LOWER LIMB FRACTURES NAME OF THE FRACTURE DISLOCATION OF HIP JOINT TYPES a) Posterior b) Anterior c) Central fracture dislocation.

CAUSES/MECHANISM OF INJURY POSTERIOR DISLOCATION IS COMMENET TYPE RTA-HIP IN FLEXED AND ADDUCTED POSITION ANTERIOR DISLOCATION LESS COMMON-INJURY TO MEDIAL ASPECT OF HIP HIP FLEXION ,ABDUCTION AND EXTERNAL ROTATION CENTRAL DISLOCATION THIS IS A RARE TYPE AND IS ALWAYS A FRACTURE DISLOCATION. INJURY TO LATERAL ASPECT OF HIP CLINCIAL FEATURES PAIN SWELLING TENDERNESS RESTRICTED/ABNORMAL ROM DEFORMITY DEFORMITY/COMPLICATIONS TREATMENT Immediate: i. Associated fracture acetabular rim. ii. Sciatic nerve palsy. Late: i. Avascular necrosis of head of femur. ii. Myositis ossificans. HIP SPICA CAST FOR 12-16 WEEKS

FRACTURE NECK OF FEMUR Classification:

Two broad groups of fractures are recognized in the neck of femur (1) Intracapsular fractures (2) Extra capsular fractures. INTRACAPSULAR FRACTURE inside the joint/joint capsule fracture neck of femur EXTRACAPSULAR FRACTURE outside the joint /joint capsule Trochanteric fractures

INTRACAPSULAR FRACTURE OF NECK OF FEMUR NAME OF THE FRACTURE CAUSES/MECHANIS M OF INJURY CLINCIAL FEATURES DEFORMITY/COMPLICATIO NS TREATMENT

INTRACAPSULAR FRACTURE OF NECK OF FEMUR This is also called a high fracture neck of femur. ANATOMICAL CLASSIFICATION

THIS IS SERIOUS COMMON INJURY IN ELDERLY DUE TO A FALL OR MINOR

PAIN SWELLING TENDERNESS RESTRICTED/ABNORM AL ROM DEFORMITY DIFFICULT TO WALK HIP ROTATED

a) Non-union b) b) Avascular necrosis of head of femur

ELDERLYARTHROPLAST Y ADULT-HIP SPICA CAST SKELETAL TRACTION

1) Subcapital (Below the head) 2) Transcervical(middl e) 3) Basal (At the base)

trauma FOR EXTERNALLY ELDERLY HIGH ENERGY TRAUMA IN ADULT

ORIF

GARDENS CLASSIFICATION 1. Incomplete fracture. 2. Complete fracture without displacement. 3. Complete fracture with partial displacement. 4. Complete fracture with full displacement.

EXTRACAPSULAR FRACTURE OF NECK OF FEMUR NAME OF THE FRACTURE EXTRACAPSULAR FRACTURE OF NECK OF FEMUR These are also called low fractures classified as (i) Stable, (ii) Unstable fractures. CAUSES/MECHANISM OF INJURY HIGH ENERGY TRAUMA CLINCIAL FEATURES PAIN SWELLING TENDERNESS RESTRICTED/ABNORMAL ROM DEFORMITY The normal neck shaft angle is about 115 degrees. When the angle is reduced to nearer 90 degrees, the deformity is called CoxaVara DEFORMITY/COMPLICATIONS TREATMENT malunionwith coxavara and shortening. If the coxavara is gross, it can be corrected by osteotomy ELDERLY-ARTHROPLASTY ADULT-HIP SPICA CAST SKELETAL TRACTION ORIF

FRACTURE SHAFT OF FEMUR NAME OF THE FRACTURE FRACTURE SHAFR OF FEMUR CLASSIFICATION The fractures of the femoral shaft can be classified as: a) Subtrochanteric fracture (Proximal). b) Midshaft - Middle third. c) Distal third including CAUSES/MECHANISM OF INJURY HIGH ENERGY TRAUMA CLINCIAL FEATURES PAIN SWELLING TENDERNESS RESTRICTED/ABNORMAL ROM DEFORMITY DEFORMITY/COMPLICATIONS TREATMENT SKIN/SKELETAL TRACTION WITH THOMAS SPLINT IN HIP ABDUCTION AND FLEXION SURGICAL TREATMENT ORIF-Kuntscher intramedullary nail.

supracondylar fracture

INJURIES OF THE KNEE AND LEG 1. Fractures of the Femoral condyles. 2. Fractures of the Tibial condyles. 3. Fracture Patella. 4. Injuries to the extensor mechanism. 5. Internal Derangements of the knee (I.D.K.). 6. Dislocation of the knee. NAME OF THE FRACTURE FRACTURE OF THE FEMORAL CONDYLES CAUSES/MECHANISM OF INJURY Direct violence or by sudden valgus or varus strains on the knee joint. CLINCIAL FEATURES It can be bicondylar extending into the articular surface in a T or Y shaped manner. PAIN SWELLING TENDERNESS RESTRICTED/ABNORMAL ROM DEFORMITY DEFORMITY/COMPLICATIONS TREATMENT haemarthrosis

NAME OF THE FRACTURE FRACTURE OF THE TIBIAL CONDYLES 1) UNICONDYLAR, 2) BICONDYLAR. THE TYPES ARE: 1) UNDISPLACED CRACK FRACTURE 2) DISPLACED OR DEPRESSED FRACTURES WITH OR WITHOUT COMMINUTION.

CAUSES/MECHANISM OF INJURY DIRECT INJURY WITH VALGUS STRESS IN LATERAL ASPECT OF KNEE-STANDING DEPENDING ON THE SEVERITY OF THE VALGUS VIOLENCE THE OTHER STRUCTURES DAMAGED ARE, THE MEDIAL COLLATERAL LIGAMENT AND ANTERIOR CRUCIATE LIGAMENT (BUMPER INJURY).

CLINCIAL FEATURES PAIN SWELLING TENDERNESS RESTRICTED/ABNORMAL ROM DEFORMITY

DEFORMITY/COMPLICATIONS TREATMENT HAEMARTHROSIS INJURY TO THE LATERAL POPLITEAL NERVE

NAME OF THE FRACTURE FRACTURE PATELLA THE PATELLA IS THE BIGGEST SESAMOID BONE IN THE BODY.

CAUSES/MECHANISM OF INJURY MUSCULAR VIOLENCE: A SUDDEN CONTRACTION OF THE MUSCLE TO PREVENT A FALL CAUSES A TRANSVERSE FRACTURE OF THE PATELLA, ALONG WITH A TEAR OF THE QUADRICEPS EXPANSION. DIRECT VIOLENCE: A DIRECT INJURY ON THE PATELLA DUE TO A FALL ON THE KNEE PRODUCES USUALLY A STELLATE FRACTURE OF THE PATELLA WITH A COMMINUTION OF THE BONE. IN THIS TYPE THE QUADRICEPS EXPANSION IS INTACT.

CLINCIAL FEATURES PAIN SWELLING TENDERNESS RESTRICTED/ABNORMAL ROM DEFORMITY

DEFORMITY/COMPLICATIONS TREATMENT