Distal femur and knee

2018 ◽  
Author(s):  
Jim Hughes
Keyword(s):  
Distal Femur ◽  
High Energy ◽  
The Body ◽  
Long Bones ◽  
Surgical Equipment ◽  
Load Bearing ◽  
High Energy Trauma ◽  
Articular Surfaces ◽  
Cerclage Wiring ◽  
Selection Of

The knee is one of the main load-bearing joints of the body, and injuries to it can involve damage to the joint or articular surfaces, or fractures to the long bones in case of high-energy trauma. The position of the contralateral leg can cause difficulty in positioning for imaging, but good positioning and technique should allow demonstration of the region for intervention. This chapter covers a selection of orthopaedic procedures involving the distal femur and knee, covering distal femoral plating and LISS plates, tension band wiring of the patella, and cerclage wiring of the patella. Each procedure includes images that demonstrate the position of the C-arm, patient, and surgical equipment, with accompanying radiographs demonstrating the resulting images.

scholarly journals Features of surgical treatment of intra- and periarticular fractures of the lower third of the femur in patients with polytrauma

2019 ◽  
Vol 26 (2) ◽  
pp. 14-18
Author(s):  
E. I Solod ◽  
N. V Zagorodni ◽  
A. F Lazarev ◽  
M. A Abdulkhabirov ◽  
Ya. M Alsmadi ◽  
...  
Keyword(s):  
Distal Part ◽  
Distal Femur ◽  
Traumatic Shock ◽  
High Energy ◽  
Optimal Time ◽  
Prospective Analysis ◽  
Severity Scale ◽  
Duration Of Treatment ◽  
High Energy Trauma ◽  
Results Of Treatment

Treatment of patients with fractures of femur has a particular relevance in modern traumatology, especially in patients with polytrauma. The treatment of such fractures is complicated by the fact that it depends not only on the nature of the fracture, but also on the general condition of the patient. These fractures are caused by high-energy trauma, they have the tendency to be splintered or fragmented, and often accompanied by neurovascular complications, especially in the distal part. Such fractures are often accompanied by soft tissue damage. Purpose: improving the results of treatment of intra-and periarticular fractures of the distal femur in patients with polytrauma. Material and methods. In the present study, a prospective analysis of using conversion osteosynthesis in the treatment of 72 patients with intra-and periarticular fractures of the lower third of the femur patients with polytrauma, according to the ISS severity scale (ISS 17-40) was performed in a multidisciplinary hospital. Results. The most optimal time for conversion osteosynthesis to patients with polytrauma was 5-7 days, which prevented the occurrence of traumatic shock and prevented the occurrence of inflammatory complications in the postoperative period. Conclusion. The study confirmed the feasibility of conversion osteosynthesis in the treatment of patients with intra-and periarticular fractures of the lower third of the femur. The use of the technique of transferring the fixation of fragments by the external fixation to the internal osteosynthesis (conversion) contributed to a reduction in the duration of treatment of patients in the hospital with fractures of the long bones.

Forearm and wrist

2018 ◽  
Author(s):  
Jim Hughes
Keyword(s):  
The Body ◽  
Surgical Equipment ◽  
Direct Trauma ◽  
Selection Of

This chapter covers a selection of orthopaedic procedures involving the forearm and wrist, covering plating of the radius and ulna, and plating and/or K-wiring of the wrist. Each procedure includes images that demonstrate the position of the C-arm, patient, and surgical equipment with accompanying radiographs demonstrating the resulting images. The wrist is one of the most commonly injured regions of the body, as it is used with the hands to protect the body and head when falling. The forearm is more often injured in direct trauma, but any injuries to it may also affect the articulations at the wrist or elbow.

scholarly journals Traumatic infra-renal aortic dissection after a high-energy trauma: a case report of a primary missed diagnosis

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Holger Godry ◽  
Guido Rölleke ◽  
Achim Mumme ◽  
Thomas A. Schildhauer ◽  
Martin Gothner
Keyword(s):  
Aortic Dissection ◽  
Ct Scan ◽  
High Energy ◽  
The Body ◽  
Trauma Patients ◽  
Traumatic Injuries ◽  
High Energy Trauma ◽  
Missed Injuries ◽  
Lumbar Vertebral Body ◽  
Life Threatening

