VSAQS IN ORTHOPEDICS

1.SLUMP TEST:-
The Slump test is used to evaluate for lumbar nerve root
impingement or irritation. It begins with the patient seated
on the table with both hips and knees positioned at 90°.
The examiner stands to the side of the patient. The patient
is instructed to slump forward while maintaining the head
and neck in neutral position. The physician extends one
leg with one hand while using the other hand to apply
overpressure to the patient’s thoracic spine; thus
exacerbating the curvature of the spine. Once in this
position, the patient is instructed to lower the chin to the
chest, producing cervical flexion.
2.COMPLICATIONS FOLLOWING SUPRACONDYLAR
#OF HUMERUS
Complications
malunion: resulting in cubitus varus (varus deformity of the
elbow, also known as gunstock deformity)
ischemic contracture (Volkmann contracture) due to
damage/occlusion to the brachial artery and resulting in
volar compartment syndrome.
damage to the ulnar nerve , median nerve, or radial nerve.
3.CLINICAL SIGNIFICANCE OF FROMENTS SIGN
Froment's sign is a physical examination of the hand to
test for palsy of the ulnar nerve which results in reduced
functionality and muscle weakness of the pinch grip. It
tests the strength of the adductor pollicus of the thumb,
which is innervated by the ulnar nerve and is weakened in
ulnar nerve palsy.
Froment's sign presents after damage to the ulnar nerve,
which innervates the adductor pollicis and interossei
muscles, which provide adduction of the thumb and
extension of the interphalangeal joint. The flexor pollicis
longus (innervated by the median nerve), will substitute for
the adductor pollicis (innervated by the ulnar nerve) and
cause the thumb to go into hyperflexion. Ulnar nerve palsy
can be as a result of dysfunction at the cervical spine,
elbow (cubital tunnel syndrome) or at the wrist (Guyons
canal syndrome).
4.SPURLINGS TEST /CERVICALQUADRANT TEST
The patient is seated and asked to sidebend and slightly
rotate head to the painful side.
The clinician places a compressive force of approximately
7 kg through the top of the head in an effort to further
narrow the intervertebral foramen.
The test is considered positive when it reproduces the
patient’s symptoms. The test is not indicated if the patient
does not have upper extremity or scapular region
symptoms.
5.WIND SWEPT DEFORMITY:
The term “windswept deformity” describes the appearance
of abnormal valgus deformity of one knee in association
with varus deformity of the other. It is commonly seen in
young children in certain part of Africa. But the deformity
occurred in adult is rare.
6.SWAN NECK DEFORMITY:-
Swan neck deformity is a deformed position of the finger,
in which the joint closest to the fingertip is permanently
bent toward the palm while the nearest joint to the palm is
bent away from it (DIP flexion with PIP hyperextension). It
is commonly caused by injury or inflammatory conditions
like rheumatoid arthritis or sometimes familial.
7.BOUTANNIRE NECK DEFORMITY :-
Boutonniere deformity is a deformed position of the fingers
or toes, in which the joint nearest the knuckle (the proximal
interphalangeal joint, or PIP) is permanently bent toward
the palm while the farthest joint (the distal interphalangeal
joint, or DIP) is bent back away (PIP flexion with DIP
hyperextension). Causes include injury, inflammatory
conditions like rheumatoid arthritis, and genetic conditions.

8.TWO SPECIAL TESTS FOR CARPAL TUNNEL

SYNDROME
Tinel’s sign: In this test, the physician taps over the median
nerwve at the wrist to see if it produces a tingling sensation
in the fingers.
Wrist flexion test (or Phalen test): In this test, the patient
rests his or her elbows on a table and allows the wrist to
fall forward freely. Individuals with carpal tunnel syndrome
will experience numbness and tingling in the fingers within
60 seconds. The more quickly symptoms appear, the more
severe the carpal tunnel syndrome.
9.GRADES IN SPONDYLOLISTHESIS
Spondylolisthesis is defined as anterior displacement of
vertebrae at lower lumbar region&it occurs in different
degrees based on the amount of slippage of one vertebra
on another. These degrees of slippage are medically
termed grades. Accordingly, grade I is 0%-25%, grade II is
25%-50%, grade III is 50%-75%, grade IV is 75%-100%,
and grade V is >100%.
