THE MINISTRY OF HEALTHCARE OF THE REPUBLIC OF UZBEKISTAN
TASHKENT MEDICAL ACADEMY
DEPARTMENT OF TRAUMATOLOGY, NEUROSURGERY AND FIELD MILITARY
SURGERY
«APPROVE»
VICE
RECTOR
ON
EDUCATIONAL AFFAIRS
PROF. TESHAEV O.R._______
"___"______________2012г.
THE MEDICAL FACULTY STUDENTS’ WORK PROGRAM ON PEDIATRIC
TRAUMATOLOGY
FOR 2011-2012 ACADEMIC YEAR
Ministry of education
720000 – “Healthcare ” field,
5720100 – “Treatment work”,
5140900 – “Specific education” field (treatment work)
TASHKENT - 2012
I. SUMMARY
Pediatric trauma has the characteristic features of scientific and practical. The
growth of child injury, increasing the proportion of heavy road accidents, which
often leads to death or severe injury, causing great damage to society. Practice
shows that the number of children affected with multiple associated injuries and
non-continuously increasing. Despite the fact that data on injuries in children in
domestic and foreign literature are not uncommon, many aspects of childhood
trauma continues to attract attention. Analysis of a large number of children from
the adverse effects of damage shows that many errors and complications are not
careful initial examination of children, and particularly cases of polytrauma, gross
mistakes in the provision of emergency assistance to them in the prehospital
setting.
II. GOAL AND TASKS
The program aims to teach students diagnostic tactics and rehabilitation of
children with injuries of the musculoskeletal system, providing outpatient care for
children.
As a result of the discipline, students
should to know:
1. anatomy of the musculoskeletal system in children
2. especially fractures of the musculoskeletal system in children
Be able to:
1. survey procedure childhood trauma patients.
2. Identify the main symptoms of the various trauma injuries.
3. primary care in traumatic injuries.
4. be able to diagnose children's polyclinic damage and identify indications for
hospitalization trauma disorders.
To be familiar:
1. the basics of primary care pediatric trauma patients.
III. THE MAIN PRINCIPLES, METHODS AND TEACHING DEVICES
Knowledge of the basic principles of pediatric trauma allow future general
practitioners hold medical care trauma patients. Teaching should be carried out
by students after passing a course in general surgery and trauma, which will
facilitate learning. Theoretical knowledge must be supported by clinical as
follows:
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interrogation of the patient;
study to help trauma patients;
study of laboratory tests and other advanced research methods of patient;
formulation of initial diagnosis;
filling in questionnaires outpatients;
prepare a brief oral report on the analysis of the patient.
Improving the effectiveness of learning requires integration with other scientific teaching units. It is clear that in the provision of training hours (18) pediatric
trauma teaching program has limited space.
To the success of training of general practitioners is particularly important issue
of scientific information. Need to introduce students to the latest developments
in the historical aspect of Traumatology. One of the important directions in the
improvement of the educational process is the implementation of programmed
training in pediatric trauma with the use of computer technology.
Practical exercises are conducted in trauma wards and emergency room clinic.
During employment should be fully utilized fragments educational films, slides,
drugs, tables, simulation passes.
Self-study is aimed at strengthening and deepening of the acquired knowledge,
skills and abilities in pediatric traumatology. Only the creative activity and high
autonomy will successfully learn complex material on pediatric trauma and
improve the knowledge to practice. In independent work includes preparation for
the presentation as "Power Point".
To achieve the above objectives the student must during the cycle to perform the
3 to 4 manipulations between themselves and the sick. Working with plaster,
prepare their own splints, plaster bandages under teachers and their overlap.
Actively participate in the repositioning of fractures and dislocations reduction.
Treating patients in the emergency department and be able to sort and provide
first aid.
The student should be able to end the cycle correctly diagnose, good to know the
terminology and be able to provide first aid to trauma patients.
