Read e-book online 100 Cases in Orthopaedics and Rheumatology PDF
By Parminder J Singh, Catherine Swales
A 24-year-old girl attends rheumatology outpatients with an eight-week heritage of painful arms. On exam she is tearful and skinny. you're the medic on duty...
100 situations in Orthopaedics and Rheumatology provides a hundred situations normally obvious by way of scientific scholars and junior medical professionals in orthopaedic and rheumatology clinics, or within the emergency division. A succinct precis of the patient's background, exam and preliminary investigations, with scientific and/or imaging photos, is by means of questions about the prognosis and administration of every case. the reply incorporates a distinctive dialogue on every one subject, with additional representation the place applicable, delivering a necessary revision reduction in addition to a pragmatic advisor for college students and junior medical professionals.
Making medical judgements and selecting the easiest plan of action is without doubt one of the so much demanding and tough elements of educating to turn into a physician. those situations will educate scholars and junior medical professionals to acknowledge very important signs and symptoms and, the place acceptable, their dating to different health conditions, and to increase their diagnostic and administration abilities.
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1 Questions • What is the diagnosis? • What are the risk factors for this injury? • How would you classify these injuries? • How would you manage this patient? 25 100 Cases in Orthopaedics and Rheumatology ANSWER 9 The X-ray shows an extra-articular fracture of the distal radius. There is some dorsal angulation of the distal fragment and radial shortening. The diagnosis is thus a distal radius fracture. These injuries were ﬁrst described by an Irish surgeon, Abraham Colles, in 1814, and are commonly called Colles’ fractures.
The major muscles that surround the hip create signiﬁcant forces that contribute to fracture deformity. The gluteus medius and gluteus minimus tendons attach to the greater trochanter and abduct the proximal fragment. The psoas and iliacus attach to the lesser trochanter and ﬂex the proximal fragment – as in this case. The adductors pull the distal fragment medially. Intramedullary nails are emerging as the treatment of choice for subtrochanteric femur fractures. For some fractures with extension above the lesser trochanter, a ﬁxed-angle device such as a blade-plate or dynamic condylar screw can be considered as surgical options.
With a stress fracture, there is often a history of a recent change in activity level and the pain typically increases during weight-bearing and improves with rest. The classiﬁcation system most widely adopted for open tibial shaft fractures is Gustilo and Anderson’s (see the box). Open fractures are surgical emergencies and ideally should be taken to the operating theatre as soon as possible or put on the next available operating list. In the emergency room, an antibiotic should be administered, plus analgesia and a splint.
100 Cases in Orthopaedics and Rheumatology by Parminder J Singh, Catherine Swales