prevention of diabetic ulcers
modify healing detriments
causes of lumbar disc prolapse
lifting heavy stuff age decrease H2O contents of disk disk spaces narrowing aggravated by smoking
presentation of nerve root pain
limb pain worse than back pain
pain in nerve root distribution
drugs for osteoporosis
bisphosphonates
HRT
Selective Estrogen Receptor Modulators (SERMs)
what T score is bad for DEXA scan osteoporosis
< -2.5
management foraminal stenosis
- nerve root injection
- epidural injection
- surgery
causes of cervical and lumbar spondylosis
discs degnerate casuing misalignment of facet joint
management closed nerve injury
- spontaneous recovery is possible
surgery is indicated after 3 months
paraesthetic
pins and needles
common causes of axillary nerve palsy
shoulder dislocation
fracture @ NOhumerus
management cauda equina syndrome
MEDICAL EMERGENCY
emergency operation asap but within 48 hours of onset
management neurotmesis
no recovery unless repaired (by direct suturing or grafting)
endoneural tubes disrupted so high chance of “miswiring” during regeneration
prognosis poor
common sources of infection for osteomyelitis
- UTI
- arterial line
- open#
- bone surgery
- joint replacement
- haematogenous
presentation tarsal tunnel syndrome
numbness in foot radiating to big toe in first 3
pain, burning, electrical sensations
tingling over base of foot or heel
define tarsal tunnel syndrome
compression, or squeezing, on the posterior tibial nerve that produces symptoms anywhere along the path of the nerve running from the inside of the ankle into the foot
describe footballers ankle
chronic ankle pain caused by bone spurs on anterior aspect of ankle bone, developed by long term kicking
potential complications tetraplegia
- resp failure
- hypoxia
tetraplegia/ quadriplegia
partial or total loss of use of all 4 limbs and the trunk
define subluxation
partial dislocation - not fully out of joint
management open fracture
- photograph
- tetanus and antibiotic prophylaxis
- repeated examination
- no provisional irrigation/ exploration
- radiographs
- fixation
- grafts
- do not clean unless gross contamination
define type III C open #
- high energy
- extensive soft tissue damage
- severe fracture
- > 10cm wound
- any gunshot/ farm/ segmental# / bone loss/ severe crush injury/ marine
associated neuromuscular complications
essential examination for pelvic fractures
rectal exam
