1.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPARING TO PRACTICAL LESSON
MODULE 1
“GENERAL QUESTIONS of TRAUMATOLOGY and ORTHOPAEDY”
PRACTICAL Lesson N. 1
Theme 1. Introduction to speciality. Features of examination of traumatology and orthopaedic
patients. Damages of ligaments, tendons and muscles. Traumatic dislocations.
4 hours.
Theoretical questions for independent study and discussion to practical Lesson N. 1– 2 hours.
1.
Study of Traumatology and Orthopaedy as disciplines.
2.
History of development and modern achievements of domestic traumatology.
3.
Features of collection of anamnesis for patients with pathology of the skeletal system.
4.
Main complaints of patient at breaks and dislocations of extremities.
5.
Main anatomic signs of damages of the skeletal system .Walking.
6.
Methods of determination of axis of extremity, spine. Basic types of deformation of
extremities and spine
7.
Identification points and lines which are determined at the investigation of orthopeadotraumatology patients.
8.
Measuring of length and circumference of extremity. Types of shortening and methods
of their
determination.
9.
Measuring of degree of motions in joints. Types of limitations of motions of joints
(contractura, their kinds, reason).
9.
Relative and reliable signs of breaks and dislocations.
10.
Roentgenologic signs of breaks, dislocations and orthopaedic diseases. Use of
MRT, tomography, BRIDLES and densitometry for diagnostics of damages.
11.
Providing fundamental knowledge.
2.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“GENERAL QUESTIONS of TRAUMATOLOGY and ORTHOPAEDY”
PRACTICAL Lesson N.2
Theme 1. Introduction, to specialty. Features of examination, of traumatological and orthopaedic
patients. Damages of ligaments, tendons and muscles. Traumatic dislocation.
Theoretical questions for verification of independent study and discussion to practical Lesson
N.2.2
1. Mechanism and clinical displays of damages of ligaments, tendons, and muscles
(two-headed muscle of shoulder, 4-headed muscle of thigh, heelstring (Akhilla,
ligament of talocrural joint). Principles of their treatment, prophylaxis of
complications.
2. Determination of concept «dislocation», «sub dislocation». Pathmorphylogical.
General classification.
3. General clinical symptoms of dislocation.
4. Mechanogenesis, classification, clinic of dislocations of shoulder, forearm, thigh,
shin.
5. Providing of medical care at dislocations before hospital stage.
6. Treatment of dislocations in the conditions of the specialized permanent
establishment.
7. Usual dislocation of shoulder. Reason, treatment and prophylaxis
8. Complications of dislocations, their prophylaxis and treatment.
3.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“GENERAL QUESTIONS of TRAUMATOLOGY and ORTHOPAEDY”
PRACTICAL Lesson N. 3
Theme 2. Traumatic illness. Polytrauma, modern principles of treatment of fractures. Taking of
patient’s Case history.
Theoretical questions for out department of independent study and discussion to practical
employment
1. Concept about traumatic illness and polytrauma.
2. Classification of traumatic illness.
3. Diagnostics of traumatic illness.
4. First aid to patient with polytrauma.
5. Transport immobilization at polytrauma.
6. Features of treatment of polytrauma.
7. Classification of fractures.
8. Clinical, diagnostics of fractures.
8. Modern principles of treatment of fractures.
9. Slow union of fractures.
10. New arthrosis.
11. slow consolidation.
12. Prophylaxis and treatments of complications which arise at treatment of fractures.
13. Classification of the opened fractures and their anatomic-morphology features.
14. Treatment of opened fractures.
15. Posttraumatic osteomyelitis.
16. Classification of posttraumatic osteomyelitis.
17. Clinical and roentgenologic diagnostics of posttraumatic osteomyelitis.
18. Principles of general and local treatment of posttraumatic osteomyelitis
19.Roentgenologic signs of fractures, new arthrosiss, slow consolidation fractures, osteomyelitis.
