Short Notes in Orthopaedics

 Viva 1 A child has hx of fever, malaise & painful walking on his right side.  How to approach patient ?  Assess in line of Septic Arthritis and Acute Osteomyelitis  How do you manage ?  Detailed Hx. -  Treatment Hx. -  Past Hx. -allergy to Amy medications if any  Examination- BP , pulse , Temperature  Local examination  Gait  Inspection  Resting Posture of Hip (FABER )  ROM  local tenderness  USG - hip effusion 7 mm  Inv.  AP / Lateral radiographs of hip - to r/o fractures , any structural abnormality Predictive markers of hip sepsis  Temperature> 38 .5 deg. Celcius  WBC > 12,000 cells /mm3  ESR > 40  NWB  X 1 = 3 % , x 2= 40 % ,x 3 = 93 % ,x 4= 96.6 %  Sx .  Anterolateral Approach to hip  Remove ellipse of capsule , allow free drainage  Samples for c/s  Irrigation  Hip Spicas - post operative -to prevent subluxation and dysplasia...

 Viva 1  Mx of Crush Injury  Relevant History  Handedness , Occupation , MOI, Comorbidities  - Tetanus prophylaxisis- if indicated Antiseptic (Betadine ) dressing   Radiographs to exclude #s Wound Exploration  Repair nail under LA ( digital block and digital tourniquet)  Steps of procedure  Remove nail plate Inspect nail bed, wash thoroughly Copious lavage lavage Reduce fracture , stabilize using k- wire Removal- at 4 weeks fapairs mail bud i a Gutare (VICRYL fapide) 60 abebable Repair nail bed with a absorbable suture 6-0 ( vicryl rapide )  Wash and replace nail plate  Use Figure of Eight suture to hold nail plate in place  what to explain to patient ?  - Nat Plate falls off & new one comes which will be disfigured . -Risk of long term nail defirmity  -Discomfort in region of nail deformity  -DIP jt stiffness. Viva 2  →Describe radiographic findings, AP pelvic radiograph showing a dislocated ...