Академический Документы
Профессиональный Документы
Культура Документы
1.Fractures
2.Sprains
3.Severe soft-tissue injuries
4.Reduced joint dislocations
5.Inflammatory conditions: arthritis,
tendinopathy, tenosynovitis
6.Deep laceration repairs across joints
7.Tendon lacerations
Boyd AS et al: Principles of Casting and Splinting.
Am Fam Physician. 2009 Jan 1;79(1):16-22.
COMPLICATIONS OF IMMOBILIZATION
1. Compartment syndrome
2. Ischemia
3. Heat injury
4. Pressure sores and skin breakdown
5. Infection
6. Dermatitis
7. Joint stiffness
8. Neurologic injury
Boyd AS et al: Principles of Casting and Splinting.
Am Fam Physician. 2009 Jan 1;79(1):16-22.
INDICATIONS
Bhlers 3R principles:
I. Reduction
II. Retention
III. Rehabilitation
Splint
Circular split casting
Full circular cast /additional reduction: wedging of cast/
Upper extremity / lower extremity casts
Desault-bandage + cast fixation
Spica cast: shoulder spica, single hip spica
Body casts: Minerva cast
padding
tools
casting material
Proper padding
STRANGULATION
Lorenz Bhler
1885.01.15.-1973.01.20.
ELBOW BRACES
INDICATIONS:
Tennis elbow
Golfer elbow
Dislocations
Ligament injuries
After elbow surgeries
Treatment of selected fracture types
Wrist strain
Overuse injuries
Inflammation, tendinitis
Ligament injuries
After wrist surgeries
Treatment of selected fracture types
Augusto Sarmiento
Miami Brace 1964
Ankle strain
Overuse injuries
Inflammation, tendinitis
Ligament injuries: lateral ankle ligaments,
proprioceptive training!!
After ankle and foot surgeries
Treatment of selected fracture types
KINESIOLOGY TAPES
KINESIOLOGY TAPES
KINESIOLOGY TAPES
KINESIOLOGY TAPES
1. Pain Relief
A) Physically, the lifting action of the kinesiology tape relieves
pressure on pain receptors directly under the skin, allowing for
both immediate and lasting relief.
B) Sensory stimulation of other types of nerve fibers. In these
circumstance, kinesiology tape may be effective for pain that
persists for a longer time.
2. Swelling Reduction
By lifting this skin, kinesiology taping provides a negative
pressure under the tape, allowing the lymphatic drainage
channels to drain swelling and other inflammatory cells away
from the injured area quickly.
KINESIOLOGY TAPES
3. Lymphoedema Reduction
Based on the same physical lifting principle, kinesiology taping
can be very effective in the reduction of lymphoedema.
4. Reduced Muscle Fatigue, Cramps and DOMS.
Exercise and repeated muscle contractions produces postexercise byproducts such as lactic acid. Lactic acid can cause
poor muscle performance, fatigue cramping and delayed onset
muscle soreness (DOMS).
Kinesiology tape can help remove lactic acid and other
exercise byproducts from the region, which can assist muscle
performance, reduce fatigue, cramps and DOMS.
KINESIOLOGY TAPES
KINESIOLOGY TAPES
Kinesiology tapes can be used for hundreds of common
injuries such as lower back pain, knee pain, shin splints,
carpal tunnel syndrome, and tennis elbow...
Ankle
Neck
Calf and
arch
Hamstring
Hip
Lower back
Full knee
Groin
Posture
Power
strips
abrasion (superficial)
vulnus abrasum
cut (sharp)
vulnus scissum
cut (blunt)
vulnus caesum
contusion
laceration
vulnus lacerum
stab
vulnus punctum
gunshot
vulnus sclopetarium
bite
vulnus morsum
I. Inflammatory phase
SKIN GRAFTS
SKIN GRAFTS
I.
Indication: pre-operative wound maintenance and postoperative graft healing is the use of negative pressure
wound therapy (NPWT)
Mechanism: NPWT system works by placing a section of
foam cut to size over the wound, then laying a perforated
tube onto the foam. The arrangement is then secured
with bandages.
A vacuum unit creates negative pressure, sealing the
edges of the wound to the foam, and drawing out excess
blood and fluids.
Advantages: helps to maintain cleanliness, promotes the
development of new blood vessels, and induces fibroblast
proliferation.
Indication in trauma care: soft tissue defects, especially
after septic complications or major traumas
KEY POINTS
INTRODUCTION
WHAT IS IT?
Since its inception more than 20 years ago, negative pressure wound therapy (NPWT) has had a
major impact in the management of orthopedic
injuries. NPWT has been widely adopted for use
in a variety of clinical scenarios, and has had reported success in the setting of high-energy
trauma, open fractures, infections, and excessive
soft tissue damage. However, although its success has led to widespread use in orthopedic
trauma, a deeper understanding of its mechanism
of action, along with the ideal clinical scenarios
for use, is required. This article reviews the nuances of NPWT application, including its mechanism of action, clinical indications, and specific
strategies used in order to achieve desired clinical
outcomes.
orthopedic.theclinics.com
! Negative pressure wound therapy (NPWT) is ideal for soft tissue defects that can heal through secondary intention or require skin grafting.
! NPWT prevents desiccation, reduces edema, limits hematoma, and facilitates wound drainage.
! NPWT is an effective way to downscale the complexity of soft tissue reconstruction.
! NPWT can decreases the risk of wound complication when applied to high-risk incisions after fracture surgery.
FLAPS
FLAPS
Classifications:
type of blood supply
type of tissue to be transferred
location of donor site.
FLAPS
FLAPS
FLAPS
B, Tissue to be transferred:
In general, flaps may comprise in part or in whole almost
any component of the human body, as long as an
adequate blood supply to the flap can be ensured
once the tissue has been transferred.
FLAPS
B, Tissue to be transferred:
Flaps may be composed of just one type of tissue or
several different types of tissue.
Flaps composed of one type of tissue include skin
(cutaneous), fascia, muscle, bone, and visceral (eg,
colon, small intestine, omentum) flaps.
Composite flaps include fasciocutaneous (eg, radial
forearm flap), myocutaneous (eg, transverse rectus
abdominis muscle [TRAM] flap), osseocutaneous (eg,
fibula flap), tendocutaneous (eg, dorsalis pedis flap), and
sensory/innervated flaps (eg, dorsalis pedis flap with
deep peroneal nerve).
FLAPS
FLAPS
If you are interested in, please, check the following links for
further information:
1. AO / ASIF
www.aotrauma.org: AO Surgery Reference & Online Education
2. Orthopaedic Trauma Association (OTA)
http://ota.org/about/
3. trauma.org
http://www.trauma.org/archive/traumabank.html
4. AAOS: www.aaos.org