Use MRI, Tomography, ultrasound and densitometry in diagnostics of defeats of locomotion.
4.
A CHART OF HOSPITAL CHART IS ON TRAUMATOLOGY AND ORTHOPAEDY
Right side:
Winnitca national medical university the name by N.I. Pirogov.Department of traumatology and
orthopaedy.
Chif of department:
Teacher:
Hospital chart
( First, second, last name of the patient )
Clinical diagnosis: basic disease
concomitant disease
complication
Beginning of study:
End of study:
Student.________ the course_______ group
Top page:
General information about the patient
1.1. First, second, last name of the patient
1.2. Age
1.3. Profession
1.4. Address
1.5. Diagnosis of establishment which sent a patient
1.6. Diagnosis which is set at entering clinic
1.7. Clinical diagnosis: a basic disease, a concomitant disease of complication
1.8. Date of receipt
1.9. Date and name of operation
1.10. Date of extract
Second page:
2.
Complaints of patient.
3.
Anamnesis of illness (time of trauma, circumstance, first aid, who given, terms of delivery in
permanent establishment, immobilization, transport.)
4.
Anamnesis of life: for orthopaedic patients innate and inherited diseases, illnesses of relatives.
5.
Objektivne investigation:
5.1. External review.
5.2. Research of breathing organs
5.3. Research of the cardio system
5.4. Research of organs of digestion
5.5. Research of the urine-sexy system
5.6. Research of the endocrine system
5.7. Research of the nervous system
6.
Status of localis
7.
Previous diagnosis
8.
Plan of inspection (investigation)
9.
Sciagramm.
10. Clinical diagnosis and his ground (basic disease, a concomitant ,complication)
11. Plan of treatment. Ground of testimonies and contra-indications to conservative treatment is a
testimony and contra-indications, types of possible methods of treatment, chart of operations. Preoperated
preparation. Anaesthetizing. Prophylaxis of the postoperation complications. A type of immobilization after
an operation.
12. Rehabilitation in late periods of treatment.
13. Ekspertno- labour conclusion ( terms of immobilization, terms for unworking , prognosis for life,
for work, for final convalescence)
14. Diary.
Date, pulse, t bodies Given questioning and inspection sick,
Manipulations
Changing of the bandage
In addition is a temperature letter
14. Literature which was utillized (author, name of work, source, year, pages.)
Date__________
Signature_______
5.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“GENERAL QUESTIONS of TRAUMATOLOGY and ORTHOPAEDY”
PRACTICAL Lesson N. 5
Theme 3. Amputation of extremities. Rehabilitation and prosthetics of
invalid slipshod extremities. Treatment of traumatological and orthopaedic patients
in ambulatory terms.
1. Historical aspects of development and modern achievements of domestic
amputation surgery.
Absolute and relative testimonies to amputation, kinds and methods of it’s
implementation.
2. Features of implementation of amputations on different segments taking into
account a rational level, methods of muscle and bone of plastic arts, features
of treatment of bone end, vessels and nerves.
3. Preparation of amputation stumps of extremities to prosthetics in ambulatory
and stationary point.
4. Testimonies and contra-indications to prosthetics. The ground of concepts
early prosthetics and express-prosthetics.
5. Types of prosthetic appliances and terms of prosthetics, estimation of
efficiency of prosthetic wares.
6. Vices and diseases of amputation stump, methods of diagnostics, features of
prophylaxis and treatment.
7. Features of inspection of sick with amputation of stumps extremities with
the use of clinical, roentgenologic, physiological (EKG, REOVGR),
instrumental (densitometry) and laboratory methods of research.
6.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“Outpatient care of orthopedic and trauma patients”
PRACTICAL Lesson N. 6
Theme 2. Outpatient care of orthopedic and trauma patients.
Theoretical questions for out department of independent study and discussion
to practical employment
The definition of trauma and injuries.
