HIP DISORDERS: CME - At Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh

8/7/2019 HIP DISORDERS: CME - At Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh.

1/65

9

Qrgpirgc my -Cr. @c Oizrub jsbi`, @MMT, @.Td.Tupgrvjsgc my -Cr. Tn. Immis uccjo Ie`gc@T (lrtel), il(misjd), il(spjog).

Qrgsgotjok my -

Cr. Klbi` @iei`uc TueiseFrl` -Cgpirt`got Lf Lrtelpigcjd & Sriu`itlblky,Teieggc Tueriwircy @gcjdib Dlbbgkg Elspjtib.

Ceini.

D@G

]gdgot Icviodg`got

Ejp Turkgry IocEjp-]gpbidg`got

LO


2/65

]gdgot Icviodg`got


Ejp-cjslrcgrs

]gdgot Icviodg`got


=


3/65

Ejp js teg hljot wegrg ylurtejke mlog `ggts ylur pgbvjsmlog.

Ejps irg vgry stimbg. [ego tegyirg egibtey, jt tings krgit flrdgtl eurt teg`.

Dl``lo Ejp-cjslrcgrs irg- TtrijosMursjtjsCjsblditjlos

Fridturgs

]gdgot Icviodg`got


Lvgr vjgw

4


4/65

]gdgot Icviodg`got


Dlotgots8

3

Fuodtjlos lf Ejp-hljot@gdeiojs`s Ejp johury

@lst Dl``lo Sypgs lf Ejp Johury- Gpjcg`jlblky Ioitl`y lf Ejp-hljot Qitelpeysjlblky lf Ejp-Johury Dbjojdib fgiturgs lf Ejp-Johury-

Jovgstjkitjlos Cjikolsjs@ioikg`got ]geimjbjtitjlos

Dl`pbjditjlos Qrlkolsjs Lf Ejp-]gpbidg`got- Dlodbusjlos Sltib Ejp ]gpbidg`got it Teieggc

Tueriwrcy @gcjdib Dlbbgkg Elpjtib-


5/65

Fuodtjlos lf Ejp-hljot

7

]gdgot Icviodg`got


Sl prlvjcg stimjbjty flr wgjket

mgirjok- stiocjok, wibnjok &ruoojok. Sl ibblw `lmjbjty lf teg bgk jospidg. Sl trios`jt teg blics frl` tegtejke ioc tego tl teg blwgr bj`m.


6/65

6

Cjrgdt Ttrgss

l Fg`lrib Ogdn fridturg

l Jotgr-trldeiotgrjd fridturg ]gpgitgc strgss

l Cgkgogritjvg hljot cjsgisg (CHC) lf teg

Ejp

Cgflr`jtjgsl Dlokgojtib cjsblditjlo lf teg Ejp (DCE)

/ Cgvgblp`gotib cyspbisji lf teg Ejp (CCE).

@gdeiojs`s Ejp johury-


7/65

Ejp Ttrijo js io lvgrusg lr johury teit

tgirs lr strgtdegs teg ùsdbg fjmgrs.

@lst lf teg tj`g, ùsdbg strijos jo tegejp irgi lddur wego i strgtdegc

ùsdbg js flrdgc tl dlotridt succgoby.

I fibb lr cjrgdt mblw tl teg ùsdbg,

lvgrstrgtdejok ioc lvgrusg dio tgir

ùsdbg fjmgrs, rgsubtjok jo i strijo.

;

]gdgot Icviodg`got


Ttrijos

@lst Dl``lo

Sypgs Lf Ejp Johury-

@lst Dl``lo



8/65

Mursi js i fbujc fjbbgc sid teit ibblws

s`llte `ltjlo mgtwggo twl uogvgosurfidgs.

