UVA Student Handbook for Orthopaedic Surgery Handbook 2020
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Orthopaedics Essentials
Frykman Classification of Distal Fracture of base of the first Neer classification of proximal humeral head # Radial # metacarpal bone 1-part 2-part 3-part 4-part GT GT+SN “CLASSIC” SN LT+SN (RARE) “VALGUS IMPACTED” Galeazzi Fracture LN (RARE) Impression # Head split Gartland’s classification of supracondylar Fracture shaft of ulnar, together with distal third of radius with fracture of humerus disruption of the proximal radioulnar dislocation or subluxation of distal joint and dislocation of radiocapitallar radio-ulnar joint joint Salter–Harris fracture = Fracture that involves the epiphyseal plate or growth plate of a bone Type I: undisplaced or minimally displaced fractures. Type II: displaced with posterior cortex intact Type III: displaced with no cortical intact Gustillo Anderson Classification of Open Fracture I – open fracture with a wound <1cm and clean II – open fracture with wound > 1cm with extensive soft tissue damage and avulsion of flaps IIIa – open fracture with adequate soft tissue coverage of bone in • Galeazzi fracture - a fracture of the radius spite of extensive soft tissue laceration or flaps or high energy with dislocation of the distal radioulnar joint trauma irrespective of size of wound • Colles' fracture - a distal fracture of the IIIb – open fracture with extensive soft tissue loss, periosteal radius with dorsal (posterior) displacement of the wrist and hand stripping and exposure of bone • Smith's fracture - a distal fracture of the IIIc – open fracture associated with an arterial injury which requires radius with volar (ventral) displacement of the I II IIIa IIIb IIIc repair wrist and hand • Barton's fracture - an intra-articular fracture of the distal radius with dislocation of Irrigation: 3L 6L 9L ORTHOPAEDICS CLASSIFICATION the radiocarpal joint • Essex-Lopresti fracture - a fracture of PART 1 (UPPER LIMB) the radial head with concomitant dislocation HTARW5B/GKS2013/3- of the distal radio-ulnar joint with disruption of Together In Delivering Excellence (T.I.D.E.) the interosseous membrane Contributors: Dr. -
DUKE UNIVERSITY School of Medicine Pathologists' Assistant
DUKE UNIVERSITY School of Medicine Pathologists’ Assistant Program Department of Pathology Academic Programs The Department of Pathology at Duke University offers a wide array of training programs to fit individual requirements and goals. The Residency Training program is an ACGME approved program and is available as an Anatomic Pathology/Clinical Pathology combined program, a shorter Anatomic Pathology only program, or an Anatomic Pathology/Neuropathology program. Subspecialty fellowships in Cytopathology, Dermatopathology, Hematopathology, Medical Microbiology, and Neuropathology are also ACGME approved. These programs provide the highest quality of graduate medical education by drawing on the depth and breadth of faculty expertise in the Department in all aspects of anatomic and clinical pathology and the availability of a wide variety of often complex clinical cases seen at Duke University Health System. For medical students interested in a career in Pathology pre-doctoral fellowships, internships and externships are available. Research Training in Experimental pathology can be obtained through Pre- and postdoctoral fellowships of one to five years. All pre-doctoral fellows are candidates for the Ph.D. degree in pathology. The Ph.D. is optional in postdoctoral programs, which provide didactic and research training in various aspects of modern experimental pathology. A two year NAACLS accredited Pathologists’ Assistant Program leads to a Master of Health Science degree, certifies graduates to sit for the ASCP Board of Certification examination, and leads to exciting career opportunities in a variety of anatomic pathology laboratory settings. Pathologists’ assistants are analogous to physician assistants, but with highly specialized training in autopsy and surgical pathology. This profession was pioneered in the Duke Department of Pathology 50 years ago, and is one of only twelve such programs in existence today. -
Body Mass Index As a Predictor for Diagnosis of Associated Injuries in Femoral Head Fracture Patients: a Retrospective Study Edem GAP*, Zhijun P, Jiaqi W and Jiang L
