Principles of Orthopaedic Surgery

At the end of this course, students should be able to: 1. enumerate the general approach to an injured patient and the various steps to be taken; 2. define what fracture, causes, classification, principles of managements; 3. discuss about missile and blast, the injuries they cause and the approach to patient management; 137 4. explain amputation, indications, preparing patient for surgery; 5. list principles of management of hand injuries and the principles of hand infections; 6. list compartment syndrome especially the danger signs and how to prevent them; 7. explain the basis of congenital talipes equinovarus deformity and its management; and 8. list fundamentals of congenital hand abnormalities and bone tumours.

Clerking in orthopaedics, examination where appley’s principles of look, feel and move are emphasised. Management of multiply injured patient. Management details, both field and hospital management, ATLS protocol of resuscitation and then a good secondary survey to outline the various injuries which aid planning of definitive management. Management is multi-disciplinary. Fracture management. Missile and blast injuries. A list of injuries according to systems is given. Management highlights triaging patient in mass casualty situations and then following ATLS protocol for resuscitation. Principles of amputation. Diagnosis of the patient disease, resuscitation and preparation for surgery with emphasis on consent taking. A highlight of other pre-op, intra-op and op management is given as well as complications and how to prevent or manage them. Preventive measures on amputation. Spinal injured patient. Acute and chronic osteomyelitis, acute osteomyelitis. Chronic osteomyelitis. Bone metabolism especially the role of vitamin D, parathyroid hormones, calcitonin among others, the various diseases affecting these processes such as rickets, osteomalacia are discussed. Tuberculous arthritis and Pott’s disease. Hand infections. Hand injuries. The anatomy and functions of the hand. Prosthesis are all discussed. Compartment syndrome and VIC. Various causes like tight splint, close fractures and even open fractures. Congenital talipes equinovarus (idiopathic vs syndromic). Treatment or early referral at birth or soon afterwards to commence serial manipulation and casting which is the mainstay of treatment. Congenital hand abnormalities. Bone tumours.