CLINICAL CENTER

CLINIC OF ORTHOPEDIC SURGERY AND TRAUMATOLOGYCLINIC OF ORTHOPEDIC SURGERY AND TRAUMATOLOGY

ORTHOPEDICSORTHOPEDICS

ANDAND

TRAUMATOLOGYTRAUMATOLOGY “ “

DIAGNOSTIC AND THERAPEUTIC METHODS IN ORTHOPEDICS

Medical Faculty Medical Faculty Novi Sad Novi Sad Clinic of ortopaedic surgery and traumatologyClinic of ortopaedic surgery and traumatology

DIAGNOSTIC METHODS DIAGNOSTIC METHODS IN ORTHOPEDICSIN ORTHOPEDICS

I ANAMNESISI ANAMNESIS IDENTIFICATION AND IDENTIFICATION AND

DEMOGRAPHICSDEMOGRAPHICS CHIEF COMPLAINTCHIEF COMPLAINT HISTORY OF PRESENT ILLNESSHISTORY OF PRESENT ILLNESS PAST MEDICAL HISTORYPAST MEDICAL HISTORY FAMILY DISEASESFAMILY DISEASES ANAMNESTIC CONCLUSIONANAMNESTIC CONCLUSION

DIAGNOSTIC METHODS DIAGNOSTIC METHODS IN ORTHOPEDICSIN ORTHOPEDICS

11. PHYSICAL EXAMINATION. PHYSICAL EXAMINATION STATUS PRAESENSSTATUS PRAESENS STATUS LOCALISSTATUS LOCALIS

( STATUS ORTHOPAEDICUS)( STATUS ORTHOPAEDICUS) -- SPINESPINE

- PELVIS- PELVIS

- UPPER LIMB- UPPER LIMB

- LOWER LIMB- LOWER LIMB

DIAGNOSTIC METHODS DIAGNOSTIC METHODS IN ORTHOPEDICSIN ORTHOPEDICS

1.1. INSPECTIONINSPECTION

2.2. PALPATIONPALPATION

3.3. PERCUSSIONPERCUSSION

4.4. AUSCULTATIONAUSCULTATION

5.5. ORTHOPEDIC EXAMINATIONORTHOPEDIC EXAMINATION

6.6. VASCULAR EXAMINATIONVASCULAR EXAMINATION

7.7. NEUROLOGICAL INVESTIGATIONNEUROLOGICAL INVESTIGATION

8.8. FUNCTIONAL STATE REWIEVFUNCTIONAL STATE REWIEV

9.9. SPECIFIC TESTSSPECIFIC TESTS

DIAGNOSTIC METHODS DIAGNOSTIC METHODS IN ORTHOPEDICSIN ORTHOPEDICS

INSPECTIONINSPECTION

--POSITIONPOSITION

-POSTURE (ANTALGIC)-POSTURE (ANTALGIC)-PART OF THE BODY CONFIGURATION-PART OF THE BODY CONFIGURATION-SKIN-SKIN

PHYSICAL EXAMINATION PHYSICAL EXAMINATION

INSPECTIONINSPECTIONINSPECTIONINSPECTION

PHYSICAL EXAMINATION PHYSICAL EXAMINATION

INSPECTIONINSPECTIONINSPECTIONINSPECTION

PAT_OAKR0398

PHYSICAL EXAMINATION PHYSICAL EXAMINATION

DIAGNOSTIC METHODS DIAGNOSTIC METHODS IN ORTHOPEDICSIN ORTHOPEDICS

PALPATIONPALPATION-SUPERFICIAL-DEEP-SUPERFICIAL-DEEP

-REST AND MOTION-REST AND MOTION

-PUNCTUM MAX OF PAIN-PUNCTUM MAX OF PAIN

-TUMEFACTION-TUMEFACTION

-BLOOD VESSELS-BLOOD VESSELS

-LYMPH NODES-LYMPH NODES

DIAGNOSTIC METHODS DIAGNOSTIC METHODS IN ORTHOPEDICSIN ORTHOPEDICS

PERCUSSIONPERCUSSION

-DIRECT-DIRECT

-INDIRECT-INDIRECT

AUSCULTATIONAUSCULTATION

DIAGNOSTIC METHODS DIAGNOSTIC METHODS IN ORTHOPEDICSIN ORTHOPEDICS

ORTHOPEDIC MEASUREMENTSORTHOPEDIC MEASUREMENTS-ORIENTATION POINTS-ORIENTATION POINTS-STRECHED POSITION AND FLACCID MUSCLES-STRECHED POSITION AND FLACCID MUSCLES