Ejp mursjtjs js i dl``lo prlmbg`teit diusgs pijo lvgr teg lutsjcg lf

teg uppgr tejke.[ego teg mursib sid mgdl`gs

jofbi`gc, gide tj`g teg tgoclo eis tl`lvg lvgr teg mlog, pijo rgsubts.Mgdiusg pitjgots wjte ejp mursjtjs`lvg tejs tgoclo wjte gide stgp, ejpmursjtjs sy`ptl`s dio mg qujtg

pijofub. 5

]gdgot Icviodg`got


Mursjtjs

@lst Dl``lo



9/65

Sypgs lf cjsblditjlo8

DlokgojtjdibIdqujrgcIotgrjlrDgotrib Qlstgrjlr (:1%)

:

]gdgot Icviodg`got


@lst Dl``lo


Cjsblditjlos- EJQ


10/65

91

Cjsblditjlos

IL/LSI Dbissjfjditjlo

@lst telrluke.

Mgst flr rgplrtjok citi, tl ibblwdl`pirjslo lf pitjgots frl` cjffgrgotstucjgs.

41-C91 Iotgrjlr EjpCjsblditjlo

41-C99 Qlstgrjlr EjpCjsblditjlo

41-C41 Lmturitlr (Iotgrjlr-Jofgrjlr) EjpCjsblditjlo

]gdgot Icviodg`got



11/65

FridturgsFridturg lf Idgtimubir Dl`plogotIdgtimubir fridturg

Dgotrib cjsblditjlo

Fridturg lf Fg`lrib Dl`plogots 9. Fg`lrib Ogdn fridturg (OLF),

=. Fg`lrib egic fridturg 4. Tbjppgc dipjtib fg`lrib gpjpeysjs jo

dejbcrgo

3. Srldeiotgrjd fridturg

EJQ dio mrgin it ioy ikg, mut teg

krgit `ihlrjty lf ejp fridturgs lddur

jo pglpbg lbcgr teio 67..

99

]gdgot Icviodg`got


@lst Dl``lo



12/65

[lrbcwjcg kgocgr cjstrjmutjlo lf Ejp Fridturg @go8 3-7 pgr 9,111

[l`go8 5-91 pgr 9,111

@go8 41%

[l`go8 ;1% @lrmjcjty ioc @lrtibjty

@lrtibjty =1% wjtejo 9 ygir Ejp Fridturg

l @go8 49% `lrtibjty jo 9 ygir

l [l`go8 9;% `lrtibjty jo 9 ygirl ICB issjstiodg oggcgc jo 71% lf Ejp Fridturgs

l Blok tgr` dirg oggcgc jo =7% lf Ejp Fridturgs.

Dllpgr (9::=) Lstglplrls Jot =8=57-:

Flrsgo (9:::) Lstglplrls Jot 918;4-5

Gpjcg`jlblky

9=

]gdgot Icviodg`got



13/65

94

Ioitl`y lf Ejp-hljot]gdgot Icviodg`got


Seg ejp hljot js i mibb ioc sldngthljot, flr`gc my teg egic lf tegFgùr (tejke mlog) ioc teg

idgtimubu` lf teg pgbvjs.Seg cl`g-seipgc egic lf teg fgùrflr`s teg mibb, wejde fjts soukkby jotlteg dlodivg sldngt lf teg idgtimubu`.

Seg ejp hljot js i vgry sturcy hljot,cug tl teg tjket fjttjok lf teg mlogsioc teg strlok surrluocjok bjki`gotsioc ùsdbgs.

Jotrlcudtjlo tl ejp hljot ioitl`y


14/65

]gdgot Icviodg`got


93

Ioitl`y lf Ejp-hljot

Mlogs lf teg ejp hljot Seg ejp hljot dipsubg Bjki`gots lf teg ejp hljot

Bimru` lf teg ejp hljot @usdbg Krlups surrluocjokteg ejp hljot.

Ogurl-visdubir Dl`plogots.

VjtibDl`plogots lf Ejp-hljot -


15/65

Seg jbju`8 Sejs js tegbirkgst irgi lf teg ejp mlogs. Seg jsdeju`8 Seg jsdeju`

dlosjsts lf = mrlic durvgs lfmlog, log lo gide sjcg, wejdebjg mgblw teg jbju`, Seg pumjs8 Seg pumjs js teg

frlot-`lst irgi lf teg ejpmlogs. Jt ittidegs tl teg jbju`lo teg sjcgs ioc teg jsdeju`lo teg mlttl`.

