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CLINICAL CENTER

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Title: CLINICAL CENTER


1
CLINICAL CENTER CLINIC OF ORTHOPEDIC SURGERY AND
TRAUMATOLOGY ORTHOPEDICS AND
TRAUMATOLOGY


2
DIAGNOSTIC AND THERAPEUTIC METHODSĀ IN ORTHOPEDICS
Medical Faculty Novi Sad Clinic of ortopaedic
surgery and traumatology

3
DIAGNOSTIC METHODS IN ORTHOPEDICS
  • I ANAMNESIS
  • IDENTIFICATION AND DEMOGRAPHICS
  • CHIEF COMPLAINT
  • HISTORY OF PRESENT ILLNESS
  • PAST MEDICAL HISTORY
  • FAMILY DISEASES
  • ANAMNESTIC CONCLUSION

4
DIAGNOSTIC METHODS IN ORTHOPEDICS
  • 1. PHYSICAL EXAMINATION
  • STATUS PRAESENS
  • STATUS LOCALIS
  • ( STATUS ORTHOPAEDICUS)
  • - SPINE
  • - PELVIS
  • - UPPER LIMB
  • - LOWER LIMB

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DIAGNOSTIC METHODS IN ORTHOPEDICS
  • INSPECTION
  • PALPATION
  • PERCUSSION
  • AUSCULTATION
  • ORTHOPEDIC EXAMINATION
  • VASCULAR EXAMINATION
  • NEUROLOGICAL INVESTIGATION
  • FUNCTIONAL STATE REWIEV
  • SPECIFIC TESTS

6
DIAGNOSTIC METHODS IN ORTHOPEDICS
  • INSPECTION
  • -POSITION
  • -POSTURE (ANTALGIC)
  • -PART OF THE BODY CONFIGURATION
  • -SKIN

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PHYSICAL EXAMINATION
INSPECTION
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PHYSICAL EXAMINATION
INSPECTION
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PHYSICAL EXAMINATION
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DIAGNOSTIC METHODS IN ORTHOPEDICS
  • PALPATION
  • -SUPERFICIAL-DEEP
  • -REST AND MOTION
  • -PUNCTUM MAX OF PAIN
  • -TUMEFACTION
  • -BLOOD VESSELS
  • -LYMPH NODES

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DIAGNOSTIC METHODS IN ORTHOPEDICS
  • PERCUSSION
  • -DIRECT
  • -INDIRECT
  • AUSCULTATION

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DIAGNOSTIC METHODS IN ORTHOPEDICS
  • ORTHOPEDIC MEASUREMENTS
  • -ORIENTATION POINTS
  • -STRECHED POSITION AND FLACCID MUSCLES
  • 1.SCOPE
  • 2.LENGTH
  • 3.AXIS
  • 4.JOINT MOBILITY
  • 5.DIMENSIONS OF PATHOLOGIC CHANGES

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DIAGNOSTIC METHODS IN ORTHOPEDICS
  • EXAMINATION OF VASCULAR STATUS
  • SKIN-VARICOSE VEINS
  • TEMPERATURE
  • CAPILLARY NAIL REFILL TEST
  • PERIPHERAL ARTERIES

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DIAGNOSTIC METHODS IN ORTHOPEDICS
  • EXAMINATION OF NEUROLOGICAL STATUS
  • CMN-PMN
  • TENDON REFLEXES
  • SENSORY EXAMINATION
  • VEGETATIVE FUNCTIONS

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DIAGNOSTIC METHODS IN ORTHOPEDICS
  • SPECIFIC TESTS EXAMINATION

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PHYSICAL EXAMINATION
JOINT INSTABILITY SIGNS
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PHYSICAL EXAMINATION
INSTABILITY
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  • SPECIAL TESTS EXAMINATION

30
DIAGNOSTIC METHODS IN ORTHOPEDICS
  • FUNCTIONAL STATE REWIEV
  • HAND (FEEDING, TOILET, DRESSING, WRITING)
  • CLOTHESPEG-TWEEZERS-FIST-HOOK
  • LEG (STANDING-SUPPORT, GAIT)

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DIAGNOSTIC METHODS IN ORTHOPEDICS
  • 2. ADDITIONAL DIJAGNOSTIC METHODS
  • RADIOGRAPHY
  • ULTRASONOGRAPHY
  • SCINTIGRAPHY
  • CT
  • EMG
  • MRI
  • ARTROSCOPY

33
RADIOGRAPHY
PLAIN(AP,LL) SPECIAL POSITION(OBLIQUE,
TUNEL,STRESS..) SPECIAL RTG METHODS CONTRAST
RTG METHODS
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RADIOGRAPHY
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RADIOGRAPHY
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NUCLEAR MAGNETIC RESONANCE
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DIAGNOSTIC METHODS IN ORTHOPEDICS
  • LABORATORY TESTS
  • HEMATOLOGY (Se, CBC with diferential...)
  • CLINICAL BIOCHEMISTRY (urine, glucose, crp...)
  • IMMUNOLOGY (asto, rf, hla...)
  • BACTERIOLOGY
  • CYTOPATHOLOGY

40
Treatment PLASTER IMMOBILIZATION
  • PRINCIPLES
  • Physiological position
  • Initially sets the splint
  • Two adjacent joints
  • Decubitus prevention
  • Control of limb epyphises
  • Principles of reduction
  • PLASTER MAKER !

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PLASTER IMMOBILIZATION
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ORTHOTICS
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ORTHOTICS
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SKELETAL PIN TRACTION
45
SKIN TRACTION
46
CRANIAL TRACTION
47
Treatment prosthetic surgery
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Treatment prosthetic surgery
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Treatment knee ligamentoplasty
50
Treatment Spinal surgery
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Treatment Spinal surgery
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Treatment long bones osteosynthesis
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Treatment long bones osteosynthesis
54
Internal fixation - principles
55
Internal fixation - principles
Tension band and wires ( zuggutrung)
56
Internal fixation - principles
Intramedullary fixation
57
Internal fixation - principles
Hybrid Fixation
58
Treatment - amputation
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