III.1. THE NUMBER OF CONTROL ACTIVITIES TO ASSESS STUDENT
KNOWLEDGE
Knowledge students are evaluated by the current and final control:
1. Current control (TC) is implemented in each practical session (3 sessions).
During the TC will be assessed theoretical knowledge in each class - 30% and
practical skills (examination of the patient on the use of diagnostic equipment,
interpretation of existing surveys, etc.) - 40%, and the decision at the end of each
session of situational problems - 30 %.
2. The final control (IR) - is carried out on the final day, during which will assess
the theoretical part on the topics of practical training (20%) ownership of
practical skills (40%), assessment of supervised clinical records of patients (20%).
IR is conducted in OSCE.
III.2. NEW EDUCATIONAL TECHNOLOGY
In order to improve the learning process and improve learning disciplines will use
the following educational technology:
• «The Weakest Link"
• «The Cat in the bag"
• «The handle on the table '
In addition will be the traditional teaching of technology:
The training will be used:
• Training videos;
• Educational software;
• Training and testing programs;
• Library Foundation Chair.
IV. Training facilities
Base for teaching are the emergency room, emergency department and trauma
surgery department of large joints and wrist clinics second TMA (two classes will
be held on the basis of pediatric trauma TMPI).
V. EDUCATIONAL PLAN
Faculty
GP
Course
VII
Lectures
2 hrs
Practical classes
18 hrs
Semester
XIII-XIV
VI. THEMATIC PLAN OF LECTURES ON DISASTER MEDICINE
FOR THE VII YEAR STUDENTS OF GP FACULTY TMA
№ Theme of the lecture
1 Features damage ODA
in children
Hours
2
Short Annotation
Anatomical and morphological features of ODA in
children. Characteristic lesions in children.
Psychological aspects of the clinical examination in
children. Terms fixation of fractures. Post-traumatic
complications.
VII. THEMATIC PLAN CALENDAR OF PRACTICAL CLASSES ON PEDIATRIC
TRAUMATOLOGY FOR THE VII YEARS STUDENTS OF GP FACULTY
№
Theme of the lesson
1 Especially fractures of the
chest, shoulders, upper
limb in children
2
3
Features of spinal, pelvic,
lower extremity in children
Congenital and acquired
deformities in children ODA
Hours
6
6
6
Short Annotation of the theme
Subperiosteal fractures. Epiphysiolysis and
osteoepifizeolizy. Apofizeolizy. Fractures of the
clavicle, humerus, forearm, hand bones.
Diagnosis and treatment.
Fractures of the femur. Damage to the knee.
Fractures of the lower leg bones. Fractures of the
foot and toes. Clinical features, diagnosis and
treatment.
Clinical, radiological symptomatology, diagnosis,
and treatment policy.
VII. List of educational aids and EQUIPMENT
 Movies in pediatric traumatology.
 Stands and posters, drawings and photographs.
 X-rays.
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CT and MRI.
Dummies.
Handout.
Video on practical skills in pediatric traumatology.
Virtual Library for pediatric trauma.
Guidelines.
CONTENTS
TOPIC - 1. Especially fractures of chest, shoulders, upper limbs in children
The increasing "epidemic of injuries," which entails our industrialized,
mechanized and motorized age, covers an expanding wave, both adults and
children. Among the total number of affected children is 25-30%, the mortality
rate among them from injury in third place after the newborn pathology and
respiratory diseases.
Characteristically, among all pediatric surgical pathology damage are also about
25-30%. Lack of familiarity with the peculiarities of child injury, the specifics of
childhood trauma, current traumatic disease in children today is unacceptable, it
often leads to errors in diagnosis, and, consequently, incorrect treatment strategy
will inevitably lead to complications and adverse outcomes.
General characteristics, frequency and location. Fractures of the type of "green
branches" or "rubber tube." Anatomical features of the structure of children's
bones. Epiphysiolysis, osteoepifizeolizy, and epimetafizarnye epiphyseal
fractures. Periarticular fractures, and osteoepifizeolizy perelomovyvihi. Cracked
subperiosteal fractures epiphysiolysis, osteoepifizeolizy and apofizeolizy. Cracked
and broken by the type of green branches or wicker. Apofizeoliz. Types of
displacement of bone fragments and their characteristics. Rotary displacement.
