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Pool Hydrotherapy in Musculoskeletal Pain Management

March 22, 2009 By Leave a Comment

In hydrotherapy, water is used as a therapeutic measure. Already ice water therapy has been discussed. The pool therapy is one wherein patients are mobilized to do activities in warm swimming pool.

This warmth of water reduces pain and relaxes muscle spasm. Water with its buoyancy counteracts gravity, provides support and relieves weight bearing in degenerated joints or unstable joints.

Pool therapy is indicated in

Indications

  • Degenerative arthritis
  • Neurological disorders-hemiplegia, paraplegia

Contraindications

  • Infection
  • Haemodynamically unstable patients
  • Major systemic illness
  • Tracheostomy
  • Vertigo, epilepsy
  • Others

Popularity: 1% [?]

Filed Under: Physiotherapy Tagged With: , ,

Implant Failure – Xray of Broken Intramedullary Interlocked Nail In Fracture of Femur

March 21, 2009 By 2 Comments

Broken inrameduallry interlock nail in femur fracture. Implant has failed before union of fracture

Broken inrameduallry interlock nail in femur fracture. Implant has failed before union of fracture

Intramedullary interlocked nail is a very common implant used for treatment of diaphyseal fractures of long bones. It allows early mobilization of the limb owing to stable fixation. The implant is called interocked because screws are used on eitherside to lock the implant to the bone.

Implant failure is one of the  problems associated with implant surgery. In this the impant metal gets fatigued before a fracture could have united. It is basically a race against time between fatigue of the implant and union of the fracture.

Two of the major causes of implant failure are poor implant [In terms of design, strength etc.] and poor surgical technique.

In the present image the implant has broken at the fracture site and the fracture has not united. The patient was 48 years old and the implant broke after 4 months of surgery. [Read more...]

Popularity: 4% [?]

Filed Under: Femoral Fractures, Orthopaedic Images Tagged With: , , , ,

Single Shot of Hyaluronic Acid Only As Effective As Placebo In Hip Osteoarthritis

March 19, 2009 By Leave a Comment

A recent study published in March issue of Arthritis and Rheumatism has concluded that a single intraarticular injection of hyaluronic acid is no more effective than placebo in treating the symptoms of hip osteoarthritis.

This is in contrast to the findings by earlier researchers who suggested that one injection of HA could be an effective therapy for hip osteoarthritis.

The present study was a multicenter trial conducted on randomly assigned 85 patients of radiographically confirmed hip osteoarthritis who either received fluoroscopically guided intraarticular injection of hyaluronic acid, or placebo injection. A placebo is a substance or procedure a patient accepts as medicine or therapy, but which has no objectively verifiable therapeutic activity. Any therapeutic effect is thought to be based on the power of suggestion. [Read more...]

Popularity: 1% [?]

Filed Under: Osteoarthiritis Tagged With: , , ,

Radial Head Fractures – Clinical Presentation and Treatment

March 15, 2009 By 2 Comments

A fracture of the head of radius presents with pain and swelling in the elbow region. There may be associated injuries to the structures in the neighborhood. These include distal humeral region, upper end of ulna. Radial head fractures are seen in quite a number of elbow dislocations.

The diagnosis may be difficult to make on clinical examination. Radiograms are required to confirm the diagnosis.X-rays in the anteroposterior, lateral, and oblique planes of the elbow are usually sufficient to diagnose the fracture. [Read more...]

Popularity: 3% [?]

Filed Under: Elbow Injuries, Fractures-Dislocations Tagged With: , , , , ,

Xray of Fracture of Lateral Malleolus

March 14, 2009 By 16 Comments
Fracture of Lateral Malleolus. Anteroposterior and lateral views. Click To Enlarge

Fracture of Lateral Malleolus. Anteroposterior and lateral views. Click To Enlarge

Lateral malleolus is extension of fibula beyond the ankle joint.

It can be fractured in direct trauma or twisting injuries of ankle.

It is usuallly accompanied by ligamentous injuries on the medial side or fracture of medial malleolus.

The xray shows an undisplaced fracture of lateral malleolus in 34 year old man which resulted following a twisting injury to the ankle.

One of the concerns in malleolar fractures is subluxation of the ankle joint which may result if the fracture is displaced.

An undisplaced fracture of lateral malleolus is very well treated by non operative methods.

Popularity: 6% [?]

Filed Under: Musculoskeletal Radiology, Orthopaedic Images Tagged With: , ,

Xray of Supracondylar Fracture of Humerus In A Child

March 6, 2009 By Leave a Comment
Suprcondylar fracture of humerus AP & lateral views. Click the image to enlarge.

Suprcondylar fracture of humerus AP & lateral views. Click the image to enlarge.

Supracondylar fractures of humerus are very common injuries in children. These injuries frequently result when the child falls on outstretched hand.

Supracondylar region in children is weaker in children as the part is growing.

The xrays  in the picture are anteroposterior and lateral views of elbow of seven year old child who sustained injury after he fell from a tree.

Fracture humerus can be divided in to three grades as suggested by Gartland.

This is type I Gartland fracture of supracondylar region of humerus.

Grade 2 and grade 3 fractures are more severe. [Read more...]

Popularity: 10% [?]

Filed Under: Elbow Injuries, Musculoskeletal Radiology, Orthopaedic Images Tagged With: , ,

What Is Essex Lopresti Fracture?

March 4, 2009 By 3 Comments

Essex Lopresti Fracture consists of injury to radial head, interosseous ligament or membrane of the forearm and distal radio ulnar joint.

The injury has following elements

  • Comminuted displacedlaced fracture of the radial head
  • Subluxation or dislocation of the distal radioulnar joint.
  • Disruption of the interosseous membrane occurs.

In addition, there could be proximal migration of the radial shaft. The extent of migration depends on the severity of the injury and amount of disruption of interossous membrane.

This injury can result from a fracture-dislocation of the elbow or from application of a longitudinal force to the outstretched hand that causes impaction of the capitulum and radial head.

Patient would present with severe injury and pain in elbow and wrist.

Radiographs of both the elbow and wrist are required for diagnosis.

The treatment consists of  management of both the fractures.

Popularity: 3% [?]

Filed Under: Elbow Injuries Tagged With: , ,

Postoperative Xray of Oblique Subtrochanteric Fracture of Femur With Dynamic Hip Screw and Interfragmentary Screw

March 2, 2009 By Leave a Comment
DHS and Interfragmentary screw in subtrochanteric fracture

DHS and Interfragmentary screw in subtrochanteric fracture

Subtrochanteric factures are fractures below the intertrochanteric line of femur. These are high velocity fractures and quite common in young active adults.

The xray in the picture is of a 43 years old man who sustained this fracture after fall from height.

The xray is one month following the surgery and fracture is showing union in most of its surface.

Fractures of subtrochanteric region are not amenable to surgical treatment and are treated by operative methods.

Popularity: 4% [?]

Filed Under: Femoral Fractures, Musculoskeletal Radiology, Orthopaedic Images Tagged With: , , ,

Fractures of Radial Head or Head of Radius – The Biomechanics

March 1, 2009 By 4 Comments

The radial head  articulates with ulna at its proximal end through  the lesser sigmoid notch. It maintains contact with the ulna throughout forearm pronation and supination.

Radial head fracture is very common in adults. Radial head had been previously excised for fractures of head of radius and fractures of neck of radius.  However a very common complication that occurs with excision of radial head is proximal migration of  the radius bone . It results from loss of strut that used to support and block this when radial head was intact. [Read more...]

Popularity: 3% [?]

Filed Under: Elbow Injuries Tagged With: , , , ,