Orthopedic Care and Consultation
Injury is a global public health problem and the dominant cause of death and disability of the young and active people, particularly in industrialized countries.
Injury is the seventh cause of death worldwide , and the number one cause of death in the young.
Injury is an unwanted side effect of industrialization. Automobiles form an integral part of our surrounding. It is projected that road traffic fatalities will rise to the third leading global cause of death by the year 2020.
Injury Severity Score is based on Abbreviated Injury Scale and is used in assessment of injury in adults an children both. It along with pediatric trauma score are quite reliable in predicting injury measure in children.
Abbreviated Injury Scale is an anatomical scoring system where injuries are ranked on a scale of 1 to 6, with 1 being minor, 5 severe, and 6 a nonsurvivable injury.
The objective of Abbreviated Injury Scale is to gauge threat to life associated with an injury and is not meant to represent a comprehensive measure of severity. [Read more...]
One of the most frightening situation for a person is inability to reach anyone for help. while it may be frightening, it is not uncommon.
Patients of trauma falls into minor injuries or major injuries. A person with major injuries can be conscious or unconscious. Minor injuries can be managed or help for them can be sought at later time.
If one id alone and unconscious, he/she would be helped only when someone discovers him [If he is fortunate enough to be discovered within time where help can be offered].
Our main focus of article is the third group. If you are injured and you are conscious, finding yourself alone with injury is a kind of nightmare. [Read more...]
Recurrent dislocation of the patella is not a common entity. When it does occur, displacement is almost always lateral.
It may be congenital, developmental, or post-traumatic.
In contrast, recurrent subluxation of the patella is quite common. It is more common in females.
A familial tendency has been noted in recurrent subluxation of the patella.
Following causes have been thought of contributing to recurrent dislocation of patella
Ligaments Laxity
Laxity of the medial capsule of the knee is a definite factor. In children with diseases that cause ligamentous laxity (e.g. osteogenesis imperfecta, arachnodactyly, or the “Ehlers-Danlos syndrome), lateral dislocation is more common.
Lateral Patellar Soft Tissue Contracture
The lateral patellar retinaculum and patellofemoral ligament are taut. The vastus lateralis may be contracted, hypertrophied, and inserted low.
The iliotibial tract, a thickened strip of fascia lata may abnormally insert on lateral border of the patella. When the knee is flexed, it axis of iloitibial tract passes behind knee and contributes to subluxation of patella.
Muscular Imbalance
Atrophy, weakness, or a high oblique insertion of the vastus medialis is a factor in most patients. The vastus medialis is a dynamic medial stabilizer of the patella.
Malalignment of the Lower Limb
Lateral tibiofibular torsion, and genu valgum will displace the insertion of the patellar ligament laterally and cause valgus position of the quadriceps mechanism.
Q angle is the angle formed between the patellar tendon with a vertical line extended distally from the center of the inferior pole of the patella. Its value can provide guide to the rotatory-angular forces.
Patella Alta
This is a high riding patella. In this the normal buttressing effect of the lateral femoral condyle, which serves to check the tendency to lateral patellar displacement, will be lost.
Injury
A traumatic lateral dislocation inadequately treated will result in stretching and weakening of the medial capsule of the knee and insufficiency of the vastus medialis, predisposing to recurrent lateral subluxation.
Normal meniscus of the knee is semilunar in shape. In discoid meniscus the meniscus of the knee is discoid rater than semilunar in shape. This is a common cause of popping or snapping knee.
The lateral meniscus is most frequently affected, though on occasion, the condition may occur in the medial meniscus.
Involvement is often bilateral.
There is no difference in occurence in either sex.
The condition is diagnosed comparatively rarely, and it may often go unrecognized. Familial incidence of discoid lateral meniscus is known. [Read more...]
Visceral injuries are a potential source of life-threatening complications in a pelvic fracture. Injury to the lower urinary tract is a common consequence of a disruption of the anterior pelvic ring, and it can involve the ureter or, more commonly, the bladder and urethra.
Urogenital system injury (injury to urethra, bladder, kidney) occurs in as many as 25% of all cases involving disruption of the pelvic ring.
It is more common with bilateral pubic arch injury. Potential sites of visceral injury with a pelvic fracture. other potential sites of injury are
Pain in the heel occurs frequently in people who stand or walk a great deal. This pain may be entirely absent during rest and aggravated by use. The painful area is usually found by manual pressure.
Among the various causes of heel pain injury is the foremost.
Heel pain can manifest in various ways.
There are two bursas between the heel bone and tendoachilles.They are at risk of inflammation from friction produced by ill fitting footwear. [Read more...]
Pregnant women should wear seat belts, not only to save themselves in the event of a car accident but also to save their fetus.
According to a new study published in the April issue of the American Journal of Obstetrics & Gynecology, almost 200 fetuses each year or half of all fetal losses in motor-vehicle crashes could be saved if pregnant women buckled up properly.
Dr. Richard Jones, assistant professor of obstetrics/gynecology at Texas A&M Health Science Center College of Medicine, said, “Pregnant women need to be properly wearing seat belts,” with the best type of seat belt the three-point restraint. [Read more...]
Skiers and snowboarders should always wear helmets to protect themselves from head injuries on the slopes, researchers say.
Findings from studies conducted in Canada and Norway, as well as the most recently conducted study in the U.S have all found evidence that ski helmets reduce the risk of head injury. [Read more...]
The xray in image shows a comminuted fracture of upper end of tibia. The xray in present picture is anteroposterior view.
Author’s Note:
These fractures are high velocity injuries and an extension to knee joint is very common.
Because of their configuration these kinds of fractures often require surgical treatment.
A cause for concern in these patients is compartment syndrome that might develop due to continued bleed in fracture.
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