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Orthopaedics

Organisation of the Body

QuestionAnswer
Orthopaedic Specialties Trauma Limb Reconstruction Sarcoma Foot/ankle Shoulder/elbow Hand Spinal Paediatric Knee Hip
Trauma Large pelvic fracture - increase in pelvic volume, often fatal combined with internal bleeding Treated with binding to allow tamponade and blood clotting
Limb reconstruction Osteotomy - rebreak bones and externally fix them Infected bone removed and healthy bone pulled apart, new bone grows in the gap due to high proliferation rate of bone If bone necrotic nothing can be done Can attempt to remove dead bone
Sarcoma - bone tumours Labelled glucose scan - metabolically active areas e.g. tumours show up Can use any bone reconstruction to treat e.g. fibular transplant into place of tibia - grows in response to load
Foot and ankle Diabetics are prone to foot issues Neuropathy - cannot feel if the foot is injured high glucose and vascular compromises - good for pathogens High risk of infection leading to amputation
Shoulder and elbow High risk of dislocation - surrounding tissue is torn increasing risk of further dislocation can use keyhole surgery to repair torn structures Or can completely replace joints
Hand surgery Rheumatoid arthritis - treatable Carpal tunnel - median nerve compression, look at muscle size Issues with connective tissue - hand deformities
Paediatric surgery Club foot - feet point inwards Previously treated by surgery - left non-malleable feet with limited movement Now treated by progressive casts - as structures still growing the feet move back Hip dysplasia - treated with harness for 3 months
Knee surgery Joint under patella often involved in injury Hip and knee replacements have a major impact on peoples lives Can use robots to guide surgery e.g. cast and implants Glasses can give constant feedback of where bone is in relation to tissue etc
ACL rupture Common in athletes Treated with the tendon of hamstring and semitendinosus muscles
Hip surgery Worn out hips with no cartilage can be replaced Infections/unrelated fractures are a large problem - very little bone left as a template Uses metal on polyethene Not always successful
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