Ioitl`y lf Ejp-hljot Mlogs

97

]gdgot Icviodg`got


Ejp mlogs -
http://www.wikidoc.org/index.php/Ilium_(bone)http://www.wikidoc.org/index.php/Ischiumhttp://www.wikidoc.org/index.php/Pubis_(bone)http://www.wikidoc.org/index.php/Pubis_(bone)http://www.wikidoc.org/index.php/Ischiumhttp://www.wikidoc.org/index.php/Ilium_(bone)


16/65

@usdbgs @usdbgs wejde ittide tl lrdlvgr teg ejp hljot8

Kbutgibs. Yuicrjdgps- Jbjlpslis. Ei`strjoks. Krljo `usdbgs.

Bjki`gots. Jbjlfg`lrib bjki`got8 Qumlfg`lrib bjki`got8 Jsdejlfg`lrib bjki`got8

@usdbgs Ioc Bjki`gots-

96

]gdgot Icviodg`got



17/65

9;

@ijoby my

@gcjib ioc bitgrib djrdu`fbgx

fg`lrib irtgrjgs. Ioc

Cggp cjvjsjlo lf teg supgrjlr

kbutgib irtgryJofgrjlr kbutgib irtgry

Qlstgrjlr cjvjsjlo lf teg lmturitlr

irtgry(Egic lf teg fg`ur ).

Mbllc suppby

]gdgot Icviodg`got


Ogurlvisdubir Dl`plogot


18/65

]gdgot Icviodg`got


95

Fg`lrib ogrvg - Vji ogrvg tlteg rgdtus fg`lrjs ùsdbg Lmturitlr ogrvg -Vji jtsiotgrjlr cjvjsjlo. Tdjitjd ogrvg -Vji teg ogrvg tlteg quicritus fg`lrjs ùsdbg. Tupgrjlr kbutgib ogrvg - Egrg

teg fg`lrib, sdjitjd ioc lmuritlrogrvgs ibsl suppby teg nogg hljot,sl ejp cjsgisg ìy diusg i

rgfgrgc pijo tl teg ejphljot.

Ogrvg suppby

Ogurlvisdubir Dl`plogot


19/65

]gdgot Icviodg`got


9:

Ikg. Seg ritg jodrgisgs flr pglpbg 67 ioc lbcgr.

Kgocgr.[l`go eivg twl tl tergg tj`gs is`ioy ejp fridturgs is `go. Egrgcjty.I fi`jby ejstlry lf fridturgs jo bitgrbjfg, pirtjdubirby jo Diudisjios ioc Isjios. Is`ibb-mlogc, sbgocgr mlcy. Outrjtjlo.I blw dibdju` cjgtiry joting lrrgcudgc imjbjty tl imslrm dibdju`. Qgrsloib eimjts. T`lnjok lr gxdgssjvg ibdlelbusg.

Qeysjdib j`pijr`gots. Qeysjdib frijbty,irterjtjs, uostgicy mibiodg, ioc pllr gygsjket. @gotib j`pijr`gots. Tgojbjty, cg`gotji, g.k.,Ibzegj`gr's cjsgisg.

[ginogss lr cjzzjogss frl` sjcg gffgdts lf`gcjditjlo

Qitelpeysjlblky lf Ejp-Johury

[el jsvubogrimbg tlejp fridturg


20/65


21/65

=9

Ejp fridturgs usuibby irg diusgc my i

fibb. Jf ylu fridturg ylur ejp, ylu ìygxpgrjgodg teg flbblwjok sy`ptl`s8Tgvgrg pijo jo ylur ejp lr pgbvjdirgiMrujsjok ioc/lr swgbbjok jo ylurejp irgiJoimjbjty tl put wgjket lo ylur ejp

Cjffjdubty wibnjokSeg johurgc bgk ìy blln selrtgrteio teg ltegr bgk ioc ìy mgturogc lutwirc.

sy`ptl`s

]gdgot Icviodg`got


Dbjojdib fgiturgslf Ejp-Johury-


22/65

==

Dl`pbgtg `gcjdib ejstlry Qeysjdib gxi`joitjlo tl issgss ejp`lmjbjty, strgokte, ioc ibjko`got.

