Emergencies in Orthopaedics John Ebnezar
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1Step by Step Emergencies in Orthopaedics
2Step by Step Emergencies in Orthopaedics
John Ebnezar MMBS, D'Ortho, DNB (Ortho), MNAMS (Ortho), DAc, DMT Consulting Orthopaedic and Spine Surgeon and Holistic Orthopaedic Expert Bengaluru (Karnataka)
3Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
B-3 EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi 110 002, India
Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021+91-11-23245672
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e-mail: jaypee@jaypeebrothers.com, Visit our website: www.jaypeebrothers.com
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Step by Step Emergencies in Orthopaedics
© 2008, John Ebnezar
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
This book has been published in good faith that the material provided by author is original. Every effort is made to ensure accuracy of material, but the publisher, printer and author will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only.
First Edition: 2008
9788184482515
Typeset at JPBMP typesetting unit
Printed at Ajanta Offset
4
to
My mother (Late) Sampath Kumari
who taught me that life is more than self and
there is more joy in giving and
sharing than taking
My wife Dr Parimala, my lovely children
Rakesh and Priyanka
who are an epitome of love, sacrifice,
encouragement and inspiration
All my teachers
who made me what I am today
&
All my students past and present
5Foreword
There is a wise saying, A Stitch in time saves nine. In any sphere of life quick and timely action taken prevents greater problems and helps avert disasters. Likewise in the management of emergencies, what you do in the first 60 minutes of injury determines the final outcome of the recovery of an injured victim. This is the Golden Hour principle. So many lives have been lost and so many maimed due to improper care at the accident site. It is imperative that one understands the value of this golden concept and adheres to it in an emergency situation. In this fast paced and modern world there is no dearth for emergencies and hence it is all the more important that one is fully trained to handle the emergency situations effectively. Knowledge is power and is the tool to dispel ignorance and apathy.
I am very happy that Dr John Ebnezar has brought out a book that highlights the techniques of management of emergencies particularly the Orthopedic emergencies. He has in a very lucid manner dealt with a wide array of orthopedic emergencies and their management. This book gives all the important knowledge of emergency management technique so important in the Golden hour period. If one adheres to the practices mentioned in this book I am sure a golden era will dawn in the golden hour management. The Presidential theme of the Indian Orthopedic Association for this year has been the GOLDEN HOUR Management and I am very happy to write a foreword and release it during the IOA Annual Conference in Kolkata.6
This book is useful to everyone from students, teachers, lay-people, medical students, junior doctors and orthopedic surgeons. It emphasizes the value of being a good Samaritan in emergency situations. It has an ubiquitous appeal. I recommend everyone to possess and read this book and treasure it. The illustrations are excellent and the language is simple. This is what endears the book to all sundry.
HKT Raza
President
Indian Orthopedic Association
7Preface
Orthopaedic emergencies are on an unprecedented high, thanks to the increase in road traffic accidents, industrial and domestic violence, natural calamities, and sports related accidents and also due to the computer booms! Management of Orthopaedic emergencies assumes lots of importance because of the Golden Hour concept which emphasizes the value of the treatment in the first 60 minutes of injury. It is believed that what we do in this first 60 minutes of injury determines the final outcome of total recovery, morbidity or mortality. Thus it is vital to acquaint oneself with the know how of management of orthopaedic emergencies to make a difference.
Through this book, which is first of its kind in orthopaedics, I have strived to present to you various types of orthopaedic emergencies and the ways and means of tackling these. Knowledge is the all important tool to counter ignorance, apathy, fear and prejudice that may cause an impediment in caring for the victims of orthopaedic emergencies. This book provides a Golden chance to learn Golden techniques to give Golden results in the ever important Golden Hour so that it transforms you into a Golden human being.
This book has six chapters. The First Chapter deals with general principles of emergency management and the life saving skills that is so important before dealing with orthopaedic emergencies. The Second Chapter deals with the general principles of management of orthopaedic emergencies and the eight effective steps. The Third Chapter deals in great depth the various types of orthopaedic emergencies and their management. Chapter 8Four deals with making of an Emergency Orthopaedic kit, essential in the house and offices. Chapter Five gives you an insight into the management of certain common orthopaedic problems in a hospital set up. Lastly the prevention of orthopaedic emergencies is stressed in Chapter Six. Thus, this book gives you a comprehensive knowledge about emergency management of an injured victim. Excellent illustrations and diagrams have been provided to make the reading enjoyable and also thought provoking. Criticisms and suggestions are welcome to make the book more effective.
John Ebnezar
9Acknowledgments
This book is the result of a team work involving the staff of my hospital. I would like to thank Dr Yogita, my junior assistant, Ravi, our senior OT staff, Kala, and Yogesh without whose help and cooperation it would have been virtually impossible for me to bring out this book.
I thank my wife Dr Parimala, my children Rakesh and Priyanka for their support and encouragement. I also thank Shri Jitendar P Vij, Chairman and Managing Director and the entire team of M/s Jaypee Brothers Medical Publishers (P) Ltd., New Delhi for their full-fledged support and cooperation. They have done an excellent job and their effort is there for all to see.
I thank all my patients and also God for his kindness and grace which has kept me alive and kicking and has made me what I am today.
My special thanks to our dynamic president of the Indian Orthopaedic Association Dr HKT Raza for writing the foreword for this book. In fact I am thrilled that the Presidential theme for this year has been the importance of Golden Hour in the management of an injured victim. This book is a tribute to his zeal and enthusiasm in promoting the Golden Hour Principle.
I also thank the office bearers of the Indian Orthopaedic Association for giving this book an official release during the inaugural functions of the IOA at Kolkata.