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Musculoskeletal Principals and Terminology. Dr J G Myburgh. The Tree Of Andry (1741). Orthopaedia. ORTHOS (Straight) + PAIS (Child). Orthopaedic Surgery. Deals with disability in: Bones Joints Muscles Tendons Nerves. Orthopaedic Surgery.
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Musculoskeletal Principals and Terminology Dr J G Myburgh
Orthopaedia ORTHOS (Straight) + PAIS (Child)
Orthopaedic Surgery Deals with disability in: • Bones • Joints • Muscles • Tendons • Nerves
Orthopaedic Surgery • Congenital and developemental abnormalities • Infections • Artritis and rheumatic disorders • Metabolic and endocrine disorders • Tumors and pseudo tumors • Sensory disturbance and muscle weakness • Injury and mechanical derangement
Symptoms • Pain • Stiffness • Swelling • Deformity • Weakness • Instability • Sensory change • Loss of function
Examination • Look -Skin -Shape -Position • Feel -Skin -Soft tissue -Bones and joints • Move - Active - Passive - Abnormal
Muscle power • Grade 0 – no movement • Grade 1 – flicker • Grade 2 – gravity eliminated • Grade 3 – against gravity • Grade 4 – against resistance • Grade 5 – normal power
Causes of Bone Deformity • Congenital (pseudarthrosis) • Bone softening (rickets) • Displasia (multiple exostosis) • Growth plate injury • Fracture malunion • Paget’s disease
Causes of Joint deformity • Skin contracture • Fascial contracture • Muscle contracture • Muscle imbalance • Joint instability • Joint destruction
Terminology • Coxa - Hip • Genu – Knee • Pes – Foot • Hallux – Big toe • Pollices - Thumb
Operations on bones Bones can be: • Cut (Osteotomy) • Joined (Osteosynthesis) • Grafted • Lengthened • Drained
Operations on ligaments Ligaments can be: • Repaired • Reconstructed • Shortened
Operations on nerves Nerves can be: • Decompressed • Sutured • Grafted • Epineurolysis
Nerve injury • Neurapraxia- caused by a focal lesion, usually demyelinating, and followed by a complete recovery • Axonotmesis- • Neurotmesis
Fractures Complete or incomplete break in the continuity of bone, associated with an open or closed soft tissue injury of varying severity.
How Fractures Happen • Single traumatic event • Repetitive stress • Abnormal weakening of bone
Trauma • Twisting • Compression • Bending • Tension • Avulsion
Fracture displacement • Translation • Angulation • Rotation • Length (shortening/impaction)
Fracture complications • Vascular injury • Haemarthrosis • Compartement syndrome • Nerve injury • Infection • Fat embolism • Visceral injury