Orthopaedics: Definitions, Specialties, and Red Flags

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Explore the world of orthopaedics with insights into its meaning, specialties, and the importance of red flags in identifying urgent conditions. Gain knowledge on orthopedic surgery, sub-specialties, and the critical role of clinical examination tests.

  • Orthopaedics
  • Specialties
  • Red Flags
  • Orthopedic Surgery
  • Clinical Examination

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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: Orthopaedics 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 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.

  9. 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

  10. 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. Cauda Equina Syndrome : compression of the nerve roots of the Cauda Equina 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 Septic Arthritis :Infection of the joint. Cellulitis :spreading Infection of the soft tissue. May cause septicemia or irreversible damage : Infection of the bone.

  11. Alignment terminology

  12. Alignment Terminology: Cubitus Varus

  13. Alignment terminology: Cubitus Valgus

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

  15. Congenital Anomaly : Talepoequinovarus TEV

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

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

  18. Fractures: Break in the continuity of bone

  19. 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

  20. Fracture Dislocation

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

  22. 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

  23. Soft tissue injuries of the knee

  24. Anterior Cruciate Ligament injury: MRI

  25. ACL Injury: Lachmans test

  26. MCL: Value of Stress X-rays

  27. (Developmental Dislocation of Hip) DDH

  28. Orthosis : Pavlick Harness for DDH

  29. Developmental: SCFE (Slipped Capital Femoral Epiphysis)

  30. Spinal Deformities: Kyphosis or Hyperlordosis

  31. Spinal Deformity: Scoliosis

  32. Developmental Foot deformity: Hallux Valgus File:Hallux Valgus-Aspect pr op d charge.JPG

  33. 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

  34. OA Hip

  35. Total Hip Arthroplasty ( THA )

  36. Osteoarthosis of Knee

  37. Osteoarthritis of Knee

  38. Metabolic Disorders (Rickets): Bow Legs

  39. Osteoporosis: Fractured NOF

  40. Osteoporosis: Displaced Intracapsular Fracture

  41. Hemi-Arthroplasty Lt Hip

  42. Spinal Osteoporosis

  43. Osteoporosis: Colles fracture

  44. Bone Tumors

  45. Bone Tumor

  46. Bone tumors

  47. Neurological Evaluation : Sensory

  48. Axillary Nerve or Circumflex Nerve

  49. Nerve Injury: Muscle wasting

  50. Nerve Injury: Sensory Loss

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