A traumatic infra-renal aortic dissection is a rare but life-threatening injury that follows deceleration injuries. The mechanism of blunt abdominal aortic injury involves both direct and indirect forces. The successful management of patients with traumatic injuries depends on a prompt suspicion of the injury and early diagnosis and therapy. Missed injuries in trauma patients are well-described phenomena and implementation of the ATLS® trauma schedule led to a decrease in the number of missed injuries, but trauma computed tomography (CT) scans in injured patients are still not standard. We report on a 54-year old Caucasian female patient who was involved in a car accident. The fellow passenger of the car was seriously injured. The patient had been previously treated at two different hospitals, and a dislocated acetabular fracture had been diagnosed. Because of this injury, the patient was transferred to our institution, a level 1 trauma-center where, according to the nature of the accident as a high-energy trauma, a complete polytrauma management was performed at the time of admission. During the body check, a moderate tension of the lower parts of the abdomen was detected. During the CT scan, an aneurysm of the infra-renal aorta with a dissection from the height of the second lumbar vertebral body to the iliac artery was observed. The patient required an operation on the day of admission. After 19 days post-trauma care the patient was able to leave our hospital in good general condition. Therefore, missed injuries in multiple injury patients could be fatal, and it is essential that the orthopedic surgeon leaves room for suspicion of injuries based on the nature of the trauma. Traumatic injuries of the abdominal aorta are rare. According to the ATLS® trauma schedule, all of the patients who have experienced high-energy trauma and associated fractures should undergo routine screening using a trauma CT scan with contrast agents to detect potential life-threatening injuries. In case of abdominal trauma, an aortic dissection, which can easily be overlooked, has to be considered.

CLINICO – RADIOLOGICAL OUTCOME OF FEMUR DIAPHYSEAL FRACTURES TREATED WITH INTRAMEDULLARY INTERLOCKING NAILING

2021 ◽  
pp. 46-47
Author(s):  
Phani Teja Villa ◽  
P Sadhana ◽  
K Thulasi Ram
Keyword(s):  
Lower Extremity ◽  
High Energy ◽  
Radiological Outcome ◽  
Internal Organs ◽  
Load Bearing ◽  
Mortality And Morbidity ◽  
High Energy Trauma ◽  
Male Predominance ◽  
Orthopedic Surgeon ◽  
Diaphyseal Fractures

Background: Fracture diaphysis of a femur is one of the most common fractures that an orthopedic surgeon comes across. Since femur is one of the principal load bearing bones in the lower extremity, femur diaphyseal fractures resulting from high energy trauma, and are often associated with concomitant injury of internal organs. Thus these fractures are associated with considerable mortality and morbidity. Results: In the present study, we used WINQUEST AND HANSENS CLASSIFICATION to classify the fractures , 14 (46.66%) cases were type 0 fractures; type1 fractures were 6 (21.33%). The age of the patients ranges from 18-70 years, with a mean age of 37.6 yrs. Male predominance was seen; about 76.66% (23 cases) were males and the rest females, i.e., 23.33% (7 cases). Eighteen cases (18) were right-sided, and twelve cases (12) were left-sided fracture diaphysis of the femur

scholarly journals MANAGEMENT OF DISTAL FEMUR FRACTURES IN ADULT WITH LOCKING COMPRESSION PLATE

2021 ◽  
Vol 9 (01) ◽  
pp. 895-902
Author(s):  
Mohammed Moustafa Hamid Ali Nasser ◽  
◽  
Ali Tawfik Elalfy ◽  
Mohammed Elsadek Atia ◽  
Sameh Mohammed Holail ◽  
...  
Keyword(s):  
Distal Femur ◽  
Locking Plate ◽  
Plate Fixation ◽  
High Energy ◽  
Locking Compression Plate ◽  
University Hospitals ◽  
High Energy Trauma ◽  
Emergency Hospital ◽  
Femur Fractures ◽  
Compression Plate

Objective: To evaluate the clinical outcomes and radiological union of distal third femur fractures by using distal femur locking plate, in Zagazig university hospitals and KafrSaad emergency hospital. Design: Clinical trial. Methods: Data collected for the study was from the patients admitted in orthopedic department in Zagazig university hospitals and KafrSaad emergency hospital, with distal femur fracture AO 33,during the period of August 2019 to July 2020 and treated with open reduction and internal fixation with distal femur locking compression plate with 4.5 system. All patients were followed up for an average of 6 months. Outcomes were assessed by Neers score. Results: Outof 12 patients (4 were females&8were males), mean age was 45.6 years (20 to 70 years). 10 cases wereduo to high energy trauma and 2 cases wereduo to low high energy trauma.5 out of total 12 cases had open fractures and rest 7 cases had closed fractures.Out of total 12 cases, five cases were extra-articular and rest 7 cases were intra-articular. Out of 12 fractures treated, 8 fractures showed radiological signs of union within 12-16 weeks,3 fractures showed radiological signs of union within 20 weeks and one fracture showed radiological signs of union within 24 weeks.1 patient got superficial infection and no implantfailure, mean range of motion of all patients was 113°. Conclusion:ORIF of distal femur fractures with locking compression plate provides good angular stability, restoration of limb alignment, length, rotation and give a good purchase in osteoporotic patientswith minimal complications. Best results are optioned when standard protocol of locking plate fixation is followed with good soft tissue care, early knee bending exercises and physiotherapy.

