OrthopaedicsOrthopaedics

Correcting problems with the Correcting problems with the Musculoskeletal systemMusculoskeletal system

Today’s objectives: (What I need to Today’s objectives: (What I need to know)know)

To define OrthopaedicsTo define Orthopaedics

To list some common musculoskeletal To list some common musculoskeletal disorders and injuries and explain their disorders and injuries and explain their causescauses

To describe appropriate treatments for To describe appropriate treatments for these injuries and disordersthese injuries and disorders

OrthopaedicsOrthopaedics

Orthopaedics deals Orthopaedics deals with all disorders with all disorders and injuries and injuries (trauma) of the (trauma) of the musculoskeletal musculoskeletal systemsystemOrthopaedics Orthopaedics involves the involves the diagnosis and diagnosis and treatment of these treatment of these injuries and injuries and disordersdisorders

There are many things that can go There are many things that can go wrong with the muscles and skeletonwrong with the muscles and skeleton

FracturesFractures

Joint wear/ damage Joint wear/ damage (osteoarthritis)(osteoarthritis)

Bone wasting (osteoporosis)Bone wasting (osteoporosis)

DeformityDeformity

Tendon TearsTendon Tears

Ligament tearsLigament tears

Inflammation of muscles, Inflammation of muscles, cartilage, tendons and cartilage, tendons and ligamentsligaments

Why do these problems arise?Why do these problems arise?

Born that way Born that way (congenital)(congenital)

Sports injury.Sports injury.

Inappropriate postureInappropriate posture

Inappropriate exerciseInappropriate exercise

Old ageOld age

Damaging workplaceDamaging workplace

Traffic or other Traffic or other accidentaccident

FracturesFractures

The way bone breaks varies The way bone breaks varies with age:with age:

The very young tend not to The very young tend not to fracture or sustain fracture or sustain greenstick fracturesgreenstick fracturesAdults and teenagers Adults and teenagers fracture more fracture more easily easily complete or partial complete or partial fracturesfracturesThe Elderley fracture very The Elderley fracture very easily due to reduced bone easily due to reduced bone density. Because of the density. Because of the brittleness the fractures are brittleness the fractures are often often impacted fracturesimpacted fractures

Fractures – Fractures – simple and compoundsimple and compound

Simple describes Simple describes those which don’t those which don’t break through break through muscles and skinmuscles and skinCompound fractures Compound fractures break through break through muscles and skinmuscles and skinThe latter are The latter are associated with care associated with care accidents or great accidents or great falls.falls.

Comminuted fracturesComminuted fractures

This is when bones This is when bones break into three or break into three or more piecesmore piecesOften these are Often these are difficult to deal withdifficult to deal withThey can damage or They can damage or threaten to damage threaten to damage soft tissuessoft tissuesHow would you deal How would you deal with a shattered with a shattered femur?femur?

A vulnerable area – spinal fractureA vulnerable area – spinal fracture

Fractures such as whiplash Fractures such as whiplash fracture are incredibly fracture are incredibly dangerousdangerous

The most dangerous area is The most dangerous area is in the cervical regionin the cervical region

Why is this?Why is this?

If the spinal cord is severed If the spinal cord is severed the patient will be paralysed the patient will be paralysed from that pint downfrom that pint down

This is why neck braces are This is why neck braces are always used if in doubt.always used if in doubt.

ArthroscopyArthroscopyDeveloped by Developed by

Dr. Watanabe of JapanDr. Watanabe of Japan

It is performed before keyhole It is performed before keyhole surgerysurgery

The joint is punctured and The joint is punctured and flooded with sterile fluid at flooded with sterile fluid at

high pressure high pressure

After the assessment…After the assessment…

Once the surgeon has assessed what the Once the surgeon has assessed what the problem is surgery can begin.problem is surgery can begin.

This often happens straight awayThis often happens straight away

Small tools are used to perform the Small tools are used to perform the surgery (e.g. removing loose cartilage)surgery (e.g. removing loose cartilage)

Keyhole surgeryKeyhole surgery

The benefits of keyhole The benefits of keyhole surgery are:surgery are:

The whole area doesn’t The whole area doesn’t have to be opened have to be opened (infection minimized(infection minimized

Fewer tissues are damagedFewer tissues are damaged

So… fewer tissues have to So… fewer tissues have to healheal

The patient recovers more The patient recovers more quicklyquickly

Joint ReplacementJoint Replacement

Sometimes a joint is so Sometimes a joint is so badly damaged it has to be badly damaged it has to be replacedreplaced Typical this happens in the Typical this happens in the very old or severe car very old or severe car accidentsaccidents Hip replacements are Hip replacements are commoncommonThe femur head is removed The femur head is removed and a titanium alloy head and a titanium alloy head insertedinsertedThe hip socket is hollowed The hip socket is hollowed out and a plastic cup out and a plastic cup insertedinserted

ArthrodesisArthrodesis

Sometimes badly Sometimes badly damaged joints are damaged joints are fusedfused

This happens, This happens, especially if the joint especially if the joint has limited movement has limited movement anywayanyway

Pain is alleviatedPain is alleviated

QuestionsQuestions

Name two possible features of a Name two possible features of a comminuted fracture.comminuted fracture.Why do paramedics often put a stable Why do paramedics often put a stable collar on victims of severe road traffic collar on victims of severe road traffic accidents?accidents?Give two advantages of keyhole surgery Give two advantages of keyhole surgery over conventional surgery.over conventional surgery.What is Arthroscopy? What does it literally What is Arthroscopy? What does it literally mean?mean?