musculoskeletal injury-english ver 16 feb 2011

8/2/2019 Musculoskeletal Injury-English Ver 16 Feb 2011

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PuntodewoDept. of Orthopaedics & Traumatology

Faculty of Medicine, UGM/ RS Dr Sardjito,YOGYAKARTA

MUSCULOSKELETALINJURY


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Background

Swelling number of vehicles and increasedspeed of vehicles

No concomitant increase in trafficmanagement system

Sports: lifestyle, hobby risk of injury

High incidence of RTA


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Extremity

Upper extremity

Shoulder

Upper Arm

Lower ArmHand

Lower extremity

Hip

Upper leg

Lower leg

Foot


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Musculoskeletal Injury

Muscle contusion

Sprain, strain

Open & closed fracture Dislocation and fracture-dislocation

Fracture with nerve injury and/orvascular (bleeding)

Compartment syndrome


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Musculoskeletal Injury

Thorough clinical examination is essential

Proper investigation is essential


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AC joint injury

Sling Surgery: TBW

+ screw

Docimo S Jr. et al. (2008). Surgical treatment foracromioclavicular joint osteoarthritis: patient

selection, surgical options, complications, andoutcome. Curr Rev Musculoskelet Med. 2008June; 1(2): 154160.


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Back injuries

Strain Fracture

Bracing

G J Browne (2006). Cervical spinal injuryin childrens community rugby football BrJ Sports Med 2006;40:6871.


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Hamstring Strain

RICE

Analgesics

Heiderscheit, BC. (2010). Hamstring Strain Injuries:Recommendations for Diagnosis, Rehabilitation and Injury

Prevention. J Orthop Sports Phys Ther. 2010February; 40(2): 6781.


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Patellofemoral Pain Syndrome

Activity modification

Bracing

Wilson, NA. (2009). In Vivo Noninvasive Evaluation of

Abnormal Patellar Tracking During Squatting in Patientswith Patellofemoral Pain. J Bone Joint Surg Am. 2009 March1; 91(3): 558566.


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Patella tendinitis

Activitymodification

BracinAbate M, et al. (2009). Pathogenesis of tendinopathies: inflammation ordegeneration?Arthritis Res Ther. 2009; 11(3): 235.


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Meniscus injury

Bracing Surgery: repair or

excision

Open or Arthroscopy

Suter LG et al (2009). Medical Decision Making in

Patients With Knee Pain, Meniscal Tear, andOsteoarthritis. Arthritis Rheum. 2009 November


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Runners knee

-Splinting

Fairclough J et al. (2006). The functional anatomy ofthe iliotibial band during flexion and extension of

the knee: implications for understanding iliotibialband syndrome. J Anat. 2006 March; 208(3): 309


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Knee cartilage injury

Surgery:

micro-

fracturization,implantation

THOMPSON LR et al (2009).The Knee Pain Map: Reliabilityof a Method to Identify Knee Pain Location and Pattern.

Arthritis Rheum. 2009 June 15; 61(6): 725731.


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Knee ligaments rupture

Bracing/ Casting

Surgery: Repair

Phisitkul P. et al. (2006). MCL Injuries of theKnee: Current Concepts Review. Iowa Orthop

J. 2006; 26: 7790.


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Knee Ligament Rupture (cont.)

Han, HS et al. (2008). AnteriorCruciate LigamentReconstruction: Quadriceps VersusPatellar Autograft. Clin Orthop RelatRes. 2008 January; 466(1): 198204.


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Shin splints

Activity modification

Bracing

van Gent RN et al. (2007)., Incidence anddeterminants of lower extremity runninginjuries in long distance runners: a systematicreview. Br J Sports Med. 2007 August; 41(8):469480.


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Ankle sprain

N. Kofotolis (2007). Ankle Sprain Injuries: A 2-Year Prospective Cohort Study in Female GreekProfessional Basketball Players. Journal of

Athletic Training2007;42(3):388394


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Footballers ankle

Bracing Unloading

N. Kofotolis (2007). Ankle Sprain Injuries: A 2-Year Prospective Cohort Study in Female GreekProfessional Basketball Players. Journal of

Athletic Training2007;42(3):388394


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Achilles Tendinitis,Achilles tendon rupture

Splinting

Surgery:repair

Munteanu SE (2009). Efficacy of customised foot orthoses in the treatment of Achillestendinopathy: study protocol for a randomised trial. J Foot Ankle Res. 2009; 2: 27.


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Plantar fasciitis

Bracing Stretching

Shoe

modification

Radford JA et al. (2007). Effectivenessof calf muscle stretching for the short-term treatment of plantar heel pain: arandomised trial. BMC MusculoskeletDisord. 2007; 8: 36.


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(Open) Fracture

Fracture

Wound microbial contamination


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General EmergencyManagement : Airway,Breathing, Circulation

Initial stabilization :Splint, slab,compressive dressing

Open FracturePrinciples of Management


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Open FracturePrinciples of Management

Antibiotic

Irrigation and debridement :

to decrease microbialconcentration

Stabilization/fixation

(definitive) : IF/EF Rehabilitation


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Dislocation& Fracture-Dislocation

Attitude

Risk of

neurovasculardisturbance

Early reduction

General anesthesia immobilization

Rehabilitation


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Dislocated shoulder

Closedreduction

Surgeryfor

neglected


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Bleeding

Pelvic fracture : 2 L

Femur fracture : 1,5 L

Fluid resuscitation Stabilization of fracture

Internal fixation

External fixation


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Increased fluid content incompartment

Compartment

Syndrome

External compression

Constriction ofcompartment


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Arterial Trauma Trauma / fracture exercise (athlete) Old compression

Edema Bleeding

Increased pressure within thecompartment

Intracompartmental pressure exceedsCritical Closing Pressure

Muscle ischemia Nerve ischemia

Volkmann contracture

MUSCLE INFARCTION

FASCIOTOMY


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musculoskeletal injury-english ver 16 feb 2011

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