Trauma
Reduction is a surgical procedure to restore a fracture or dislocation to the correct alignment. This sense of the term “reduction” does not imply any sort of removal or quantitative decrease but rather implies a restoration. When a bone fractures, the fragments lose their alignment in the form of displacement or angulation. For the fractured bone to heal without any deformity the bony fragments must be re-aligned to their normal anatomical position. Orthopedic surgery attempts to recreate the normal anatomy of the fractured bone by reduction of the displacement.
Reduction could be by “closed” or “open” methods.
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Open reduction is where the fracture fragments are exposed surgically by dissecting the tissues.
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Closed reduction is the manipulation of the bone fragments without surgical exposure of the fragments.
Because the process of reduction can briefly be intensely painful, it is commonly done under a short-acting anaesthetic, sedative, or nerve block. Once the fragments are reduced, the reduction is maintained by application of casts, traction or held by plates, screws, or other implants which may in turn be external or internal. It is very important to verify the accuracy of reduction by clinical tests and X-ray, especially in the case with joint dislocations.
An orthopedic cast, or simply cast, is a shell, frequently made from plaster or fiberglass, encasing a limb (or, in some cases, large portions of the body) to stabilize and hold anatomical structures, most often a broken bone (or bones), in place until healing is confirmed. It is similar in function to a splint. The setting of unmodified plaster starts about 10 minutes after mixing and is complete in about 45 minutes; however, the cast is not fully dry for 72 hours.
Nowadays bandages of synthetic materials are often used, often knitted fiberglass bandages impregnated with polyurethane, sometimes bandages of thermoplastic. These are lighter and dry much faster than plaster bandages. However, plaster can be more easily moulded to make a snug and therefore more comfortable fit. In addition, plaster is much smoother and does not snag clothing or abrade the skin.
Orthopedic surgery or orthopedics, also spelled orthopaedic[s], is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders
Hand Surgery
Carpal tunnel syndrome (CTS) is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel. The main symptoms are pain, numbness, and tingling, in the thumb, index finger, middle finger, and the thumb side of the ring fingers.
De Quervain’s tenosynovitis is inflammation of tendons on the side of the wrist at the base of the thumb. These tendons include the extensor pollicis brevis and the abductor pollicis longus tendons, which extend the joints of the thumb.
Tendon repair is surgery done to treat a torn or otherwise damaged tendon. Tendons are the soft, band-like tissues that connect muscles to bone. When the muscles contract, the tendons pull the bones and cause the joints to move. When tendon damage occurs, movement may be seriously limited. The damaged area may feel weak or painful. Tendon repair surgery may be helpful for people who have tendon injuries that are making it difficult for them to move a joint or are very painful.
Hand surgery is sometimes required when the bones are unstable as in a compound hand fracture in which bones visibly pierce the skin. Fractured hand surgery is also necessary if bones are shattered, often the result of a crushing injury. If your hand requires surgery, your doctor can implant wires, screws or plates in the fractured hand to hold the pieces of bone in place.
A ganglion cyst is a tumor or swelling on top of a joint or the covering of a tendon (tissue that connects muscle to bone). It looks like a sac of liquid (cyst). Inside the cyst is a thick, sticky, clear, colorless, jellylike material. Depending on the size, cysts may feel firm or spongy.
Elbow
Tennis elbow or lateral epicondylitis is a condition in which the outer part of the elbow becomes sore and tender at the lateral epicondyle. The forearm muscles and tendons become damaged from repetitive overuse. This leads to pain and tenderness on the outside of the elbow. Any activity, including playing tennis, that involves repetitive use of the extensor muscles of the forearm can cause acute or chronic tendonitis of the tendinous insertion of these muscles at the lateral epicondyle of the elbow. The condition is common in carpenters and laborers who swing a hammer or other tool with the forearm, and is similar to golfer’s elbow, which affects the medial epicondyle on the inside of the elbow. Continuing activity after onset of the condition and avoiding mandatory rest may lead to permanent onset of pain and only treatable via surgery.
