Mari Belajar Orthopaedic

Tahukah anda apa itu Orthopaedic??

Ia adalah bahagian tulang2 ,klu nak jadi orthopaedic surgeon,kena operate pasal tulang-temulang tu la.

Okeh,let's get down to bussiness..

Td aku baca psl Compartment Syndrome which can occur in fracture of elbow,forearm bones and tibial plateau (proximal 3rd of tibia)..

So,pathophysiology dia cmni..

When there is fracture a.k.a #,the arterial blood flow will be disrupted and arterial damage develops.So,it causes ischaemia.Because of the direct injury to the # site as well,there will be oedema around the site.So,when there is oedema,the compartment pressure will increase,thus causing reduce blood flow and further aggravates the ischaemia.And the cycle continues.Bleh byg ka cycle dia? haha..malas plak nak lukis.Ni explanation bhs senang la bg aku.Klu salah betulkan la eh.

So,clinical features of compartment syndrome klu merujuk kpd buku Apley mmg mcm criteria for Acute Limb Ischaemia.Ala,yg 5@6P tu :

1)Pallor (pale)
2)Pain
3)Paraesthesia
4)Paralysis
5)Pulselessness
6)Perishingly cold limb

And theoretically,we have to measure the compartment pressure.How??
Measure the difference between the diastolic P and compartment P (if the difference is <30mmhg,that>

But,actually,according to Prof H,we suspect compartment syndrome by clinical examination.And the features would be : Painful,tender,shiny,tense skin.Org tua kata tgk pun tau la P tinggi.

So,how to treat??
Cepat2la buat decompression by making 2 incisions,which are medial n lateral incisions.So biarkan terbukak kat situ ja.And buat skin graft klu x silap aku.(based on apa yg aku tgk kat ward).Hehe..

So,the next things to learn adalah :
1)About Hip Dislocation.
Tahukah anda why posterior hip dislocation is more common than anterior?
Answer : This is because there is Y ligament of Bigelow a.k.a iliofemoral ligament duduk kat bhgn depan ur hip joint.And this ligament is very strong,so it prevents the hip from being anteriorly displaced,xkesahla dlm kes accident cmna pn.And accident yg common yg bleh sebabkan Posterior Hip Dislocation ni adalah when your knees strike against dashboard.Bleh bayang??

2)Stages of # of Neck of Femur
Answer : Garden's Classification
There are 4 stages :

Stage 1 -incomplete,impacted #
Stage 2-complete,undisplaced #
Stage 3 -complete,moderately displaced #
Stage 4-complete, severely displaced #

Sudahlah tu,byk lg baca,xkan suma nak tulis kat sni.Ntah org paham ke tidak.Haha..

P/s : kan dah ckp dlm previous post,bila mood exam ja,mungkin aku update psl benda yg masuk exam.Agar post2 ni x la kedengaran lagha sgt.Hehe..

I realized that bones are much more interesting than kids~