Pelvis

2018 ◽  
Author(s):  
Jim Hughes
Keyword(s):  
Surgical Procedures ◽  
Lower Energy ◽  
High Energy ◽  
Surgical Equipment ◽  
Avulsion Fractures ◽  
High Energy Trauma ◽  
Medical Emergencies ◽  
Surgical Fixation

The pelvis is a complex area of anatomy, and fractures to it may be stable or unstable, depending on the location and nature of the injury. Lower-energy trauma may result in avulsion fractures and stable injuries that can be treated conservatively. High-energy trauma to the pelvis can result in unstable combinations of primary and contrecoup fractures. Such injuries are medical emergencies and will require surgical fixation. This chapter provides an overview of orthopaedic surgical procedures of the pelvis. The discussion includes images that demonstrate the position of the C-arm, patient, and surgical equipment, with accompanying radiographs demonstrating the resulting images.

scholarly journals Impaired Fracture Healing of the Distal Femur after High Energy Trauma

2017 ◽  
Vol 1 (1) ◽  
pp. 1-5
Author(s):  
Karhof S ◽  
Bastian OW ◽  
Olden GDJ van ◽  
Leenen LPH ◽  
Kolkman KA ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Distal Femur ◽  
High Energy ◽  
High Energy Trauma

Bone Substitute Used in a Bilateral Calcaneal Fracture-Case Presentation

2014 ◽  
Vol 614 ◽  
pp. 163-167
Author(s):  
Olivera Lupescu ◽  
Mihail Nagea ◽  
Dragos Zamfirescu ◽  
Alexandru Dimitriu ◽  
Mihai Coltan ◽  
...  
Keyword(s):  
Young Patients ◽  
Bone Substitutes ◽  
High Energy ◽  
The Body ◽  
Team Work ◽  
Concomitant Treatment ◽  
Septic Complications ◽  
Modern Approach ◽  
High Energy Trauma ◽  
The Impact

Modern traumatology is characterized by high energy trauma, simultaneously affecting parts of the body especially in young patients. One of the most severe aspects resulting of high energy trauma is that of multiple skeletal injuries, with bone loss, which require complex treatment; this refers both to methods of filling the bone defects and to interdisciplinary approach whenever soft tissues are injured, as well. This case demonstrate the impact of modern approach in high energy trauma, with multiple aspects: bone substitutes as effective technique of bone filling and prevention of septic complications, as well as team work for concomitant treatment of associated injuries. The outcome of the patient, compared to the initial status, demonstrate the benefit of bone substitutes for a rapid recovery of trauma patients, with major impact on social and professional recovery.

PENGEMBANGAN BAHAN AJAR IPA SMP PADA TEMA ENERGI DALAM TUBUH MENGGUNAKAN METODE 4STMD

EDUSAINS ◽  
2019 ◽  
Vol 8 (2) ◽  
pp. 166-175
Author(s):  
Gia Juniar Nur Wahidah ◽  
Sjaeful Anwar
Keyword(s):  
Concept Maps ◽  
The Body ◽  
Instructional Materials ◽  
Teaching Material ◽  
Test Results ◽  
Teaching Materials ◽  
Eligibility Criteria ◽  
Material Development ◽  
Selection Step ◽  
Selection Of

