Principles of Fractures Management

Surgery, Orthopaedic

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Data 2fimages 2fvdipxjtrncylype4uhnx 190405 s0 haidar hammad principles of fractures management intro
01:13
Principles of Fractures Management
Data 2fimages 2fsrw5rlhcsro0zgjbsg6m 190405 s1 haidar hammad reduction of fractures
07:45
Reduction of Fractures
Data 2fimages 2f3urstaf6tm2nqgm4wjzz 190405 s2 haidar hammad continuous traction
12:33
Continuous Traction
Data 2fimages 2foz3unwazsai3kjqy8x2f 190405 s3 haidar hammad brace and splint
12:55
Brace and Splint
Data 2fimages 2ftgobcpoqrwugyz18svfw 190405 s4 haidar hammad internal and external fixation
14:30
Internal and External Fixation
Data 2fimages 2fyod0v09ss2vmutmpkx6g 190405 s5 haidar hammad management of open fractures
19:26
Management of Open Fractures

Lecture´s Description

Principles of fractures management is the key element of this sqadia.com medical video lecture. All the methods of managing the fracture are described in this lecture ranging from closed reduction, open reduction, methods of holding reduction, continuous traction along with traction method. Alongside, cast splintage, functional bracing, internal and external fixation are comprehensively elaborated. Lastly, comments are also given on management of open fractures and gunshot injuries.

Reduction of Fractures

Reduction should aim for adequate apposition and normal alignment of the bone fragments. There are two methods of reduction i.e. closed and open. In closed reduction, the fracture is reduced by a three-fold manoeuvre. For some muscle’s, traction is needed because of strong muscle pull. Open reduction or operative reduction is indicated when closed reduction fails regardless of the reason.

Continuous Traction

Continuous traction, cast splintage, functional bracing, internal fixation, and external fixation are the methods of holding reduction. Carrying on with the discussion, contraindications to non-operative methods are described. Continuous traction is also used for acetabular fractures with femoral head subluxation. Traction by gravity, skin traction, and skeletal traction are the traction methods.

Brace and Splint

After the fracture has been reduced, the technique of cast splintage is used in which stockinette is threaded over the limb and the bony prominences are protected with wool. Its associated complications are also presented. Functional bracing is one way of preventing joint stiffness while still permitting fracture splintage and loading. Dr. Hammad Haider also elaborates the technique of functional bracing.

Internal and External Fixation

Internal fixation holds fracture securely. Internal fixation is indicated for fractures that cannot be reduced except by operation. Interfragmentary lag screws, and, plates and screws are the types of internal fixation. Likewise, external fixation has also been brought into debate. It is used for fractures of femur, humerus, distal radius. External fixation is indicated for fractures associated with severe soft-tissue damage.

Management of Open Fractures

Initial management of open fractures is the wound inspection. Then Gustilo’s classification of open fractures is given. Orthopaedic surgeon sheds light on four essential principles of treatment. Following this, information about antibiotics for open fractures is given. Discussion continues on debridement. Sequels to open fractures are pursued later on along with gunshot injuries. Emergency treatment is the arrest of bleeding. Dr. Hammad Haider also notify about definitive treatment of low-velocity wounds and high-velocity injuries.

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