For Independent Work of Student

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 orthopeado-

traumatology 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).

1. Relative and reliable signs of breaks and dislocations.
2. Roentgenologic signs of breaks, dislocations and orthopaedic diseases. Use of MRT, tomography, BRIDLES and densitometry for diagnostics of damages.
3. 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. 1

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 withpolytrauma.

5. Transport immobilization atpolytrauma.

6. Features of treatment ofpolytrauma.

7. Classification of fractures.

8. Clinical, diagnostics offractures.

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 ofposttraumatic 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.

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 stumpsof 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 ofstumps 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.

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 UPPEREXTREMITIES.

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.A fracture of olecranon is classification, clinic, diagnostics. Testimonies to the conservative and operative method of treatment of fracture of olecranon.

2. A fracture of head of raduis is a mechanism of origin, classification, clinic, diagnostics and treatment.

3.Classification of fracture of bones of forearm, mechanism of origin and feature of displacement at a диафизарном fracture.

4.The isolated fracture of the body of ones bone of forearm is a clinic, diagnostics and treatments of fracture.

5.A fracture of the bodies of both bones of forearm is a clinic, diagnostics and treatment.

6.A damage of Montedzha and Galeacci- is a clinic, diagnostics and treatment.

7.Classification, mechanism of origin, clinic, diagnostics and treatment of fracture of raduis in a typical place.

8.Clinic, diagnostics and treatment of fracture of bones of wrist and brush.

9.Clinic, diagnostics and treatment of fracture of пястных bones and phalanxes of fingers.

10.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 bodiesof vertebrae. Clinic, diagnostics.

5. Fractures of vertebrae, complicated the damage of spinal cord. Clinic, diagnostics.

6. Ruptures of inter-spinous ligaments ofspinal column. Clinic, diagnostics.

7. Tension ofspinal 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 forverification of independent study and discussion to practical lesson.

Fractures of proximal region of the femur. Classification. Mechanism of fractures. Clinic. Diagnostics. Providing of medical carebefore 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 offractures.

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 of conservative and operative treatment

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 – 2006- Lippincott 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 manifestationsof hallux valgus.
7. Diagnosis and treatment of hallux valgus.
8. Hammer like fingers: symptoms, diagnosis and treatment.
9. Valgus deformity offlatfoot: 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.