Summary

samenvatting Orthopedie als onderdeel van MOB2a

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Course
Module Onderzoek En Bahandeling IIA

Institution
Vrije Universiteit Brussel (VUB)

Dit is een samenvatting van de hoorcollege's van Orthopedie gegeven door Johan Vanlauwe. Dit is een onderdeel van MOB2a. Ik heb gewerkt in puntjes en niet met volzinnen. Ik heb ook waar nodig prentjes erbij gezet ter verduidelijking.

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Uploaded on January 7, 2023
Number of pages 47
Written in 2022/2023
Type Summary

fracturen
weke delen letsels
letsels musculoskeletale systeem

Institution
Vrije Universiteit Brussel (VUB)
Education
Revalidatiewetenschappen En Kinesitherapie
Course
Module Onderzoek En Bahandeling IIA

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Inhoudsopgave
1. Algemeen ................................................................................................................................................................... 1
Wat is orthopedie? ..................................................................................................................................................... 1
Wat is traumatologie? ................................................................................................................................................ 1
Letsels v/h musculoskeletale systeem ....................................................................................................................... 1
Contusie ................................................................................................................................................................. 1
Distorsie/verstuiking .............................................................................................................................................. 1
Dislocatie ................................................................................................................................................................ 2
Spier/peesscheur.................................................................................................................................................... 2
Algemeen: fracturen v/h bot .................................................................................................................................. 2
2. Fracturen .................................................................................................................................................................... 3
Soorten fracturen ....................................................................................................................................................... 3
Fractuurgenezing........................................................................................................................................................ 5
Gunstige factoren ................................................................................................................................................... 5
Ongunstige factoren ............................................................................................................................................... 6
Behandelingsprincipes ........................................................................................................................................... 6
Onderste lidmaat ....................................................................................................................................................... 7
Heupfracturen ........................................................................................................................................................ 7
Fracturen femur ..................................................................................................................................................... 9
Patella fracturen ................................................................................................................................................... 10
Tibiaplateau fracturen .......................................................................................................................................... 11
Tibiadiafyse fracturen .......................................................................................................................................... 12
Fracturen v/d enkel & distale tibia ....................................................................................................................... 12
Tarsus fracturen (beentjes v/d achtervoet) ......................................................................................................... 13
Bovenste lidmaat ..................................................................................................................................................... 14
Claviculafractuur .................................................................................................................................................. 14
Scapulafractuur .................................................................................................................................................... 15
Humeruskopfractuur ............................................................................................................................................ 15
Humerusdiafysefractuur ...................................................................................................................................... 15
Sternoclaviculaire luxaties.................................................................................................................................... 16
Acromioclaviculaire luxaties ................................................................................................................................. 16
Humeruskopluxatie .............................................................................................................................................. 16
Distale humerusfractuur ...................................................................................................................................... 17
Radiuskop fractuur ............................................................................................................................................... 17
Olecranon fractuur ............................................................................................................................................... 18
Elleboogluxatie ..................................................................................................................................................... 18
Monteggia fractuurluxatie ................................................................................................................................... 18
Galeazzi fractuurluxatie........................................................................................................................................ 19
Ongecompliceerde onderarmfracturen ............................................................................................................... 19
Distale radius- en/of ulnafracturen ...................................................................................................................... 19

, Scafoïd fracturen .................................................................................................................................................. 20
Luxaties & ligamentaire pols letsels ..................................................................................................................... 20
Metacarpaal fracturen ......................................................................................................................................... 20
Metacarpophalangeale instabiliteit: skiduim ....................................................................................................... 20
Interphalangeale luxatie ...................................................................................................................................... 21
Phalanx fractuur ................................................................................................................................................... 21
3. Artrose...................................................................................................................................................................... 21
Gradaties kraakbeenslijtage ................................................................................................................................. 21
Klachten bij artrose .............................................................................................................................................. 21
Osteotomie........................................................................................................................................................... 21
De heup .................................................................................................................................................................... 22
Diagnose heupartrose .......................................................................................................................................... 22
Conservatieve behandeling .................................................................................................................................. 22
Heelkundige behandeling ..................................................................................................................................... 22
Heupprothesen .................................................................................................................................................... 23
Vroegtijdige problemen ....................................................................................................................................... 23
Knieartrose ............................................................................................................................................................... 23
Heelkundige behandeling kraakbeenletsel .......................................................................................................... 23
Oorzaken knieartrose ........................................................................................................................................... 24
Viscosupplementatie ............................................................................................................................................ 24
Diagnose ............................................................................................................................................................... 25
Conservatieve behandeling .................................................................................................................................. 25
Als dit niet lukt → chirurgie ................................................................................................................................. 25
Prothese chirurgie ................................................................................................................................................ 26
Revalidatie na prothese ....................................................................................................................................... 26
Tevredenheid na knieprothese ............................................................................................................................ 27
Tibiotalaire artrose ................................................................................................................................................... 27
Hallux rigidus ............................................................................................................................................................ 27
Acromioclaviculaire OA ............................................................................................................................................ 27
Glenohumerale OA ................................................................................................................................................... 27
Elleboog OA .............................................................................................................................................................. 28
Pols OA ..................................................................................................................................................................... 28
Duimartrose (rhizartrose) ........................................................................................................................................ 28
4. Weke delen .............................................................................................................................................................. 28
Femoro-acetabulair impingement ........................................................................................................................... 28
Femurkopnecrose .................................................................................................................................................... 29
oorzaken ............................................................................................................................................................... 29
Diagnose ............................................................................................................................................................... 30
Behandeling.......................................................................................................................................................... 30
Snapping hip ............................................................................................................................................................. 30

