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Orthopaedic Surgery and Musculoskeletal Disorders

Orthopaedic surgery deals with disabilities in bones, joints, muscles, tendons, and nerves. Learn about symptoms, examination methods, causes of deformities, terminology, operations, fractures, and healing processes. Understand fracture patterns, types, complications, and how fractures happen.

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Orthopaedic Surgery and Musculoskeletal Disorders

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  1. Musculoskeletal Principals and Terminology Dr J G Myburgh

  2. The Tree Of Andry (1741)

  3. Orthopaedia ORTHOS (Straight) + PAIS (Child)

  4. Orthopaedic Surgery Deals with disability in: • Bones • Joints • Muscles • Tendons • Nerves

  5. 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

  6. Symptoms • Pain • Stiffness • Swelling • Deformity • Weakness • Instability • Sensory change • Loss of function

  7. Examination • Look -Skin -Shape -Position • Feel -Skin -Soft tissue -Bones and joints • Move - Active - Passive - Abnormal

  8. 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

  9. Flexion & Extention

  10. Abduction & Adduction

  11. Internal & external rotation

  12. Pronation & Supination

  13. Causes of Bone Deformity • Congenital (pseudarthrosis) • Bone softening (rickets) • Displasia (multiple exostosis) • Growth plate injury • Fracture malunion • Paget’s disease

  14. Causes of Joint deformity • Skin contracture • Fascial contracture • Muscle contracture • Muscle imbalance • Joint instability • Joint destruction

  15. Terminology • Coxa - Hip • Genu – Knee • Pes – Foot • Hallux – Big toe • Pollices - Thumb

  16. Genu valgum & Genu varum

  17. Scoliosis

  18. Kyphosis & kyphos (hump)

  19. Septic artritis

  20. Rheumatoid Arthritis

  21. OA Total Hip Replacement

  22. Giant cell tumor

  23. Osteosarcoma

  24. Operations on bones Bones can be: • Cut (Osteotomy) • Joined (Osteosynthesis) • Grafted • Lengthened • Drained

  25. Operations on ligaments Ligaments can be: • Repaired • Reconstructed • Shortened

  26. Operations on nerves Nerves can be: • Decompressed • Sutured • Grafted • Epineurolysis

  27. Painfull Arc

  28. Nerve Compression

  29. Nerve injury • Neurapraxia- caused by a focal lesion, usually demyelinating, and followed by a complete recovery • Axonotmesis- • Neurotmesis

  30. Subluxation & dislocation

  31. Anterior shoulder dislocation

  32. Rotator cuff arthropathy

  33. AC Dislocation

  34. Fractures Complete or incomplete break in the continuity of bone, associated with an open or closed soft tissue injury of varying severity.

  35. How Fractures Happen • Single traumatic event • Repetitive stress • Abnormal weakening of bone

  36. Trauma • Twisting • Compression • Bending • Tension • Avulsion

  37. Fracture Patterns

  38. Fracture types

  39. Impacted Fracture

  40. Comminuted Fracture

  41. Fracture displacement • Translation • Angulation • Rotation • Length (shortening/impaction)

  42. Fracture displacement

  43. Deforming Forces

  44. How Fractures Heal

  45. Fracture complications • Vascular injury • Haemarthrosis • Compartement syndrome • Nerve injury • Infection • Fat embolism • Visceral injury

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