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25.5.11

Traumatology in any case of Fracture.Symptoms and Complications of a fracture

Fractures usually due to trauma which may be :
-direct trauma which is inflected to the bone itself for exemple in case of car accident.
-indirect trauma: trauma is not inflicted to the bone which is broken indirectly.

Less commonly is Pathological Fracture : the bone weakened by disease (osteomyelitis,metastasis) that leads at minor trauma.

Classification of Fracture:
1.According to the presence of skin wound:
-Simple (close) fracture :Overlying skin is intact.
-Compound  (open) fracture: associated with overlying skin wound.

2.According to displacement and deformity:
-displaced (angulation,over-riding,rotation,anterior or posterior,lateral).
-undisplaced fracture.

3.According to the shape of the fracture:
-transverse fracture
-longitudinal fracture
-oblique fracture
-comminuted fracture
-spiral fracture
-impacted fracture.

4.Stable or unstable
5.Complete or Incomplete Fisure Fracture
6.Complicated or uncomplicated fracture.

Complications of Fractures:
1.General Complications: (only in fracture femur,pelvis or spine).
-Shock : neurogenic due to severe pain and haemorrhage
-Paralytic ileus and acute gastric dilatation
-Fat embolism
-Complications of prolonged bed rest especially in old people.
-Traumatic anuria in crushing injury
-Urinary calculi
-Tetanus.

Local Complications:
-injury of the skin leading to compound fracture and infection.
-injury of vessels leading to haemorrhage,spasm.
-injury of nerves: may be immediate injury or delayed injury
injury of muscles: loss of muvement,deformity
-injury of joints:ligament injuries,effusion,dislocation.

Symptoms of a fracture:
-Inability to move the part and loss of function
-Pain and tenderness
-Deformity
-Swelling
-abnormal mobility

For investigation is necessary plain X-ray.

22.5.11

Whipworm-Parasite of unwashed hands,unwashed vegetables and unsanitary water



Trichocephalus Trichiurus known by common name as Whipworm is more prevalent in poor sanitary areas and is more common in children.

Man is the only definitive host.The adult worms live in the caecum and appendix with the thin and anterior portion embedded in the mucosa parallel to the digestive tract.In heavy infection,it may extend into the colon and even the rectum.Each female deposits 3000-6000 eggs a day.

Under favourable conditions like warm regions,shaded,moist soil,the eggs develops a rhabditiform larva within 3 to 4 weeks.


Man parasites infection by ingestion of mature egg with contaminated food (green raw vegetables)unsanitary water and unwashed hands.In the lawer part of the small intestine,the larva hatches through one of the poles of the egg,passes directly to the caecum,moults 4 times and becomes sexually mature.
Egga appears in faeces 3 months after infection.

In light infection no symptoms,presence of the parasite is discovered only on stool examination.
The heavy infection results in:
-extensive inflammation and irritation of the mucous membrane at the points of attachement with hemorrhage that leads to submucosal absesses and ulcers.Appears abdominal pain,most commonly in the lower right quadrant of the abdomen,nausea,vomiting and diarrhoea with streaks of blood.
-appendicitis
-anaemia
-dysentery.

Whipworm can be detected by faeces laboratory.