10.FOOT DROP
Foot drop is a gait abnormality in which the dropping of the
forefoot happens due to weakness, irritation or damage to
the common fibular nerve including the sciatic nerve, or
paralysis of the muscles in the anterior portion of the lower
leg. It is usually a symptom of a greater problem, not a
disease in itself. Foot drop is characterized by inability or
impaired ability to raise the toes or raise the foot from the
ankle (dorsiflexion). Foot drop may be temporary or
permanent, depending on the extent of muscle weakness
or paralysis and it can occur in one or both feet. In walking,
the raised leg is slightly bent at the knee to prevent the foot
from dragging along the ground.
11.TORTICOLLIS( WRY NECK)
Congenital muscular torticollis (CMT) or wry neck is a
condition in infants detected at birth or shortly after. It is
characterized by rotational deformity of the cervical spine
with secondary tilting of the head . There is a lateral head
tilt to one side and contralateral rotation.It is most
commonly the result of unilateral shortening and thickening
or excessive contraction of the sternocleido mastoid
muscle. It leads to a limitation of the head mobility in both
rotation and lateral flexion and progressive degrees of
neck contracture.
12.SPINA BIFIDA
Spina Bifida, in general, is defined as "a neural tube defect
(NTD) that results when the inferior neuropore does not
close. Developing vertebrae do not close around an
incomplete neural tube, resulting in a bony defect at the
distal end of the tube.
Types of spinal bifida
Spina Bifida Occulta is described as a "benign closed NTD
posterior vertebral defect only without a meningeal sac;
location: lumbar-sacral spine; usually asymptomatic but
can be associated with occult spinal dysraphism; usually
no associated defects."
Meningocele is described as a "closed NTD without
extrusion of spinal cord elements into a meningeal sac;
location: cervical, thoracic, lumbar, and/or sacral spine;
motor deficits are less likely than with myelomeningocele;
structural brain anomalies and Chiari II malformation are
less likely."
Myelomeningocele is described as an "open NTD posterior
vertebral defect and extrusion of spinal cord elements into
a meningeal sac; location: cervical, thoracic, lumbar,
and/or sacral spine, leads to paraplegia and insensitivity
below the lesion and neurogenic bowel and bladder;
associated defects include structural brain anamolies.
13.PAINFUL ARC SYNDROME/IMPINGEMENT
SYNDROME
Shoulder impingement syndrome is a syndrome involving
tendonitis (inflammation of tendons) of the rotator cuff
muscles as they pass through the subacromial space, the
passage beneath the acromion. It is particularly associated
with tendonitis of the supraspinatus muscle.This can result
in pain, weakness, and loss of movement at the shoulder.
The range of motion at the shoulder may be limited by
pain. A painful arc of movement may be present during
forward elevation of the arm from 60° to 120°. Passive
movement at the shoulder will appear painful when a
downward force is applied at the acromion but the pain will
ease once the force is removed.
14.FROZEN SHOULDER
Adhesive capsulitis (AC), often referred to as frozen
shoulder is characterized by initially painful and later
progressively restricted active and passive glenohumeral
joint range of motion with spontaneous complete or near-
complete recovery over a varied period of time.
This inflammatory condition that causes fibrosis of the
glenohumeral joint capsule is accompanied by gradually
progressive stiffness and significant restriction of range of
motion (typically external rotation).
Stages of frozen shoulder:-
1.Acute/freezing/painful phase: gradual onset of shoulder
pain at rest with sharp pain at extremes of motion, and
pain at night with sleep interruption which may last
anywhere from 3-9 months.
2.Adhesive/frozen/stiffening phase: Pain starts to subside,
progressive loss of glenohumeral motion in capsular
pattern. Pain is apparent only at extremes of movement.
This phase may occur at around 4 months and last til
about 12 months.
3.Resolution/thawing phase: Spontaneous, progressive
improvement in functional range of motion which can last
anywhere from 1 to 3.5 years.
Management
Very gentle shoulder mobilisation, muscle releases,
acupuncture, dry needling and kinesiology taping for pain-
relief can assist during this painful inflammation phase.
The application of a TENS machine was shown reduce
pain and increase range of motion.
