina at the spinal canal which affect motor and nerve supply to lower limbs and bladder (also saddle or peri-anal area). Infection of Bone, Joint and Soft Tissue : Osteomyelitis : Infection of the bone. Septic Arthritis :Infection of the joint. Cellulitis:spreading Infection of the soft tissue. May cause septicemia or irreversible damage.

  12. Alignment terminology

  13. Alignment Terminology: CubitusVarus

  14. Alignment terminology: CubitusValgus

  15. Orthopedic Diseases: Congenital or Acquired ? Congenital : present since birth( though may not be evident till some time later). Acquired : develop or begin after birth.

  16. Congenital Anomaly : Talepoequinovarus TEV

  17. Acquired Orthopedic Conditions Acquired conditions include : Trauma Developmental Inflammation Infection Neuromuscular Degenerative Metabolic Tumor

  18. Traumatic Injuries Fractures. Dislocations. Fracture dislocation: dislocation associated with nearby fracture. Soft tissues injuries: ligaments, tendons, menisci. Nerve injuries. Epiphyseal injuries.

  19. Fractures: Break in the continuity of bone

  20. Dislocations Complete separation of the articular surface Distal to proximal fragment Anterior, Posterior, Inferior, Superior. Acute dislocation may be complicated by neurovascular injury. Acute dislocations require urgent reduction

  21. Fracture Dislocation

  22. Dislocation and Fracture dislocation of the Spine often results in Paralysis

  23. Intra-articular Fractures If displaced ; should always be treated by ORIF= (Open Reduction and Internal Fixation) failure to reduce and fix such fracture results in loss of function, deformity and early degenerative changes

  24. Epiphyseal Injuries: Salter-Harris classification

  25. Soft tissue injuries of the knee

  26. Knee effusion, ACL and PCL on MRI sagittal cuts

  27. Anterior Cruciate Ligament injury: MRI

  28. ACL Injury: Lachman’s test

  29. MCL: Value of Stress X-rays

  30. (Developmental Dislocation of Hip) DDH

  31. Orthosis : Pavlick Harness for DDH

  32. Developmental: SCFE (Slipped Capital Femoral Epiphysis)

  33. Spinal Deformities: Kyphosis or Hyperlordosis

  34. Spinal Deformity: Scoliosis

  35. Developmental Foot deformity: Hallux Valgus

  36. Degenerative Disorders Occur at any joint Can be primary or secondary Increased wear and tear Can lead to pain and/or deformity and/or loss of function Increase with advancing age Management depends on type and age

  37. OA Hip

  38. Total Hip Arthroplasty ( THA )

  39. Osteoarthosis of Knee

  40. Osteoarthritis of Knee

  41. Bilateral TKR: AP view

  42. Bilateral TKR : lateral view

  43. Metabolic Disorders (Rickets): Bow Legs

  44. Osteoporosis: Fractured NOF

  45. Osteoporosis: Displaced Intracapsular Fracture

  46. Hemi-Arthroplasty Lt Hip

  47. Spinal Osteoporosis

  48. Osteoporosis: Colles fracture

  49. Bone Tumors

  50. Bone Tumor

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