FRACTURES and of THE LOWER LIMBS.pptx

FRACTURES AND DISLOCATIONS IN THE lower LIMBS

1. Common FRACTURES AND DISLOCATIONS IN THE LOWER LIMBS Babalola o m

2. Anatomy of the lower limbs

3. highlights Hip dislocations Fracture femur – proximal, shaft, distal Knee patella dislocations Fracture – proximal, shaft, distal Ankle fracture/dislocation Fracture foot – hind, mid, forefoot

4. Stages of wound healing Inflammation Destruction Healing Consolidation Pediatric and adult Factors affecting wound healing – local & systemic

5. Principles of fracture management Close fracture Open fractures – when fracture hematoma communicate with the exterior Non-operative – cast immobilization, traction – skin traction, skeletal traction, gravity Cast immobilization – immobilize joint above and below the fracture at the position of function Operative – orif open reduction and internal fixation/ closed reduction and internal fixation; screws, plate & screws, intramedullary nailing – locked/unlocked External fixation

6. complications Compartment syndrome – emergency – prox tibia, foot, hand, forearm Nerve compression Vascular injury Delayed union/non-union Malunion Pressures sores Volkmann ischemic contracture

7. Hip dislocation

8. Posterior hip dislocation Traumatic – dashboard injury 3 rd most common dislocation 90% posterior dislocation Inability to bear weight in acute situation Limb is shortened, internally rotated, adducted Swelling in the gluteus Associated knee injury

9. Posterior hip dislocation Emergency that needs acute reduction within 12hrs X-ray for confirmation Ct scan for fracture dislocation and other injuries Emergency reduction Confirm stability after reduction with protected weight bearing 4-6wks Complications – avn , irreducible dislocation, sciatic nerve palsy Open reduction for fracture dislocation due to instability of the hip joint, failed reduction and delayed presentation

10. Classification for hip dislocation

11. Fracture neck of femur classification

12. Intertrochanteric femur fracture

13. INTERTROCHANTERIC FRACTURE

14. arthroplasty

15. Dynamic hip screw

16. Avascular necrosis

17. Skeletal traction

18. Im nailing and p/s

19. Supracondylar femur fracture

20. Knee dislocation

21. Fracture patella

22. Patella dislocation

23. Tibia plateau fracture

24. Compartment syndrome and fasciotomy

25. Ankle fractures

26. Lisfranc fracture

27. Jones fracture

28. Thank you end