Modalities, such as hot packs, can be applied before or
during treatment. Moist heat used in conjunction with
stretching can help to improve muscle extensibility and
range of motion by reducing muscle viscosity and
neuromuscular mediated relaxation
15.DE QUERVAINS TENOSYNOVITIS & SPECIAL TEST
FOR IT
De Quervain's Tenosynovitis is a painful inflammation of
tendons on the side of the wrist at the base of the thumb.
These tendons include the extensor pollicis brevis (EPB)
and the abductor pollicis longus (APL). These muscles are
located on the dorsal side of the forearm and go to the
lateral side of the thumb through a fibrous-osseous tunnel
made of the processus styloideus radii and the extensor
retinaculum. The pain, which is the main complaint, gets
worse with abduction of the thumb, grasping action of the
hand and an ulnar deviation of the wrist. Thickening and
swelling can also be present.
Finkelstein's test is a test used to diagnose de Quervain's
tenosynovitis in people who have wrist pain. Classical
descriptions of the Finkelstein's test are when the
examiner grasps the thumb and ulnar deviates the hand
sharply. If sharp pain occurs along the distal radius, de
Quervain's tenosynovitis is likely to be there.
16.VOLKMANNS ISCHEMIC CONTRACTURE (V. I. C.)
.DEFINITION
This is an ischaemic injury to the muscles and nerves of
the flexor Compartment of the forearm.
ETIOLOGY
It is caused by the occlusion of the brachial artery by a
supracondylar fracture.
Deficit in arteriovenous circulation
Crush injuries
Burns
Animal bites
Excessive exercise
PATHOPHYSIOLOGY :-
Volkmann's ischaemia is the result of diminished blood
supply to the flexor muscles of the forearm. The muscles
supplied by the anterior interosseous artery are most
susceptible to ischaemic damage because this artery is an
end-artery*. Most commonly affected muscles are theflexor
pollicis longus and flexor digitorum profundus
(medial-half). The muscle ischaemia leads to compartment
syndrome.
In severe cases it may eventually lead a contracture due to
gradual replacement of ischaemic muscles by fibrous
tissue which contracts in a rigid way & draws the fingers &
wrist into Flexion known as Volkmanns ischaemic
contrcture (V.I.C.)
CLINICAL FEATURES
PAIN -persistent pain on palpation (Tenderness)
PARAESTHESIA-altered /abnormal sensations due to
peripheral nerve (sensory)involvement.
PALLOR- paleness due to lack of sufficient blood flow.
PULSELESSNESS-No pulsations are felt on forearm
PARALYSIS -in extreme cases when the motor nerves are
involved.
INVESTIGATIONS :-
Diagnosis: Early diagnosis of Volkmann's ischaemia
is of extreme importance. The following are some of
the early signs:
.The patient complains of severe pain in the forearm.
He is unable to move the fingers fully.
Ischaemic pain is much severe than the pain
due to the fracture.
VOLKMANNS SIGN :In this sign, it is possible to extendthe
fingers fully at Interphalangeal joints only when the
wrist is flexed. On Extending the Wrist the fingers get
flexed at Interphalangeal joints.
MANAGEMENT:-
Mild deformities can be corrected by passive stretching
using a Volkmanns splint/Turnbuckle splint.
Moderate deformities Soft tissue/ Muscle Release
Techniques are adopted.
For Severe cases, Surgical Excision of forearm/carpal
bones may be required.
A patient needing more than usual doses of analgesics
may be developing a Compartment syndrome.
17.CUBITUS VALGUS
Cubitus valgus is a medical deformity in which the forearm
is angled away from the body to a greater degree than
normal when fully extended. A small degree of cubitus
valgus (known as the carrying angle) is acceptable and
occurs in the general population.The physiological cubitus
valgus varies from 3° to 29°. Women usually have a more
pronounced Cubitus valgus than men. The deformity can
also occur as a complication of fracture of the lateral
condyle of the humerus, which may lead to tardy/delayed
ulnar nerve palsy.
18.AMPUTATIONS TYPES IN UPPER LIMB
Fingers or partial hand (transphalangeal or transcarpal)
Wrist disarticulation (through the wrist joint)
Below-elbow (transradial)
Elbow disarticulation (through the elbow joint)
Above-elbow (transhumeral)
Bilateral (both sides of the body are affected)
Shoulder disarticulation (through the shoulder joint)
Interscapular Thoracic (removal of entire shoulder girdle
AMPUTATIONS TYPES IN LOWER LIMB
Levels of Lower Extremity Amputations include:
Foot, including toes or partial foot
At the ankle (ankle disarticulation)
Below the knee (transtibial)
At the knee (knee disarticulation)
Above the knee (transfemoral)
At the hip (hip disarticulation).
