Thomas & Epstein classification
Hip dislocation
Hip dislocation
Thomas&epstein
Sciatic nerve injury 10%
In x ray show ( anterior) large
(Posterior) small
Ttt»> emergent ( allis & stimson)
AOM
8-12 y
Staph aureus 80%
Inflammation start in (Metaphysis)
Septic arthritis»» increase in adult
And childern( except lower end of femur & upper end of humerous & head of radius ) and infants
Symptoms»_space; ( FAHM& swelling & severe pain)
Signs» (High temp & tachycardia & tenderness)
DD»_space; ( Septic arthritis & cellulitis & RA$Ewing sarcoma & Haemoarthroais)
X-Ray»_space;> decrease density ( hyperemia)
Complications»_space; ( Toxemia&septicemia & COM & Pathological Fx )
Ttt 3A 3B 3S
COM
Decrease FAHM
X-ray»_space;> hyperopaque
Sinogram»_space;> show sinus tract
Complications»_space;> ( Pathological fx & Malignancy & Amylodosis )
Ttt (mainly surgical)»_space;>
-Sinusectomy
-sequestrectomy and saucerizaion of bone cavity
-Closure of bone cavity (muscle flap & gentamycin beads )
Radical ttt»_space;> illizarov apparatus
Vascularized gradt ( tibialization of the fibula)
-Amputation in ( carcinoma& amyloid )
Compartmental $
Causes» (Tight cast &bleeding with in space & traumatic muscle swelling& arterial injury & fx & soft tissue trauma& burns )
Mechanism»_space;> compression»_space; decrease VR»_space; increase capillary permeability»_space; swelling» spasm of the artery & decrease perfusion&Ischemia of muscle& Crush $
C/p»_space;> 6P
Ttt»> prevention( splintage & elevation the-limb& anti edematous drug & close follow up ) curative( fasciotomy)
