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Samenvatting orthopedie, kinderorthopedie en trauma wervelzuil met lesnotities
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Samenvatting orthopedie, kinderorthopedie en trauma wervelzuil met lesnotities
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InhoudHoofdstuk 1: Inleiding (algemene principes)........................................................................................... 8
1.1 Structuur ........................................................................................................................................ 9
1.2 Functie ........................................................................................................................................... 9
1.3 Soorten pathologie ........................................................................................................................ 9
1.4 Basiskenmerken bot .................................................................................................................... 10
1.4.1 Morfologie ............................................................................................................................ 10
1.4.2 Structuur ............................................................................................................................... 10
1.5 Gewricht ...................................................................................................................................... 11
1.5.1 Momentarm ......................................................................................................................... 11
1.5.2 Kinematica ............................................................................................................................ 11
1.5.3 Stabiliteit vs mobiliteit .......................................................................................................... 11
1.6 Ligamenten .................................................................................................................................. 12
1.7 Fracturen ..................................................................................................................................... 12
1.7.1 Indeling !!! ............................................................................................................................ 13
1.7.2 Diagnose ............................................................................................................................... 14
1.7.3 Fractuurheling en behandeling............................................................................................. 15
1.7.4 Verwikkelingen ..................................................................................................................... 19
Hoofdstuk 2: Pathologie van de schouder............................................................................................. 21
2.1 Functionele anatomie.................................................................................................................. 21
2.2 Acromioclaviculaire pathologie ................................................................................................... 22
2.2.1 Diagnose ............................................................................................................................... 23
2.2.2 Behandeling .......................................................................................................................... 23
2.3 Claviculafractuur .......................................................................................................................... 23
2.4 Schouderluxatie (glenohumeraal) ............................................................................................... 24
2.4.1 Anterieure schouderluxatie .................................................................................................. 24
2.4.2 Atraumatische schouderluxatie ............................................................................................ 28
2.4.3 Multidirectionele atraumatische schouderluxatie ............................................................... 28
2.4.4 Posterieure traumatische schouderluxatie........................................................................... 28
2.4.5 Samenvatting ........................................................................................................................ 28
2.5 Frozen Shoulder ........................................................................................................................... 29
2.6 Degeneratieve schouderpathologie ............................................................................................ 29
2.6.1Bursitis/ tendinitis calcarean ................................................................................................. 29
2.6.2 Impingement ........................................................................................................................ 29
2.6.3 Rotatoren cuff scheur ........................................................................................................... 30
1
, 2.6.4 Bicepspees scheur ................................................................................................................ 30
2.6.5 Omartrose (= artrose van de schouder) ............................................................................... 30
2.7 Humerusfracturen ....................................................................................................................... 31
2.7.1 Proximale humerusfracturen ................................................................................................ 31
2.7.2 Humerusdiafysefracturen ..................................................................................................... 31
2.8 Gerefereerde schouderpijn ......................................................................................................... 32
Hoofdstuk 3: Pathologie van de elleboog.............................................................................................. 33
3.1 Functionele anatomie.................................................................................................................. 33
3.2 Elleboogluxatie ............................................................................................................................ 34
3.3 Distale humerusfractuur .............................................................................................................. 36
3.4 Olecranonfractuur ....................................................................................................................... 36
3.5 Radiuskop .................................................................................................................................... 36
3.5.1 Fractuur ................................................................................................................................ 36
3.5.2 Luxatie .................................................................................................................................. 37
3.6 Voorarm ....................................................................................................................................... 38
3.6.1 Monteggia fractuur............................................................................................................... 38
3.6.2 Galeazzi................................................................................................................................. 38
3.7 Pronation douloureuse ................................................................................................................ 38
3.8 Epidcondylitis = overbelastings – en degeneratieve letsels ........................................................ 38
3.8.1 Epicondylitis lateralis ............................................................................................................ 38
3.8.2 Epicondylitis medialis ........................................................................................................... 39
3.9 Distale bicepspeesruputuur......................................................................................................... 39
3.10 Bursitis olecrani ......................................................................................................................... 39
3.11 Distale radiusfractuur ................................................................................................................ 39
3.11.1 Colles of Pouteau ................................................................................................................ 40
3.11.2 Smith................................................................................................................................... 40
3.11.3 Barton ................................................................................................................................. 40
3.11.4 Die – punch ......................................................................................................................... 40
3.11.5 Chauffeur ............................................................................................................................ 40
3.11.6 Behandeling ........................................................................................................................ 40
Hoofdstuk 4: Pathologie van de pols en hand ....................................................................................... 42
4.1 Inleiding ....................................................................................................................................... 42
4.2 Pijndiagram .................................................................................................................................. 42
4.3 Inklemming .................................................................................................................................. 43
4.3.1 Carpaal tunnel syndroom ..................................................................................................... 43
4.3.2 De Quervain tenosynovitis ................................................................................................... 43
