By Parminder J Singh, Catherine Swales
A 24-year-old lady attends rheumatology outpatients with an eight-week background of painful fingers. On exam she is tearful and skinny. you're the medic on duty...
100 instances in Orthopaedics and Rheumatology provides a hundred eventualities generally visible by means of clinical scholars and junior medical professionals in orthopaedic and rheumatology clinics, or within the emergency division. A succinct precis of the patient's historical past, exam and preliminary investigations, with scientific and/or imaging pictures, is by means of questions about the prognosis and administration of every case. the reply contains a particular dialogue on every one subject, with additional representation the place acceptable, supplying a necessary revision relief in addition to a realistic advisor for college students and junior medical professionals.
Making medical judgements and selecting the simplest plan of action is likely one of the such a lot demanding and hard elements of educating to develop into a physician. those circumstances will educate scholars and junior medical professionals to acknowledge very important indicators and indicators and, the place acceptable, their courting to different health conditions, and to improve their diagnostic and administration abilities.
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Extra info for 100 Cases in Orthopaedics and Rheumatology
How would you manage this patient? 39 100 Cases in Orthopaedics and Rheumatology ANSWER 14 The diagnosis is a fracture of the femoral shaft. The X-rays show signiﬁcant shortening and displacement. These types of fracture are usually caused by direct, high-energy forces, and may be life-threatening. Isolated fractures can occur with repetitive stress and in the presence of metabolic bone disorders, or primary or secondary bone tumours. The area most susceptible to stress fracture is the medial junction of the proximal and middle third of the femur, which occurs as a result of the compression forces on the medial femur.
Bruising extending along the arm distally and along the chest wall is often present a few days following injury. The proximal humerus consists of four bony parts: humeral head (articular surface), greater tuberosity, lesser tuberosity and the humeral diaphysis. Radiographs should include anteroposterior, lateral and axillary views, and often a CT reconstruction scan to assess the fragments involved. Fracture stability can be assessed by placing one hand on the humeral head while gently rotating the humeral shaft internally and externally.
The purpose of fasciotomy is to achieve prompt and adequate decompression so as to restore the tissue perfusion. The surgeon should be familiar with the visual recognition of necrotic tissue because thorough debridement reduces the potential of infection and improves the chances of tissue recovery. Regardless of the approach used, all compartments of the leg must be thoroughly decompressed. A delay in surgery could lead to ischaemic contractures or even amputation. 54 Orthopaedics KEY POINTS • Compartment syndrome is an orthopaedic emergency.