Orthopedics is a branch of medicine that deals with the prevention and correction of injuries or disorders of the skeletal system and associated muscles, joints, and ligaments. It’s quite obvious to clear the basics before entering into the main stream. Many medicos skip them and switch to the juicy content. But wait, what’s the use when you don’t even know what’s the difference between sprain and strain?
In this article, we will quickly review basics of orthopedics. Remember, this is part 1, upcoming articles will clear the concept further more. As we strengthen our basics, we will move to the juicy content. Following are the key points to remember in orthopedics in Fourth Year of MBBS:
Basics of Orthopedics
What is a Fracture (#)?
Break in continuity of bone.
What are types of Fracture?
- On basis of Etiology: Traumatic and Pathological
- On basis of Displacement: Undisplaced and Displaced
- On basis of External environmental: Open and Closed
- On basis of complexity: Simple and Complex
What are common causes of Pathological Fracture?
- At birth- Osteogenesis imperfecta (OI)
- 0-5 yrs- OI, Osteomyelitis (OM)
- 5-20 yrs- OM, Simple Bone Cyst, Primary bone malignancy
- 20-50yrs- Cystic lesion of bone, Malignancy, Osteomalacia, Giant cell tumor
- After 50 years- Osteoporosis, Multiple myeloma, Secondaries in bone
How are Pathological Fracture diagnosed?
- Suspicion- # without trauma
- Additional tests done
What is treatment of Pathological Fracture?
- OI/Osteoporosis- General methods
- Cyst/Tumor- unite late
- Osteomyelitis- Late unite/ non-union
- Malignancy- Non-union
Injuries to Joints
- Subluxation- partial displacement with some contact retained
- Displacement- complete displacement
Sprain- Injury to ligament
- 1st degree- pain +, swelling +
- 2nd degree- pain ++, swelling ++, functional inability to move joints
- 3rd degree- pain +, swelling ++, joint open up as well (extra movement at joints)
Xray– Normal, chip of bone in 3rd degree (Stress xray)
Treatment of Sprain?
Ice, rest, compression bandages, elevation (RICE)
Injuries to muscle- Strain
Injuries to Tendon
Rupture- either due to abnormality or weak tendons (wear and tear)
Due to degeneration
Rheumatoid arthritis, SLE, Senile degeneration
Wear and tear
Most common- biceps (long head) and Extensor pollicis longus tendon
Treatment of Tendon Rupture?
In sequence of line of management:
- End to end repair
- Tendon graft
- Tendon transfer
Rx in old people- if minimal functional disability, no treatment required
Stay tuned for more upcoming basics. We will be proceeding with details of Bone anatomy and Fracture in the next section.