Mbllc tgstsU-riys (ricjlkripes) tl cgtgr`jog teggxtgot lf ci`ikg lr cgflr`jty jo ylurejp.

@]J / DS sdio. Wbtrisluoc sdios Mlog sdios Mjlpsy

Seglrtelpigcjdgvibuitjlowjbbtypjdibbyjodbucg -

Jovgstjkitjlos]gdgot Icviodg`got



23/65

Jovgstjkitjlos

]gdgot Icviodg`got


=4

9. Mbllc tgsts.=. Njcogy, Bjvgr tgsts.

4. Buoks, Egirt ioc Ogurlblkjdibissgss`gots.

9. Issgss`got lf mlog strgokte=. Issgss`got lf mlog jofgdtjlo4. Issgss`got lf mlog SM/ Dirdjol`i.3. Issgss`got lf `gtimlbjd/systg`jdmlog cjsgisgs.

]lutjog Qrg-lpgritjvgJovgstjkitjlos-

Mlog pitelblky spgdjfjdJovgstjkitjlos-

@] Irterlkri`


24/65

]gdgot Icviodg`got


Ejp Uriy Wsuibby jcgotjfjgs Fridturg ioc

Cjsblditjlo Ejp @]J (S9-wgjketgc) Jocjditgc flr ejke suspjdjlo

cgspjtg olr`ib U]iy Sgst Tgosjtjvjty8 911% Clgs olt rgqujrg cgbiy iftgrjohury

Ejp Mlog Tdio wjte Sgdeogtju`Sd::` Qlbypelspeitg Sgst Tgosjtjvjty8 :5% Cgbiy sdio it bgist ;= elurs

iftgr tj`g lf johury =3

J`ikjoklk i

@] Irterlkri`

Io @]J iy jcgotjfy iejp fridturg ltegrwjsg`jssgc lo pbijo U-riy.
http://www.fpnotebook.com/Ortho/Fracture/Frctr.htmhttp://www.fpnotebook.com/Prevent/Epi/TstSnstvty.htmhttp://www.fpnotebook.com/Prevent/Epi/TstSnstvty.htmhttp://www.fpnotebook.com/Prevent/Epi/TstSnstvty.htmhttp://www.fpnotebook.com/Prevent/Epi/TstSnstvty.htmhttp://www.fpnotebook.com/Prevent/Epi/TstSnstvty.htmhttp://www.fpnotebook.com/Prevent/Epi/TstSnstvty.htmhttp://www.fpnotebook.com/Ortho/Fracture/Frctr.htm


25/65

Cjikolsjs]gdgot Icviodg`got


=7

Tumhgdtjvg Issgss`got Qijo bldibjzgc jo ejp rgkjlo Gxikkgritgc kijt pittgro (bj`p) Jodrgisg jo pijo wego wgjketmirrjok ]gcudtjlo jo teg cgkrgg lf ]L@

Is teg cgkgogritjlo lf teg hljotwlrsgo, jocjvjcuib `iy mg iwingogcit ojket wjte pijo

Mlog spurs `iy lddur


26/65

=6

Lmhgdtjvg Issgss`got Kijt pittgro Iciptjvg wibnjok

pittgro teit rgcudgs prgssurg lo tegiffgdtgc sjcg. @usdbg itrlpey @usdbgs jo iffgdtgcirgi irg olt usgc is `ude cug tl pijo,

tegrgflrg, usg-jt-lr-blsg-jt ippbjgs.Idtjvg ]iokg Lf @ltjlo Bj`jtgc]L@, stjffogssQissjvg ]L@ Goc fggbs diusgs sgvgrgpijoU-riy dbgir cgkgogritjlo lf teg mlog @]J cgtgr`jogs uocgrbyjok

dl`pbjditjlos (g.k.ivisdubir ogdrlsjs)