Axial displacement. Diagnosis of bone lesions in children. Treatment of closed
fractures in children. Surgery of fractures in children shows.
Fractures of the humerus. Kinds of damage to the proximal end of the humerus in
children and their clinical manifestation. Over - and supracondylar fractures of
the humerus. Complications of fractures of the humerus. Conservative treatment
and methods for repositioning humeral fractures. Surgery of humeral fractures.
Fractures of the forearm bones. Typical types of fractures and their clinical
manifestation. Repositioning methods depending on the displacement of the
radial head. Diagnosis of fracture and damage Montedzhi Brecht. Indications for
surgery for fractures of the forearm bones.
Fractures of the bones of the hand. Radiographic signs. Types of immobilization.
TOPIC - 2. Especially fractures of the spine, pelvis, lower limbs in children
Fractures of the femur. Kinds of damage to the femur in children with localization
and their clinical manifestation. Types of immobilization. Methods of reduction.
Surgery. Stages of treatment of children with fractures of the femoral shaft.
Methods and types of traction. Complications of skeletal traction in children.
Damage to the knee. Hemarthrosis. Intra-and periarticular fractures. Menisci. The
clinical picture of traumatic dislocation of the patella. Conservative treatment of
injuries of the knee. Surgery of the knee injury.
Fractures of the lower leg bones. Kinds of damage to the lower leg. Epiphysiolysis
osteoepifizeolizy and the proximal and distal ends of the tibia, diaphyseal
fractures, avulsion intercondylar elevation - clinical picture, treatment.
Fractures of the foot and toes. Fractures of the calcaneus and talus. The clinical
picture. Treatment.
TOPIC - 3. Congenital and acquired deformities in children ODA
Dysplasia b / c of the joint. Junior epiphysiolysis femoral head. Stenosing
ligamentity. Osgood-Shlyattera. Haglund disease-Sivertseva. Legg-Calve-Perthes
disease. Varus and valgus deformities l / s, f / s. Anatomical and physiological and
biomechanical characteristics. Clinical and radiological symptomatology and
diagnosis. Treatment policy.
LIST FOR FINAL QUIZ SOFTWARE PEDIATRIC TRAUMA
1. The main causes of child injury.
2. Lots of bones, through which the bone growth.
3. The typical damage in children.
4. Describe subperiosteal fractures.
5. What is epiphysiolysis.
6. Explain cracked and broken by type of green branches.
7. What is apofizeoliz.
8. Types of conservative treatment of fractures in children.
9. What is a rotating shift.
10.Tell us about the axial displacement.
11.What are the reasons for extending immobilize fractures in children.
12.Classification GA Bairova fracture of the humerus
13.The typical clinical picture with humeral fractures
14.Treatment for fractures of the humerus.
15.When is surgical treatment for fractures of the humerus.
16.Pronation dislocated radial head.
17.Tell Bennett fracture.
18.Damage to the knee.
19.Failure mechanism of the knee.
20.The clinical picture of a fracture of the femur.
21.Localization of fractures of the femur.
22.Tell a symptom of "sticky heels."
23.Treatment of fractures of the femur.
24.The clinical picture of traumatic dislocation of the patella.
25.The mechanism of fracture tibia.
26.Tibial fracture clinic.
27.The clinical picture of fractures of the talus.
28.The mechanism of fracture calcaneus.
29.Treatment for fractures of the calcaneus.
30.Name the reduction of traumatic dislocation of the humeral head on the
author.
31.What are the most characteristic lesions elbow and forearm.
32.The main types of dislocation of the femur.
33.The clinical picture of traumatic dislocation of the femoral head.
34.Treatment of dislocation of the femur.
35.Tell causes pathological fractures.
36.What is an imperfect bone formation.
37.What recommendations do you know with frequent fractures accompanied by
deformation of the limbs.
38.Diagnosis of pathological fractures.
