⛔️Complication of fracure of Femur shaft:

-Vein&nerve Injury.
-Fat embolism.
-Delay nonunion or malunion.

⛔Supracondylar fracture of femur:

Due to high enegry trauma.
-Ttt by open reduction internal fixation.
May occur Injury to femoral A & popliteal A.

🚨🚨🚨‼️

¹ Shaft # of humerus = Radial N injury = wrist drop

² surgical neck # = axillary N injury = flat shoulder

³ supracondylar # or elbow dislocation = median N injury = ape hand

⁴ median epicondylar # = ulnar N injury = claw hand

⁵ long thoracic N injury = winged scapula

⛔Sciatic nerve يعطينا branches tibia and common peroneal nerves و injery for sciatic lead to drop foot.

common peroneal يعطينا زوز برنشات deep peroneal and superficial peroneal
Deep: يعطينا أحساس بين صبع الكبير والثاني

Superfacial : يعطي إحساس لباقي
dorsum ( ماعدا sensation between 1st & 2nd ) .

فلذلك لما الدكتور يسألك عندك كسر وتبي تحدد أي نيرف تضرر بتقوله بندير sensory examination،
كان foot drop وفاقد الإحساس من تحت الركبة هذه common perneal بطوبته مضروب.

لو foot drop والإحساس كله تمام ومافيش إحساس بين الصبع الأول والثاني معنها هذه deep

لو foot drop والإحساس كله مهناش ولكن فيه بين الصبع الأول والثاني هذه super facia.

بعض ال Classifications of bones المهمة
اللي انسي حاجة يراجعها من الورقة هذه 😌
وبارك الله في زميلتنا بعثتها.❤

#Ortho
Principles of Fructures

- Impacted fracture: also called a torus or buckle fracture, is a piece of the bone may impact another bone, happen as in Corticocalcaneus junction.
Cortico bone have medullary canal.
Calcaneus bone haven't medullary canal.
Its common in # neck of femor, lower end of radius B/w diaphysia (cortical) & metaphysis (calcaneus) called Colles #.

- Referred pain: its pain feel away from its origin.

- Open reduction: means reduce the # under direct vision.
- closed reduction: means reduce the # without exposure the # size.
- pelvis يمشي معاه CT scan أكثر من ال Xray

- Different b/w lig & tendon????

- Dont say open # by X-ray this is wrong but by clinical examination to Pt.

- in examination say Normal range of motion.
Or restricted range of motion.

- Commonuted #: its # of more than 2 paices of bone of fragments.

- Compound #: its Open#. 😉

- Types of dislocation:
Congenital dislocation
Aquired dislocation :
1A) trumatic //
B) pos , Ant, dislocation
C) Central // (femor تخش داخل ال Pelvis )
2A) paralytic //
B) dislocation as in poliomylitis
3) Pathological dislocation.

- Note/ number bone of hand is 27
& All upper limb 30 bone
Both U.L is 60 bone.
- Number bone of foot 26 & 4 in L.L
So All L.L is 60
Both U.L & L.L is 120 bones.

The knee & leg

- Any Pus in Joint should be drainge before antibiotics.

- في hemoarthrosis دير Aspiration حتشوف بعينك حاجة في العينة نفسها تعرف انه عنده #؟
حتلقى Fatty bubbles
In Femor condyle or tebeal platou or in patella.

- Para patellar gutters = parapatellar sulcus
علق عليه ب Fullness not swalling

- Locking: its sudden inability to complete a certain movement suggest mechanical block.

- Osteoarthritis: degenrative changes in the bone.

Knee:
- 3 Types of condylar #:
A) Supracondylar # .
B) Unicondylar # medial or lateral "Hoffa" #
" Frontal plane".
C) Intercondylar # - T or Y types.

- Buttress plate  يعني تتكى عليها بس في علاج displaced.

Donohugus triad :
MCL,  MM , ACL injury.

- Test for meniscal injury:-
Thessalays test :
Pt standing on affected limb with support & asked to IR & ER lower limb.
Pain S/O injury.

- Osteomylitis emergency! B/c dystruction to joint. (( Topic infection))

Hemiarthroplasty = Excisional of head & neck.

Upper limb

- Long thoracic nerve supply serratus ms.

- whats the typical displacement in lower end of radius " Colles #" ? In distal fragment.!!

- Distal radius have special # complication as carbul tunnel syndrome & tendone ruptures.

- in Calcaneus bone have no delayed or non union but in cortical happen malunion.!

- Inserion of extensor pollices longus tendon in medial border of anatomical snafbox at the base of the distal phalanx of DIP the thumb.

- injuries caused on FOOSH in upper limb?
1) colles#
2) Clavicle#
3) # of scaphoid
4) Lunate dislocation
5) # of both bone forearm
6) elbow dislocation
7) Supracondylar # of humerus
8) # surgical neck of humerus
9) shoulder dislocation

- Causes of tenderness in snuff box ?
1) Scaphoid #.
2) # of styloid process
3) # of base of 1st metacarbal and wrist spur.

- Boxer #: its # of neck of 5th metacarbal bone
لما تلقاها معناها ضرب حد او ضرب ايده على الحيط مش طاح ! 😉عليها.
Rx / according to degree of displacement :
If slightly : conservative.
If high: ORIF.

Kienböck's disease: idiopathic avuscular necrosis of lunate, C/P with pain & Dx confirm by radio & MRI , TTT : with partial or complete fusion of wrist.

Bone tumors

- The M.C benign tumor bone in pediatrics is Osteochondroma.
- M.C malignant tumor bone in pediatrics is Osteosarcoma.
- M.C malignancy bone tumor in metastatic bone is Carcinoma.
- Most common site of Giant cell tumor in distal radius, Proximal tibia, distal femor, epiphysis in hip below head of femor.
- you should be see tumor Grading by microscopic (histopathology).
But Staging by CT scan.
- Multiple myeloma only 1ry malignant in the adult & others is 2ry.
- What are the big 5 lesions can be memic anything in X-ray?
1) Metastatic carcinoma.
2) Cartilaginous tumor.
3) Fibrous dysplasia.
4) Eosinophilic granuloma.
5) Osteomyelitis.

Stages of bone tumor 1A, 1B, 2A, 2B, 3.. the last stage is 3 ( Dont say 4🙂).

- measure radiation by centigray.

إضافات الكلية في الأورثو لمستشفى ابوسليم وم. الطبي ⬆️🔥
ربي يوفقنا ويسهل علينا جميعاً يارب.❤️

Salter Harris classification:
2️⃣ most common type.
5️⃣ Worest prognosis.

شيت ملخص الأورثو 30 ورقة لي د. السنوسي.⬆️

#أذكار الصباح .
احفظ اللّه يحفظك❤