Hyperbaric oxygen therapy in orthopedics

Hyperbaric oxygen therapy in orthopedics Hyperbaric oxygen treatment involves intermittent inhalation of 100% oxygen at greater than atmospheric pressure. This treatment is administered in a hyperbaric chamber, which is compressed with air, while the patient breathes oxygen at ambient pressure through a mask. Inspiration of oxygen at high pressure increases the amount of oxygen dissolved in the plasma in direct proportion to the rise in ambient pressure. Thus, when oxygen is inhaled at 2 to 2.4...
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Advances in Achilles tendon repair

Advances in Achilles tendon repair Achilles tendon pathologies include rupture and tendonitis. Achilles tendon rupture, a complete disruption of the tendon, is observed most commonly in patients aged 30-50 years who have had no previous injury or problem in the affected leg and are typically "weekend warriors" who are active intermittently. Achilles tendon pathologies include rupture and tendonitis. Many experts now believe, however, that tendonitis is a misleading term that should no longer...
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Prevention and Management of Heel ulcer in Orthopedics

Prevention and Management of Heel ulcer in Orthopedics The Danger of Heel Ulcers Pressure ulcers and, in particular, heel ulcers are common facility-acquired skin tissue injuries that occur most frequently among immobile patients in long-term, acute care facilities. Surgical patients are among the most susceptible. Heel ulcers are painful and physically debilitating. Left untreated, they can lead to serious complications, such as infection, cellulitis, osteomyelitis, septicemia, limb amput...
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Changing Trends In DVT prophylaxis in Orthopedics

Changing Trends In DVT prophylaxis in Orthopedics Venous thromboembolism (VTE) has been identified as an immediate threat to patients undergoing major orthopedic procedures such as total hip arthroplasty (THA) and total knee arthroplasty (TKA). Given the known dangers of VTE, arthroplasty surgeons are sensitive to the need for VTE thromboprophylaxis. However, the modalities of thromboprophylaxis used to minimize the risks to patients have been variable. Clinical practice guidelines have been pu...
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Morel Lavallee lesions in orthopedics

Morel Lavallee lesions
Morel Lavallee lesions in orthopedics   A Morel Lavallee lesion is a post-traumatic soft tissue degloving injury, originally described by French surgeon Victor Auguste Francois Morel-Lavallee in 1863. These lesions result from direct or tangential shearing forces that separate the skin and subcutaneous tissues from the underlying fascia. These shearing forces can disrupt perforating vessels and nerves, creating a potential space that fills with blood, lymph, debris, and fat (necrotic an...
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Optimizing use of Tourniquet in Orthopedics

Optimizing Tourniquet use in orthopedics
Optimizing use of Tourniquet in Orthopedics Tourniquet is invaluable instrument to plastic, hand and orthopedic surgeon. It helps create a bloodless field for easy operation and reduces operative time. The advantages of tourniquet is no without its share of complication including nerve and skin injuries and devastating vascular lesions leading to amputation or death. A thorough understanding of the local and systemic effect of tourniquet is essential to minimize the complication. Various physic...
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Minimizing Blood Loss in Orthopedics

Minimizing Blood Loss in Orthopedics "Every blood transfusion is like a miniature organ transplant, with the potential for reactions, errors and infection."     In modern day orthopedic surgeries, apart from the complications directly related to fractures and implants, a surgeon faces numerous perioperative complications. These range from excessive intraoperative and postoperative blood loss, infection, poor wound healing, electrolyte imbalance to even acute renal shut down...
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Avoiding Malpractice Claims in Orthopedics

Avoiding Malpractice Claims in Orthopedics
Avoiding Malpractice Claims in Orthopedics     Orthopaedic surgery ranks fifth among medical specialties in the total number of claims filed and also fifth in the cumulative amount of financial payments. Approximately 30% of filed cases ultimately result in some form of financial payment. The driving force behind litigation is financial gain for patients's lawyers and compensation for patients. The motive is not the improvement of medical delivery systems or individual doc...
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Heroic reconstruction or amputation in limb trauma.

Heroic reconstruction or amputation in limb trauma. Before I start off the article would like  people have a different perception about  prosthesis. Can Prosthetics Outperform Real Limbs?   Salvage or amputation? One of the most difficult decisions an orthopaedic surgeon may face is that of whether to salvage or amputate a severely injured limb. Such a decision is rarely clear-cut. Several factors require consideration: the degree of damage to the extremity and the severity of ...
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Management of Fasciotomy Wounds

Management of Fasciotomy Wounds
Management of Fasciotomy Wounds Acute compartment syndrome occurs when the tissue pressure within a closed muscle compartment exceeds the perfusion pressure and results in muscle and nerve ischemia. It typically occurs subsequent to a traumatic event, most commonly a fracture. The cycle of events leading to acute compartment syndrome begins when the tissue pressure exceeds the venous pressure and impairs blood outflow. Lack of oxygenated blood and accumulation of waste products result in pai...
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Wound Closure in Orthopedics- Current evidence

Wound closure orthopedics
Wound Closure in Orthopedics Surgical wound complications are a significant problem in orthopaedic surgery with wound infection, dehiscence, and poor cosmesis contributing significantly to patient morbidity. Surgical techniques and adjunctive modalities continue to be introduced with the goals of avoiding these issues, and an increasing number of research studies have been undertaken to characterize clinical outcomes. A thorough understanding of surgical wound closure strategies and the efficac...
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Role Of Ultraviolet C in Orthopaedics

Role Of Ultraviolet C in Orthopedics Maintaining quality of life for our ageing population increasingly involves provision of surgical solutions to ease discomfort and impaired mobility associated with musculoskeletal degenerative disorders. Although rates vary considerably between nations, increasing numbers of hip and knee replacements are being undertaken in most countries. As such, management of this demand and minimizing risk of complication, including infection, are ever more pressing. ...
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Correction of Pin Tract Scar

Correction of Pin Tract Scar External Fixator and Distractors are commonly being used for management of complex fractures. A good alignment and  bony union is the main concern of the orthopaedician. Prolonged placement of pin causes epidermal in growth and also tethering of scar to underlying bone. Though cosmetic appearance may not be the prime concern for the doctor, patient do complain of unsightly scar over limbs. Also a tethering of skin to bone or muscle does not permit gliding of skin le...
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