ORTHOPAEDICS AND TRAUMATOLOGY Paper XXIII

Course Description

The major orthopaedic problems that need to be learnt by students are listed in order of relative importance: traumatic lesions, bone and joint infections, painful conditions, congenital anomalies, bone tumors and metabolic bone diseases. The course, enables student relieve pain, prevent deformity and disability; recognize simple conditions at an early stage and treat adequately.

Students will be able to make decisions regarding referral and participate in community programmes concerning prevention of accidents and rehabilitation of the physically disabled. Lectures will be supplemented by inpatient and out-patient clinical teaching and visits to physiotherapy department, orthopaedics appliances center and Khagendra New Life Centre, clinical assignments. Observation of operative procedures and postoperative follow up provide the opportunity for developing clinical acumen.

Specific objectives

Students will be able to

  • take appropriate history from the patients, perform physical examination and recognize pathophyiological process.
  • diagnose and manage the follow emergencies:

Fractures: Colles, supracondylar of the humerus, radius and ulna; shaft of humerus; small bones of hand and feet; bone fracture if no surgery is required, stable spinal fracture with no neurological complications, fracture tibia;

  • diagnose and manage following conditions: dislocations of the shoulder, elbow, finger joint, hip, knee, ankle and joints of the feet; Crush injury; Wounds: Toilet, excision, and suture;
  • perform emergency amputation if necessary;
  • diagnose, manage and refer: complicated fractures with neurological or vascular injury, complicated dislocations, fracture neck of the femur, fracture shaft of the femur with displacement, Pott’s fracture of grade II or more; Monteggia fracture, dislocation, unstable fracture radius and ulna, fracture lateral condyle humerus in children, unstable fracture of spine; fracture involving joint surface and epiphyseal plate, unstable displace fracture, fracture of the tibial plateau: rotator cuff rupture, rupture biceps or quadriceps, brachial plexus injury, ligamentous injury if unstable; late cases with malunion and non-union with defects and disability; able to advise possibility of treatment and/or rehabilitation at referral center.
  • Carry out following procedures such as plaster removal, exercises and rehabilitation of the patient who return to their community from referral hospitals.

Bone and Joint Infection

Students will be able to

  • diagnose and manage the following common conditions: acute osteomyelitis, TB spine without neurological complications, TB of other joints;
  • diagnose, treat initially and refer: chronic osteomyelitis, complicated TB.

Painful conditions

Students will be able to

  • diagnose rheumatoid arthritis, ankylosing spondylitis, osteoarthritis and gout;
  • manage the above conditions through provision of drugs for relief of pain, support and splint age and suitable exercises.

Congenital conditions

Students will be able to

  • diagnose in newborn: clubfoot, Spina bifida, CDH, Erb’s palsy, syndactyly.

Muscular conditions

Students will be able to

  • diagnose and manage: acute poliomyhelitis and refer paralytic polio.

Bone diseases

Metabolic Bone diseases

Students will be able to

  • diagnose and treat rickets and scurvy; refer deformed cases of rickets.

Bone tumor:

  • Suspect bone tumor and refer the cases

Techniques for Immobilisation

Students will be able to

  • apply, spica, limb plasters

Traction Technique

Students will be able to

  • set up skin traction, Russell traction, Gallows traction.

Rehabilitation

Students will be able to

  • outline the contribution of physiotherapy, walking aids, artificial limbs and braces

X-ray Interpretation

Students will be able to

  • interpret X-ray of common fractures dislocations, and infection

Textbooks

  1. Apley’s system of orthopaedics and Fractures-Apley, Solomon
  2. Outline of fractures- John Crawferd Adzma, David L. Hamblen
  3. Outline of orthopaedics- John Crawford Adzma, David L. Hamblen
  4. Clinical Orthopaedics Exam-Ronald McR
  5. Watson-Jones-Fractures and Joint Injuries (Volume I and II)
  6. Campbell’s operative Orthopaedics (Volume I to V) -A . H. Crenshaw