19.ADVANTAGES OF ORTHOTICS
1.Custom orthotics can help provide superior comfort
allowing you to stand, walk, and run comfortably.
2.Assist in fighting off pain in the foot, ankle and leg.
3.Improve balance by allowing your feet the necessary
support to maintain a functionally correct position.
4. Help absorb shock and redirect pressure away from
painful areas in the foot and ankle.
5. Enhances athletic performance. Lowers the risk of
injury.
20.ARTHROSCOPY -IT'S INDICATIONS
Arthroscopy (also called arthroscopic or keyhole surgery)
is a minimally invasive surgical procedure on a joint in
which an examination and sometimes treatment of
damage is performed using an arthroscope, an endoscope
that is inserted into the joint through a small incision.
Arthroscopic procedures can be performed during ACL
reconstruction.
Arthroscopy is commonly used for treatment of diseases of
the shoulder including subacromial impingement,
acromioclavicular osteoarthritis, rotator cuff tears, frozen
shoulder (adhesive capsulitis), chronic tendonitis, removal
of loose bodies and partial tears of the long biceps tendon,
SLAP lesions and shoulder.
21.TRIGGER FINGER
Trigger finger is a common finger aliment, thought to be
caused by inflammation and subsequent narrowing of the
retinacular sheath, which causes pain, clicking, catching,
and loss of motion of the affected finger. Although it can
occur in anyone, it is seen more frequently in the diabetic
population and in women, typically in the fifth to the sixth
decade of life. Several causes of trigger finger such as
repetitive finger movements and local trauma are
possibilities. Stress and degenerative force also account
for an increased incidence of trigger finger in the dominant
hand.
22.COMPLICATIONS OF AMPUTATIONS
Wound breakdown and skin problems
Swelling
Edema
Joint contractures
Pain
Phantom limb sensation
23.AVASCULAR NECROSIS
Avascular necrosis is the death of bone tissue due to a
lack of blood supply. Also called osteonecrosis, it can lead
to tiny breaks in the bone and the bone's eventual
collapse.
A broken bone or dislocated joint can interrupt the blood
flow to a section of bone. Avascular necrosis is also
associated with long-term use of high-dose steroid
medications and excessive alcohol intake.
24.RADIOLOGICAL FEATURES OF OSTEOPOROSIS
The main radiographic features of generalized
osteoporosis are increased radiolucency and cortical
thinning. Increased radiolucency is the result of resorption
and thinning of the trabeculae, some of which may be lost.
As a consequence, the term osteopenia (“poverty of bone”)
is used as a generic designation for radiographic signs of
decreased bone density. Trabecular bone responds to
metabolic changes faster than does cortical
bone.Trabecular bone changes are most prominent in the
axial skeleton and in the ends of the long and trabecular
bones of the appendicular skeleton (juxtaarticular) (eg,
proximal femur and distal radius), which have a relatively
large proportion of trabecular bone. Low-rate trabecular
bone loss (as in senile osteoporosis) occurs in a
predictable pattern.
25.PIRIFORMIS SYNDROME
Piriformis syndrome is a condition which is believed to
result from compression of the sciatic nerve by the
piriformis muscle.Symptoms may include pain and
numbness in the buttocks and down the leg.Often
symptoms are worsened with sitting or running.
Treatment may include avoiding activities that cause
symptoms, stretching, physiotherapy, and medication such
as NSAIDs. Steroid or botulinum toxin injections may be
used in those who do not improve. Surgery is not typically
recommended.
26.SACH FOOT
Solid Ankle, Cushioned Heel (SACH) feet are prosthetic
feet at their most basic.
SACH feet have no moving parts and an internal keel. In
passive SACH feet the keel will not flex within the foot.
To perform the necessary foot function(s), rubber regions
provide areas which will bend, flex or deform under load.
A heel wedge compresses at heel strike. This lowers the
forefoot to the ground as weight is transferred onto the
foot. As the user rolls over the toe the toe break flexes to
smooth the transition.