Research iMedPub Journals ARCHIVES OF MEDICINE 2018 www.imedpub.com Vol.10 No.6:3 ISSN 1989-5216 DOI: 10.21767/1989-5216.1000290 Body Mass Index as a Predictor for Diagnosis of Associated Injuries in Femoral Head Fracture Patients: A Retrospective Study Edem GAP*, Zhijun P, Jiaqi W and Jiang L Department of Orthopedic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China *Corresponding author: Ghamor-Amegavi Prince Edem, Department of Orthopedic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China, Tel: +8613588064446; E-mail: [email protected] Received date: October 29, 2018; Accepted date: November 20, 2018; Published date: November 23, 2018 Citation: Edem GAP, Zhijun P, Jiaqi W, Jiang L (2018) Body Mass Index as a Predictor for Diagnosis of Associated Injuries in Femoral Head Fracture Patients: A Retrospective Study. Arch Med Vol No:10 Iss No:6:3 Copyright: ©2018 Edem GAP, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction Abstract In 1895, an autopsy was performed on a 35-year-old woman who had fallen from 2nd floor story building by John [1]. He Purpose: To investigate the relationship between observed prior to the procedure that the left leg was inverted associated injuries (AI) suffered at time of accident in and slightly shorter than the right leg. This was the first report femoral head fracture (FHF) patients with age, sex, of femoral head fracture (FHF) in history. -
HUMAN BODIES to TEACH ANATOMY: IMPORTANCE and PROCUREMENT – EXPERIENCE with CADAVER DONATION Susana N
Procurement and use of cadavers – Part II Rev Arg de Anat Clin; 2014, 6 (3): 162-175 __________________________________________________________________________________________ Debate PART II - HUMAN BODIES TO TEACH ANATOMY: IMPORTANCE AND PROCUREMENT – EXPERIENCE WITH CADAVER DONATION Susana N. Biasutto1 (Coordination), Namita A. Sharma2, Jennifer McBride3, Subramaniam Krishnan4, Puranam Vatsalaswamy5, Rajendra S. Garud2, Vidya S. Kharat2, Don F. du Toit6, Christopher Redwood7, Wesley Fisk8, Grant Townsend7, Monika L. Piplani9, Rafael Romero-Reverón10, Guenevere Rae11, David Kachlik12, Cagatay Barut13, Radik M Khayrullin14 1Chair of Normal Anatomy, Faculty of Medical Sciences, National University of Cordoba, Cordoba, Argentina. 2Bharati Vidyapeeth Dental College and Hospital, Pune, India. 3Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, Ohio, USA. 4Department of Anatomy, MAHSA University, Kuala Lumpur, Malaysia. 5Department of Anatomy,Dr. D. Y. Patil Medical College, Hospital and Research Center,Pimpri, Pune, India. 6Division of Anatomy and Histology, Faculty of Medicine, University of Stellenbosch, Parow, Western Cape, South Africa. 7School of Dentistry, The University of Adelaide, Adelaide, South Australia. 8School of Medical Sciences, The University of Adelaide, Adelaide, South Australia, 9SGRDIMS&R, Amritsar, India. 10Department of Human Anatomy, José María Vargas Medical School, Faculty of Medicine, Central University of Venezuela. 11Department of Cell Biology and Anatomy, -
Ipsilateral Intertrochanteric and Pipkin Fractures
Case Report & Literature Review Ipsilateral Intertrochanteric and Pipkin The Role of Fractures: An Unusual Case Aspirin Mustafa H. Khan, MD, Vonda J. Wright, MD, and Michael J. Prayson, MD racture-dislocation of the femoral head most com- and internal fixation (ORIF). He was returned to the operat- Keith R monly results from high-energy trauma, such as that ing room on postoperative day 5. The anterior approach was sustained in falls and motor vehicle accidents. This used to remove several small loose osteochondral fragments injury may be associated with ipsilateral femoral from the hip, and the femoral head fracture fragment was Fneck and acetabular fractures. However, femoral head frac- reduced and fixed with 2 countersunk 4.0-mm cancellous ture-dislocation with an ipsilateral intertrochanteric fracture screws. Intraoperative fluoroscopy showed that the hip had is an extremely rare injury, with only 2 previous cases full, smooth range of motion without fracture displacement. reported in the literature.1,2 Postoperative x-rays showed successful reduction and fixa- In the present report, we describe a case of this unusual tion of the fracture (Figure 3). fracture pattern and briefly review the relevant literature, anatomy, and treatment options. CASE REPORT A man in his early 40s sustained injuries in a car acci- dent. At presentation he was awake and alert and com- plained of pain in the chest, right hip, and right leg. The evaluation and treatment of his orthopedic injuries are described in this case report. Orthopedic evaluation revealed a right posterior hip dislocation with an associated femoral head fracture, a right femoral intertrochanteric fracture, right superior and inferior pelvic rami fractures (Figure 1), and an open type IIIA right tibia fracture. -
Clinical and Radiographic Outcomes of Femoral Head Fractures
