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عرض

General Surgery

Mosul university- College of dentistry-oral & maxillofacial surgery department
Orthopedics and bone infections

Fracture is a structural break in normal continuity of bone (bone wound)

Fracture
Mosul university- College of dentistry-oral & maxillofacial surgery department


Bones are very active tissues. Each bone is made up of several types of tissues and so is an organ. Bone functions include: muscle attachment, protection and support, blood cell production, and storage of minerals.
Bone tissue
Mosul university- College of dentistry-oral & maxillofacial surgery department


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A. Support and Protection B. Body Movement - Levers C. Hematopoiesis D. Storage of Inorganic Salts - Calcium phosphate
Bone Functions
Mosul university- College of dentistry-oral & maxillofacial surgery department



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CopyrightThe McGraw-Hill Companies, Inc. Permission required for reproduction or display.

* Right Humerus

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* CopyrightThe McGraw-Hill Companies, Inc. Permission required for reproduction or display.

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Direct Indirect Types of fracture Simple , compound , comminuted , complicated , pathologic, green stick.
Mechanism of bone fracture
Mosul university- College of dentistry-oral & maxillofacial surgery department

look feel move X-ray Clinical presentation

General principles of examination
Mosul university- College of dentistry-oral & maxillofacial surgery department

Haemorrhage Inflammation Hematoma Provisional callus Definitive callus Remodeling

Healing of bone fracture
Mosul university- College of dentistry-oral & maxillofacial surgery department


1- general factors increasing age Disease : eg DM Drugs : eg steroids Deficiency : malnutrition 2- local factors Infection Foreign body Mobility Poor vascularity irradiation
Factors affecting fracture healing
Mosul university- College of dentistry-oral & maxillofacial surgery department



1- emergency treatment ABC 2- definitive Debridment Reduction Closed Traction Open Fixation External (External pin) Internal non rigid( transosseous, intramedulary pin), rigid (screw) Immobilisation Functional rehabilitation

Management

Mosul university- College of dentistry-oral & maxillofacial surgery department


Infection hematoma ( 5p: pain ,pallor, pulseless, paresthesia, paralysis) Shock Crush syndrome Compartment syndrome Non union Delayed union Malunion Disuse osteoporosis Myositis ossificans

Complication of bony fractures

Mosul university- College of dentistry-oral & maxillofacial surgery department


Osteomyelitis: Inflammation of bone and marrow Types 1-Pyogenic osteomyelitis: Always caused by bacteria Routes of infection Hematogenous spread Extension from a contiguous site Direct implantation 2- Tuberculous osteomyelitis

Osteomyelitis

Mosul university- College of dentistry-oral & maxillofacial surgery department

Mosul university- College of dentistry-oral & maxillofacial surgery department

Osteomyelitis



Sequestrum (necrotic bone) Involucrum (new bone) Signs and Symptoms Constant bone pain Swelling Tenderness Warmth at site Continuous Drainage
Mosul university- College of dentistry-oral & maxillofacial surgery department
Osteomyelitis


Lab study:WBC  May be elevated, Usually normal C-Reactive Protein (CRP) Erythrocyte Sedimentation Rate (Usually is elevated at presentation Falls with successful therapy)Blood cultureImagingRadiology:NormalSoft tissue swellingPeriosteal elevationLytic changeSclerotic change Mosul university- College of dentistry-oral & maxillofacial surgery department
Diagnosis:


Vigorous and prolonged intravenous (IV) antibiotic therapy Treatment of choice for acute osteomyelitis As long bone ischemia has not occurred Cultures or bone biopsy should be done if possible Delaying antibiotic treatment may require surgical debridement and decompression Hyperbaric oxygen therapy with 100% oxygen as adjunct therapy Stimulate circulation and healing Orthopedic prosthetic devices, if source of infection must be removed Muscle flaps, skin grafting provide wound coverage over dead space (cavity) in bone
Mosul university- College of dentistry-oral & maxillofacial surgery department
Treatment :





رفعت المحاضرة من قبل: Ayado Al-Qaissy
المشاهدات: لقد قام 9 أعضاء و 165 زائراً بقراءة هذه المحاضرة








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