Golfer’s elbow (medial epicondylitis) causes pain and inflammation in the tendons that connect the forearm to the elbow. The pain centers on the bony bump on the inside of your elbow and may radiate into the forearm. It can usually be treated effectively with rest.
Ulnar nerve compression (also called cubital tunnel syndrome) is a condition where there is increased pressure on the ulnar nerve, usually resulting in numbness in your ring and little fingers. Ulnar nerve release surgery aims to resolve this.
Tommy John Surgery is a surgical procedure in which a healthy tendon extracted from an arm (or sometimes a leg) is used to replace an arm’s torn ligament. The healthy tendon is threaded through holes drilled into the bone above and below the elbow.
Arthroscopy is a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope, an endoscope that is inserted into the joint through a small incision.
An elbow dislocation occurs when the bones of the forearm (the radius and ulna) move out of place compared with the bone of the arm (the humerus). The elbow joint, formed where these three bones meet, becomes dislocated, or out of joint.
Shoulder
Rotator cuff (arthroscopic) – Shoulder arthroscopy. Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The arthroscope is inserted through a small cut (incision) in your skin.
Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in your shoulder joint. Signs and symptoms typically begin gradually, worsen over time and then resolve, usually within one to three years.
A dislocated shoulder is when the head of the humerus is out of the shoulder joint. Symptoms include shoulder pain and instability. Complications may include a Bankart lesion, Hill-Sachs lesion, rotator cuff tear, or injury to the axillary nerve.
The term SLAP stands for Superior Labrum Anterior and Posterior. In a SLAP injury, the top (superior) part of the labrum is injured. This top area is also where the biceps tendon attaches to the labrum. A SLAP tear occurs both in front (anterior) and back (posterior) of this attachment point.
Subacromial decompression (acromioplasty) is an operation on your shoulder. It’s used to treat a condition called shoulder impingement. This is when the bones and tendons in your shoulder rub against each other when you raise your arm, causing pain. The word ‘subacromial‘ means ‘under the acromion’.
Shoulder replacement – An orthopedic surgeon will replace the natural bone in the ball and socket of your shoulder joint with a material that could be metal or plastic. It’s a major surgery that’ll keep you in the hospital for several days. You’ll also need several weeks of physical therapy afterward.
The intra-articular steroid injections are a treatment method for relief from joint pain. These steroids are used to decrease the inflammatory reaction associated with osteoarthritis and rheumatoid arthritis. The most prominent indication of the use of such steroid injection is conservative management of an impingement.
Fractures are broken bones. Fractures commonly involve the clavicle (collar bone), proximal humerus (top of the upper arm bone), and scapula (shoulder blade). Dislocations occur when the bones on opposite sides of a joint do not line up. Dislocations can involve any of three different joints.
Hip
A hip fracture is a break in the upper quarter of the femur (thigh) bone. The extent of the break depends on the forces that are involved. The type of surgery used to treat a hip fracture is primarily based on the bones and soft tissues affected or on the level of the fracture.
Femoroacetabular Impingement (FAI), or hip impingement syndrome, may affect the hip joint in young and middle-aged adults and occurs when the ball shaped femoral head rubs abnormally or does not permit a normal range of motion in the acetabular socket. Damage can occur to the articular cartilage, or labral cartilage (soft tissue bumper of the socket), or both. Treatment options range from conservative to arthroscopic to open surgery.
Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement.
Such joint replacement orthopaedic surgery is generally conducted to relieve arthritis pain or in some hip fractures. A total hip replacement (total hip arthroplasty) consists of replacing both the acetabulum and the femoral head while hemiarthroplasty generally only replaces the femoral head. Hip replacement is currently one of the most common orthopaedic operations
Labral tears are often caused by a direct injury to the shoulder, such as falling on an outstretched hand. The labrum can also become torn from the wear and tear of activity, a condition called overuse. An injured labrum can lead to shoulder instability. … The biceps tendon attaches to the front part of the labrum.