ORIGINAL ARTICLE Clinical and Radiographic Outcomes of Femoral Head Fractures Associated with Traumatic Hip Dislocations Michael A Del Core1 , Bruno Gross2 , Junho Ahn3 , Stephen Blake Wallace4 , Adam Starr5 ABSTRACT Background: Femoral head fractures are an uncommon but severe injury. These high-energy injuries typically occur in association with traumatic hip dislocations. Initial treatment includes urgent concentric reduction; however, controversy exists regarding specific fracture management. The well-known complications of avascular necrosis (AVN), posttraumatic arthritis (PTA), and heterotrophic ossification can leave patients with a significant functional loss of their affected hip. The purpose of this study is to evaluate the clinical and radiographic outcomes of femoral head fractures. Methods: A retrospective review was performed at our institution assessing all patients who presented from 2007 to 2015 with a femoral head fracture associated with a hip dislocation and at least 6 months of clinical and radiographic follow-up. Twenty-two patients met our inclusion criteria. There were 15 males and 7 females with an average age of 36 years (range: 17–55). The average follow-up time was 18 months (range: 6–102). Fractures were classified according to the Pipkin classification. The Thompson and Epstein score was used to determine functional outcomes. Results: There were five, Pipkin I, 3 Pipkin II, 0 Pipkin III, and 14 Pipkin IV, femoral head fractures. Sixteen patients were successfully closed reduced in the emergency department (ED) and six patients required open reduction after failed reduction in the ED. Four patients (18%) were successfully treated with closed reduction alone and 18 patients (82%) required operative intervention. Of those undergoing operative intervention, one patient underwent excision of the femoral head fragment, seven underwent open reduction internal fixation (ORIF) of the femoral head, nine underwent ORIF of the acetabulum, and one underwent ORIF of the femoral head and the acetabulum. -
AUTOPSY PATHOLOGY (SHANDS HOSPITAL at the UNIVERSITY of FLORIDA and MRVAMC): Rotation Director: Martha Burt, M.D., Autopsy Unit Director (Revised 2/14/2011)
AUTOPSY PATHOLOGY (SHANDS HOSPITAL AT THE UNIVERSITY OF FLORIDA and MRVAMC): Rotation Director: Martha Burt, M.D., Autopsy Unit Director (revised 2/14/2011) 1. Description of the rotation: The Autopsy Service of the Department of Pathology provides consultation services to all the Departments of the College of Medicine, to the MRVAMC and to outside hospitals or families upon request. Its mission is to improve diagnosis and care by providing timely examinations of the highest quality that meet the expectations of clinical colleagues. The resident's responsibilities begin with direct initial and continued contacts with the patient’s physician about the details and results of the autopsy (ACGME competency #1: Pt. Care). Under faculty supervision, residents learn the technical elements of autopsy performance, tissue preparations, gross and microscopic analysis, case analysis, and report writing, assuming increasing responsibility as their skill levels improve. There are no Fellows on this service. However, more experienced residents will help supervise junior residents during their initial rotations and both are given credit for the examination as the senior assists in the training of the junior resident. When a resident has developed the skills needed for independent performance, cases are assigned for their performance without oversight by a senior resident. All residents are introduced to the key legal and social aspects of the autopsy, from the rights of families to requirements of the legal system and elements and rules of the medical examiner statutes (ACGME competency #6: Systems-Based Practice). The sanctity of the autopsy contract and one’s responsibilities under that contract are emphasized. Confidentiality, managing the inquiries of family and others are stressed. -
Lower Extremity Fracture Eponyms (Part 2) Philip Kin-Wai Wong1, Tarek N Hanna2*, Waqas Shuaib3, Stephen M Sanders4 and Faisal Khosa2
