This document summarizes a seminar on shoulder dislocation presented by Dr. Abraham A. The seminar covered the anatomy and stabilizers of the shoulder, mechanisms of injury, classification, clinical presentation, imaging, treatment including closed and open reduction techniques, post-operative management, and complications. The objectives of the seminar were to learn how to properly diagnose shoulder dislocations, understand important x-rays for diagnosis, and techniques for closed reduction.
This document discusses the management of traumatic anterior shoulder dislocations. It begins by describing the shoulder's anatomy and how its mobility makes it prone to instability. It then reviews the history and clinical examination findings that help determine appropriate treatment. Arthroscopic findings from studies of acute and chronic dislocations are presented, showing common lesions like Bankart tears. Treatment options are explored, including arthroscopic stabilization which can address all lesions with minimal morbidity. Arthroscopy allows accurate diagnosis and repair of injuries while facilitating early rehabilitation. The conclusion is that arthroscopy is now often the treatment of choice for traumatic shoulder dislocations.
32,Principles of Dislocation Manangment.pptxBedrumohammed2
This document outlines principles of managing common joint dislocations. It discusses the anatomy, mechanisms, clinical presentation, imaging and treatment approaches for dislocations of the shoulder, elbow, hip and knee. For each joint, it describes techniques for closed and open reduction as well as post-reduction care and rehabilitation. Complications of joint dislocations like recurrent instability, stiffness and avascular necrosis are also summarized.
This document provides an overview of orthopedic injuries of the upper extremity, including the shoulder, arm, elbow, forearm, and wrist. It reviews fractures, dislocations, and ligament injuries of these areas. Specific topics covered include sternoclavicular joint injuries, acromioclavicular joint injuries, clavicle fractures, scapular injuries, glenohumeral joint dislocations, rotator cuff injuries, and complications of shoulder dislocations such as Hill-Sachs deformities and Bankart fractures. Treatment options and techniques for reducing shoulder dislocations are also discussed.
Shoulder dislocation: Types and Management Methods of ReductionUzair Siddiqui
Shoulder dislocations have been depicted in Egyptian tomb art from 3000 BC. There are different types of shoulder dislocations including anterior, posterior, and inferior. Anterior dislocations are the most common. Clinical signs include pain, inability to contour the shoulder, and an anterior bulge. Radiographs can confirm and classify the dislocation. Reduction maneuvers include traction-countertraction, Hippocrates, Kocher, and scapular manipulation methods. Post-reduction, patients are immobilized and followed up to prevent recurrent dislocations, which occur in 50-90% of young patients.
This document discusses shoulder dislocations, including the types, causes, clinical presentation, evaluation, and management. The main types of dislocation are traumatic, atraumatic, and acquired. Traumatic dislocations are usually anterior and caused by forceful external rotation and abduction. Clinical features include pain, inability to abduct or externally rotate the arm. Reduction techniques discussed include Kocher, Stimson, traction/countertraction maneuvers. Post-reduction immobilization for 3-4 weeks is recommended. Recurrent dislocations may require surgical repair such as Bankart repair to reattach the detached labrum.
The document discusses shoulder instability, including its definition, causes, clinical presentation, evaluation, and treatment options. Static factors like bony anatomy and ligaments contribute to stability, while dynamic factors include muscle forces. Pathologies include labral tears and capsular injuries. Treatment depends on factors like age, activity level, and pathology. Non-operative options include immobilization, while surgery repairs tissues like the labrum or tightens the capsule. Rehabilitation progresses from rest to strengthening and sport-specific training.
The document provides an overview of orthopedic injuries of the upper extremity, including the shoulder, arm, elbow, forearm, and wrist. It reviews common fractures and dislocations, their presentations, diagnostic approaches, and treatment options. Key injuries discussed include sternoclavicular dislocations, acromioclavicular separations, clavicle and scapula fractures, and shoulder dislocations.
This document provides a review of rotator cuff tears, including their anatomy, function, pathophysiology, clinical presentation, diagnostic tests, differential diagnosis, imaging, and treatment options. It describes the rotator cuff muscles and their role in stabilizing the shoulder joint. Common causes of tears include repeated impingement against bony structures or age-related degeneration. Clinical exams aim to isolate each muscle while imaging such as MRI can determine the size and location of tears. Conservative treatment includes corticosteroid injections and physical therapy, while surgical repair is considered for larger or symptomatic tears.