Cjikolsjs

]gdgot Icviodg`got



27/65

@ioikg`got]gdgot Icviodg`got


Srgit`got flr ejp cjslrcgrs `iyjodbucg-

@gcjdib- ]gst, @gcjdjogs, Qeysjdib tegripy J``lmjbjzitjlo ioc/ lr ]gcudtjlo(cjsblditjlo)

=;


28/65

=5

Turkjdib-

Lstgltl`y

L]JF

EJQ ]gsurfidjok

Ejp rgpbidg`got.

@ioikg`got

] t Ic t


29/65

=:

Idgtimubir Dl`plogot- Cyspbisji, J`pjokg`got.Fg`lrib Dl`plogots.

Dl``lo EJQ Dlocjtjlo[ejde ]gqujrgs Jotgroib

Fjxitjlo-

Fjxitjlo

]gdgot Icviodg`got


9. Fg`lrib Ogdnfridturg (OLF),

=. Fg`lrib egic fridturg

4. Tbjppgc dipjtib fg`lribgpjpeysjs jo dejbcrgo

3. Srldeiotgrjd fridturg

] t Ic t


30/65

41

EJQ ]gsurfidjok-

Cgvgblpgc jo bitg ojogtjgs jo WN myCr.Cgrgn @d`joo

Turfidg ejp rgpbidg`gots

Blokgvjty lf ioy prjìry SEI diooltmg prgcjdtgc

]gvjsjlo rgìjos io jssug

Zluok/idtjvg pitjgot ìy lutbjvgprjìry SEI.

Ejp rgsurfidjok gxtgocs dlotjouu` lfdirg jo yluok pitjgots wjte ejp cjsgisg

]gdgot Icviodg`got


]gdgot Icviodg`got


31/65

www.ejpsurkgry.jo

Diocjcitgs flr ejp

rgsurfidjok

Zluok & idtjvg pitjgots wjte ejpirterjtjs lr sgdlociry lstgl-irterjtjs

Qrj`iry LI jo yluok pitjgots Ivisdubir ogdrlsjs

Ionyblsjok splocybjtjs

Qlst triu`itjd irterjtjs CCE

Tbjppgc dipjtib fg`lrib gpjpeysjs

49

]gdgot Icviodg`got


EJQ ]gsurfidjok

]gdgot Icviodg`got


32/65

4=

]gdgot Icviodg`got


EJQ ]gsurfidjok Ejp rgsurfidjok-

dlosjcgritjlos ioc stgps-Egic lf fg`ur js sdubptgc ioc olt

delppgc lff tl rgdgjvg i dip lr

rgsurfidgc.

Tldngt js cggpgogc ioc i ogw

sldngt miokgc jo

Dlubc survjvg flr blok tgr` is

mgirjoks irg `icg lf `gtib lo`gtib Wonolwo it prgsgot

]gdlvgry js fistgr.

Fuodtjlo js mgttgr.

]gdgot Icviodg`got


33/65

44

EJQ

]GQBIDG@GOS

]gdgot Icviodg`got


Ibtgroitjvg Oi`gsEjp irterlpbisty>

Sltib ejp rgpbidg`got>

Ejp eg`jirterlpbisty.

Cgfjojtjlo lf Ejp hljotrgpbidg`got8Ejp hljot rgpbidg`got js

surkgry tl rgpbidg ibb lr pirtlf teg ejp hljot wjte ioirtjfjdjib hljot. Seg irtjfjdjibhljot js dibbgc i prlstegsjs.
http://www.umm.edu/ency/article/002286.htmhttp://www.umm.edu/ency/article/002286.htm


34/65

43

Cgsdrjptjlo8Seg irtjfjdjib ejp hljot eis 3 pirts8

I. I sldngt teit rgpbidgs ylur lbc ejpsldngt. Seg sldngt js usuibby `icg lf`gtib.

M. Seg bjogr fjts josjcg teg sldngt. Jt jsusuibby pbistjd, mut sl`g surkglos irgolw tryjok ltegr `itgrjibs, bjngdgri`jd ioc `gtib. Seg bjogr ibblwsteg ejp tl `lvg s`llteby.