Advantages :-
SACH feet can be made lighter than almost any other foot
of the same size.
Reasonably waterproof.
Quite durable.
Inexpensive.
Stable.
Ideally suited to low activity and lighter weight users.
Disadvantages :-
Rigid keel cannot bend.
Heel height is fixed and cannot be readily customized.
Minimal shock absorption.
Almost no option to tune the foot to a users requirements.
Fixed with a single bolt which can fail without warning.
Active users will quickly overpower a passive SACH foot.
27.INTRINSIC PLUS DEFORMITY
It is Caused by muscles imbalance between spastic
intrinsics (interosseoi and lumbricals) weak extrinsics
(FDS, FDP, EDC)
It is Characterized by MCP flexion PIP & DIP extension
Etiology :trauma
direct trauma
indirect trauma
vascular injury&
compartment syndrome
28.BAMBOO SPINE
In ankylosing sponfylosis, Affected joints progressively
become stiff and sensitive due to a bone formation at the
level of the joint capsule and cartilage. It causes a
decreased range of motion and gives the spine an
appearance similar to bamboo, hence the alternative name
"bamboo spine".
29.FAT EMBOLISM
fat embolism is the presence of fat particles within the
microcirculation, while FES is the systemic manifestation
of fat emboli within the microcirculation. Common systemic
manifestations include respiratory distress, altered mental
status, and a rash. FES is most often associated with
orthopedic trauma.
30.BATTERED BABY SYNDROME
Battered child syndrome: A disease in which children are
physically abused. The battered child syndrome is a form
of child abuse. The abuse usually is inflicted by boyfriends,
step-parents, baby sitters, and others responsible for the
child's care. Abuse is more common among stepchildren,
handicapped, and first-born children. Most victims are
younger than 2 years of age,196 with a reported average
age of 16 months.
31.ILLIZAROV TECHNIQUE
The Ilizarov apparatus is a type of external fixation used in
orthopedic surgery to lengthen or reshape limb bones; as a
limb-sparing technique to treat complex and/or open bone
fractures; and in cases of infected nonunions of bones that
are not amenable with other techniques. The device is a
specialized form of external fixator, a circular fixator,
modular in construction. Stainless steel (or titanium) rings
are fixed to the bone via stainless heavy-gauge wire
(called "pins" or Kirschner wires). The rings are connected
to each other with threaded rods attached through
adjustable nuts. The circular construction and tensioned
wires of the Ilizarov apparatus provide far more structural
support than the traditional monolateral fixator system.
This allows early weightbearing.
32.BONE GRAFTING
Bone grafting is a surgical procedure that replaces missing
bone in order to repair bone fractures that are extremely
complex, pose a significant health risk to the patient, or fail
to heal properly. Some kind of small or acute fractures can
be cured but the risk is greater for large fractures like
compound fractures.Autologous (or autogenous) bone
grafting involves utilizing bone obtained from the same
individual receiving the graft.Allograft bone, like
autogenous bone, is derived from humans; the difference
is that allograft is harvested from an individual other than
the one receiving the graft.Alloplastic grafts may be made
from hydroxylapatite, a naturally occurring mineral that is
also the main mineral component of bone. They may be
made from bioactive glass.
33.TRENDELENBURG TEST
The Trendelenburg Test, or Trendelenburg Sign, is
commonly used in orthopedic examinations of the hip to
test for impairment of hip abduction.
A positive Trendelenburg test usually indicates weakness
in the hip abductor muscles: gluteus medius and gluteus
minimus.A positive test is one in which the pelvis drops on
the contralateral side during a single leg stand on the
affected side. This can also be identified during gait:
compensation occurs by side flexing the trunk towards the
involved side during stance phase on the affected
extremity.
34.WRIST DROP
Wrist drop, is a medical condition in which the wrist and
the fingers cannot extend at the metacarpophalangeal
joints. The wrist remains partially flexed due to an
opposing action of flexor muscles of the forearm. As a
result, the extensor muscles in the posterior compartment
remain paralyzed.
Cock up splint is given.
35.PYOGENIC /SEPTICARTHRITIS
Septic arthritis, also known as joint infection or infectious
arthritis, is the invasion of a joint by an infectious agent
resulting in joint inflammation. Symptoms typically include
redness, heat and pain in a single joint associated with a
decreased ability to move the joint.Onset is usually rapid.