This document discusses the management of traumatic anterior shoulder dislocations. It begins by describing the shoulder's anatomy and how its mobility makes it prone to instability. It then reviews the history and clinical examination findings that help determine appropriate treatment. Arthroscopic findings from studies of acute and chronic dislocations are presented, showing common lesions like Bankart tears. Treatment options are explored, including arthroscopic stabilization which can address all lesions with minimal morbidity. Arthroscopy allows accurate diagnosis and repair of injuries while facilitating early rehabilitation. The conclusion is that arthroscopy is now often the treatment of choice for traumatic shoulder dislocations.
32,Principles of Dislocation Manangment.pptxBedrumohammed2
This document outlines principles of managing common joint dislocations. It discusses the anatomy, mechanisms, clinical presentation, imaging and treatment approaches for dislocations of the shoulder, elbow, hip and knee. For each joint, it describes techniques for closed and open reduction as well as post-reduction care and rehabilitation. Complications of joint dislocations like recurrent instability, stiffness and avascular necrosis are also summarized.
This document provides an overview of orthopedic injuries of the upper extremity, including the shoulder, arm, elbow, forearm, and wrist. It reviews fractures, dislocations, and ligament injuries of these areas. Specific topics covered include sternoclavicular joint injuries, acromioclavicular joint injuries, clavicle fractures, scapular injuries, glenohumeral joint dislocations, rotator cuff injuries, and complications of shoulder dislocations such as Hill-Sachs deformities and Bankart fractures. Treatment options and techniques for reducing shoulder dislocations are also discussed.
Shoulder dislocation: Types and Management Methods of ReductionUzair Siddiqui
Shoulder dislocations have been depicted in Egyptian tomb art from 3000 BC. There are different types of shoulder dislocations including anterior, posterior, and inferior. Anterior dislocations are the most common. Clinical signs include pain, inability to contour the shoulder, and an anterior bulge. Radiographs can confirm and classify the dislocation. Reduction maneuvers include traction-countertraction, Hippocrates, Kocher, and scapular manipulation methods. Post-reduction, patients are immobilized and followed up to prevent recurrent dislocations, which occur in 50-90% of young patients.
This document discusses shoulder dislocations, including the types, causes, clinical presentation, evaluation, and management. The main types of dislocation are traumatic, atraumatic, and acquired. Traumatic dislocations are usually anterior and caused by forceful external rotation and abduction. Clinical features include pain, inability to abduct or externally rotate the arm. Reduction techniques discussed include Kocher, Stimson, traction/countertraction maneuvers. Post-reduction immobilization for 3-4 weeks is recommended. Recurrent dislocations may require surgical repair such as Bankart repair to reattach the detached labrum.
The document discusses shoulder instability, including its definition, causes, clinical presentation, evaluation, and treatment options. Static factors like bony anatomy and ligaments contribute to stability, while dynamic factors include muscle forces. Pathologies include labral tears and capsular injuries. Treatment depends on factors like age, activity level, and pathology. Non-operative options include immobilization, while surgery repairs tissues like the labrum or tightens the capsule. Rehabilitation progresses from rest to strengthening and sport-specific training.
The document provides an overview of orthopedic injuries of the upper extremity, including the shoulder, arm, elbow, forearm, and wrist. It reviews common fractures and dislocations, their presentations, diagnostic approaches, and treatment options. Key injuries discussed include sternoclavicular dislocations, acromioclavicular separations, clavicle and scapula fractures, and shoulder dislocations.
This document provides a review of rotator cuff tears, including their anatomy, function, pathophysiology, clinical presentation, diagnostic tests, differential diagnosis, imaging, and treatment options. It describes the rotator cuff muscles and their role in stabilizing the shoulder joint. Common causes of tears include repeated impingement against bony structures or age-related degeneration. Clinical exams aim to isolate each muscle while imaging such as MRI can determine the size and location of tears. Conservative treatment includes corticosteroid injections and physical therapy, while surgical repair is considered for larger or symptomatic tears.
This document provides information on evaluating the elbow on x-ray, including normal anatomy, common injuries, and signs to look for. It discusses the fat pad sign seen with joint effusion, anatomical lines used to evaluate fractures and dislocations, common elbow fractures in adults and children, and positioning for optimal elbow x-rays. Key points covered include the anterior humeral line and radiocapitellar line, supracondylar fractures, radial head fractures, elbow dislocations, and using the fat pad sign to detect subtle injuries.