Abstract This research aims to produce science teaching materials in junior level with Energy in The Body as the theme using Four Steps Teaching Material Development  (4STMD). The material is presented in an integrated way so that students can  think holistically and contextually. The method used in this study is Research and Development. In this R&D methods is used 4STMD. There are four steps done on the development of teaching materials, the selection step, structuring step, characterization, and didactic reduction. Selection step includes the selection of indicators in accordance with the demands of the curriculum which is then developed with the selection of concepts and values that are integrated with the concept of science. Structuring step includes make macro structures, concept maps, and multiple representations. Characterization's step includes preparation instruments, then  trial to students to identify difficult concepts. The last, didactic reduction was done by neglect and the annotations in the form of sketches.The test results readability aspect instructional materials lead to the conclusion that by determining the main idea, the legibility of teaching materials reached 67%, with moderate readability criteria. Test results of feasibility aspects based on the results of questionnaires to the 11 teachers lead to the conclusion that the overall, level of eligibility teaching materials reached 91% with the eligibility criteria well. Keywords: teaching materials; energy; 4STMD Abstrak Penelitian ini bertujuan untuk menghasilkan bahan ajar IPA SMP pada tema Energi dalam Tubuh menggunakan metode Four Steps Teaching Material Development (4STMD). Materi disajikan secara terpadu sehingga memacu siswa untuk berpikir secara holistik dan kontekstual. Metode penelitian yang digunakan pada penelitian ini adalah metode penelitian dan pengembangan. Dalam penelitian dan pengembangan yang ini, digunakan metode Four Steps Teaching Material Development (4STMD). Terdapat empat tahap yang dilakukan pada pengembangan bahan ajar, yakni tahap seleksi, strukturisasi, karakterisasi, dan reduksi didaktik. Tahap seleksi meliputi pemilihan indikator yang sesuai dengan tuntutan kurikulum yang kemudian dikembangkan dengan pemilihan konsep dan nilai yang diintegrasikan dengan konsep IPA. Tahap strukturisasi meliputi pembuatan struktur makro, peta konsep, dan multipel representasi dari materi. Tahap karakterisasi meliputi penyusunan instrumen karakterisasi, kemudian uji coba kepada siswa untuk mengidentifikasi konsep sulit. Tahap terakhir, yaitu reduksi didaktik konsep terhadap konsep sulit. Reduksi didaktik yang dilakukan berupa pengabaian dan penggunaan penjelasan berupa sketsa. Hasil uji aspek keterbacaan bahan ajar menghasilkan kesimpulan bahwa berdasarkan penentuan ide pokok, keterbacaan bahan ajar mencapai 67%, dengan kriteria keterbacaan tinggi. Hasil uji aspek kelayakan berdasarkan hasil angket terhadap 11 orang guru menghasilkan kesimpulan bahwa secara keseluruhan tingkat kelayakan bahan ajar mencapai 91% dengan kriteria kelayakan baik sekali. Kata Kunci: bahan ajar; energi; 4STMD  Permalink/DOI: http://dx.doi.org/10.15408/es.v8i2.2039  

Digestibility of nutrients and milk productivity of cows when using the concentrate mixture with the inclusion of rapeseed presscake

2020 ◽  
pp. 48-53
Author(s):  
L. Yarmots ◽  
G. Yarmots ◽  
A. Belenkaya
Keyword(s):  
Protein Digestibility ◽  
High Energy ◽  
Negative Influence ◽  
The Body ◽  
Milk Productivity ◽  
Lactating Cows ◽  
Low Protein ◽  
Concentrate Mixture ◽  
Almost All ◽  
Experimental Group

For ruminants, especially high-yielding animals in addition to the complete supply of animals with protein, its digestibility in the rumen is important. With low protein digestibility in the rumen, the released ammonia will be more effectively used by the rumen microflora, and the undigestible protein in the subsequent sections of the digestive tract can serve as a source of amino acids for the body. The use of concentrate mixtures with the inclusion of local, affordable and cheaper grain feeds, in particular a high-energy and protein ingredient- rapeseed presscake makes it possible to increase the milk productivity of cows throughout lactation. These presscakes are well balanced in their amino acid composition and belong to feeds whose protein has a low degree of digestibility in the rumen. The purpose of the researches was to study the digestibility of nutrients and milk productivity of cows when using the concentrate mixture with the inclusion of rapeseed presscake. In the scientific and economic experiment has been carried out on lactating cows, where the cows of the experimental group in the concentrate mixture of peas has been replaced with rapeseed presscake the digestibility of nutrients in the ration, energy metabolism and milk productivity have been studied. Studies have shown that almost all the nutrients were significantly better digested by the animals of the experimental group. Energy in milk was more allocated by cows of the experimental group by 6,29 MJ. From cows of the experimental group for 100 and 305 days of lactation has been obtained more milk by 6,27 and 7,06 %, respectively, than from control herdmates. The biochemical parameters of blood were within the limits of the physiological norm in animals of both groups. Thus, the replacement of peas with rapeseed presscake in the concentrate mixture did not have a negative influence on the metabolic processes and helped to increase the milk productivity of cows.

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