Clinical Medicine

Clinical Medicine

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  Soft Tissue Injury RANA SALMAN  Malik Abdul Rehman
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  SOFT TISSUE The structurewhich connect and support the organs in the body Muscle Ligament Tendon Bursa fascia Soft tissue injury Injury of these structure in known as STI
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  Muscle A body tissueconsisting of long cells that can contract and produce motion is known muscle Muscle injury usually called strain Tendon A fibrous connective tissue attach muscle to bone Tendon injury called sprain
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  Degree of injury Firstdegree mild Second degree moderate Third degree severe Sprain is more sever then strain
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  ligament A fibrous connectivetissue that attach bone to bone Sprain Total tear can be as painful as a broken bone
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  Fascia A thin connectivetissue that sround and hold every organ, blood vessel ,bone nerve fibre and muscle in proper place Symptoms of facia injury mimic like muscle and tendon BURSA Fluid filled sac or sac like cavity ,especially one countering friction in a joint
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  Management of upper extremity
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  Management of shoulderregion Any pathology in these joint Glenohumeral JOINT ACROMIOCLAVICULAR Sternoclavicular Joint NONOPRATIVEMANAGEMENT lead the condition of hypo mobility Impairment Of Body Structure And FUNCTION  Inflammation  Pain  Edema  Muscle spasm  Joint effusion
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  PLAN OF CAREAND INTERVENTION  Educate the patient  Control pain and edema  Maintain integrity of associated areas  Passive range of motion  Active assisted range of motion  Increase joint play OPRATIVE MANAGEMENT • TSR • TS Arthroplasty • Glenohumeral arthroplasty • Rotator cuff arthroplasty MANAGEMENT Early shoulder motion passively and assistive only for six weeks Maintain humeral depression Avoid superior translation Stretching strengthening
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  CONTRAINDICATION Don’t allow activeshoulder flexion and abduction until the patient can lift the arm without hiking the shoulder
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  MANAGEMENT FOR ELBOWDISORDER Tennis elbow lead to hypomobility micro tear in ECRB ACUTE Joint effusion Pain Muscle guarding Fracture dislocation SUBACuTE cRONIC Capsular pattern variation
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  STAGE FOR RECOVERY STAGE1 STAGE 2 STAGE 3 Rest ,ice, compression PROM, ACTIVE ROM,STRETCHING, BRACING RESISTED ROM AND STRENGTHINING
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  MANAGEMENT  Educate thepatient  Maintain soft tissue and joint mobility  Maintain integrity of associated areas  Gentle ocellation of grade 1 and 2 OPRATIVE • TER • TEA
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  MANAGEMENT Immobilized for 1,3week at 45 to 90 degree Maintain mobility shoulder wrist and hand Regain motion of elbow and forearm Manage edema Maintain mobility of uninvolved joint Increase range of motion Improve muscle strength and endurance
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  WRIST AND HAND Whencompression of median and ulnar nerve Pain radiate with different pattern NON OPRATIVE MANAGEMENT  Patient educate  Pain management  Activity modification  Maintain joint tendon mobility and muscle integrity
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  OPRATIVE MANAGEMENT  Metacarpophalangealimplant arthroplasty  Proximal inter phalangeal  Carpometacarpal arthroplasty of thumb All these occur due severe fracture over use syndrome or deformity MANAGEMENT Prevent adhesion Restore control and mobility of wrist Maintain mobility of uninvolved joint PRECaution  SSI
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  MANAGEMENT OF LOWER EXTRIMITIES
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  maNAGEMENT OF HIPREGION Sciatic nerve Obturator nerve Femoral nerve L1, L2, L3, S1, S2 NON OPRATIVE Educate the patient Decrease pain Decrease stiffness Joint mobilization Stretching  Increase ROM
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  SURGRICAL  THR  THA MANAGEMENT oEducate patient o Positioning o Improve strength in both extremities o Gait training PRECauTION Foot is in neutral position
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  MANAGEMENT FOR KNEEREGION  Peroneal nerve  Saphenous nerve With damaging sensory loss and muscle weakness Innervation of medial side of knee and leg also effect Management Educate the patient Limit its functional activity Maintain associated muscle function Joint mobilization PRECauTION Prevent patellar adhesion
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  SURGERY • TKR  TKA Patellar instability MANAGEMENT Compression to wrap to control effusion Pain modulation Ankle pump passive ROM Active assistive ROM of knee Superior or inferior patellar mobilization Gait training
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  THE ANKLE ANDFOOT REGION Common fibular nerve Posterior tibial nerve p Plantar and calcaneal nerve Nerve root is L4 L5 and S1 When these nerve entrap pain radiate with different pattern  Movement restrict  Muscle weakness  Gait deviation MANAGEMENT • Educate patient • Decrease pain • Maintain joint • Prevent muscle integrity • Increase joint play • PROM +AROM • Improve gait and balance training
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  SURGERY • TAA • TAR MANAGEMENT oImmobilized o Weight bearing o Prevent DVT o functional mobility o Proper neutral position o Prevent dystrophy of associated areas
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  THANK YOU
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  Do a gooddeed and throw it in the river.one day it will back to you in the desert