- Shoulder dislocations are commonly caused by trauma that places the shoulder in positions of extreme range of motion. Anterior dislocations are the most common type.
- The shoulder joint is inherently unstable due to its anatomy, relying on both passive structures like the labrum and ligaments as well as active stabilizers like muscles.
- Clinical evaluation and radiographs are used to diagnose the type of dislocation and assess for complications like fractures.
- Treatment involves closed reduction for most acute dislocations. Recurrent or complicated dislocations may require surgery and immobilization followed by physical therapy.
The document provides information on shoulder instability, including definitions, anatomy, evaluation, classification, pathoanatomy, and treatment options. It discusses the static and dynamic stabilizers of the shoulder joint. Common injuries in instability include Bankart lesions, Hill-Sachs lesions, and capsular injuries. Treatment depends on the direction and chronicity of instability and may involve non-operative management, arthroscopic procedures like Bankart repair, or open procedures like Latarjet for significant bone loss.
This document provides information on scaphoid fractures, including anatomy, biomechanics, classification, diagnosis, treatment and complications. Scaphoid fractures make up 60-70% of carpal bone fractures and often result from falls on an outstretched hand. Treatment depends on factors like location, displacement and time since injury. Options include cast immobilization for nondisplaced fractures or surgery like open reduction and internal fixation for displaced fractures. Complications can include nonunion, malunion and osteoarthritis if not treated properly.
This document discusses fractures of the carpal bones, with a focus on scaphoid fractures. Scaphoid fractures make up 60-70% of carpal fractures and are often caused by falls onto an outstretched hand. Diagnosis involves x-rays and sometimes CT or MRI. Treatment depends on fracture location and stability, ranging from casting to surgical fixation. Fractures of other carpal bones like the triquetrum, trapezium, capitate and hamate are also discussed, along with their mechanisms, presentations and treatment approaches.
This document provides an overview of common injuries around the hip joint, including dislocation of the hip, fracture of the femoral neck, and intertrochanteric fracture of the femur. It describes the mechanisms, clinical presentations, investigations, complications and treatment approaches for each of these injuries. Key points covered include the posterior dislocation of the hip being the most common type, various classification systems for femoral neck fractures, options for internal or external fixation, arthroplasty or hemiarthroplasty, and complications such as nonunion, avascular necrosis and osteoarthritis.
Management of Shoulder dislocations and shoulder instability in sports BhaskarBorgohain4
acute shoulder dislocation is one of the most common sports injuries especially in contact sports. recurrent dislocations are quite common after anterior dislocation of shoulder especially in young athletes who are engaged in sports with lots of overhead activities during their games. Bankarts lesion, Hill sachs lesion are common predisposing factors for recurrence. Simple acute first time dislocations may be reduced on the field by a trained person but further referral is must for detail evaluation. recurrent dislocation can be reduced on field too by less trained. complicated dislocations, neurovascular deficits, fracture dislocation are to be referred to hospital immediately. Practical scientific algorithms are presented for their appropriate management here.
Total Shoulder Arthroplasty | Reverse Shoulder Replacement | South Windsor, R...James Mazzara
https://hartfordsportsorthopedics.com/
In this presentation, Dr. Mazzara discusses the pathology, surgical techniques, and potential complications during a total shoulder replacement and a reverse total shoulder replacement.
To learn more about shoulder replacements, please visit: https://hartfordsportsorthopedics.com/total-shoulder-replacement-arthroplasty-south-windsor-rocky-hill-glastonbury-ct/
The document discusses the anatomy and radiographic evaluation of shoulder injuries. It describes common fractures and lesions seen, including Bankart lesions, Hill-Sachs lesions, fractures of the humerus and clavicle. It recommends specific radiographic views like AP, external rotation, and Grashey's view to evaluate different shoulder injuries and assess for fractures, dislocations, and arthritis.
Acromioclavicular joint arthritis is a degenerative disease of the joint between the clavicle and acromion. It causes pain and stiffness. Risk factors include age over 45, previous injury to the joint, and weightlifting activities. The disease can be caused by primary osteoarthritis, post-traumatic osteoarthritis following an injury, or distal clavicle osteolysis from repetitive microtrauma. It is diagnosed based on symptoms, physical examination findings like tenderness over the joint, and imaging like x-rays showing signs of arthritis.