Wong et al. International Journal of Emergency Medicine (2015) 8:25 DOI 10.1186/s12245-015-0076-1 REVIEW Open Access What’s in a name? Lower extremity fracture eponyms (Part 2) Philip Kin-Wai Wong1, Tarek N Hanna2*, Waqas Shuaib3, Stephen M Sanders4 and Faisal Khosa2 Abstract Eponymous extremity fractures are commonly encountered in the emergency setting. Correct eponym usage allows rapid, succinct communication of complex injuries. We review both common and less frequently encountered extremity fracture eponyms, focusing on imaging features to identify and differentiate these injuries. We focus on plain radiographic findings, with supporting computed tomography (CT) images. For each injury, important radiologic descriptors are discussed which may need to be communicated to clinicians. Aspects of management and follow-up imaging recommendations are included. This is a two-part review: Part 1 focuses on fracture eponyms of the upper extremity, while Part 2 encompasses fracture eponyms of the lower extremity. Keywords: Eponyms; Fractures; Lower extremities; Imaging Introduction Review: Lower extremity fracture eponyms Eponyms are embedded throughout medicine; they Pipkin fracture can be found in medical literature, textbooks, and Femoral head fractures are relatively uncommon and even mass media. Their use allows physicians to are typically associated with hip dislocations after se- quickly provide a concise description of a complex vere high-impact trauma such as a motor vehicle colli- injury pattern. Eponymous extremity fractures are sion. Femoral head fractures are commonly grouped commonly encountered in the emergency setting and into the Pipkin classification (see Table 1) after the work are frequently used in interactions amongst radiolo- of the orthopedic surgeon Garrett Pipkin in 1957 (Fig. -
The Use of Animals in Higher Education
THE USE OF P R O B L E M S, A L T E R N A T I V E S , & RECOMMENDA T I O N S HUMANE SOCIETY PR E S S by Jonathan Balcombe, Ph.D. PUBLIC PO L I C Y SE R I E S Public Policy Series THE USE OF An i m a l s IN Higher Ed u c a t i o n P R O B L E M S, A L T E R N A T I V E S , & RECOMMENDA T I O N S by Jonathan Balcombe, Ph.D. Humane Society Press an affiliate of Jonathan Balcombe, Ph.D., has been associate director for education in the Animal Res e a r ch Issues section of The Humane Society of the United States since 1993. Born in England and raised in New Zealand and Canada, Dr . Balcombe studied biology at York University in Tor onto before obtaining his masters of science degree from Carleton University in Ottawa and his Ph.D. in ethology at the University of Tennessee. Ack n ow l e d g m e n t s The author wishes to thank Andrew Rowan, Martin Stephens, Gretchen Yost, Marilyn Balcombe, and Francine Dolins for reviewing and commenting on earlier versions of this monograph. Leslie Adams, Kathleen Conlee, Lori Do n l e y , Adrienne Gleason, Daniel Kos s o w , and Brandy Richardson helped with various aspects of its research and preparation. Copyright © 2000 by The Humane Society of the United States. -
For Femoral Head Fractures with Hip Dislocation
DISSERTATION ON OUTCOMES OF TREATMENT FOR FEMORAL HEAD FRACTURES WITH HIP DISLOCATION SUBMITTED TO THE TAMILNADU DR. M.G.R. MEDICAL UNIVERSITY CHENNAI, TAMILNADU In Partial fulfillment of the regulations for the award of the degree of M.S. (ORTHOPAEDIC SURGERY) BRANCH II MADRAS MEDICAL COLLEGE CHENNAI APRIL 2016 CERTIFICATE This is to certify that this dissertation titled “Outcomes of Treatment for Femoral Head Fractures with Hip Dislocation ” is a bonafide record of work done by Dr.SENTHIL.S, during the period of his postgraduate study from July 2013 to September 2015 under guidance and supervision in the INSTITUTE OF ORTHOPAEDICS AND TRAUMATOLOGY, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai- 600003, in partial fulfillment of the requirement for M.S.ORTHOPAEDIC SURGERY degree examination of The Tamilnadu Dr. M.G.R. Medical University to be held in April 2016. PROF.DEEN MUHAMMAD ISMAIL, PROF.V.SINGARAVADIVELU, D.Ortho., M.S.Ortho., M.S.Ortho., Ph.D., Director I/C Professor of Orthopaedic surgery, Professor of Orthopaedic surgery, Institute of Orthopaedics and Traumatology Institute of Orthopaedics and Traumatology Madras Medical College and Madras Medical College and Rajiv Gandhi Government General Hospital, Rajiv Gandhi Government General Hospital, Chennai-600003.Tamilnadu. Chennai-600003.Tamilnadu. Prof. Dr. R.VIMALA , M.D., Dean, Madras Medical College, Rajiv Gandhi Govt. General Hospital, Chennai – 600003. DECLARATION I declare that the dissertation entitled “Outcomes of Treatment for Femoral Head Fractures with Hip Dislocation ” submitted by me for the degree of M.S is the record work carried out by me during the period of July 2013 to September 2015 under the guidance of PROF .V.SINGARAVADIVELU, M.S.ORTHO., PhD., Professor of Orthopaedics, Institute of Orthopaedics and Traumatology, Madras Medical College, Chennai. -
Histopathology from the Dissecting Room: Are Cadavers a Suitable Source of Educationally Useful Histopathology Specimens?
