PRINCIPLE OF ORTHOPAEDIC TREATMENT PRINCIPLE OF ORTHOPAEDIC TREATMENT

PRINCIPLE OF ORTHOPAEDIC TREATMENT

PRINCIPLE OF ORTHOPAEDIC TREATMENT • CONSERVATIVE TREATMENT NON-MEDICATION • OPERATIVE TREATMENT CLOSED REDUCTION INTERNAL FIXATION OPEN REDUCTION EXTERNAL FIXATION • MINIMAL INVASIVE SURGERY (MIS)

NON-MEDICATION RICE • REST- ICE – COMPRESSION – ELEVATION PT • NWB – PWB – FWB – Toe touch WB

Ambulation with walker

SPLINT • PRESSURE SORE – HEEL – MALLEOLUS – HEAD FIBULA • NERVE COMPRESSION – UPPER LIMB ULNAR NERVE – LOWER LIMB PERONEAL NERVE

เฝอกปน Plaster of Paris • 1852 s Dutch military surgeon • PLASTER OF PARIS For house construction in 1700 s manufacture from Montmartre in Paris • Any of a group of gypsum cements, essentially hemihydrated calcium sulfate, Ca. SO 4· 1/2 H 2 O

TRACTION • Known as the “American Method” • Skin traction used extensively in Civil War for fractured femurs • Skeletal traction by a pin through bone introduced by Steinmann and Kirschner

TRACTION Requires meticulous nursing care

Skin traction Forearm traction Buck’s traction

Skin traction Split Russell’s Traction • May be used in Fx femur in children

Skull traction Gardner-Wells tong

Skeletal traction calcaneal traction

Balanced Suspension with Pearson Attachment

MEDICATION • ANALGESIC • NSAIDS (NON-STEROIDAL ANTI-INFLAMMATORY DRUGS) • STEROIDS • MUSCLE RELAXANTS

ANALGESIC • Acetaminophen ใชไดถงวนละ 4 กรม • Tramadol ระวงการใชรวมกบ liver toxicity Antidepressants – convulsion

NSAIDS • ยาแกอกเสบ acetic acid diclofenac, indomethacin, aspirin • ยาแกอกเสบ propionic acid ibuprofen, naproxen, ketoprofen • ยาแกอกเสบ oxicams piroxicam, meloxicam • ยาแกอกเสบ cox-2 celecoxib, etoricoxib

MUSCLE RELAXANTS • Tolperisone – Skeletal muscle relaxant – Keep dry – Allergy • Orphenadine – Anticholinergic skeletal and smooth muscle relaxant – Glaucoma, BPH

OPERATIVE TREATMENT • INTERNAL FIXATION – – K-WIRE TENSION BAND WIRING PLATE NAIL • EXTERNAL FIXATION • SALVAGE PROCEDURE

INTERNAL FIXATION TEMPORARY FIXATION • KIRSCHNER WIRE – – 0. 035 INCH(0. 9 MM) 0. 045 INCH(1. 2 MM) 0. 062 INCH(1. 5 MM) 2 MM • STEINMANN PIN – 4, 4. 5, 5 MM

TENSION BAND WIRING • AVULSION FRACTURE • TRACTION FORCE COMPRESSION FORCE

PLATE • DYNAMIC COMPRESSION PLATE(DCP)

PLATE • ANATOMICAL PLATE • BUTTRESSING

PLATE • LOCKING COMPRESSION PLATE (LCP)

LCP & DCP

PLATE DYNAMIC HIP SCREW(DHS) • FRACTURE SITE COMPRESSION

NAIL KUNTSCHER NAIL • RAILROAD • 3 POINT FIXATION

NAIL INTERLOCKING NAIL • COMMINUTION • SEGMENTAL • UNFITTED CANAL

NAIL PRXIMAL FEMORAL NAIL (PFN) • NECK • INTERTRCHANTER • SUBTROCHANTER

PFN & DHS

EXTERNAL FIXATOR (EF) • • MINIMAL INVASIVE RIGID WOUND CARE CONTINUOUS TRACTION

EF & LCP

INTERNAL EXTERNAL FIXATOR PEDICULAR SCREWS

SALVAGE PROCEDURE TOTAL ARTHROPLASTY HEMIARTHROPLASTY MOORE’S BIPOLAR

ARTHROPLASTY PRIMARY PROCEDURE IN ELDERY

SALVAGE PROCEDURE • • ARTHRODESIS DESTROYED JOINT ACTIVE LIFE STABLE NO MOTION

MINIMAL INVASIVE SURGERY (MIS) • ARTHROSCOPIC SURGERY • ENDOSCOPIC SURGERY • MICROPSCOPIC SURGERY • MINIMAL INCISION PLATE OSTEOSYNTHESIS (MIPO)

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