This document provides an overview of shoulder anatomy and common shoulder conditions. It discusses the bones, joints, muscles and other structures of the shoulder. Key pathologies covered include impingement syndrome, rotator cuff injuries, adhesive capsulitis, acromioclavicular joint problems, and recurrent shoulder dislocations. For each condition, the document outlines causes, symptoms, diagnostic approaches and treatment options. Surgical and non-surgical management techniques are described.
The document describes the anatomy and classification of injuries to the clavicle, acromioclavicular joint, and sternoclavicular joint. It discusses the clavicle bone, its joints, ligaments, muscle attachments, mechanisms of injury, physical exam, radiographic evaluation, classification of fractures, and treatment options for fractures and dislocations which can include nonoperative treatment, plate fixation, intramedullary fixation, coracoclavicular screw fixation, and distal clavicle excision.
The document discusses shoulder anatomy and common shoulder conditions including:
- Impingement syndrome which occurs when the rotator cuff is pinched between the acromion and humerus bone. Risk factors include age over 40 and overhead activities. Treatment involves rest, physiotherapy, and surgery if conservative measures fail.
- Rotator cuff pathology which can cause tears. Causes include overuse or trauma. Treatment depends on the size and chronicity of the tear and may involve surgery.
- Adhesive capsulitis (frozen shoulder) which causes pain and stiffness. It typically resolves over 2 years with physiotherapy and injections.
- Acromioclavicular joint pathology like arthritis which can cause pain
Supra condylar humerus fracture in childrenSubodh Pathak
Upper-extremity fractures account for 65-75% of all fractures in children, with 7-9% involving the elbow. Supracondylar fractures of the distal humerus are the most common elbow injuries in children, typically occurring between ages 5-10 years old. These fractures are classified into Types 1-3 based on displacement. Type 1 fractures are non-displaced, Type 2 have angulation/displacement with an intact posterior cortex, and Type 3 have complete displacement of fragments. Closed reduction and percutaneous pinning is the most common treatment, with pins placed medially and laterally for stability. Open reduction is rarely needed but may be indicated for inadequate closed reduction or vascular injury.
shoulder dislocation,scapula ,clavicle and all injuries around shoulder jointsAayush Rai
1. The document discusses fractures and dislocations that can occur in the shoulder girdle, which includes the clavicle, scapula, and humerus.
2. It describes the mechanisms of injury, clinical presentations, treatments, and complications for fractures of the clavicle and scapula as well as dislocations of the sternoclavicular joint, acromioclavicular joint, and glenohumeral joint.
3. The treatments discussed include slings, braces, closed reduction, open reduction with internal fixation, and surgical procedures like the Bankart repair.
Presentation1.pptx, ultrasound examination of the shoulder joint.Abdellah Nazeer
This ultrasound examination document provides images and descriptions of normal shoulder anatomy as well as common shoulder pathologies. It begins with transverse, longitudinal, and axial views of normal structures like the biceps, subscapularis, supraspinatus, and infraspinatus tendons. Patient positioning and scanning techniques are described. Common conditions like rotator cuff tears, bursitis, tendinosis, and biceps tendinitis are then discussed along with their ultrasound appearances. The document concludes with limitations of ultrasound and tips for equipment selection and scanning techniques.
This document provides information on evaluating the elbow on x-ray, including normal anatomy, common injuries, and signs to look for. It discusses the fat pad sign seen with joint effusion, anatomical lines used to evaluate fractures and dislocations, common elbow fractures in adults and children, and positioning for optimal elbow x-rays. Key points covered include the anterior humeral line and radiocapitellar line, supracondylar fractures, radial head fractures, elbow dislocations, and using the fat pad sign to detect subtle injuries.
- Shoulder dislocations are commonly caused by trauma that places the shoulder in positions of extreme range of motion. Anterior dislocations are the most common type.
- The shoulder joint is inherently unstable due to its anatomy, relying on both passive structures like the labrum and ligaments as well as active stabilizers like muscles.
- Clinical evaluation and radiographs are used to diagnose the type of dislocation and assess for complications like fractures.
- Treatment involves closed reduction for most acute dislocations. Recurrent or complicated dislocations may require surgery and immobilization followed by physical therapy.
The document provides information on shoulder instability, including definitions, anatomy, evaluation, classification, pathoanatomy, and treatment options. It discusses the static and dynamic stabilizers of the shoulder joint. Common injuries in instability include Bankart lesions, Hill-Sachs lesions, and capsular injuries. Treatment depends on the direction and chronicity of instability and may involve non-operative management, arthroscopic procedures like Bankart repair, or open procedures like Latarjet for significant bone loss.
