GENERAL PRINCIPLES AND

SPECIFIC METHODS OF
MUSCULOSCKELETAL
TREATMENT
General Principles of Treatment

1. Frist do no harm
2. Base treatment on an acurate diagnosis
and prognosis
3. Select tratment with spesific aims
4. Cooperate with the lows of nature
5. Be realistic and practical in your treatmen
6. Select treatment for your patiens as an
individual
 A Litany For Medical
Practitioners
from inability to let well alone,
From too much zeal for new and contempt for what is
old,
From putting knowledge before wisdom,
Science befor art, and cleverness before common
sense,
From treating patients as case, and from making the
cure of the disease more grievous than endurance of
the same,
Good Lord, Deliver us.
Sir Robert Hutchinson, 1953.
GENERAL FORMS
AND SPECIFIK
METODS OF
TREATMENT
1. Psychological Considerations

ought not treat the body

wirhout the mind Socrates,
400BC
 2. Therapeutic Drugs

1. Analgesics
2. Nonsteroidal Anti-inflammatory
Drugs
3. Chemoterapeutic Agents
4. Vitamins
5. Specific Drugs
3. Orthopaedic Apparatus and
Appliances
1. Rest
Prolonged and continous bed rest is associated with
many harmfull effects
. Disuse atrophy of muscles with resultant generalized
weakness
. Disuse atrophy of bone
. Increased calcium excretion
. Deeo vein thrombosis
. Decubitus ulcers
 Rest
Continuous traction
Continuous traction is used for the following purpose :
1. To stretch gradually soft tissues that have become
shortened secondary to a long standing join
deformity or dislocation
2. To relieve painful muscle spasm associated with
join unflammation or injury
3. To maintain legth of the limb and alignment of
fracture fragments
Suport for Muscle Weakness
and Join Instability
4. Physical and Occupational
Therapy
1. Join motion
. Active movement
. Intermittent passive movement
2. Muscle strength
. Active exercise
. Isometrik Exercises
3. Improvement of Musculoskeletal Function
. Functional training
5. Surgical Manupulation

Correct deformity
Regain motion
 6. Surgucal operations

1. Operations on muscles, tendon and

ligamen
2. Operations on nerves
3. Prosthetic join replacement
4. Osteocartilaginous Allografts
5. Artoscopic surgery
6. Operations on bones
7. microsurgery
7. Elektrical stimulation of
fracture healing
1. Constant direct current through
percutaneous wire cathodes
2. Constant direct current trough
implanted elektrodes and power
pack
3. Inductive coupling trhough
electromagnetic coil
 8. Continous Passive motion
Indications :
1. Arthrotomy, capsulotomy, debridement, and artholysis of join
2. Open reduction of intra articular fractures
3. Patellectomy
4. Repair of ligamentous injuries
5. Synovectommy of rheumatoid arthritis and hemophilic arthropathy
6. Arthtotomy and drainage of acute septic arthritis
7. Biological resurfacing for major defect in an join surface
8. Surgical repair of a complete laceration of tendon
9. Rigid internal fixation of metaphyseal osteotomy
10. Total prosthetik join replacement
 Radiation therapy

1. The radiotherapy is a highly scientific and technical

form of treatment involving the administration of
ionizing radiation
2. The value of ionizing radiation as a form of
treatment lines in its relatively selective destruction
3. Imature and undifferentiated cells are particulary
vulnerable or sensitive to the effect of ionizing
radiation
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