Theme № 1

Subject and tasks of traumatology and orthopedics. The

history of development traumatology and orthopedics. Injury
and traumatism.
Features of examination with injuries and diseases of the
musculoskeletal system (MSS).
 Introduction into
Traumatology and
Orthopedics.
History of
Traumatology and
Orthopedics.
„Traumatology ” to make from Greece
„ trauma ” ─ wound and „logos”-sciense,
and attend to studies of injures of the
humen body.
 History of the development of
traumatology, orthopedics
 In medicine, traumatology (from Greek trauma, meaning injury or wound) is
the study of wounds and injuries caused by accidents or violence to a person,
and the surgical therapy and repair of the damage. Traumatology is a branch
of medicine. It is often considered a subset of surgery and in countries
without the specialty of trauma surgery it is most often a sub-specialty
to orthopedic surgery. Traumatology may also be known as accident surgery.

 Nicholas Andry coined the word in French as orthopédie, derived from

the Greek words ὀρθός orthos ("correct", "straight") and
παιδίον paidion ("child"), when he published Orthopedie (translated
as Orthopædia: Or the Art of Correcting and Preventing Deformities in
Children[1]) in 1741. The word was assimilated into English
as orthopædics; the ligatureæ was common in that era for ae in Greek-
and Latin-based words. Though, as the name implies, the discipline was
initially developed with attention to children, the correction of spinal and
bone deformities in all stages of life eventually became the cornerstone
of orthopedic practice.
Ficsation of the fractures with palm leters
Injury and traumatism.
 1

3
АО - system use:
1) the rots for intramedular
osteosintesis;
2) the plates;
3) the screws
 BONE SCREWS

There are two types of screws = Machine screws &

Wood screws.
Bone screws are machine screws.
A wood screw is inserted into a small pilot hole. The
screw threads compress the wood, which is less stiff
than the screw, resulting in an elastic force.
A machine screw is inserted into a pre-drilled & pre-
tapped hole. The screw itself deforms plastically when
inserted into metal.
X-ray diagnostics of injuries and
diseases of the musculoskeletal system.
INTRAMEDULLARY
NAILS
 PLATES:

Benefits:
anatomical reduction of the fracture with open techniques
stability for early function of muscle-tendon units and joints

Disadvantages:
risk of bone refracture after their removal
stress protection and osteoporosis beneath a plate
plate irritation, nonunion, infection
G. A. Ilizarov.
Aparates for external fixation
 FIXATOR ILIZAROV EXTERNAL
wires= 1.5mm in adults & children; 1.8mm in adult
femur.
wire types= smooth & olives (for
stability/translation)
Insertion= Push-Drill-Tap
Aim for wires at 90deg. to each other & 4-5 wires
per segment
Bring the ring to the wire- Not the wire to ring -
Tether through muscles in joint extension
Wire Tension= 1.2mm-90kg; 1.5mm-110kg; 1.8mm-
150kg
Focus = fracture / non-union site
Segments = bone fragments
Factors affecting construct stiffness:
EXTERNAL FIXATION:

Advantages:

Apply quickly
Tecnically easy to perform
Adjust later
Soft tissues not disturbed
Access to wounds
Joints can be mobilised
Can dynamize
Easy removal
Reconstruction surgery
 Disadvantages:

Pin tract infection

Malunion
Patient compliance required
Useful for:
Any fracture
Bone transport
Limb lengthening
Angular correction
Soft tissue reconstruction
Contractures
Posttraumatic
contractures of
knee joints
The endoprothesis of the knee and hip joints.
Other special, couple clinical methods of
examination in traumatology and orthopedics
(computed tomography, magnetic resonance
imaging, etc.).
The artroscopic method of treatment