This document provides information on scaphoid fractures, including anatomy, biomechanics, classification, diagnosis, treatment and complications. Scaphoid fractures make up 60-70% of carpal bone fractures and often result from falls on an outstretched hand. Treatment depends on factors like location, displacement and time since injury. Options include cast immobilization for nondisplaced fractures or surgery like open reduction and internal fixation for displaced fractures. Complications can include nonunion, malunion and osteoarthritis if not treated properly.
This document discusses fractures of the carpal bones, with a focus on scaphoid fractures. Scaphoid fractures make up 60-70% of carpal fractures and are often caused by falls onto an outstretched hand. Diagnosis involves x-rays and sometimes CT or MRI. Treatment depends on fracture location and stability, ranging from casting to surgical fixation. Fractures of other carpal bones like the triquetrum, trapezium, capitate and hamate are also discussed, along with their mechanisms, presentations and treatment approaches.
This document provides an overview of common injuries around the hip joint, including dislocation of the hip, fracture of the femoral neck, and intertrochanteric fracture of the femur. It describes the mechanisms, clinical presentations, investigations, complications and treatment approaches for each of these injuries. Key points covered include the posterior dislocation of the hip being the most common type, various classification systems for femoral neck fractures, options for internal or external fixation, arthroplasty or hemiarthroplasty, and complications such as nonunion, avascular necrosis and osteoarthritis.
Management of Shoulder dislocations and shoulder instability in sports BhaskarBorgohain4
acute shoulder dislocation is one of the most common sports injuries especially in contact sports. recurrent dislocations are quite common after anterior dislocation of shoulder especially in young athletes who are engaged in sports with lots of overhead activities during their games. Bankarts lesion, Hill sachs lesion are common predisposing factors for recurrence. Simple acute first time dislocations may be reduced on the field by a trained person but further referral is must for detail evaluation. recurrent dislocation can be reduced on field too by less trained. complicated dislocations, neurovascular deficits, fracture dislocation are to be referred to hospital immediately. Practical scientific algorithms are presented for their appropriate management here.
Total Shoulder Arthroplasty | Reverse Shoulder Replacement | South Windsor, R...James Mazzara
https://hartfordsportsorthopedics.com/
In this presentation, Dr. Mazzara discusses the pathology, surgical techniques, and potential complications during a total shoulder replacement and a reverse total shoulder replacement.
To learn more about shoulder replacements, please visit: https://hartfordsportsorthopedics.com/total-shoulder-replacement-arthroplasty-south-windsor-rocky-hill-glastonbury-ct/
The document discusses the anatomy and radiographic evaluation of shoulder injuries. It describes common fractures and lesions seen, including Bankart lesions, Hill-Sachs lesions, fractures of the humerus and clavicle. It recommends specific radiographic views like AP, external rotation, and Grashey's view to evaluate different shoulder injuries and assess for fractures, dislocations, and arthritis.
Acromioclavicular joint arthritis is a degenerative disease of the joint between the clavicle and acromion. It causes pain and stiffness. Risk factors include age over 45, previous injury to the joint, and weightlifting activities. The disease can be caused by primary osteoarthritis, post-traumatic osteoarthritis following an injury, or distal clavicle osteolysis from repetitive microtrauma. It is diagnosed based on symptoms, physical examination findings like tenderness over the joint, and imaging like x-rays showing signs of arthritis.
This document provides an overview of shoulder anatomy and common shoulder conditions. It discusses the bones, joints, muscles and other structures of the shoulder. Key pathologies covered include impingement syndrome, rotator cuff injuries, adhesive capsulitis, acromioclavicular joint problems, and recurrent shoulder dislocations. For each condition, the document outlines causes, symptoms, diagnostic approaches and treatment options. Surgical and non-surgical management techniques are described.
The document describes the anatomy and classification of injuries to the clavicle, acromioclavicular joint, and sternoclavicular joint. It discusses the clavicle bone, its joints, ligaments, muscle attachments, mechanisms of injury, physical exam, radiographic evaluation, classification of fractures, and treatment options for fractures and dislocations which can include nonoperative treatment, plate fixation, intramedullary fixation, coracoclavicular screw fixation, and distal clavicle excision.