2. Classification of injuries, determine its frequency and severity.
3. Role and tasks of outpatient care of orthopedic and trauma patients.
4. Features of primary and re-admission orthopedic trauma patients in clinics
and hospitals.
5. Role and tasks of the health units in industry.
6. Setting time of temporary disability, especially the letter sick with various
injuries and diseases of the musculoskeletal system.
9. Justification hits for a disability caused by injuries and diseases of the
musculoskeletal system, the criteria for determining disability groups.
References:
1. http://www.ota.org/committees/otso.html
2. A patient guide to Orthopaedic trauma Care at the bwh.
3. Netter's Orthopaedics, 1st ed., - 2006.
5. Oxford Handbook of Clinical Specialties, 7th Edition – 2006- Oxford University
Press
6. Rockwood & Green's Fractures in Adults, 6th Edition – 2006- Lippincott
Williams & Wilkins
7. Handbook of Fractures, 3rd Edition – 2006 - Lippincott Williams & Wilkins
7.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“GENERAL QUESTIONS of TRAUMATOLOGY and ORTHOPAEDY”
CONTENT MODULE 2
DAMAGE of SPINE, PELVIS; DAMAGE of BONES and JOINTS of UPPER EXTREMITIES
and LOWER EXTREMITIES.
PRACTICAL Lesson N. 7
Theme 4. DAMAGE of BONES, and JOINTS of UPPER EXTREMITIES.
1. Fracture of clavicle. Mechanism of origin, classification, clinic,
diagnostics. Methods of treatment.
2. Dislocation of acromion and sternal parts of clavicle. Mechanism of origin,
clinic, diagnostics and treatment.
3. Mechanism of origin of fracture of scapular, classification, clinic, diagnostics
and treatment.
4. Fracture of the proximal part of humeral bone. Mechanism of origin,
classification, clinic, diagnostics and treatments of the fractures.
5. A fracture of diphysis (middle) part of humeral bone, a clinic, diagnostics
and treatment.
6. A supracondylar break of humeral bone, a mechanism of origin,
classification, clinic, diagnostics and treatment.
7. A fracture of condoyle of humeral bone, a mechanism of origin,
classification, clinic, diagnostics and treatment.
8.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“GENERAL QUESTIONS of TRAUMATOLOGY and ORTHOPAEDY”
PRACTICAL Lesson N. 8
Theme 4. DAMAGE of SPINE, PELVIS, BONES and JOINTS of UPPER and LOWER
EXTREMITIES. 4 hour.
Theoretical questions for vneauditornogo of independent study and discussion to practical
Lesson N. 2 – 2 hours.
1.
2.
A fracture of olecranon is classification, clinic, diagnostics. Testimonies to the
conservative and operative method of treatment of fracture of olecranon.
A fracture of head of raduis is a mechanism of origin, classification, clinic, diagnostics
and treatment.
3.
4.
5.
6.
7.
8.
9.
10.
Classification of fracture of bones of forearm, mechanism of origin and feature of
displacement at a диафизарном fracture.
The isolated fracture of the body of ones bone of forearm is a clinic, diagnostics and
treatments of fracture.
A fracture of the bodies of both bones of forearm is a clinic, diagnostics and treatment.
A damage of Montedzha and Galeacci- is a clinic, diagnostics and treatment.
Classification, mechanism of origin, clinic, diagnostics and treatment of fracture of
raduis in a typical place.
Clinic, diagnostics and treatment of fracture of bones of wrist and brush.
Clinic, diagnostics and treatment of fracture of пястных bones and phalanxes of fingers.
A damage of tendons of flecture and extenzorsof fingers is a clinic, diagnostics and
treatment.
9.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“GENERAL QUESTIONS of TRAUMATOLOGY and ORTHOPAEDY”
CONTENT MODULE 2
LOWER EXTREMITIES.
Practical Lesson N. 9 – 2 hours.
