Pathology of Trauma

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CPC4.3.4- 19y Karen & Mike, ,[object Object],[object Object],[object Object]

CPC4.3.4- At the Scene… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CPC4.3.4- At the Scene… ,[object Object],[object Object],[object Object],[object Object]

CPC4.3.4- Core learning Issues… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CPC4.3.4- Core learning Issues… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

"People blame their circumstances for what they are. I don't believe in circumstances. The people who get on in the world are the people who get up and look for the circumstances they want, and if they can't find them, make them ….!" - George Bernard Shaw

Pathology of Bone Fracture & Healing Dr. Venkatesh M. Shashidhar Senior Lecturer & Head of Pathology

Introduction: ,[object Object],[object Object],[object Object],[object Object]

Bone Anatomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Bone tissue: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cancellous bone: (Polarization.M) Osteocyte Lamellae

Bone histology: lines of stress: (Black arrows)

Compact Bone: ,[object Object],[object Object],[object Object],[object Object],[object Object]

The matrix of bone : ,[object Object],[object Object],[object Object],[object Object],[object Object]

Bone is dynamic  cont. remodeling ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Osteoblasts & Osteocytes in Osteoid: Osteocyte Osteoblasts Osteoid

Osteoclast in lacuna; Osteoclast Lacuna

Growth plate: Mature bone Immature bone

Osteoblasts & Osteoid: Osteocyte Osteoblasts Osteoid

Bone Review: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Key Words: Mineralization Calcification Ossification Osteoid Tensile strength Volkmann’s canal Haversian canal Lacunae Osteon Compact bone Trabecular bone

Obstacles cannot crush me. Every obstacle yields to stern resolve. -Leonardo da Vinci

Fractures: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

An individual at prolonged bed rest quickly begins to lose bone mineral density (BMD). Conversely, physical activity increases BMD . Use it or Loose it….!

Fracture Types: Transverse Spiral Oblique Linear

Fracture Types: Pott’s Incomplete Impacted Green stick

Fracture Types: Comminuted Colle’s Compound

Fracture Healing: 1 day 1-3 Week (Soft) 6 Weeks (Hard) >8 Weeks

Stages of fracture healing: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Bone healing - Callus Fracture Fibula 6 weeks later Callus Fracture

[object Object],[object Object],[object Object],[object Object],Callus – Woven bone

Fracture with Callus ,[object Object],[object Object],[object Object]

Factors affecting Bone Healing: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Complications: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Crush Syndrome: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Osteomyelitis – excess Callus

Complications of # ,[object Object]

Pseudoarthrosis ,[object Object],[object Object]

Cubitus valgus deformity: ,[object Object],[object Object],[object Object]

Bone necrosis, Sequestrum - involucrum Sequestrum - Involucrum Sequestrum

Disorders of Bone Paget’s Disease

CPC4.3.4- Core learning Issues… ,[object Object],[object Object],[object Object],[object Object],[object Object]

Summary & Further Reading: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

He who is fixed to a star does not change his mind because of rough road. -Leonardo da Vinci

CPC-3.4– MSS - Trauma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

What Nerve Injury? ,[object Object],[object Object],[object Object],[object Object],[object Object]

Fracture ? ,[object Object],[object Object],[object Object],[object Object],[object Object]

16y Boy, fracture. ? Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],A B

16y Boy, bone, Identify structure A: ,[object Object],[object Object],[object Object],[object Object],[object Object],A B C B

Which nerve injury is most likely? ,[object Object],[object Object],[object Object],[object Object],[object Object]

28y man, increasing back pain & hat size! ,[object Object],[object Object],[object Object],[object Object],[object Object]

Fracture ? Type of tissue ,[object Object],[object Object],[object Object],[object Object],[object Object]

28y man, Leg fracture. Identify ‘B’ ,[object Object],[object Object],[object Object],[object Object],[object Object],A B C D E

Fracture ? Identify structure B ,[object Object],[object Object],[object Object],[object Object],[object Object]

Fracture ? Expected complications ,[object Object],[object Object],[object Object],[object Object],[object Object]

Pathology CLI: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CPC-3.4– KFP Questions/theme: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

"I learned that good judgment comes from experience and that experience grows out of mistakes ." – Omar Bradley

Fracture Cases Self Assessment Questions.

? Fracture - ? complications. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

What Nerve Injury? ,[object Object],[object Object],[object Object],[object Object],[object Object],A median nerve palsy due to a wound on the palmar aspect of the wrist. This is causing wasting and paralysis of the thenar muscles.

What Nerve Injury? ,[object Object],[object Object],[object Object],[object Object],[object Object],Median nerve injuries lead to loss of wrist flexion strength, ulnar deviation of the wrist, loss of thumb opposition, and loss of finger flexion of the thumb, index and long finger interphalangeal joints. When making a fist, the ring and small fingers flex while the long and index tend to stay straight. In low median nerve injuries the fingers are still able to flex, but thumb opposition is often lost.

? Fracture ? complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],? Fracture ? complications

? Trauma ? findings ,[object Object]

Todays Summary: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Spiritual Wisdom All your suffering start with your desires. Stop desiring and you won't suffer. Jalaluddin Rumi

22 Female Motorcycle accident internal fixation was used after the fracture was reduced, and a Rush nail was inserted up the fibula to maintain alignment. Debridement and split skin grafting done. Surprisingly recovery… as no major vascular or nerve damage.

Spleen Rupture: ,[object Object],[object Object],[object Object],[object Object]

Blunt Trauma: ,[object Object]

?Trauma: ? findings ,[object Object]

? Fracture ? complications  What is this shadow?

[object Object],? Fracture ? complications

[object Object],[object Object],[object Object],? Fracture ? complications

? Fracture ? complications ,[object Object],[object Object],[object Object]

? Fracture ? complications Cervical spine - C1 post ring fracture right side. C2 fracture body with listhesis.

Spinal Injuries ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Ignite the spark within your soul , for it will reveal that which is your truth . Ellie Crystal

Pathology of Trauma

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Pathology of Trauma