Surgery 1 - Third Year BHMS Contents
1. INTRODUCTION TO SURGERY 6. WOUNDS AND WOUND HEALING 9. FLUID, ELECTROLYTE AND ACID BASE BALANCE 15. CONCEPT OF INFECTIOUS DISEASE AND HOST RESPONSE 17. CONCEPT OF SWELLING – TUMOURS AND CYST 19. SPINAL AND VERTEBRAL COLUMN DISEASES FRACTURES AND DISLOCATIONS 21. DISEASES OF THE JOINTS 22. MUSCLES, TENDONS AND FASCIA 23. ORTHOPAEDIC CONDITIONS 26. NOSE AND PARANASAL SINUSES Courses BHMS Surgery 1 - Third Year BHMS JOINT INJURY Definition
Joint injury refers to the damage or disruption of the joint's structural integrity, which can be caused by trauma, overuse, or degenerative conditions.
Types
Traumatic joint injuries : caused by direct blows or sudden movements.
→ Fractures or dislocations of the joint bones.
→ Ligament sprains or tears.
→ Meniscal or articular cartilage damage.Overuse joint injuries : caused by repetitive stress or strain.
→ Tendinitis or tendinosis.
→ Bursitis or olecranon bursitis.
→ Stress fractures.Degenerative joint injuries : caused by wear and tear or age-related changes.
→ Osteoarthritis.
→ Rheumatoid arthritis.
→ Chondromalacia patellae.
Causes
Direct blows or sudden movements.
Repetitive stress or strain.
Wear and tear or age-related changes.
Sports or athletic activities.
Poor joint mechanics or biomechanics.
Infections or inflammatory conditions.
Clinical Features
Pain or tenderness in the affected joint.
Limited range of motion or stiffness.
Swelling or inflammation.
Instability or feeling of looseness.
Deformity or abnormal joint alignment.
Investigations
Physical examination and medical history.
Imaging studies (X-rays, CT scans, MRI).
Laboratory tests (blood work, joint fluid analysis).
Complications
Chronic pain or disability.
Joint instability or deformity.
Limited function or mobility.
Infection or sepsis.
Arthritis or osteoarthritis.
Management
Acute phase :
→ Rest, ice, compression, and elevation (RICE).
→ Pain management with medication.
→ Physical therapy or rehabilitation.Chronic phase :
→ Lifestyle modifications (diet, exercise, stress management).
→ Medications (pain relief, anti-inflammatory).
→ Joint injections or surgery.
Treatment
Non-surgical :
→ Physical therapy or rehabilitation.
→ Joint injections or corticosteroids.
→ Pain management with medication.Surgical :
→ Repair or reconstruction of damaged ligaments or tendons.
→ Removal of bone fragments or debris.
→ Joint replacement or fusion.
Homoeopathic Therapeutic Approach
Arnica montana : for bruises, inflammation, and pain.Rhus toxicodendron : for joint pain, stiffness, and inflammation.Bryonia alba : for joint pain, inflammation, and swelling.Calcarea carbonica : for joint pain, stiffness, and degenerative conditions.
Joint Injury Define Dislocation and Subluxation
Dislocation: Complete separation of the articular ends of two adjacent bones resulting in the loss of joint congruity.
Subluxation: Partial displacement of the articular ends of two adjacent bones resulting in the loss of joint congruity.
Clinical Features of Joint Dislocation
Sudden Onset : Joint dislocation often occurs suddenly, usually due to a traumatic injury.Pain : Severe pain at the joint, which may be exacerbated by movement or weight-bearing.Deformity : Visible deformity of the joint, which may be due to the dislocation of the bones.Swelling : Swelling and bruising around the affected joint.Limited Mobility : Limited mobility of the affected joint due to pain and swelling.Instability : Instability of the affected joint, which may cause feelings of insecurity or apprehension.Numbness or Tingling : Numbness or tingling sensations in the affected limb, due to nerve compression or damage.
Types of Joint Dislocation
Reducible Dislocation : A dislocation that can be easily reduced or put back into place.Irreducible Dislocation : A dislocation that cannot be easily reduced or put back into place.Reciprocal Dislocation : A dislocation where one bone is displaced in one direction and the other bone is displaced in the opposite direction.
Causes of Joint Dislocation
Trauma : A sudden, forceful injury to the joint, such as a fall or a sports injury.Overuse : Repetitive stress or overuse of the joint, leading to wear and tear.Underlying Medical Conditions : Certain medical conditions, such as osteoporosis or bone cancer, can increase the risk of joint dislocation.
Investigations
X-rays : To confirm the diagnosis and assess the extent of the dislocation.MRI : To assess the extent of soft tissue damage and to rule out other conditions.CT Scan : To assess the extent of bony damage and to rule out other conditions.
Complications
Nerve Damage : Nerve damage or compression can occur due to the dislocation.Vascular Damage : Vascular damage or compression can occur due to the dislocation.Infection : Infection can occur due to the trauma or surgery associated with the dislocation.Arthritis : Osteoarthritis or other forms of arthritis can occur due to the wear and tear on the joint.
Management and Treatment
Reduction : The joint is reduced or put back into place.** immobilization**: The joint is immobilized using a cast, splint, or sling.
Pain Management : Pain is managed using analgesics or other medications.Physical Therapy : Physical therapy is used to restore mobility and strength to the affected joint.Surgery : Surgery may be necessary to repair any damaged tissues or to stabilize the joint.
Homoeopathic Therapeutic Approach
Arsenicum album : For dislocations with intense pain and inflammation.Bryonia : For dislocations with stiffness and limited mobility.Hypericum : For dislocations with nerve damage or compression.Rhus toxicodendron : For dislocations with stiffness and limited mobility.