Other symptoms may include fever, weakness and
headache.Occasionally, more than one joint may be
involved.
36.CODMANS EXERCISES
Codman's (pendulum) Exercises
Bend forward at the waist, (back parallel to ground is
ideal). Allow involved arm to hang down, perpendicular to
the floor. Keep arm and shoulder muscles relaxed. Move
arm slowly, increasing the arc as tolerated.
37.EXERCISES FOR PES PLANUS FLAT FOOT
.Heel stretches
Tennis/golf ball rolls
Arch lifts
Calf raises
Stair arch raises
Towel curls
Toe raises
38.PHYSIOLOGICAL CLASSIFICATION OF C. P.
There are four major types of cerebral palsy: spastic,
athetoid, ataxic and mixed type. The type of movement
issues seen in a person with CP depends on how severely
a brain injury has impacted muscle tone. Muscle tone is
defined as the strength and tension of the muscles.
39.CONTRAINDICATIONS TO MANUAL THERAPY
Included in the list of contraindications are vertebral
malignancy, cauda equina syndrome, joint instability due to
fractures and dislocations, severe degenerative joint
disease and other rheumatological processes as well as
spondyloarthropa- thies, hypermobility syndromes,
osteomalacia and osteoporosis.
40.SURGICAL PROCEDURES IN POLIO
Contracture release surgery.
Muscle transplantation.
Joint stabilization, joint fusion, and joint replacement
surgery.
Limb lengthening.
Foot correction surgery.
41.LUMBAR LORDOSIS
Lordosis is the normal inward lordotic curvature of the
lumbar and cervical regions of the human spine.
Lumbar hyperlordosis is excessive extension of the lumbar
region, and is commonly called hollow back, sway back, or
saddle back (after a similar condition that affects some
horses).
42.ERGONOMIC ADVICES FOR L. B. A.
1.etting up your screen: If your computer screen is set too
high or low, this could contribute to shoulder or neck
fatigue at the end of a long day. The top of the screen
should be set at eye level; this way you do not have to
consistently look up or down
2.Ergonomic chair : Consider using a chair with a backrest
that supports the curve of your lower (lumbar) back. Sit
back in the chair and position your thighs horizontal to your
knees at hip level. Rest your feet comfortably on the floor
or on a footrest.
3.Avoid cell phone when answering emails: If possible,
avoid cell phone or tablet use when answering emails. If
you will be spending more than a few minutes answering
an email it’s best to sit at a desk on your computer with
proper posture.
4.Posture and keyboard techniques: Adjust your keyboard
to a height where your elbows are bent approximately 90
degrees and your shoulders do not slump.
5.Computer Glasses: If you use progressive lenses in your
glasses, a slight head tilt is needed for these glasses to
function. This tilting action may be the cause of your
fatigued neck. Consider asking your eye doctor for glasses
that can be worn while at your desk.
43.COCCYDYNIA
Coccydynia is a medical term meaning pain in the coccyx
or tailbone area, often brought on by a fall onto the coccyx
or by persistent irritation usually from sitting.
Coccydynia (Tailbone Pain):
Management and Treatment
Treatment usually consists of non-steroidal anti-
inflammatory drugs (NSAIDs) -- such as ibuprofen and
naproxen -- to reduce inflammation (swelling), and the use
of a therapeutic sitting cushion to take the pressure off the
tailbone when sitting.
44.THORACIC OUTLET SYNDROME
Thoracic outlet syndrome is a group of disorders that occur
when blood vessels or nerves in the space between your
collarbone and your first rib (thoracic outlet) are
compressed. This can cause pain in your shoulders and
neck and numbness in your fingers.
Common causes of thoracic outlet syndrome include
physical trauma from a car accident, repetitive injuries from
job- or sports-related activities, certain anatomical defects
(such as having an extra rib), and pregnancy.
45.PYLON
Prosthesis. Pylon is a rigid, usually tubular structure
between the socket (or knee unit) and the foot that
provides a weight bearing shock-absorbing support shaft
for the prosthesis.
46.POTTS SPINE
pott's spine, tuberculous spondylitis, spinal tuberculosis.
Pott disease is tuberculosis of the spine, usually due to
haematogenous spread from other sites, often the lungs.