The document discusses shoulder anatomy and common shoulder conditions including:
- Impingement syndrome which occurs when the rotator cuff is pinched between the acromion and humerus bone. Risk factors include age over 40 and overhead activities. Treatment involves rest, physiotherapy, and surgery if conservative measures fail.
- Rotator cuff pathology which can cause tears. Causes include overuse or trauma. Treatment depends on the size and chronicity of the tear and may involve surgery.
- Adhesive capsulitis (frozen shoulder) which causes pain and stiffness. It typically resolves over 2 years with physiotherapy and injections.
- Acromioclavicular joint pathology like arthritis which can cause pain
Supra condylar humerus fracture in childrenSubodh Pathak
Upper-extremity fractures account for 65-75% of all fractures in children, with 7-9% involving the elbow. Supracondylar fractures of the distal humerus are the most common elbow injuries in children, typically occurring between ages 5-10 years old. These fractures are classified into Types 1-3 based on displacement. Type 1 fractures are non-displaced, Type 2 have angulation/displacement with an intact posterior cortex, and Type 3 have complete displacement of fragments. Closed reduction and percutaneous pinning is the most common treatment, with pins placed medially and laterally for stability. Open reduction is rarely needed but may be indicated for inadequate closed reduction or vascular injury.
shoulder dislocation,scapula ,clavicle and all injuries around shoulder jointsAayush Rai
1. The document discusses fractures and dislocations that can occur in the shoulder girdle, which includes the clavicle, scapula, and humerus.
2. It describes the mechanisms of injury, clinical presentations, treatments, and complications for fractures of the clavicle and scapula as well as dislocations of the sternoclavicular joint, acromioclavicular joint, and glenohumeral joint.
3. The treatments discussed include slings, braces, closed reduction, open reduction with internal fixation, and surgical procedures like the Bankart repair.
Presentation1.pptx, ultrasound examination of the shoulder joint.Abdellah Nazeer
This ultrasound examination document provides images and descriptions of normal shoulder anatomy as well as common shoulder pathologies. It begins with transverse, longitudinal, and axial views of normal structures like the biceps, subscapularis, supraspinatus, and infraspinatus tendons. Patient positioning and scanning techniques are described. Common conditions like rotator cuff tears, bursitis, tendinosis, and biceps tendinitis are then discussed along with their ultrasound appearances. The document concludes with limitations of ultrasound and tips for equipment selection and scanning techniques.
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La pandemia de COVID-19 ha tenido un impacto significativo en la economía mundial y las vidas de las personas. Muchos países han impuesto medidas de confinamiento que han cerrado negocios y escuelas, y han pedido a la gente que se quede en casa tanto como sea posible para frenar la propagación del virus. A medida que los países comienzan a reabrir gradualmente, los expertos advierten que es probable que se produzcan nuevos brotes a menos que se realicen pruebas generalizadas y se implementen sistemas de rastreo de contactos para identificar rá
The document discusses the benefits of exercise for both physical and mental health. Regular exercise can improve cardiovascular health, reduce symptoms of depression and anxiety, enhance mood, and boost brain function. Staying physically active helps fight diseases and conditions, increases energy levels, and promotes better quality of life.
The document discusses the benefits of meditation for reducing stress and anxiety. Regular meditation practice can help calm the mind and body by lowering heart rate and blood pressure. Meditation may also have psychological benefits like reducing rumination and negative thought patterns that often accompany stress and worry.
The document discusses the surgical management of peptic ulcer disease (PUD). It covers the epidemiology, anatomy, pathophysiology, complications, and various surgical techniques for PUD, including vagotomy, pyloroplasty, gastrojejunostomy, and gastric resection. Specific procedures discussed are truncal vagotomy, selective vagotomy, proximal gastric vagotomy/highly selective vagotomy, Heineke-Mikulicz pyloroplasty, Finney pyloroplasty, and Jaboulay gastroduodenostomy. Post-operative complications are also addressed.
This document summarizes the surgical management of peptic ulcer disease. It discusses the pathophysiology, clinical presentation, diagnosis, complications and surgical treatments. For surgical management, the key indications are protracted bleeding, perforation, and obstruction. Common procedures include patch closure for perforated duodenal ulcers and distal gastric resection for perforated gastric ulcers. Endoscopic methods are first-line for treating bleeding but surgery is needed for recurrent or severe bleeding. Postoperative care involves NG tube, IV PPIs and H. pylori treatment if present.
