Ortho unit 1 Flashcards
(97 cards)
orthopaedics
straight children
acute disease
strikes suddenly, production of polymorphs- leucocytes
chronic disease
takes a long time to develop, characterised by lymphocytes- produced in bone marrow and spleen
opening a joint
arthrotomy
removing something e.g. removing a meniscus
ectomyw eg menisectomy
what is most joint replacement surgery aimed at
pain relief
self limiting
temporary and will get better e.g. muscle tears and ligament sprains
congenital abnormalities
defects associated with development in the womb
inflammatory abnormalities
bacterial infection causing inflammation of joint (infective arthritis) or bone (osteomyelitis). Sometimes inflammation is unknown cause e.g. RA
metabolic disorders
gout- uric acid crystals deposited on cartilaginous surface of joints
degenerative disorders
normal structure of the joint has been disturbed through deterioration and wear- OA
trauma
msk system suffered damage
2 principle symptoms in orthopaedics
pain and stiffness
osteoarthritis
pain and limitation of movement of joints associated with excessive wear of articular cartilage resulting from the break down of balance between wear and repair processes
Aetiology of OA
known cause- secondary arthritis, unknown cause - primary OA- majority
secondary oa
congenital dislocation of hip, perches disease, infection, trauma, gout, infection-TB, chronic inflammatory- rheumatoid
OA clinical picture
can occur at any age but becomes increasingly common later in life. Pain, loss of function of joint, stiffness (nearly always secondary to pain)
when would a GP refer OA to secondary care
when the patients sleep is disturbed by pain
examination of OA
symptoms of pain and associated limitation of movement
management of OA
all aimed at pain relief
conservative- weight loss- quite modest reductions in body weight will result in significant reductions in total loads being borne by joint
walking stick- shoulder girdle can help in tilting the pelvis and so help in weight bearing. Stick reduces the work required of the weight bearing abductor muscles
Physio- controversial- balance between excessive exercising and excessive resting (both are bad)
surgical options for OA
Arthrodesis, osteotomy, arthroplasty
arthrodesis for OA
surgical stiffening og a joint in a position of function- appropriate for a young person with a painful and limited range of movement. Stiff painful bit of bone is cut out, raw bone ends held together by external splint or screws until they heal with a bony bridge
long term disadvantage of arthrodesis
puts stress on adjacent joints e.g. in hip more stress on spine or adjacent hip
joints that can usefully be fused
ankle and wrist- small joints easier to hold bone ends together