The lower thoracic and upper lumbar vertebrae are the
areas of the spine most often affected.
47.MYOSSITIS OSSIFICANS
Myositis ossificans is a condition where bone tissue forms
inside muscle or other soft tissue after an injury. It tends to
develop in young adults and athletes who are more likely
to experience traumatic injuries.Myositis ossificans
comprises two syndromes characterized by heterotopic
ossification (calcification) of muscle.
48.SYMES AMPUTATION
A Syme amputation is an amputation done through the
ankle joint. The foot is removed but the heel pad is saved
so the. This patient had a Syme amputation and was fitted
with. a prosthesis for walking. patient can put weight on the
leg without a prosthesis (artificial limb).
49.FUNCTIONAL CAST BRACING
The principle of these is that a well fitting plaster cast is
applied and the patient uses the extremity ie walks on a
the cast. Muscle action and the intermittent axial
compression stimulates bony union.
The basis of treatment : “Continuing function while a
fracture is uniting, encourages osteogenesis, promotes the
healing of tissues & prevents the development of joint
stiffness, thus accelerating rehabilitation.”
50.REFLEX SYMPATHETIC DYSTROPHY
RSD is a syndrome that is characterized by pain out of
proportion to injury, often described as burning pain,
swelling, and discoloration of the hand. Other names for
RSD include causalgia, Sudeck’s Atrophy, and shoulder-
hand syndrome.
RSD results from a disturbance in the sympathetic
(unconscious) nervous system that controls the blood flow
and sweat glands in the hand and arm. When this
sympathetic nervous symptom becomes overactive,
burning pain is felt as well as swelling and stiffness in the
affected area.
51.MC KENZIE EXERCISES
· McKenzie's exercises are designed to reposition any
displaced intervertebral discs
.Lying on stomach
Lying on pillow
Prone on elbows
Prone press-ups
Standing extension
Lying flexion
Sitting flexion
Standing flexion.
52.SPRAIN VS STRAIN
A sprain is a stretch or tear in a ligament. Ligaments are
bands of fibrous tissue that connect bones to bones at
your joints. A strain is also a stretch or tear, but it happens
in a muscle or a tendon. Tendons link muscles to bones.
53.PATELLOFEMORAL ARTHRITIS
Patellofemoral arthritis occurs when the articular cartilage
along the trochlear groove and on the underside of the
patella wears down and becomes inflamed. When cartilage
wears away, it becomes frayed and, when the wear is
severe, the underlying bone may become exposed.
54.TENNIS ELBOW
Tennis elbow is an inflammation of the tendons that join
the forearm muscles on the outside of the elbow. The
forearm muscles and tendons become damaged from
overuse — repeating the same motions again and again.
This leads to pain and tenderness on the outside of the
elbow.
55.PLANTAR FASCITIS
Plantar fasciitis is one of the most common causes of heel
pain. It involves inflammation of a thick band of tissue that
runs across the bottom of foot and connects heel bone to
toes (plantar fascia).
Plantar fasciitis commonly causes stabbing pain that
usually occurs with first steps in the morning. As one get
up and move, the pain normally decreases, but it might
return after long periods of standing or when they stand up
after sitting.
56.Calcaneal spur
A calcaneal spur is a bony outgrowth from the calcaneal
tuberosity (heel bone). Calcaneal spurs are typically
detected by x-ray examination. It is a form of exostosis.
When a foot is exposed to constant stress, calcium
deposits build up on the bottom of the heel bone.
57.Genu recurvatum is a deformity in the knee joint, so
that the knee bends backwards. In this deformity,
excessive extension occurs in the tibiofemoral joint. Genu
recurvatum is also called knee hyperextension and back
knee.
58.The Monteggia fracture is a fracture of the proximal
third of the ulna with dislocation of the proximal head of the
radius.
59.A tendon transfer is a surgical process in which the
insertion of a tendon is moved, but the origin remains in
the same location. Tendon transfer involves redistribution
of muscle power.
Ex. DonorPronator teres
Recipient extensor carpi radialis brevis
Function wrist Extension
60.CARPAL TUNNEL SYNDROME
Carpal tunnel syndrome is a common condition that
causes pain, numbness, and tingling in the hand and arm.
The condition occurs when one of the major nerves to the
hand — the median nerve — is squeezed or compressed
as it travels through the wrist.