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Archive for March, 2010

Thanks for a good time!

Mr DundeeBones is taking a break for a few days but the Blog will still be here.

I’d  like to take up some of the suggestions you made today but it will take a while to get more SAQs together.  There’s also a chance that the platform for DundeeBones will be changing and that should make posting to the site easier.

Thanks to  everyone who has commented, contributed or asked questions – –and especially for all the feedback after today’s  lecture.

More X-rays after the weekend.

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Have your say during the 12MD summing up  lecture tomorrow.  Audience response system will be used to see what you all think as a class. 

Also time for your individual personal responses and opinions.

Would an on-going, constantly growing, regularly updated DundeeBones be of any  use later in the year?/ next year? / when you are on  4th year orthopaedic placements? / if you are lonely?

Come along to  tell us what Mr DundeeBones mean to you tomorrow.

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A leg injury from Chile

leg%20fracture[1]

This case has been provided by an orthopaedic  colleague from Santiago, Chile, who is studying at the University at the moment.

The series of pdf pages reads from p5 – p1 so scroll down to the end and then read the progression of this injury in reverse page order.

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More EMI answers

Theme : pathology

A S1 nerve root entrapment

B  spondylolisthesis

C  central  cord compression

D T1 root entrapment

E  C5/6 root entrapment

F  L3 root compression on the  left

G  infection in the L4/5 disc

H  spinal  tumour

I  cauda equina lesion

J  L3 root compression  on the right side

Match the clinical presentations below to the most appropriate pathology listed above:

4.   Back pain without radiation in a 60 year-old woman associated with pyrexia, high white cell count and a “hot spot”    on bone scan.    G

5.  Bilateral  leg pain with back pain and urinary retention.   I

6.  Loss of ankle jerk on examination.   A

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Answers to last week’s EMIs

Theme : pathology

A S1 nerve root entrapment

B  spondylolisthesis

C  central  cord compression

D T1 root entrapment

E  C5/6 root entrapment

F  L3 root compression on the  left

G  infection in the L4/5 disc

H  spinal  tumour

I  cauda equina lesion

J  L3 root compression  on the right side

Match the clinical presentations below to the most appropriate pathology listed above:

1  Neck pain and wasting of the interossei muscles in the hand         D

2  Depressed right knee jerk and weakness on knee extension           J

3  Pain shooting from the back down the side of the leg to the lateral  side of the foot       A

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More stuff on Blackboard

You might  like to  check out the in-house hip examination  and anatomy video on Blackboard.  The content is not totally comprehensive so is not overwhelming but might give you a  lead into  reading further about hip examination in a reliable text.

Also there’s the hip case of the week from HYMS which discusses a common hip  problem so clearly worth a visit.

Finally, thanks for the note about ppts of lectures absent from Bb.  I’ll try  to chase up  some of these people.

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ISKD

ISKD – overview

The Intermedullary Skeletal Kinetic Distractor (ISKD) is, as it says, an intermedullary method for producing long bone lengthening without having an external fixator exterior to the limb.

Lengthening of a tibia or femur may be indicated as a method of treating  leg length discrepency after trauma, infection or other causes of growth arrest.  Previously managed by an external fixator which could be manually wound longer every day, these cases ran the risk of developing pin track infection from the percutaneous pins used to secure the device to the bone.

In this first article  for Cutting Edge Stuff Katie Ludwig describes the role of this innovative method of leg lengthening as seen at Stracathro Hospital Regional  Treatment Centre which avoids this complication.  I thought this interesting review of the ISKD highlighted a cutting edge approach to debate.

If you have any  thoughts about the role of ISKD or have seen one in  use  elsewhere then please send a comment to DundeeBones.

Anyone who would like to send an article on another innovations in orthopaedics or on an interesting case can do so by emailing a Word doc to j.a.dent@dundee.ac.uk

Follow the link below to the full article:

ISKD – overview

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