39.Tell clinic and diagnosis of birth injury.
40.Tell treatment birth injury.
TOPICS FOR INDEPENDENT STUDENTS TRAINING
1.
2.
3.
4.
5.
6.
7.
8.
9.
Hematogenous osteomyelitis
Drowning in fresh and salt water.
Violation of posture.
First aid for electrical accident.
Myositis ossificans.
Patrimonial damage to bones and joints in children.
Post-traumatic rehabilitation of children.
Osteochondropathy.
Traumatic dislocations of the forearm in children.
LIST OF PRACTICAL SKILLS
 Orthopedic examination of the patient
 First aid for fractures of the humerus
 Retention of limbs in the mid-physiological position
"Orthopedic examination of the patient"
1. Indications: identification of deformation of the musculoskeletal system
2. Required tools: a well-lit room with natural light, a couch, stethoscope, protractor, measuring
tape
3. Student job - Describe the deformation of the musculoskeletal system.
4. Information for examiners: Identify the knowledge and skills of students to vote separately on
each of the below listed items
№
stepping through
Finished
1
History and examination
2
Palpation and auscultation
3
Determination of the amplitude of active and passive
movements of the joints using the protractor
4
Measurement of limb length and circumference measuring
tape
5
Determination of muscle strength in 5 ballnoy system manual
method
6
The diagnosis
not
fulfilled
"First aid for fractures of the humerus"
1. Indications: closed and open fractures of the humerus
2. Required tools: Bus Cramer, 10.0 ml syringe, a vial of narcotic and non-narcotic analgesics,
gauze bandages, cotton wool
3. Student assignment: tell a closed and open fractures of the humerus
4. Information for examiners: Identify the knowledge and skills of students to vote separately on
each of the below listed items
№
stepping through
1
Figuring complaints, circumstances and the mechanism of
injury
2
Patient survey (deformation, abnormal mobility, crepitus,
function n.radialis)
3
Intramuscular injection of a narcotic or non-narcotic analgesics
4
Upper extremity fixation bus Cramer
Finished
Not
fulfilled
5
transportation of the patient
"Fixing the limbs in the mid-physiological position"
1. Indications: Determination of bone fractures and dislocations.
2. Required tools: ruler, measuring tape, protractor, pen.
3. Student job: Tell us about the axis of the limbs and medium-physiological corners fixing limb
joints.
4. Information for examiners: Identify the knowledge and skills of students to vote separately on
each of the below listed items
№
stepping through
Finished
1
Middle-physiological angle for the ankle
2
Middle-physiological angle to the sacral
3
Middle-physiological angle for hip
4
Middle-physiological angle to the shoulder joint
5
Middle-physiological angle for beam joint
6
Middle-physiological angle for wrist
RATING ON CHARTER PEDIATRIC TRAUMA
№
Points
Evaluation
The level of knowledge of the student
Not
Fulfilled
Depending on the situation, to make the right decision and
concludes.
In preparation for practical training uses additional literature (both
native and English). Essentially independently analyzes the problem
of child injury.
1
Themselves can examine the patient and correct diagnoses and
treatment plan assigns prevention of complications.
96-100
Shows high activity, creativity during interactive games. Correctly
solve situational problems with full justification of the answer.
During the discussion of the CDS is actively asking questions, making
additions. Practical skill performs confidently, understand the
essence.
2
In preparation for practical training uses additional literature (both
native and English). Essentially independently analyzes the problem
of child injury. Themselves can examine the patient and correct
diagnoses and treatment plan assigns prevention of complications.
Shows high activity, creativity during interactive games. Correctly
solve situational problems with full justification of the answer.
During the discussion of the CDS is actively asking questions, making
additions. Practical skill performs confidently, understand the
essence.
91-95
Essentially independently analyzes the problem of child injury.
Shows high activity, creativity during interactive games.
Excellent
3
86-90
«5»
Correctly solve situational problems, justifies treatment is
prevention plan. AFI knows musculoskeletal system, says
confidently. There is an exact representation of the etiology,
pathogenesis, clinical picture, can carry differential diagnosis,
prescribe treatment, can take preventive measures.