Theme 5. Damages of bones, of pelvis - 4 hour.
Theoretical questions for verification of independent study and discussion to
practical Lesson N. 9 – 2 hours.
1. Fractures of bones of pelvis, mechanism of origin, classification.
2. Fractures of ischial hillock.
3. Fractures of bones of pelvis without violation of continuity of pelvic ring
(Stable, minimally displaced fractures), mechanism of origin, classification.
4. Fractures of bones of pelvis with violation of continuity of pelvic ring
(rotationally unstable, vertically unstable).
5. 5. Fractures of bones of pelvis with the damage of pelvic organs (rupture of
urethra, bladder, injury to rectum or vagina, to major vessels, to nerves, rupture of
the diaphragm).
10.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“GENERAL QUESTIONS of TRAUMATOLOGY and ORTHOPAEDY”
CONTENT MODULE 2
DAMAGE OF SPINE, PELVIS, BONES AND JOINTS OF OVERHEAD AND LOWER
EXTREMITIES.
Practical Lesson N. 10 – 2 hours.
Theme 5. Damages of spine.
Theoretical questions for verification of independent study and discussion to practical Lesson N.
10 – 2 hours.
1. Fractures of arch of vertebrae. Clinic, diagnostics.
2. Fractures of spinous processes. Clinic, diagnostics.
3. Fractures of transversal processes of vertebra. Clinic, diagnostics.
4. Fractures of bodies of vertebrae. Clinic, diagnostics.
5. Fractures of vertebrae, complicated the damage of spinal cord. Clinic, diagnostics.
6. Ruptures of inter-spinous ligaments of spinal column. Clinic, diagnostics.
7. Tension of spinal column. Clinic, diagnostics.
8. Contusion of spinal column. Clinic, diagnostics.
11.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“GENERAL QUESTIONS of TRAUMATOLOGY and ORTHOPAEDY”
CONTENT MODULE 2
DAMAGE of SPINE, PELVIS; DAMAGE of BONES and JOINTS of UPPER EXTREMITIES
and LOWER EXTREMITIES.
PRACTICAL Lesson N. 11
Theme 6 Damages of bones and joints of lower extremity. 4 hours.
Theoretical questions for verification of independent study and discussion to
practical lesson.
Fractures of proximal region of the femur. Classification. Mechanism of fractures.
Clinic. Diagnostics. Providing of medical care before hospital stage. Features of
repairative regeneration of fractures of proximal region of femur. Methods of
treatment, and features depending on localization of fractures and their kinds.
2. Fractures of diphysis of the femur. Mechanism of trauma. Clinic. Diagnostics.
Features of displacement of fragments depending on localization of fractures.
Result to the conservative and operative methods of treatment.
3. Fractures of condylus of the femur. Classification. Mechanism of trauma.
Clinic. Diagnostics. Basic principles of treatment. Result to the operative and
conservative methods of treatment.
4. Fractures of patella. Clinic. Diagnostics. Methods of treatment, depending on
the type of fractures.
12.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“GENERAL QUESTIONS of TRAUMATOLOGY and ORTHOPAEDY”
CONTENT MODULE 2
DAMAGE OF SPINE, PELVIS, BONES AND JOINTS OF LOWER EXTREMITIES.
Practical Lesson N. 12 – 2 hours.
Theme 5. Damages of spine.
Theoretical questions for verification of independent study and discussion to practical Lesson.
1. Damage of ligaments of knee-joint. Mechanism of trauma. Clinic. Diagnostics. Methods
conservative and operative treatment
of
2. Damage of meniscuses of patella. Mechanism of trauma. Clinic. Diagnostics. Treatment.
3. Damage of the soft tissues of the shin (muscles, heelstring, fibular and tibular nerves of shin).
4. Fractures of bones of shin. Classification. Mechanism of damage. Clinic. Diagnostics. Conservative
and operative methods of treatment fractures of bones of shin.
