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122 visible knowledge nodes in trauma
Rotator Cuff Impingement — Neer and Bigliani Classification
Comprehensive guide to subacromial impingement syndrome covering Neer staging, Bigliani acromial morphology, clinical tests, conservative management, subacromial decompression and outcomes.
Open topicSalter–Harris Classification — Physeal (Growth Plate) Injuries
Type I: Through physis only (slip) — good prognosis; often in younger children. Type II: Through physis and metaphysis (Thurston–Holland fragment) — most common; good prognosis. Type III: Through physis and epiphysis into joint — needs anatomic reduction (articular). Type IV: Through metaphysis, physis, and epiphysis — high risk of growth arrest; ORIF often required. Type V: Crush injury to physis — rare, poor prognosis; often diagnosed retrospectively by growth arrest. Extended: Rang VI–IX (per...
Open topicSanders CT Classification — Calcaneus
I: nondisplaced posterior facet; II: two-part; III: three-part; IV: comminuted (>3 parts). Type correlates with outcome; II–III often ORIF; IV has poorest prognosis.
Open topicScaphoid Fracture — Diagnosis & Treatment
Most common carpal fracture, usually waist (70%). Blood supply retrograde to proximal pole → high risk of AVN. Clinical: anatomical snuffbox tenderness, pain on axial loading of thumb. Investigations: X-ray may be normal; MRI is sensitive for occult fracture. Treatment: cast for undisplaced, screw fixation for displaced, vascularized bone graft for nonunion.
Open topicSchatzker Classification — Tibial Plateau
I split lateral; II split+depression; III pure depression; IV medial; V bicondylar; VI metaphyseal-diaphyseal dissociation. Severity ↑ from I→VI; medial/bicondylar often need dual plating/ex-fix; restore joint surface to avoid arthritis.
Open topicScrews in Orthopaedic Surgery — Types, Biomechanics & Clinical Applications
Comprehensive guide to orthopaedic screws covering screw anatomy and geometry, cortical and cancellous screws, lag screws and the lag technique, locking screws, cannulated screws, headless compression screws, malleolar and positional screws, bioabsorbable screws, and screw failure mechanisms with clinical applications across fracture fixation.
Open topicSeinsheimer Classification — Subtrochanteric Femur
Types I–V: nondisplaced to highly comminuted/segmental by number/configuration of fragments. Most require IM nailing; higher types have longer healing and alignment challenges.
Open topicShaft Humerus — Radial Nerve Palsy
Primary neurapraxia occurs in ~10–15% closed fractures; most recover spontaneously by 3–4 months. Immediate exploration for open fractures, vascular injury, high‑energy with suspected transection, or secondary palsy after manipulation/fixation. Expectant management: splint, serial exams/EMG at 6–12 weeks; consider exploration if no recovery by 3–4 months. Fixation choices: functional bracing vs ORIF/IM nailing based on pattern and patient factors.
Open topicShaft of Femur Fractures — Reamed Nailing
Gold standard for adult diaphyseal femur. Reaming adds biology + bigger nail. Supine position, piriformis/trochanteric entry. Complications: fat embolism, malrotation, knee pain.
Open topicShock and Resuscitation in Orthopaedics
Types: hypovolemic (hemorrhagic), distributive (septic, neurogenic), cardiogenic, obstructive. Initial approach: ATLS (Airway with C‑spine, Breathing, Circulation, Disability, Exposure). Hemorrhagic shock is most common in trauma; control bleeding + balanced transfusion (1:1:1) + permissive hypotension until hemorrhage control (except TBI). Resuscitation targets: lactate clearance, base deficit, urine output, MAP appropriate to context. Adjuncts: TXA within 3 hours of injury; damage control surg...
Open topicSkin Traction in Children
Non-invasive traction in children. Types: Gallows (
Open topicSLAP Tears — Snyder Classification & Management
Detailed review of superior labrum anterior to posterior (SLAP) tears covering Snyder classification Types I–IV and further subtypes, clinical diagnosis, MR arthrography, biceps tenodesis vs SLAP repair, and return-to-sport criteria.