Practical skill performs confidently, understand the essence.
Properly collect history, examines the patient, makes a preliminary
diagnosis. Can interpret the data Ro "research. Actively involved in
the discussion CDS.
Shows high activity during interactive games.
Correctly solve situational problems, but can not assign a specific
treatment, confusing names corrective rods. AFI knows
musculoskeletal system, says confidently. There is an exact
representation of the etiology, pathogenesis, clinical picture, can
carry differential diagnosis, prescribe treatment, but can not carry
out preventive measures.
4
Practical skills to step through.
76-80
Properly collect history, examines the patient, makes a preliminary
diagnosis. Can interpret the data Ro "research. Actively involved in
the discussion CDS.
Correctly solve situational problems, knows how to put on the
classification of the clinical diagnosis, but can not assign a plan of
treatment and prevention.
6
71-75
Good
«4»
7
AFI knows musculoskeletal system, says confidently. There is an
exact representation of the etiology, pathogenesis, clinical picture
and differential diagnosis, but can not prescribe medication.
Practical skill to perform, but confusing steps.
Properly collect history, examines the patient, makes a preliminary
diagnosis. Can interpret the data Ro "research. Actively involved in
the discussion CDS.
Correctly solve situational problems, but can not justify the clinical
diagnosis. AFI knows musculoskeletal system, says confidently.
There is an exact representation of the etiology, pathogenesis and
clinical, but can not carry out differential diagnosis and prescribe
treatment.
66-70
Properly collect history, examines the patient, but can not assess
the severity. May partly interpret data Ro "research. Actively
involved in the discussion CDS.
8
61-65
Satisfactor
y
«3»
Making mistakes in solving situational problems (can not put a
diagnosis on classification).
Knows clinic injury, but said uncertainly. There is an exact
representation of the mechanism of injury, but can not relate to the
pathogenesis of the clinic. History was unfocused, inspection is not
the scheme. Can not interpret the research data. Passive when
discussing CDS.
9
55-60
10
54 -30
11
Has a general idea of the injuries to children, said not sure. Confuses
AFIs musculoskeletal system. Alone can not interrogate and
examine a sick child. Can not interpret the data Ro "research. Does
not participate in the discussion of CDS.
Bad
Does not have an accurate picture of injuries to children.
«2»
AFI does not know of the musculoskeletal system.
Very bad
For the presence of the student in class, in due form, have a
notebook, stethoscope.
20-30
«2»
REFERENCES
Main:
1. Isakov YR "Pediatric Surgery". M., Medicine 1983.
2. Bairov GA "Trauma of Childhood." L., 1996
3. Orthopedics childhood. Ed. M.V.Volkova and GM Ter-Egizarova. M., Medicine
1983
4. Jalilov PS Holhuzhaev M. "Bolalar travmatologiyasi." T., 1996
5. Damier NG Fundamentals of childhood trauma. RM 1960
6. Shaposhnikov JG Psychotherapy ortopediya.T-February 1997
More
1.
2.
3.
4.
5.
Traumatology and orthopedics. H.A.Musalatov, G.S.Yumashev. 1995.
Volkov MV Bone disease detey.-M.Meditsina, 1985.
Dubrov Ya.G.Ambulatornaya travmatologiya.-M.: Medicine 1990.
Krasnov AF Outpatient travmatologiya.-M.: Medicine 1986.
A. Kaplan Damage to bones and joints. M.1983.
Internet sites:

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
www: travma.ru,
www.histol chuvashia.com.; donhist. fromru.com.; medmir.ru;
www.molbiol.ru;
www.pediatrica.ru; sdo.psu.edu.ru; histology narod.ru;
 http://medic.med.uth.tmc.edu/Lecture/Main/Griff5.htm;
 www.wplus.ru;
 www.rezko.ru; catalog delovik.com.
Зав. кафедрой, д.м.н.
Каримов М.Ю.