5. Fractures of lateral malleolus and medial malleolus. Classification. Mechanism of trauma. Diagnostics.
Conservative and operative treatment. Technique of the closed reposition at the typical fractures of
malleolus.
6.
Fractures of Talo and Calcaneal bones. Mechanism of their damage. Clinic. Diagnostics. Treatment.
7. Fractures of metatarsus bones and phalanges of fingers. Clinic. Diagnostics. Treatment. Features of
treatment of fractures of bones of foot.
13.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“Degenerative diseases of spine.”
PRACTICAL Lesson N. 13
Theme 2. Degenerative diseases of spine.
Theoretical questions for out department of independent study and discussion
to practical employment
1.
Etiology and pathogenesis of spinal osteochondrosis.
2. Biomechanics and physiology of the intervertebral segment.
3. Classification, clinical picture and diagnosis of spinal osteochondrosis.
4. Clinical and radiographic stages of spinal osteochondrosis in different
locations.
5. Indications for conservative and surgical methods of treatment of spinal
osteochondrosis.
6. Etiology, pathogenesis, clinical features, diagnosis and spondylosis
spondylarthrosis.
7. Principles of treatment of spondylosis and spondylarthrosis.
8. Vocational rehabilitation of patients with degenerative-dystrophic diseases
of the spine.
References:
1. A patient guide to Orthopaedic trauma Care at the bwh.
2. Netter's Orthopaedics, 1st ed., - 2006.
3. Oxford Handbook of Clinical Specialties, 7th Edition – 2006- Oxford
University Press
4. Rockwood & Green's Fractures in Adults, 6th Edition – 2006Lippincott Williams & Wilkins
5. Handbook of Fractures, 3rd Edition – 2006 - Lippincott Williams &
Wilkins
14.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“Degenerative diseases of joints.”
PRACTICAL Lesson N. 14
Theme 2. Degenerative diseases of joints.
Theoretical questions for out department of independent study and discussion
to practical employment
1. The etiology and pathogenesis of osteoarthritis.
2. Classification, clinical diagnostics and osteoarthritis.
3. Clinical and radiographic stage of osteoarthritis.
4. The principles of treatment of osteoarthritis according to the stage of the
disease.
5. Indications for conservative treatment of deforming osteoarthritis, its
methods.
6. Indications for surgical treatment of osteoarthritis and types of interventions.
References:
1.A patient guide to Orthopaedic trauma Care at the bwh.
2.Netter's Orthopaedics, 1st ed., - 2006.
3.Oxford Handbook of Clinical Specialties, 7th Edition – 2006- Oxford
University Press
4.Miller. Review of orthopaedics: fourth edition.
5.Nigel S. Broughton. Textbook Of Pediatric Orthopaedics – 1997 –
ISBN 0-7020-1962-3.
15.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“Injuries of calf and foot”
PRACTICAL Lesson N. 15
Theme 2. Injuries of calf and foot.
Theoretical questions for out department of independent study and discussion
to practical employment
1. Soft tissue calf injuries (muscles, Achilles tendon, peroneal nerve and
tibial nerve).
2. Fractures of the lower leg bones. Classification. Mechanism of injury.
Clinic. Diagnostics. Conservative and surgical treatment of leg bones
broke it. Testimony to them.
3. Fractures of the lower leg bones. Classification. The mechanism of injury.
Diagnosis. Conservative and operative treatment. Closed reduction
technique for typical fracture bones
4. Talus fractures and bone stain. The mechanism of damage. Clinic.
Diagnostics. Treatment.
5. Fractures of the metatarsals and phalanges. Clinic. Diagnostics.
Treatment. Features of treatment of fractures of the foot.
References:
1. Tan E, Schweitzer ME, Vaccaro L, AR, Spettel C, et al. Is computed
tomography of nonvisualized C7-T1 cost-effective?. J Spinal Disord
1999;12:472 - 476.