Open topicSternoclavicular Injuries
SC joint dislocations: anterior (more common, often stable after reduction) vs posterior (rare but life‑threatening due to mediastinal compression). Posterior dislocation red flags: dyspnea, dysphagia, venous congestion, neurologic symptoms—urgent reduction under anesthesia with cardiothoracic standby. Imaging: CT with contrast preferred; plain X‑rays often inadequate. Management: sling and rehab for sprain/anterior dislocation; posterior often requires closed/open reduction and stabilization (f...
Open topicSubtrochanteric Femur — Fixation
Deforming forces: flex-abd-ER proximal; add distal. Implant: CMN gold standard. Reduction aids: Schanz, cerclage, clamps. Entry point crucial (piriformis/trochanteric). Complications: malreduction, implant failure.
Open topicTalar Neck Fractures — Hawkins
Hawkins classification I–IV based on displacement/dislocation. AVN risk increases with stage: I 90%. Urgent reduction and fixation critical to preserve talar blood supply. Fixation: screws/plates, often dual incision approach. Hawkins sign (subchondral lucency) = revascularization on X-ray at 6–8 weeks.
Open topicTendon to Bone Fixation methods
Tendon-to-bone fixation is the process of securely attaching a tendon or ligament graft to bone using devices such as bone tunnels, suture anchors, interference screws, cortical buttons, and suspensory fixation systems until biological healing occurs. Successful repair depends on both strong initial mechanical fixation and gradual tendon-to-bone biological incorporation at the enthesis. The choice of fixation method varies according to the procedure, tendon quality, bone quality, and biomechanic...
Open topicTerrible Triad of the Elbow — Pattern (Not Graded)
Posterior elbow dislocation + radial head fracture + coronoid tip fracture. Requires concentric reduction, radial head fixation/replacement, coronoid/LCCL repair.
Open topicThomas Splint — Indications & Technique
Indications: femoral shaft fractures, temporary stabilization. Provides traction + splintage. Structure: proximal ring, side bars, distal crossbar. Complications: sores, nerve palsy, inadequate traction.
Open topicTibia Shaft Fractures — Compartment Risk
Tibia shaft → highest risk of compartment. Signs: pain out of proportion, stretch pain. ΔP
Open topicTibial Plateau — Schatzker
I lateral split, II split+depression, III depression, IV medial, V bicondylar, VI dissociation. Surgical principle: elevate, graft, raft screws, plate. Complications: compartment syndrome, arthritis.
Open topicTile Classification — Pelvic Ring Stability
A: stable (posterior arch intact). B: rotationally unstable, vertically stable (open-book APC or LC injuries). C: rotationally + vertically unstable (complete posterior disruption).
Open topicTillaux (SH-III) & Triplane (SH-IV) — Distal Tibial Transitional Fractures
Tillaux: Anterolateral epiphyseal avulsion (SH-III) during asymmetric physeal closure — intra-articular; >2 mm step needs fixation. Triplane: Multi-planar SH-IV variant (sagittal epiphysis, axial physis, coronal metaphysis); 2-, 3-, or 4-part patterns. CT delineates fragments to plan screw fixation; restore joint congruity to prevent arthritis.
Open topicTLICS — Thoracolumbar Injury Classification & Severity Score
Morphology (compression 1, burst 2, translation/rotation 3, distraction 4), Posterior ligamentous complex integrity (intact 0, indeterminate 2, disrupted 3), Neurologic status (intact 0, nerve root 2, complete 2, incomplete 3). Score ≥5 → surgery; ≤3 → nonoperative; 4 = gray zone.
Open topicTscherne–Oestern — Closed Fracture Soft-Tissue Injury
Grade 0: minimal; 1: superficial abrasions/contusions; 2: deep contaminated abrasions, muscle contusion; 3: extensive crush, compartment risk. Higher grades predict complications and influence timing/approach to fixation.
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