Orthopedic Surgery

Lesson Objectives

By the end of this topic, learners should be able to:

1. Identify common orthopedic surgical conditions and trauma.

2. Understand fracture classification, management principles, and indications for surgery.

3. Recognize complications and post-operative care strategies.

4. Apply nursing and medical care principles to optimize patient outcomes.

 Key Glossary Terms

1. Fracture

• Definition: Disruption in the continuity of bone.

• Types:

  • Closed: Skin intact

  • Open (Compound): Bone exposed to environment

  • Comminuted: Bone broken into multiple fragments

  • Greenstick: Incomplete fracture, common in children

• Management: Immobilization, reduction (closed or open), fixation (internal/external)

2. Dislocation

• Definition: Displacement of bone from a joint.

• Common Sites: Shoulder, hip, knee

• Management: Closed reduction, immobilization, sometimes surgical repair

3. Joint Replacement (Arthroplasty)

• Definition: Surgical replacement of a damaged joint with prosthesis.

• Common Sites: Hip, knee, shoulder

• Indications: Severe osteoarthritis, rheumatoid arthritis, trauma

• Post-Op Care: Pain management, physiotherapy, infection prevention

4. Compartment Syndrome

• Definition: Increased pressure within a closed muscle compartment leading to ischemia.

• Clinical Features: Severe pain, tense swelling, paresthesia, pallor, pulselessness

• Management: Emergency fasciotomy

5. Osteomyelitis

• Definition: Infection of bone, acute or chronic.

• Clinical Features: Pain, swelling, erythema, systemic signs of infection

• Management: Antibiotics, surgical debridement if needed

6. External Fixation

• Definition: Surgical technique where pins or screws are placed into bone and connected externally to stabilize fractures.

• Indications: Open fractures, complex trauma, temporary stabilization

7. Nursing & Medical Student Focus

• Nursing: Pain management, monitoring neurovascular status, wound care, infection prevention, mobility assistance, patient education

• Medical Students: Recognize fracture types, assess neurovascular status, plan surgical interventions, interpret X-rays, monitor post-op complications

8. Orthopedic Surgery Mnemonics

• “6 P’s of Compartment Syndrome”:

  • Pain (out of proportion)

  • Paresthesia

  • Pallor

  • Paralysis

  • Pulselessness

  • Poikilothermia (cold limb)

• “RICE” for initial fracture care:

  • Rest

  • Ice

  • Compression

  • Elevation

 Tables

Table 1: Common Orthopedic Surgical Conditions

Table 2: Post-Operative Nursing Care in Orthopedic Surgery