D. I `gtib lr dgri`jd mibb teit wjbb

rgpbidg teg rluoc egic (tlp) lf ylurtejke mlog.

C. I `gtib stg` teit js ittidegc tl tegseift lf teg mlog tl icc stimjbjty tl

teg hljot.

EJQ]GQBIDG@GOS

]gdgot Icviodg`got


35/65

47

Sypgs lf Ejp ]gpbidg`got

Sricjtjloib (Dlovgotjloib) Ejp]gpbidg`gotSricjtjloib ejp rgpbidg`got surkgryjovlbvgs ìnjok i 91- tl 9=-jode jodjsjlolo teg sjcg lf teg ejp. Seg ùsdbgs irgspbjt lr cgtidegc frl` teg ejp, ibblwjokteg ejp tl mg cjsblditgc.@jojìbby Jovisjvg Ejp ]gpbidg`got@jojìbby jovisjvg ejp rgpbidg`gotsurkgry ibblws teg surkglo tl pgrflr` tegejp rgpbidg`got terluke log lr twlsìbbgr jodjsjlos (= tl 3 jode).

]gdgot Icviodg`got


EJQ]GQBIDG@GOS

]gdgot Icviodg`got


36/65

]gdgot Icviodg`got


]egu`itljc Irterjtjs Tgdlociry Lstglirterjtjs Ionyblsjok Tplocybjtjs Lbc Qgrtegs' cjsgisg Mrlngo ejp

Mlog tu`lr Ivisdubir ogdrlsjs lf tegfg`lrib egic

Fusgc Ejp Hljot.

Ejp dlocjtjlos teit frgqugotbybgic tl tltib ejp rgpbidg`got

irg teg flbblwjok-

46

EJQ

]GQBIDG@GOS

]gdgot Icviodg`got


37/65

4;

Ejp pijo bj`jts ylur gvgryciy idtjvjtjgs sudeis wibnjok lr mgocjok. Ejp pijo dlotjougs wejbg rgstjok, gjtegr ciylr ojket.

Ttjffogss jo i ejp bj`jts ylur imjbjty tl `lvglr bjft ylur bgk.Zlu eivg bjttbg pijo rgbjgf frl` iotj-jofbi``itlry cruks lr kbudlsi`jog subfitg.

Zlu eivg eir`fub lr uopbgisiot sjcg gffgdtsfrl` ylur ejp `gcjditjlos. Ltegr trgit`gots sude is peysjdib tegripy lrteg usg lf i kijt ijc sude is i diog cl oltrgbjgvg ejp pijo.

Mgogfjt frl` ejp rgpbidg`got

surkgry jf8

]gdgot Icviodg`got


]gdgot Icviodg`got


38/65

45


]gdgot Icviodg`got


39/65

4:


Jotgbbjkgot Ejp surkgry

]gdgot Icviodg`got


40/65


31

]gdgot Icviodg`got


41/65

Dlovgotjloib Sltib Ejp

rgpbidg`gots

Jotrlcudgc jo 9:61s my Cr.HleoDeirobgy, io Gokbjse Lrtelpgcjdsurkglo.

Wppgr goc lf teg fg`ur js rgsgdtgcdlosjstjok lf teg egic ioc ogdnplrtjlo .

Tldngt lf teg pgbvjd mlog js cggpgogc Qrlstegsjs js j`pbiotgc wjte mlog

dg`got. @gtib irtjdubitgs wjte Ejke cgosjty

plbygtegybgog. ]jsn lf cjsblditjlo rgsubts jo pllr

fuodtjlo

]gdlvgry tings uptl tergg `lotes39


]gdgot Icviodg`got


42/65

@joj`ibby jovisjvg Ejp

surkgry - [eit js jt

Documents

HIP DISORDERS: CME - At Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh