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Chronic Recurrent Multifocal Osteomyelitis (CRMO)

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Chronic Recurrent Multifocal Osteomyelitis (CRMO)  affects predominantly children and adolescents, with a peak age of onset of 10 years  and a female preponderance. CRMO is characterized by recurrent inflammation at multiple skeletal sites , most commonly  involving the tibia, femur, clavicle, foot, or vertebral body and rarely the pelvis or rib cage. Associated inflammatory disorders , includes → Palmoplantar pustulosis → Chronic arthritis → Psoriasis → Inflammatory bowel disease → Pyoderma gangrenosum  → Sweet's syndrome, and  → Severe acne. Clinical Features → Multiple episodes of localized redness, pain, & swelling of insidious onset & spontaneous  regression . → Minimal functional impairment during the episodes. Pathophysiology The pathogenesis of this condition remains unexplained. Theories include an autoimm...
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Hanging Cast

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Indications 1.      For displace fracture of the humeral shaft with shortening, and also for oblique and spiral fractures –(Caldwell, 1933)  2.      Used for comminuted humeral fracture, distal humeral shaft fracture. ·       Cast must be lightweight and must extend from at least 1 inch proximal to the fracture site to wrist, with elbow at right angle & forearm in neutral rotation. ·        Arm must lie dependent to provide a traction force. ·        Patient must sleep erect or semi-erect to avoid supporting elbow when seated. ·        Erect position is maintained during the day as much as possible. ·     There should be no support under the elbow, and nothing should compress the arm against the body (such as clothing). It is frequently exchanged for functional b...
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Skeletal Traction: Common sites

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1. Olecranon Site: 1.25 inches (3 cm) distal to the tip of olecranon just deep to the subcutaneous border of upper end of the ulna. Direction:  Medial to lateral at right angles to the longitudinal axis of ulna. Avoid: Ulnar nerve injury. 2. Second & Third Metacarpals Site:  About 1 inch (2-2.5 cm) Proximal to the distal end of Second metacarpal Direction:  The wire traverses 2nd and 3rd metacarpals transversely at right angles to the longitudinal axis of the radius. 3. Greater trochanter (upper end of femur ) Site: ...
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SOMI Brace

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Sternal-Occipital-Mandibular Immobiliser  (SOMI) Brace  Cervico-Thoracic Orthoses (CTOs) provide greater motion restriction from C5-C7 spine from the increased leverage on the person’s body. The upper cervical spine has less motion restriction. CTOs are used in minimally unstable fractures . All CTO’s tend to control flexion better than extension . Parts 1. The SOMI is a rigid, 3-poster CTO that has an padded anterior chest plate extending to the xiphoid process, as well as two padded shoulder extension which hook over tops of the shoulder. 2. From these shoulder extension two Straps which cross in the interscapular region, pass downward and around the chest wall to attach to the lower part of the chest plate. 3. There are three adjustable uprights , which pass upward from the chest plate, two to the padded occipital support and one to the mandibular support. 4. A removable chin piece attaches...
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