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Case Studies
Common orthopaedic problems in general practice
Missing orthopaedic problems can lead to long term disability
When not diagnosed early and managed appropriately, common musculoskeletal injuries may result in long-term disabling conditions. Anterior cruciate ligament tears are some of the most common knee ligament injuries. Slipped capital femoral epiphysis may present with little or no hip pain, and subtle or absent physical and radiographic findings. Femoral neck stress fractures, if left untreated, may result in avascular necrosis, refractures and pseudoarthrosis. A delay in diagnosis of scaphoid fractures may cause early wrist arthrosis if nonunion results. Ulnar collateral ligament tears are a frequently overlooked injury in skiers. The diagnosis of Achilles tendon rupture is missed as often as 25 percent of the time. Posterior tibial tendon tears may result in fixed bony planus if diagnosis is delayed, necessitating hindfoot fusion rather than simple soft tissue repair. Family physicians should be familiar with the initial assessment of these conditions and, when appropriate, refer patients promptly to an orthopedic surgeon.
1 Month Male Child BL CTEV
Before Treatment
Congenital Talipes Equinovarus (CTEV), or club foot, is a common congenital orthopaedic abnormality of the foot, which is easily diagnosed but difficult to treat perfectly. Controversy in terms of its etiology, classification and management continues to exist. Delayed initial treatment in patients with clubfoot has a strong correlation with a poor outcome.
After Treatment
1 Year 3 Months Child With Blow Legs
Bowlegs are a condition in which the legs curve outward at an extreme angle at the knees while the child’s feet are together. Babies are born with bowlegs because of their folded position in the uterus (womb), so the condition is normal in infancy. The legs straighten as the child begins to put weight on them and learns to walk. If the bowlegs don’t straighten by the time the child is 2 to 3 years old, or if they worsen, they may be caused by a rare, more serious condition
9 years old girl with knock knee
Bowlegs are a condition in which the legs curve outward at an extreme angle at the knees while the child’s feet are together. Babies are born with bowlegs because of their folded position in the uterus (womb), so the condition is normal in infancy. The legs straighten as the child begins to put weight on them and learns to walk. If the bowlegs don’t straighten by the time the child is 2 to 3 years old, or if they worsen, they may be caused by a rare, more serious condition
Blood work up
CBC
S. calcium, S.Phosphorous,
S. Alk. Phosphatase
S. Vit D levels
Genu Valgum/Varum
Also called as angular deformities around knee.
Common due to nutritional rickets or Vit D deficiency in children
Genu Varum- bow legs- Abnormal after age of 3
Genu Valgum- Knock knees Abnormal after age of 8.
Can be corrected with growth modulation.
Will need osteotomy if not diagnosed in time.
3 Y F case of BL Genu Varum with Vit D Deficiency
Before Treatment
A vitamin D deficiency can affect both physical and mental health, but many people have low levels of vitamin D without realizing. The physical symptoms of a deficiency may include muscle pain in the joints, including rheumatoid arthritis (RA) pain, which often occurs in the knees, legs, and hips. In this article, we look at the evidence for a link between vitamin D and joint pain. We discuss how people can obtain vitamin D and what their daily intake should be.
After Treatment
Genu valgum or knock knee
Genu valgum (knock-knees) is a common lower leg abnormality that is usually seen in the toddler, preschool and early school age child. In genu valgum, the lower extremities turn inward, causing the appearance of the knees to be touching while the ankles remain apart. Knock knees usually is first seen in late toddlerhood. Often parents may have noticed the knees bowing out (genu varum) when the child first started walking but by age 3, the child has developed knock knees. Genu valgum is most severe by age 3 but then usually resolves on its own by age 7-8. Knock knees are slightly more common in girls than boys.
Before Treatment
15 years old female with metabolic genu valgum treated with osteotomy
Before Treatment
Genu valgum (knock-knees) is a common lower leg abnormality that is usually seen in the toddler, preschool and early school age child. In genu valgum, the lower extremities turn inward, causing the appearance of the knees to be touching while the ankles remain apart. Knock knees usually is first seen in late toddlerhood. Often parents may have noticed the knees bowing out (genu varum) when the child first started walking but by age 3, the child has developed knock knees. Genu valgum is most severe by age 3 but then usually resolves on its own by age 7-8. Knock knees are slightly more common in girls than boys.
Compound Clavicle Fracture
10 year old boy came with injury to left clavicle by kadba cutting machine
Before Treatment
This type of fracture is fairly common—accounting for about 5 percent of all adult fractures. Most clavicle fractures occur when a fall onto the shoulder or an outstretched arm puts enough pressure on the bone that it snaps or breaks. A broken collarbone can be very painful and can make it hard to move your arm. Most clavicle fractures can be treated by wearing a sling to keep the arm and shoulder from moving while the bone heals. With some clavicle fractures, however, the pieces of bone move far out of place when the injury occurs. For these more complicated fractures, surgery may be needed to realign the collarbone
After Treatment
19 years old male came with trivial fall leading to fracture distal femur
Before Treatment
Distal femur fractures include fractures of the supracondylar and intercondylar region and are relatively common injuries. The goals of treatment follow AO principles of anatomic reduction of the articular surface, restoration of limb alignment, length, and rotation. Despite improvements in implant design, management of distal femur fractures remains a challenge; fractures are often comminuted, intra-articular, and involve osteoporotic bone, making fixation challenging to achieve. In the geriatric trauma population, the incidence of co-morbidities is high and may impact the therapeutic options.
Clinical ROM of Knee 20 years old male with h/o RTA
Before Treatment
Knee pain and range of motion (ROM) are intimately linked and by focusing on improving knee movement, you can actively cutdown on your pain. Devoting a short amount of time each day to bettering knee range of motion will payoff in dividends. And you may have guessed it...this "short amount of time each day" means exercises aimed at improving mobility, flexibility, and strengthening key supporting muscles!
After Treatment
