00:01
What are the affected
decision is this?
Well, intracapsular or
extracapsular, number 1.
00:07
Number 2, that's your algorithm.
00:10
So intracapsular.
00:18
So that is a head.
00:22
If it is minimally displaced or
non-displaced as gardens 1 and 2.
00:29
One and two you can either
treat it conservatively,
or use IVUS screws
cannulated screws 1 & 2,
3 & 4 are displaced fractures.
00:40
3 and 4 as you said,
if the patient is elderly then
you go for hemiarthroplasty.
00:45
If it is an impatient say 28
year-old, gardens 4,
fracture, then you go for
a total hip replacement.
00:54
All this patient's you always
have to consider whether it's,
any point in treating
it consecutively.
01:10
Okay, displaced.
01:14
Yeah.
01:18
Yeah.
01:34
For the exam it says three and four
hemiarthroplasty or hip replacement.
01:40
No.
01:41
No, usually from 1 and 2,
we are allowed,
there are have allowed that it screws.
01:48
You can, yeah.
01:50
That's right, yeah.
01:52
But did you understand what she is trying
to get at, it's very important point?
In the elder patient,
you need to try to preserve
the head as much as you can,
because you don't want
to put hemiarthroplasty,
but then the
compromises gardens 3,
by preserving it will
or making it more,
is there a risk of
avascular necrosis.
02:15
Yeah, but the exam,
1 and 2 go for screws.
02:21
Hemiarthroplasty or
totally replacement.
02:23
Okay,
so intracapsular fractures,
undisplaced 1 and 2,
grade 1, grade 2,
displaced 3 and 4.
02:32
Undisplaced intracapsular
that is 1 and 2,
conservative or
cannulated screws?
That one.
02:40
Displaced intracapsular,
that is 3 and 4.
02:43
You can treat it conservatively,
the patient is unfit for surgery.
02:47
Then here this is exactly.
02:50
You're right.
02:50
This is exactly what he said
whether you need to go for
cannulated screws to preserve it.
02:54
But in the exam,
they won't be in that nasty.
02:59
I haven't seen
any question where
they given a
forty-year-old with...
03:04
Yeah
mobile and fit or
unfit one of them,
but you know,
yeah,
yeah.
03:15
Because this is
such a gray area,
you really don't have a correct answer
for a 34-year-old part grade 2 or 3,
what are you going do,
it's a very individual clinical decision.
03:27
But for exam you can go for...
03:31
okay,
so that's a hemiarthroplasty.
03:38
This is a extracapsular fracture,
intertrochanteric fracture.
03:43
There is no threat
to the blood supply.
03:44
It has got a large surface
area for bony union.
03:49
So, if it is a two-part
intertrochanteric fracture,
pretty much straightforward,
go for a DHS.
03:57
If it is multi-part,
pertrochanteric or subtrochanteric,
or even for a femur
you go for IM nail.
04:04
I think that's all.
04:06
Okay,
because similar to the stroma,
similar to the hemicolectomy,
right hemi,
left hemi and the resection, etc.
04:16
This is something
which comes up,
you need to know the difference
between intracapsular, extracapsular.
04:21
When do you do, what?
Any question on those?
Are you absolutely
certain about this part?
The intracapsular,
extracapsular, you are sure?
Anyone? No.
04:35
Okay.
04:38
So, trauma, head injury, scaphoid,
fracture neck of femur and shock.
04:45
Is there anything
you want to ask?
I'm sure there are so many
things we haven't covered.
04:49
We just don't have
the time to cover.
04:51
But is there anything you think,
"Oh I should have asked this".
04:56
No.
04:57
As I said, this is nothing more
than file a medical student.
05:00
It's exactly that level,
in this part of the exam, only certain
things they go to a slightly higher level.
05:11
For SPC or normal
catheterization.
05:14
Yeah.
05:16
Hydrating prostate,
blood in the urethral meatus.
05:20
Yeah.
05:24
And we need to scan them first,
then super your only option.
05:29
Yeah, four or five of those.
05:33
It's hydrating prostate, blood in the
urethral meatus, scrotal bruising,
scrotal or perennial bruising,
then what's this one
more important we do.
05:45
They'll come to me,
if you're suspecting
prindle injury.
05:49
Yeah.
05:55
Okay, the other one we
need to do is burns.
06:06
Now, burns,
you probably will get
about two questions.