Hip arthroscopy refers to the viewing of the interior of the acetabulofemoral (hip) joint through an arthroscope and the treatment of hip pathology through a minimally invasive approach. This technique is sometimes used to help in the treatment of various joint disorders and has gained popularity because of the small incisions used and shorter recovery times when compared with conventional surgical techniques (sometimes referred to as “open surgery”).
Knee
Knee fractures include fractures of: Patella: accounts for 1% of all fractures, most common in ages 20-50. Femoral condyles: these usually fracture when the knee is stressed. Tibial eminence: caused by accidents, such as a blow to the proximal tibia when the knee is flexed, or if the knee is hyperextended during an accident.
Knee arthroscopy is a surgical technique that can diagnose and treat problems in the knee joint. During the procedure, your surgeon will make a very small incision and insert a tiny camera — called an arthroscope — into your knee. This allows them to view the inside of the joint on a screen.
Meniscal tear is one of the most frequently occurring cartilage injuries of the knee. … It’s a piece of cartilage in your knee that cushions and stabilizes the joint. It protects the bones from wear and tear. But all it takes is a good twist of the knee to tear the meniscus.
Anterior cruciate ligament injury is when the anterior cruciate ligament (ACL) is either stretched, partially torn, or completely torn.[1] The most common injury is a complete tear. Symptoms include pain, a popping sound during injury, instability of the knee, and joint swelling. Swelling generally appears within a couple of hours In approximately 50% of cases, other structures of the knee such as surrounding ligaments, cartilage, or meniscus are damaged.
The definition of a multiligament knee injury is commonly recognised as a tear of at least two of the four major knee ligament structures: the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the posteromedial corner (PMC) and the posterolateral corner (PLC).
Articular cartilage, most notably that which is found in the knee joint, is generally characterized by very low friction, high wear resistance, and poor regenerative qualities. It is responsible for much of the compressive resistance and load bearing qualities of the knee joint and, without it, walking is painful to impossible. Osteoarthritis is a common condition of cartilage failure that can lead to limited range of motion, bone damage and invariably, pain. There are several different repair options available for cartilage damage or failure.
A patellar dislocation is a knee injury in which the patella (kneecap) slips out of its normal position. Often the knee is partly bent, painful and swollen. The patella is also often felt and seen out of place. Complications may include a patella fracture or arthritis.
High tibial osteotomy is an orthopaedic surgical procedure which aims to correct a varus deformation with compartmental osteoarthritis. It is usually reserved for younger patients who are generally more active.
Ankle
A fractured ankle can range from a simple break in one bone, which may not stop you from walking, to several fractures, which forces your ankle out of place and may require that you not put weight on it for a few months.
Arthroscopy (also called arthroscopic or keyhole surgery) is a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope, an endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be performed during ACL reconstruction.
A sprain, also known as a torn ligament, is damage to one or more ligaments in a joint, often caused by trauma or the joint being taken beyond its functional range of motion. The severity of sprain ranges from a minor injury which resolves in a few days to a major rupture of one or more ligaments requiring surgical fixation and a period of immobilization. Sprains can occur in any joint but are most common in the ankle and wrist.
The goal of ankle arthrodesis (also commonly known as ankle fusion) is to relieve pain and maintain or improve function for a patient with ankle arthritis. Ankle arthritis is degeneration of the cartilage that covers the ends of the bones that form the ankle joint.
Achilles tendon rupture is when the achilles tendon tears. The achilles is the most commonly injured tendon. Rupture can occur while performing actions requiring explosive acceleration, such as pushing off or jumping.
Foot
A Jones fracture is a break between the base and middle part of the fifth metatarsal of the foot. It results in pain near the midportion of the foot on the outside. There may also be bruising and difficulty walking. Onset is generally sudden.
Bunion is a deformity of the joint connecting the big toe to the foot. The big toe often bends towards the other toes and the joint becomes red and painful. Onset is gradual. Complications may include bursitis or arthritis.
A calcaneal fracture is a break of the calcaneus (heel bone). Symptoms may include pain, bruising, trouble walking, and deformity of the heel. It may be associated with breaks of the hip or back. It usually occurs when a person lands on their feet following a fall from a height or during a motor vehicle collision.