2. Blackmore CC, Mann FA, Wilson AJ. Helical CT in the primary trauma
evaluation of the cervical spine: an evidence-based approach. Skeletal
Radiol 2000;29: 632 -639.
3. A patient guide to Orthopaedic trauma Care at the bwh.
4. Netter's Orthopaedics, 1st ed., - 2006.
5. Oxford Handbook of Clinical Specialties, 7th Edition – 2006- Oxford
University Press
6. Rockwood & Green's Fractures in Adults, 6th Edition – 2006- Lippincott
Williams & Wilkins
7. Handbook of Fractures, 3rd Edition – 2006 - Lippincott Williams &
Wilkins
17.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“Feet deformities”
PRACTICAL Lesson N. 17
Theme 2. Feet deformities.
Theoretical questions for out department of independent study and discussion
to practical employment
1. Definition.
2. Classification of flatfoot.
3. Causes of flatfoot.
4. Clinic of flatfoot.
5. Prevention and treatment of flat foot.
6. Classification, clinical manifestations of hallux valgus.
7. Diagnosis and treatment of hallux valgus.
8. Hammer like fingers: symptoms, diagnosis and treatment.
9. Valgus deformity of flatfoot: symptoms, diagnosis and treatment.
References:
1.Netter's Orthopaedics, 1st ed., - 2006.
2.Oxford Handbook of Clinical Specialties, 7th Edition – 2006- Oxford
University Press
3.Miller. Review of orthopaedics: fourth edition.
4.Nigel S. Broughton. Textbook Of Pediatric Orthopaedics – 1997 –
ISBN 0-7020-1962-3.
18.
METHODICAL INSTRUCTION
FOR INDEPENDENT WORK OF STUDENT
FOR PREPERING TO PRACTICAL LESSON
MODULE 1
“Tumors and tumorlike diseases of sceleton”
PRACTICAL Lesson N. 18
Theme 2. Tumors and tumor-like diseases of sceleton.
Theoretical questions for out department of independent study and discussion
to practical employment
1.
Classification of tumors.
2. Primary benign tumors of cartilage and bone origin: chondroma,
osteoblastoklastoma, osteoma, osteoidosteoma.
3. Clinical and radiological evidence of tumor. Methods of treatment.
4. Primary malignant tumors of cartilage and bone origin: chondrosarcoma,
periosteal fibrosarcoma, osteogenic sarcoma, Ewing's sarcoma.
5. Clinical and radiological signs and methods of diagnosis of malignant
tumors and their treatment.
6. Secondary malignant tumors and metastatic germinating in bone from the
surrounding muscular tissue (sinovioma). Ambulatory treatment.
7. Tumor bone disease: solitary bone cyst, aneurismal bone cyst, osteoid
osteoma. Clinical and radiological signs. Treatment.
References:
1.Netter's Orthopaedics, 1st ed., - 2006.
2.Frassica GJ, Frassica DA, Lietman SA, McCarthy EF, Wenz JF:
Metastatic bone disease. In: Chapman MW, ed. Chapman's Orthopaedic
Surgery, 3rd edition. Philadelphia, Pa: Lippincott Williams and Wilkins;
2001:3469-3482.
3.In: Simon MA, Springfield DS, Conrad EU, ed. Surgery for Bone and
Soft-Tissue Tumors, Philadelphia, Pa: Lippincott-Raven; 1998.
4.Springfield DS, Gebbardt MC: Bone and soft tissue tumors. In:
Morrisey RT, Weinstein SL, ed. Lovell and Winter's Pediatric
Orthopaedics, 5th edition. Philadelphia, Pa: Lippincott Williams and
Wilkins; 2001:507-562.
5.Unni KK: Dahlin's Bone Tumors: General Aspects and Data on 11,087
Cases, 5th edition. Baltimore, Md, Lippincott-Raven, 1996.