1.SCOPE1.SCOPE2.LENGTH2.LENGTH

3.AXIS3.AXIS4.JOINT MOBILITY4.JOINT MOBILITY

5.DIMENSIONS OF PATHOLOGIC CHANGES5.DIMENSIONS OF PATHOLOGIC CHANGES

DIAGNOSTIC METHODS DIAGNOSTIC METHODS IN ORTHOPEDICSIN ORTHOPEDICS

EXAMINATION OF VASCULAR EXAMINATION OF VASCULAR STATUSSTATUS

SKIN-VARICOSE VEINSSKIN-VARICOSE VEINS

TEMPERATURETEMPERATURE

CAPILLARY NAIL REFILL TESTCAPILLARY NAIL REFILL TEST

PERIPHERAL ARTERIESPERIPHERAL ARTERIES

DIAGNOSTIC METHODS DIAGNOSTIC METHODS IN ORTHOPEDICSIN ORTHOPEDICS

EXAMINATION OF EXAMINATION OF NEUROLOGICAL STATUSNEUROLOGICAL STATUS

CMN-PMNCMN-PMN

TENDON REFLEXESTENDON REFLEXES

SENSORY EXAMINATIONSENSORY EXAMINATION

VEGETATIVE FUNCTIONSVEGETATIVE FUNCTIONS

DIAGNOSTIC METHODS DIAGNOSTIC METHODS IN ORTHOPEDICSIN ORTHOPEDICS

SPECIFIC TESTS EXAMINATIONSPECIFIC TESTS EXAMINATION

PHYSICAL EXAMINATION

JOINT INSTABILITY SIGNS

PHYSICAL EXAMINATIONINSTABILITYINSTABILITY

SPECIAL TESTS EXAMINATIONSPECIAL TESTS EXAMINATION

DIAGNOSTIC METHODS DIAGNOSTIC METHODS IN ORTHOPEDICSIN ORTHOPEDICS

FUNCTIONAL STATE REWIEVFUNCTIONAL STATE REWIEV HAND HAND ((FEEDING, TOILET, DRESSING, WRITINGFEEDING, TOILET, DRESSING, WRITING))

CLOTHESPEG-TWEEZERS-FIST-HOOKCLOTHESPEG-TWEEZERS-FIST-HOOK

LEGLEG (STANDING-SUPPORT, GAIT)(STANDING-SUPPORT, GAIT)

DIAGNOSTIC METHODS DIAGNOSTIC METHODS IN ORTHOPEDICSIN ORTHOPEDICS

2. 2. ADDITIONAL DIJAGNOSTIC ADDITIONAL DIJAGNOSTIC METHODSMETHODS

RADIOGRAPHYRADIOGRAPHYULTRASONOGRAPHYULTRASONOGRAPHY

SCINTIGRAPHYSCINTIGRAPHYCTCT

EMGEMGMRIMRI

ARTROSCOPYARTROSCOPY

RADIOGRAPHYRADIOGRAPHY

PLAIN(AP,LL)PLAIN(AP,LL)

SPECIAL POSITION(OBLIQUE, SPECIAL POSITION(OBLIQUE, TUNEL,STRESS..)TUNEL,STRESS..)

SPECIAL RTG METHODSSPECIAL RTG METHODS

CONTRAST RTG METHODSCONTRAST RTG METHODS

RADIOGRAPHYRADIOGRAPHY

RADIOGRAPHY

NUCLEAR MAGNETIC NUCLEAR MAGNETIC RESONANCERESONANCE

DIAGNOSTIC METHODS DIAGNOSTIC METHODS IN ORTHOPEDICSIN ORTHOPEDICS

LABORATORY TESTSLABORATORY TESTSHEMATOLOGY (Se, CBC with diferential...)HEMATOLOGY (Se, CBC with diferential...)

CLINICAL BIOCHEMISTRY (urine, glucose, crp...)CLINICAL BIOCHEMISTRY (urine, glucose, crp...)

IMMUNOLOGY (asto, rf, hla...)IMMUNOLOGY (asto, rf, hla...)

BACTERIOLOGY BACTERIOLOGY

CYTOPATHOLOGYCYTOPATHOLOGY

TreatmentTreatment – – PLASTER PLASTER IMMOBILIZATIONIMMOBILIZATION

PRINCIPLES :PRINCIPLES :

Physiological positionPhysiological position

Initially sets Initially sets the splintthe splint

Two adjacent Two adjacent jointsjoints

Decubitus Decubitus preventionprevention

Control of Control of limb epyphiseslimb epyphises

Principles of reductionPrinciples of reduction

PLASTER MAKER ! PLASTER MAKER !

PLASTER IMMOBILIZATIONPLASTER IMMOBILIZATION

ORTHOTICSORTHOTICS

ORTHOTICSORTHOTICS

SKELETAL PIN TRACTIONSKELETAL PIN TRACTION

SKIN TRACTIONSKIN TRACTION

CRANIAL TRACTIONCRANIAL TRACTION

TreatmentTreatment – – prosthetic prosthetic surgerysurgery

TreatmentTreatment – – prosthetic prosthetic surgerysurgery

TreatmentTreatment – – knee knee ligamentoplastyligamentoplasty

TreatmentTreatment – – Spinal surgerySpinal surgery

TreatmentTreatment – – Spinal surgerySpinal surgery

TreatmentTreatment – – long bones long bones osteosynthesisosteosynthesis

TreatmentTreatment – – long bones long bones osteosynthesisosteosynthesis

Internal fixation - Internal fixation - principlesprinciples

Internal fixation - Internal fixation - principlesprinciples

Tension band and wires

( “zuggutrung”

)

Internal fixation - Internal fixation - principlesprinciples

Intramedullary fixation

Internal fixation - Internal fixation - principlesprinciples

“Hybrid” Fixation

TreatmentTreatment - - amputationamputation