Kursk State Medical University.ppt

KURSK STATE MEDICAL UNIVERSITY DEPARTMENT OF TRAUMATOLOGY & EXTREME MEDICINE Head of the Department : Prof. Dubrovin G.M. Teacher in Charge: Dr. Samuel Raj

Patient’s name : Barizova Thathyana Diagnosis : Close oblique fracture of the middle third diaphysis of clavicle(right side). With displacement. Without complications' T. Ashain Nilhan Fernando Group no 03 5th year 1st semester

Kursk 2013

Name of the patient: Barizova Thathyana Age : 61 years old Sex : Female Date of admission to hospital: 13.10.2013 History of accident : Date and time of the accident : 13.10.2013 Location of accident : Home (Bathroom) The mechanism of injury : Direct

First aid which was provided to the patient before hospitalization: • Anesthesia; non narcotic-analgin (i.m) • Transport immobilization. Kramer's splint. From the healthy left shoulder joint to right base of metacarpal.

The patient's complaints on admission : • Pain • Swelling • Redness • Increase temperature • Loss of function • Pathological movement of fragments • Crepitus • Deformation • Shortening of a clavicle

The results of patient’s physical examination on admission to hospital • • • • • • • • • • •

The ability to walk : present. Without problem Consciousness : satisfactory Position of body : Forced posture Facial appearance :No Pathology Eyes: No Pathology Oral mucosa : Moist & Pink Condition of skin : Moist Results of lungs auscultation : Symmetry resonant Pulse (per min.) : 73 /min RR : 18 BP : 110/80 mmhg

The local status of patient on admission to hospital • The length of the damaged segment : 3cm • Condition the axis of the damaged segment : Deviation occurs • The possibility of movement in joints of damaged segment : Movement cause pain • The temperature of the skin of damaged segment : Increase temperature

• Sensitivity of the damaged segment : Decrease sensitivity • The presence of the arterial pulsation at the damaged extremity : Present • The presence of swelling of the damaged segment : Present • Description of wound (if it is presented) location, configuration, size : Absent

The preliminary diagnosis, which was made on the admission

Close fracture of the middle third diaphysis of clavicle(right side).

Results of laboratory, radiology and another (ultrasound, ECG, etc.) Complete blood count Hemoglobin : 117 g/dL RBC : 3.85x 10*12 /l WBC : Neutrophil : Bands : Lymphocyte : Monocytes : Eosinophil

CI : 0.9

Urinalysis pH : Acidic Volume : 110ml Specific gravity : 1.010 Protein : -absent Urea : 4mmol/l

X -ray • Right shoulder region • AP view • Close oblique fracture of the middle third diaphysis of clavicle(right side). With displacement. Without complications

Full clinical diagnosis Close oblique fracture of the middle third diaphysis of clavicle(right side). With displacement. Without complications…..

Plan of treatment • • • •

Diet : 15 (normal) Regime : Hospital region Anesthesia : Novocain block Immobilization : Smirnov – Vanshtein bandage

01.Closed fracture of the clavicle absent, a .pathological movements. b .deformation. c .appearance of bone’s fragments. d .crepitus e. Shortening of a clavicle

02.What are the basic method of anesthesia ? a .cold b .local and regional anesthesia c .narcotic and non narcotic analgesics d .immobilization e .all

03.What is the wrong answer of fracture of 1st metacarpal bone?

a. Benet's fracture b. Roland's fracture c. transverse facture of shaft d. oblique fracture of shaft e. spiral fracture of shaft

04.What is the wrong answer of sequelae of scaphoid fracture ? a. malunion b. Delayed union c. non-union d. Avascular necrosis e. Scaphoid non-union advanced collapse

05.What is the general sign ? a .pathological movements. b .deformation. c .loss of function d .crepitus e. Shortening of a clavicle