Presentation on theme: "Stephen P. England, MD MPD Department of Orthopaedic Surgery Park Nicollett Clinic."— Presentation transcript:
Stephen P. England, MD MPD Department of Orthopaedic Surgery Park Nicollett Clinic
Introduction to Orthopaedics
Test Yourself List the bones of the body. (More pts more bones!) Bone forming cells are called ______. Local stress stimulates bone formation. T or F? The knee is a/an _______joint.
What do you know from the slides? Which is the hand of the elderly adult? How old do you think the individual is on slide A? A B
Bone Structure: Orthopaedic Implications Periosteum Diaphysis Epiphysis Periosteum Endosteum Epiphyseal plates; bone growth, injury
What is the significance of the epiphyseal plate?
Bone Formation and Maintenance Types Bone = cells, protein matrix, mineral deposits Types of bone cells Function of each type bone cell Protein matrix: 98% collagen, 2% other Mineral salts: insoluble Ca/Phos = hydroxyapitite + Process of ossification
Factors Influencing Bone Growth and Formation Parathyroid What effect of low Ca? Calcitonin Effect on Ca? Source? Thyroxin Estrogen Glucocorticoids –What effect on bones with long term use of glucocorticoids? Vit C & D
Types of Joints: Identification Amphiarthrosis Synarthrosis Diarthrosis
Significance of Diarthrotic Joint Joint Capsule surrounded by ligaments Synovial Membrane: secretes synovial fluid; lines tendon and muscle sheaths Bursea: painful, but protective!
Descriptive Orthopaedic Terms Valgus: part of body distal to joint directed away from midline Varus: Part of body distal to joint directed toward midline Hallus Genu varus Genu valgus pes varus metatarus valgus metatarus varus
Hallus valgus Which foot has a valgus deformity? How do you describe this foot deformity?
Stressors of the Musculoskeletal System Trauma Infection Altered Metabolism
For the person with a musculoskeletal condition: List effects on person List “most “ frequent orthopaedic diagnosis Peripheral neurovascular dysfunction Pain (acute, chronic) Impaired skin integrity Infection, high risk for Disuse syndrome Activity intolerance Trauma. high risk for Knowledge deficit Impaired adjustment Fear, anxiety
How has orthopedic injury affected this PERSON?
Components of Assessment Chief Complaint Why seeking care Acute and chronic problem History taking; its significance Pain characteristics location character what effects Associated conditions Complications! Pain
Principles of Assessment Normal first Bilateral comparision Inspect then gentle palpation shape, size, contour signs inflammation, ecchymosis muscle condition deformity Test your skills –Changes with age –Nurtitional status –Skin integrity –Rashes –Color changes, esp with cold; arterial vs. venous –Character of joints –Bruises, swelling
Assessment of the Knee Fluid in the Knee Bulge sign: medial aspect knee, displace fluid upward, tap lateral patellar margin and note fluid return Ballottment: force fluid into joint space; displace patella
Knee Support and Stability Anterior and posterior cruciate ligaments connect the inner surfaces of the head of the femur with the head of the tibia. They cross each other, anterior ligament extend from the inside of the lateral condyle of the femur to the medial side of the tibial head, and posterior ligament extend from the inside of the medial condyle of the femur to the lateral side of the tibial head.
Assistive Devices Traction Definition Uses Types Counter traction is provided by: a. body weight b. pulleys c. traction weight d. splints Crutch-walking –Two-point –Three-point –Four-point –Swing-through –swing-to Safety in crutch- walking Cane
CPM Purpose Guidelines for Use Teaching
Bone Stimulators Indications Electronegativity Bone Remodeling Internal Percutaneous External
External Bone Stimulator
Autologous Blood Transfusions Indications for Ortho Cell Savers Criteria for Use
Cell Savers Autologous Blood
Surgical /Medical Interventions Tissue Allografts Abductor Pillow, Carter Pillow Hot Ice Machines that Aren’t! Bone Paste!