Teaching Anatomy www.anatomy.org.tr Received: March 6, 2015; Accepted: April 9, 2015 doi:10.2399/ana.14.048 Histopathology from the dissecting room: Are cadavers a suitable source of educationally useful histopathology specimens? Andrew Wood1, Susan Whiten1, Jill McVee2, Jon Issberner1, David Jackson1, C. Simon Herrington3 1The School of Medicine, University of St Andrews, St Andrews, Fife, Scotland, United Kingdom 2Biomedical Sciences Building, University of St Andrews, St Andrews, Fife, Scotland, United Kingdom 3Division of Pathology, Edinburgh Cancer Research Centre, Institute of Genetics and Molecular Medicine, Western General Hospital, University of Edinburgh, Edinburgh, United Kingdom Abstract Objectives: The requirement of the General Medical Council to ‘reduce factual overload’ has led to the development of integrated curricula in which the knowledge base related to basic medical sciences has been greatly restricted. The time allo- cated to pathology teaching in medical schools has been decreased. The challenge for educators is to introduce effective methods of learning pathology into an integrated, student-centred curriculum. The aim of this study is to assess the tissue derived from cadaveric material and report its potential for use in teaching histopathology. Methods: We have previously reported how we use cadavers’ medical histories when introducing students to their ‘first patient’. The medical histories of the seventeen cadavers that were dissected during one academic session were reviewed for evidence of reported pathology. During dissection unexpected pathological findings were noted. Standard histological processing was car- ried out on pathological tissue from the cadavers, a prosection and a specimen which was displayed in a museum pot. These specimens were then assessed for educational value by an expert clinical histopathologist. -
Frequently Asked Questions: Anatomic Pathology and Clinical
Frequently Asked Questions: Anatomic Pathology and Clinical Pathology (FAQs related to Pathology Program Requirements effective July 1, 2020) Review Committee for Pathology ACGME Question Answer Introduction Can residents leave in the middle of their Yes, as the American Board of Pathology allows residents to enter a pathology program to complete a fellowship and then fellowship program (except dermatopathology) after 24 months of residency, the return to finish their pathology residency? Review Committee allows this as well. The expectation is that once the fellowship is completed, residents return to the pathology residency program to complete their [Program Requirement: Int.C.1.] education. Programs do not need to notify the Review Committee or request exceptions for residents to pursue this pathway. In the Accreditation Data System (ADS) these residents should be listed as “In Program but Doing Research/Other Training ”while they are in a fellowship program, and reset to “Active Full time” status once the fellowship is completed and they have returned to the pathology residency program. If a resident wishes to focus only on No. All pathology programs are accredited as APCP-4, with anatomic pathology only anatomic pathology or clinical pathology, (AP-3) and clinical pathology only (CP-3) offered as tracks within the program, not as must the Sponsoring Institution apply for a separately accredited programs. There is no separate application process, as separate program or does the existing programs are free to offer these tracks to residents if they choose. The Educational program need any other approval from the Program section of the Program Requirements clearly denotes tracks so that programs Review Committee? can understand the expectations for residents in any of the tracks.