4.Management of IHPS and Intussusception.pptxmekuriatadesse
This document discusses two pediatric surgical conditions: hypertrophic pyloric stenosis and intussusception.
For hypertrophic pyloric stenosis, it provides details on the etiology, risk factors, diagnosis using ultrasound, and surgical treatment via pyloromyotomy. Intussusception is described as the invagination of the bowel where the proximal bowel telescopes into the distal bowel. It discusses the pathophysiology involving compression of blood vessels which can lead to ischemia if not treated. Types of intussusception and treatment involving surgery or enema are also outlined.
The document discusses the benefits of exercise for both physical and mental health. It notes that regular exercise can reduce the risk of diseases like heart disease and diabetes, improve mood, and reduce stress and anxiety levels. Exercise is also said to boost brain health and function by improving cognitive abilities and reducing the risk of conditions like Alzheimer's disease and dementia.
The document summarizes an approach to lower back pain presented by Dr. Yetsedaw and prepared by Dr. Mekuria. It outlines conservative management strategies including short-term bed rest, activity modification, exercise, analgesics, muscle relaxants, education, epidural steroid injections, and spinal manipulation therapy.
Lecture 6 -- Memory 2015.pptlearning occurs when a stimulus (unconditioned st...AyushGadhvi1
learning occurs when a stimulus (unconditioned stimulus) eliciting a response (unconditioned response) • is paired with another stimulus (conditioned stimulus)
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
3. Objective of the seminar
1 ….able to know how to diagnose properly
2….. Able to know which x rays are important for dx of sh
oulder dislocation
3…. able to know the techniques of closed reduction
4. Introduction
Shoulder dislocation
is a complete symptomatic dissociation of the articular surfaces of the humeral head
and glenoid without spontaneous reduction.
About 2 to 4% of shoulder injury
about 45 to 50% all dislocation
Unstable joint
Treated both non operatively and operatively
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5. Seen 17 to 23 per 100,000 per year
Bimodal
males in the 21 to 30 year age range
for women in the 61 to 80 year age range
Recurrence all ages is 50%
89% in the 14 to 20 year age group.
71.8% of dislocations occurring in men.
There was no difference based on race.
Most dislocations (58.8%) occurred during a fall, w
hereas 48.3% occurred during sports activities
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shoulder dislocation
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9. Coracoacromial ligament
limit the extent of
anterosuperior
superior
posterosuperior translation of the hu
meral head
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14. Anterior dislocation
represent 96% of shoulder dislocations
arm in abduction and external rotation
Rarely direct blow
Young <30
Older age
had associated injurys
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15. History
Mechanism of injury
Limb position
Previous Hx
Medical condition
age, occupation, hand dominance, level of sporting o
r recreational activity
16. Physical examination
Anterior dislocation
Limb position
squaring of the shoulder
prominence of the acromion
sulcus
neurovascular examination
Axillary nerve
musculocutaneous nerve
test contraction of the biceps or brachialis
test sensation of the lateral antebrachial cutaneous distribution on the lateral aspect
of the forearm.
