By Louis Solomon, David Warwick, Selvadurai Nayagam
A accomplished advent to the sphere of orthopaedics and trauma.
summary: A entire advent to the sector of orthopaedics and trauma
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Additional info for Apley's system of orthopaedics and fractures
Tendon rupture, likewise, may cause deformity. Joint instability Any unstable joint will assume a ‘deformed’ position when subjected to force. Joint destruction Trauma, infection or arthritis may destroy the joint and lead to severe deformity. g. g. g. multiple epiphyseal dysplasia). There are a myriad genetic disorders affecting the skeleton, yet BONY LUMPS A bony lump may be due to faulty development, injury, inﬂammation or a tumour. Although x-ray examination is essential, the clinical features can be highly informative.
Vertebral alignment, then at the disc spaces, and then at each vertebra separately, moving from the body to the pedicles, the facet joints and ﬁnally the spinous appendages. For the pelvis, see if the shape is symmetrical with the bones in their normal positions, then look at the sacrum, the two innominate bones, the pubic rami and the ischial tuberosities, then the femoral heads and the upper ends of the femora, always comparing the two sides. Generalized change Take note of changes in bone ‘density’ (osteopaenia or osteosclerosis).
BONE BIOPSY Bone biopsy is often the crucial means of making a diagnosis or distinguishing between local conditions that closely resemble one another. g. a collapsed vertebral body). In other cases it is obvious that the lesion is a tumour – but what type of tumour? Benign or malignant? Primary or metastatic? Radical surgery should never be undertaken for a suspected neoplasm without ﬁrst conﬁrming the diagnosis histologically, no matter how ‘typical’ or ‘obvious’ the xray appearances may be. In bone infection, the biopsy permits not only histological proof of acute inﬂammation but also bacteriological typing of the organism and tests for antibiotic sensitivity.
Apley's system of orthopaedics and fractures by Louis Solomon, David Warwick, Selvadurai Nayagam