, Diagnose ............................................................................................................................................................... 30
Behandeling.......................................................................................................................................................... 30
De patella ................................................................................................................................................................. 31
Stabiliserende factoren ........................................................................................................................................ 31
Femoropatellaire problemen ............................................................................................................................... 31
Acute patellaluxatie ............................................................................................................................................. 31
Ruptuur quadricepspees .......................................................................................................................................... 32
Patellapeesruptuur............................................................................................................................................... 32
Ligamenten in de knie .............................................................................................................................................. 32
Ligamentaire letsels ............................................................................................................................................. 32
Knieluxatie ................................................................................................................................................................ 33
Meniscale letsels ...................................................................................................................................................... 33
Baker cyste ............................................................................................................................................................... 34
Enkel impingement .................................................................................................................................................. 34
Achillespeestendinopathie ....................................................................................................................................... 35
Achillespeesruptuur ................................................................................................................................................. 35
Hielspoor/plantaire fascitis ...................................................................................................................................... 36
Morton neurinoom .................................................................................................................................................. 36
Stand afwijkingen v/d voet ...................................................................................................................................... 36
platvoeten ............................................................................................................................................................ 37
Voorvoetafwijkingen ............................................................................................................................................ 37
Humeruskopnecrose ................................................................................................................................................ 38
Impingement → subacromiale inklemming ............................................................................................................. 38
Biceps tendinopathie/ruptuur ................................................................................................................................. 39
Rotator cuff letsels ................................................................................................................................................... 39
Frozen shoulder........................................................................................................................................................ 40
Tennis elleboog: epicondylitis lateralis .................................................................................................................... 40
Golferselleboog: epicondylitis medialis ................................................................................................................... 41
N. ulnaris compressie ............................................................................................................................................... 41
Carpaal tunnel syndroom ......................................................................................................................................... 41
Peesaandoeningen ................................................................................................................................................... 42
Ziekte v Dupuytren ................................................................................................................................................... 43
Polscyste of ganglioncyste ....................................................................................................................................... 44

, 1. Algemeen
Wat is orthopedie?

• = chirurgie v musculoskeletale systeem
• Orthopedische chirurgen gebruiken chirurgie & niet-chirurgie
• ➔ houdt zich bezig met musculoskeletale aandoeningen & vooral met locoregionale aanpak ervan

Wat is traumatologie?

• Trauma = een letsel = fysiologische wonde veroorzaakt door externe bron
• Koude orthopedie → ziekten bewegingsstelsel
• Traumatologie → musculoskeletale aandoeningen tgv trauma
o Kunnen op zich aanleiding geven tot koude orthopedie
• Ontwikkeling artrose na trauma → bv knie vervangen door prothese
o Dus na trauma → na paar jaar OA dus orthopedie

Letsels v/h musculoskeletale systeem

• Contusie, distorsie, dislocatie, spier/peesscheur, fractuur, kneuzing, verstuiking, ontwrichting, breuk
• Symptomen
o Altijd dezelfde symptomen
o W rood, doet pijn, w warm, verlies v functie
• Basisprincipes
o PRICE
▪ Protect, rust, ijs, compressie, elevatie (over ijs wel discussie over de laatste tijd)

Contusie

• = heel felle blauwe plek
• Inwendige bloeduitstorting
• Rechtstreekse weefselbeschadiging
• ➔ inflammatie
• Lichaam kan dit zelf oplossen + zsm terug bewegen

Distorsie/verstuiking

• 3 graden
o Graad 1
▪ G tss 0 & 5mmm extra open gaat
▪ Functionele behandeling
o Graad 2
▪ 5-10mm open → onstabiel voor een stuk
▪ P moet het wel toelaten want dit doet pijn
▪ Brace + functionele behandeling

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