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17. Apprehension Tests and fulcrum test
getting ready to dislocate
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18. Based on humeral head location
subcoracoid
Subglenoid
Subclavicular
intrathoracic
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19. Posterior dislocation
represent 2% to 4% of shoulder dislocations
50% to 60% missed on initial examination
Indirect
adduction, flexion, and internal rotation
Electric shock or convulsive mechanisms
Direct
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20. subacromial
subspinous, and
Subglenoid
Rare dislocation type
inferior dislocation
Superior dislocation
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21. posterior dislocation
does not present with striking deformity
traditional sling position
palpable mass posterior to the shoulder
flattening of the anterior shoulder
coracoid prominent
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22. Other test
Dugas test
Callaway s sign- axillary
girth
Hamilton ruler test
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25. imaging
Trauma series x ray
AP
Scapular Y view
axillary
Other special view
West point axillary
glenoid defect
Stryker notch view
humeral head defects
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29. X ray features
Anterior dislocation
Fracture dislocation
Greater tuberosity
Bankart lesion
Hill-sachs defect
Loss of elliptical over lap
Head relatively
large,
anterior ,
medial and inferior to glenoid fossa
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34. CT scan
Fracture difficult to interpret x ray
Estimation glenoid bone loss
Pre op planning
MRI
Sub acute and chronic instablity
Capsuloligamentous structure
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35. management
Non operative
Operative
Traumatic/ a traumatic
Initial /recurrent
Young/old
Pain
Demand
Medical condition
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36. Instability severity score
variable parameter score
age >20
>20
2
0
Degree of sport
participation
Competitive
recreational
2
0
Type of sport participation Contact
other
1
0
Shoulder hyper laxity Hyper laxity
normal
1
0
Hill sachs on AP x ray Visible
Not visible
2
0
Glenoid contour loss on AP
x ray
Loss of contour
No lesion
2
0
Total = 10
< 6…recurrence is 1o%
> 6….recurrence 70%
…advised to undergo open
37. Closed reduction
Better with in 24 hr
Almost all acute traumatic dislocation except
Humeral neck fracture
Compound dislocation
Vascular injury
Indicator of success
Adequate analgesia
Early reduction
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38. Techniques
optimal technique should be quick, effective, simple to perform and should
require minimal force, analgesia and assistance
simple traction–countertraction
Stimson technique
Scapular manipulation technique
Kocher maneuver
Milch technique
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40. Stimson technique
Prone
Manual traction
5Ib weight
15 to 20 min
traction injury to a nerve
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41. Milch technique
relies on shoulder position than traction
supine or prone
abducted and externally rotated to overhead
90/90 ABD/ER
Thumb pressure to humeral head
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42. Kocher
Traction
ER
Adduction
arm is internally rotated
Complication high
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43. Scapular manipulation technique
Prone position or sitting
Traction
Manually fix superior and medial scapula
push inferior tip scapula medially
Glenoid face inferiorly
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44. Posterior dislocation
Under GA reduction
Traction in flexion adduction and internal rotation
Disengage head external rotate while pushing head anteriorly
Closed reduction is often difficult
Post reduction
Stability
Radiographs
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45. Common pitfalls of closed reduction of shoulder dislocati
ons are
o Displacement of fracture
o Acute instability
o Recurrent instability
46. Common Causes of shoulder irreducibility
Soft tissue entrapment
(Biceps , subscapularis , labrum)
Bony fragments
( glenoid , GT , hill sachs)
48. Early passive motion
ER or IR exercises at lower degrees of abduction and avoid exercises at 90
° of abduction in the 1st 6 wk
isometrics exercise –avoid muscle atrophy
Full range of active and passive motion by 8 to 10 wks.
Return to sport 4 to 6 month
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49. Operative
Indications
failed appropriate non operative therapy
recurrent dislocation at a young age
irreducible dislocation
open dislocation, and
unstable joint reduction
poor function and pain
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51. Common operations performed
LATERJET PROCEDURE
Bankart procedure
lesser tuberosity transfer
transfer of the upper one-third of the subscapularis
RECONSTRUCTION OF ANTERIOR GLENOID USING ILIAC C
REST BONE AUTOGRAFT
52. Surgical approach
Anterior approach to shoulder
work-horse for open reduction
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58. Post op management
Goal
to restore pain-free range of motion
shoulder muscle strength
Decrease recurrence
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59. post-operative rehabilitation
3-6 weeks: shoulder immobilizer or sling
6-10 weeks: limit on abduction and external rotation
10-16 weeks: gradual range of motion
>16 weeks: strengthening
>10 months: contact sports
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60. complication
Recurrence
Bone injury
Soft tissue injury
Neurovascular injury
Infection
Loss of ROM
AVN
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61. Summery
shoulder is the most unstable and commonly dislocated major joint of the
body
Stability mainly from capsuloligament struc
High recurrence rate
Majority treated non operatively
Rehabilitation is important in both non operative and operative
management
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Glenoid labrum- it depeens cavity by 50 perc and increases head coverage to 75 perc.
-The average depth of the glenoid in the anterior/posterior direction is 2.5 mm compared to 9 mm in the superior/inferior
10
dislocation is defined as a complete symptomatic
dissociation of the articular surfaces of the humeral head
and glenoid without spontaneous reduction.
subluxation is a symptomatic dissociation
of the articular surfaces with spontaneous reduction
19
20
21
22
25
Lightbulb sign… int rotation
Trough line sign ..vertical line in the medial humeral head due to impactionof z humeral head
Mouzopoulus sign .. Int rotation of z humeral head allows z GT& LT to form a M shape
Moloneys arch ….acute angle of scapulohumeral arch