2
, 4.3.3 Flexorpees tensosynovitis..................................................................................................... 44
4.4 Dupuytren.................................................................................................................................... 44
4.5 Infecties ....................................................................................................................................... 45
4.5.1 Vingertip infecties ................................................................................................................. 45
4.5.2 Flexor peesschede infectie ................................................................................................... 45
4.5.3 Bijtwonden ........................................................................................................................... 45
4.6 Peesletsels ................................................................................................................................... 46
4.6.1 Boutonnière .......................................................................................................................... 46
4.6.2 Mallet vinger......................................................................................................................... 46
4.6.3 Flexor pees letsels................................................................................................................. 46
4.7 Osteonecrose............................................................................................................................... 47
4.7.1 Os lunatum ........................................................................................................................... 47
4.7.2 Os scaphoideum ................................................................................................................... 47
4.8 Skiduim ........................................................................................................................................ 48
4.9 Fracturen en luxaties ................................................................................................................... 48
4.9.1 Os scaphoideum fractuur ..................................................................................................... 48
4.9.2 Peri – lunaire luxatie ............................................................................................................. 49
4.9.3 Vinger en metacarpaal fracturen.......................................................................................... 49
4.10 Vingeramputatie ........................................................................................................................ 49
Hoofdstuk 5: Pathologie van de heup ................................................................................................... 50
5.1 Functionele anatomie en biomechanica ..................................................................................... 50
5.2 Heupluxatie.................................................................................................................................. 52
5.2.1 Posterieure heupluxatie ....................................................................................................... 52
5.2.2 Anterieure heupluxatie ......................................................................................................... 52
5.2.3 Behandeling .......................................................................................................................... 53
5.3 Proximale femur fractuur ............................................................................................................ 53
5.3.1 Femurhalsfractuur ................................................................................................................ 53
5.3.2 Pertrochantere fractuur........................................................................................................ 55
5.3.3 4e leeftijd populatie .............................................................................................................. 55
5.4 Osteonecrose heup ..................................................................................................................... 55
5.5 Coxartrose.................................................................................................................................... 57
5.5.1 Draagkracht .......................................................................................................................... 57
5.5.2 Belasting ............................................................................................................................... 58
5.5.3 Artrose .................................................................................................................................. 58
5.5.4 Klinische symptomen............................................................................................................ 58
5.5.5 Behandelingsopties .............................................................................................................. 58
3
, 5.5.6 Indicatiestelling heupprothese ............................................................................................. 60
5.5.7 Verwikkelingen ..................................................................................................................... 60
5.6 Labrumscheuren .......................................................................................................................... 61
5.7 Trochanter bursitis ....................................................................................................................... 61
5.8 Septische artritis .......................................................................................................................... 61
5.9 Stress fractuur femurhals ............................................................................................................ 62
Hoofdstuk 6: Pathologie van de knie ..................................................................................................... 63
6.1 Functionele anatomie en kinematica .......................................................................................... 63
6.1.1 Valgus as ............................................................................................................................... 63
6.1.2 Stabiliteit knie ....................................................................................................................... 63
6.1.3 Bewegingsboog..................................................................................................................... 64
6.1.4 Assen .................................................................................................................................... 64
6.2 Anamnese en klinisch onderzoek ................................................................................................ 65
6.2.1 Anamnese ............................................................................................................................. 65
6.2.2 Klinisch onderzoek ................................................................................................................ 65
6.2.3 Punctie .................................................................................................................................. 66
6.3 Meniscusletsels ........................................................................................................................... 67
6.3.1 Algemene symptomen.......................................................................................................... 67
6.3.2 Specifieke symptomen.......................................................................................................... 67
6.3.3 Klinisch onderzoek ................................................................................................................ 67
6.3.4 Technische onderzoeken ...................................................................................................... 67
6.3.5 Behandeling .......................................................................................................................... 68
6.3.6 Soorten scheuren ................................................................................................................. 68
6.4 Ligamentletsels ............................................................................................................................ 68
6.4.1 Ontstaansmechanisme ......................................................................................................... 68
6.4.2 Voorste kruisband (VKB) ....................................................................................................... 69
6.4.3 Mediale bandletsel (MCL) .................................................................................................... 70
6.4.4 Achterste kruisband.............................................................................................................. 71
6.4.5 Systematisch stabiliteitsonderzoek ...................................................................................... 72
6.4.6 Verwikkelingen bij kruisbanden............................................................................................ 72
6.5 Kraakbeenlijden ........................................................................................................................... 72
6.5.1 Algemene weetjes ................................................................................................................ 72
6.5.2 Anatomie kraakbeen ............................................................................................................ 73
6.5.3 Oorzaken kraakbeenlijden .................................................................................................... 73
6.5.4 Kraakbeenletsels................................................................................................................... 73
6.5.5 Pathogenese ......................................................................................................................... 74
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