ORTHOPAEDIC CLERKSHIP

OBJECTIVES:

I. To understand the basic principles in the management of the multiple trauma

patient (the ATLS – Advanced Trauma and Life Support Programme).

II. To understand and learn the basic principles in the management of injuries to
the musculo-skeletal system:

(1) Classification of injuries

(2) Pathophysiology of injuries and complication, and tissue healing

(3) Classification of open injuries and management

(4) Prognosis of limb injuries: the Gustillo-Anderson classification; the

MESS score.

III. To know the management of specific musculo-skeletal injuries and disorders:

(1) Tendon and muscle injuries

(2) Nerve and vascular injuries

(3) Joint injuries: fractures

dislocations
ligament injuries

(4) Vertebral injuries with or without neurological damage

(5) Limb injuries: upper limb, clavicle, shoulder, humeral, elbow, forearm,
wrist and hand

(6) Sports injuries: Intrinsic and Extrinsic risk factors

(7) Paediatric:

(a) Fractures: (i) Salter and Harris Classification

(ii) Supra condylar fractures (elbow)

(b) Congenital problems: (i) developmental dysplastic hips

(ii) Osteogenesis imperfecta
(iii) Blount’s disease
(iv) foot problems e.g. club foot

(c) Perthes’ disease

(d) Slipped upper femoral epiphysis

(e) Scoliosis
 (8) Arthropathy:

(a) Inflammatory – Collagen vascular disease

(b) Degenerative - Osteo arthritis
(c) Secondary to sickle cell disease

(9) Musculo-skeletal infections:

(a) Osteo myelitis

(b) Septic arthritis

(10) Osteoporosis

(11) Bone tumours

At the end of the clerkship the student should be able to:

(i) take a comprehensive history from an Orthopaedic patient

(ii) do a complete examination of an Orthopaedic patient – limb
injury, associated injuries
(iii) understand basic blood and radiological investigations
(iv) know the management of common Orthopaedic injuries and
disorders
(v) apply simple casts

Assessments:

(1) Involvement in the care of patients

(a) outpatient clinic

(b) emergency duty
(c) ward (follow up) patients

(2) Audio visual (power point) PBL research presentations

(3) Clinical (case) presentations

(4) End of clerkship research/clinical report

(5) End of clerkship multiple choice examination

Textbooks: Practical fracture management - Mac Rae

Textbook on Orthopaedics – Apley

** Suggested reading will be given by the Lecturers.

All clerkships will begin on the first working day, at 7.30 am on Ward 13, General
Hospital, Port of Spain.

The head of each group should meet with Mr. Marlon Mencia the week before the
clerkship begins – call 623-7870 for an appointment.

………………………………
MARLON MENCIA, FRCS
Lecturer in Orthopaedics