אורטופדיה א - דסלוקציות של הירך

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B.P.T 1102

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: 2 . : . : . ) (. .2

.High Energy Femur Femur .Socket %05 - RIM Acetabulum ) .(Acetabulum

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Dashboard - Shaft ,Patella-.Acetabulum

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,ADD ,IR ) .(ER ) (LAT + AP - Femur -.Socket

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, -09 .FLX Traction- ER . -3 . : 1. 2. 3. 4. . 5. .6

Sciatic Nerve- .(FOOT DROP) Avascular Femur- .Osteoarthritis Necrosis . - Post Traumatic Ossification .Osteoarthristis - OA

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- ER-.ABD . LAT + AP Traction .IR .Avascular Necrosis AVN

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-.Trochanter " .Acetabulum -.Acetabulum -.CT

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- 1. Intra-Capsular 2. Extra Capsular

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Intra-Capsular : - Greater Trochanter -.Twist " . : 1. ) 1 Garden (. 2. : - ,ER , 3-2 " . 3. : , , ,ER . X-Ray , , . " . Intra 11 .

Gardens Classification1. ) (. 2. . 3. ) %05 (. 4. ) %05 (.21

2-1: Hip Screw " 2-1 .Garden -Greater Trochater . DHS Dynamic Hip Screw .RichardNailing s . . Intracapsular .Non Union ,AVN31

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4-3: 4-3 - AVN- Non Union , . ) (: 2-1 . ) ( . DHS : 1. Austin Moore & Thompson Uni-Polar 2. THR -.Acetabulum .

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Extra Capsular : Intertrochanteric Subtrochanteric

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Intertochanteric , / , ) (. AVN .Non Union : Intra Extra. : 1. . 2. ,ER Extra Capsular ER .Intra Capsular 3. Extra - .81

51-21 ) ( 02-51 ) ( Intertrochanteric :Kyle 1 - Type . 2 Type . Lesser Trochanter . 3 Type , .Great & Lesser Ilio psoas - LT- Abductor -.GT 4 Type . 4-3 .

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- Sub and Inter Trochanteric Fracrues1. DHS . 2. .Intra Medular Nail : DHS 1. . 2. Acetabulum . , NWB .FWB :Intermedular Nail . - .Inter Locking Nail Nail . Mal-Union . , .Non-Union12

Subtrochanteric Fractures , .High Energy . , . . Non Union .

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: . 6 -.Hip Spica Cast Callus . . : .Intermedullar Nail ,DHS : :Mal-Union Varus.ER :Non-Union " , .32

Femoral shaft fracture , High Energy . , , 2/1 .Femur : . Twist ), (. : . , .Acetabulum42

: . )" ( , . 8-6 ) (Callus . . 61 . ,Inter Medullar Nail . - " . .

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-Shaft . . ),Femoral Art (Sciatic Nerve ) Delay-Union 5-4 ) Mal Union ,(FWB - , )( (, Non Union ) " .(Osteotomy . " .Quadriceps 81-61 . . 72 1. 2. 3. 4.

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6.

Supracondylar fracture : High Energy , Low Energy . : .T - , Gastrocnemius -.Popliteal Art . : ,EXT/ FLX . /. . . 82

: ) , (. - 2-3 , - Cast brace 4-6 . : , . : ,PWB . : .Hip Spica92

: ) " ( / . . : Dynamic Condylar Screw DCS 2-3 CANCELLOUS SCREW Inter Medular Nail PWB-21 .

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Supracondylar fracture : ) Popliteal(. . - Non/Delay Union .

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Fractures of the femoral condyles : , " . : . T : , , , ) Hemi Arthrosis (.

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: - 8-6 : ,ORIF : . Screw, DCS NWB : , CPM -. SLR 6-21 .

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, . " , . . )Popliteal( - ) Common Fibular(

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: 1. = .Patella 2. ) ),(Quadriceps ),(Patellar Lig )(. 3. = - ,Patella - Quadriceps - .Patellar Ligament53

-Patella : : / ) (Dashboard Inj Patella . : .Quadriceps : , , ,Patella , ,

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. 4-3 , Quadriceps . - ORIF . 3 " . : Screw ) Tension Kishner Wire .(Band Wiring .Partial Patellectomy .Full Patellectomy . FWB 83

Tension band

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Screw fixation

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Extensor lag :Patella Patellofemoral .Quadriceps

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-Quadriceps Tendon . RA . , , ) (, )( )(. " MRI .Ultrasound : - 6 . - . 6 . : :Scuderi , ) Flap(. :Codvilla Tendon Repair . Flap .24

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:Osgood Schlatter DiseaseTraction tendinitis of the Tibial Tuberosity : 01-41 , " ) (. : TT , , , . , . : .Medial Condyle Of The Femur " 2 ". . - , , , , . - )(, " .44

:Osteochondritis Dissecans Of The Knee

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Dislocation of the patellaAcute dislocation Recurrent dislocation Habitual dislocation

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Acute dislocation : 1. : 2. : Valgus ,IR of Femur . -.Quadriceps : Groove, ,Genu Valgum Tibia,ER ,Patellar Hypermobility ,Patella Alta .VMO : , - PFJ OA Medial Retinaculum- .Patellofemoral Ligament84

Recurrent dislocation . : ,, , . Aprehension Test. : Patella +/-. Groove +/-. " .

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: - -.VMO : . - - Tibial Tuberosity .

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Habitual dislocation . ) (. - .

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Tibial plateau fractures .MetaPhysis : ) ( .A .Comminuted Compression .B .Depressed Platue .C Oblique Shearing " .

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:Schatzker : 1. Lateral Condyle )(Wedge 2. Lateral Condlye - Wedge + Depression 3. )(Central Depression 4. (Medial Platue) Medial Condyle 5. Y .Condyles 6. .1 6

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: 1. - :Valgus . .Bumper Fracture 2. Varus . 3. )( Y. : . .

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, Hinge Ortosis . -FLX EXT .ABD-ADD Traction . ORIF 3 " )(. " . External Fixation . : 8-12 NWB, 21-01 , 02-41 .55

1. 2. 3. 4. 5. 6.

Valgus Deformity .1 .Lateral Condyle- Knee Stiffness .2 OA .3 .Compartment Syndrome .4

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Tibial shaft fracture . " . . , . 81-21 .

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: ) (. 84-27 , , .Compartment Syndrome 4-6 Functional brace , .

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: 1. Intramedullary nail : , . ) (Interlocking screw . 2. Plate fixation ) (. ),(Periosteal stripping , . . .06

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, . ).(Debridement , ) + " external .(fixation . " ) , -.(ROM

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.Popliteal artery Compartment syndrome Infection

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:Compartment Syndrome " 3/1 .Shaft ) (. - . :Compartment Syndrome 1. PAIN . 2. PARAESTHESIA . 3. PAILNESS/ . 4. PARALYSIS ) ( 5. PULSE LESSNESS . : Fasciotomy Fascia . 46

Mal Union Delayed Union Non Union " . .Joint Stiffness Osteoperosis

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: Tibia " . " . Fibula .Tibia ". Fibula . : . :Tibia , , , . : + . : ) (. -4 . + :CT . , CT . : " 01-8 . 66

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