Transcript Fracture
JOSE S. SANTIAGO M.D. JOINT MOVEMENTS Abduction- moving a body part away from the middle Adduction- moving a body part toward the middle JOINT MOVEMENTS Circumduction- moving a body part in a circular motion Dorsiflexion- bending a body part backward Eversion- turning outward JOINT MOVEMENTS Extension- straightening a flexed limb Flexion- bending a limb Inversion- turning inward JOINT MOVEMENTS Pronation- lying with the face downward; turning the palm downward Protraction- moving a body part forward TMJ JOINT MOVEMENTS Retraction- moving a body part backward Rotation- moving a body part around a central axis Levorotation Dextrorotation JOINT MOVEMENTS Supination- lying with the face upward; turning the palm upward Dorsiflexion- upward or backward flexion of a part of the body MEDICAL WORD Bone marrow transplant- surgical process of transferring bone marrow from a donor to a patient MEDICAL WORD Flatfoot- abnormal flatness of the sole and arch of the foot; pes planus MEDICAL WORD Genu valgum- knock-knee MEDICAL WORD Genu varum- bowleg MEDICAL WORD Orthopedist- physician who specializes in orthopedics MEDICAL WORD Radiograph- film or record on which an x-ray image is produced; radiogram MEDICAL WORD Sprain- twisting a joint that causes pain and disability FIRST AID FOR SPRAINS Immediate rest Immobilization in a cast or splint Ice or cold compress Injured part should be elevated to decrease swelling FIRST AID FOR SPRAINS Immediate rest Immobilization in a cast or splint Ice or cold compress Injured part should be elevated to decrease swelling FRACTURES Fracture- break in the cortex of the bone Classification: A. External appearance B. Location of the fracture C. Nature of the break in the bone Fractures Closed (simple) fracture-only the bone is broken 18 Fractures Open (compound) fracture –bone and skin are broken 19 Fractures Comminuted fracture-bone is broken in many fragments 20 FRACTURES Transverse fracture- shaft of a bone is broken along its longitudinal axis FRACTURES Greenstick fracture- only one side of the shaft is broken, and the other is bent FRACTURES Spiral fracture- produced by twisting stresses FRACTURES Compression fracture- occurs in vertebrae subjected to extreme stress FRACTURES Depressed fracture- break in the skull in which bone fragments are pushed below the normal surface of the skull FRACTURES Pathologic fracture- weakening of bone structure because of disease -bone tumors can cause pathologic fractures FRACTURES Pott’s disease- tuberculosis of the vertebrae (Tuberculous spondylitis) FRACTURES Pott’s fracture- fracture of the medial and lateral malleolus FRACTURES Colles’ fracture- break in the distal part of the radius; result of falling with outstretched hands FRACTURES Smith’s fracture- flexion fracture of the radius (Reversed Colles’ fracture) FRACTURES Bennett’s fracture- fracture of the base of the first metacarpal bone PRINCIPLE OF FRACTURE MANAGEMENT 1. Reduction of deformity 2. Maintenance of reduction 3. Rehabilitation of function Reduction of deformity Splint- appliance used for fixation, support, and rest of an injured body part; immobilize the joints above and below the fracture Reduction of deformity Closed Reduction- manual manipulation of the fracture into a functional position Reduction of deformity Open reduction- the fracture is surgically exposed and bone fragments are manipulated directly Reduction of deformity Internal fixation- stabilization of fractured bony parts by direct fixation to one another with surgical wires, screws, pins, or plates Maintenance of reduction Surgical cast- shell that encases a limb to hold broken bones in place until healing is confirmed Maintenance of reduction External fixation- use of metal pins and compression device outside the skin Maintenance of reduction Traction- process of drawing or pulling on bones or muscles to relieve displacement and facilitate healing Purposes of traction 1. Aligns the ends of a fracture by pulling the limb into a straight position 2. Ends muscle spasm 3. Relieves pain 4. Takes the pressure off the bone ends by relaxing the muscle Types of traction 1. Skin traction uses five-to seven-pound weights attached to the skin to indirectly apply the necessary pulling force on the bone. Types of traction 2. Skeletal traction requires the placement of tongs, pins, or screws into the bone so that the weight is applied directly to the bone. Rehabilitation of Function 1. Limb is immobilized in a position of maximum function 2. Isometric exercises of immobilized muscles are started to avoid excessive atrophy Rehabilitation of Function 3. Range of motion exercises for adjacent joints that are not immobilized. 4. Active range of motion and resistive muscle strengthening exercises are started after the cast is removed. Types of arthritis 1. Osteoarthritis- results from “wear and tear” on joints; tends to occur in the hips, knees, and finger joints of older adults Types of arthritis 2. Gouty arthritis (Gout)- hereditary disease caused by hyperuricemia and deposits of uric acid crystals in and around the joints Types of arthritis 3. Rheumatoid arthritis- chronic autoimmune disease of the joints that lead to crippling deformities Pathognomonic signs of RA 1. Boutonniere (Buttonhole) deformity- the PIP joint is stuck in flexion and the DIP joint is in hyperextension Pathognomonic signs of RA 2. Swan-neck deformity- the PIP joint is hyperextended and the DIP joint is flexed Pathognomonic signs of RA 3. Ulnar deviation (Ulnar drift)- the MCP joints point towards the ulna Pathognomonic signs of RA 4. Bouchard’s nodes- swollen and painful areas over the PIP joints Pathognomonic signs of RA 5. Heberden’s nodes- swollen and painful areas over the DIP joints Treatment for Arthritis Non-surgical A. Anti-inflammatory medications 1. Corticosteroids 2. Non-steroidal (NSAIDs) B. Rehabilitation 1. Range-of-motion exercises 2. Fine motor exercises Treatment for Arthritis Surgical A. Arthrodesis- surgical fusion of joints B. Arthroplasty- surgical repair of joints End of lecture Thank you for listening!