Simplifying Orthopaedics. Note by note.
Components of evaluation When examining a patient with cerebral palsy the following components of examination are to be done. 2. Functional Assessment The function is assessed in the following categories. Functional assessment at current levels may be done by several…
Read more →Cerebral palsy (CP) is a qualitative disorder of movement and posture due to nonprogressive damage to the brain before the completion of its growth and development. The main types of CP are spastic, dyskinetic, ataxic and athetoid. Spastic type accounts…
Read more →3% of primary bone tumors. Nearly always in first 2 decades. Most often between 4-10years. 2:1 male female ratio. Pathology Common sites are proximal humerus – 50%, proximal femur- 18-27% and proximal tibia, distal tibia and calcaneum. Cyst cavity may…
Read more →I was the organising chairman for this Instructional Course Lectures on Basics of TKR conducted by Orthopaedic Association of South Indian States (OASIS) conducted on 2-11-2021. The YouTube link to the entire program is given below. Please visit.. https://www.youtube.com/watch?v=-WNfOMTJkaU
Read more →Monteggia fracture first described by Giovanni Monteggia in 1814. 16-50% of paediatric Monteggia fractures are missed initially at presentation. Anatomy Annular ligament and quadrate ligament are primary static stabilizers of proximal radioulnar joint. Weitbrecht ligament or oblique cord which extend…
Read more →Term ‘robot’ originates from the Czech word ‘robota’, which means forced labour or activity. Karel Capek first used the term ‘Robot’ in his 1921 play called Rossum’s Universal Robots. Robots are defined as an array of computer controlled machines that…
Read more →The purpose of clinical examination are many. First and foremost, the identification of patients who need emergent or urgent care and treatment, and then, identify the cause of patient’s symptoms, its impact on the patient and the needs and expectations of…
Read more →Charcot neuropathic osteoarthropathy (CNO) is a noninfective, inflammatory condition affecting periarticular soft tissue and bone in patients with peripheral neuropathy which if not properly treated may lead to progressive resorption of bone, disruption of soft tissues and disorganization of joints…
Read more →Bone is composed of cells and extracellular matrix comprised of a mainly type I collagen matrix impregnated with hydroxyapatite crystals. It is constantly remodelled by the finely balanced dual action of osteoblasts which form bone and osteoclasts which reabsorb bone. Unbalanced…
Read more →Definition Congenital dislocation of the knee is a condition characterised by hyperextension deformity of knee with varying degrees of pathological anterior displacement of the tibia present at birth. History First described by Chenssier in 1812. Subsequently reported by Chatelaine in…
Read more →The muscles and neurovascular structures of limbs are separated into closed noncompliant osteofascial compartments by tough unyielding fascia that limit the ability for volume expansion. Blood supply to the structures within the compartment depends on the difference between the arterial…
Read more →Legg Calve Perthes disease (LCPD) is a self-limiting condition caused by temporary interruption of blood supply to the growing proximal femoral epiphysis leading to necrosis, collapse and revascularization. Though the cause of vascular occlusion is not yet known, it leads…
Read more →Introduction The brachial plexus prone for injury because of following reasons. The upper limb is connected to the axial skeleton mainly by the soft tissues, with the only bone connection of upper limb to axial skeleton being the clavicle. Supraclavicular…
Read more →Anatomy During normal gait, MTPJ has to sustain more than 40 to 60% off bodyweight, during normal athletic activities this increases to 2-3 times the bodyweight. During running jump MTPJ sustains eight times the body weight. Metatarsophalangeal joint (MTPJ) is…
Read more →Definition Early pathological contact between bony prominences of femur and acetabulum during hip motion due to a variety of morphological conditions leading to pain and chondrolabral damage predisposing the patient to early osteoarthritis of hip. Introduction • First described in 2003…
Read more →Use of c-arm is now an essential part of orthopaedic practice. Use of C-arm fluoroscope in orthopaedics has improved patient outcomes by improving precision in surgery and by reducing surgical trauma by permitting minimally invasive techniques. Radiation Physics Within…
Read more →Gout is an inflammatory arthritis caused by deposition and accumulation of monosodium urate crystals in tissues, mainly synovium, cartilage and skin with or without symptoms as a result of long standing hyperuricemia. 90% of gout is due to under excretion…
Read more →Haemophilia is an X-linked genetic coagulation disorder due to deficiency of either coagulation factor VIII or IX. About 80% is due deficiency of factor VIII (Haemophilia A), 15% is due to deficiency of factor IX (Haemophilia B, Christmas disease) and…
Read more →More than two decades back when I did my house surgeoncy, I had tough time with the length of ward rounds. Ward rounds started at 7:45AM and it would continue beyond 12noon without a coffee break. My feet ached,…
Read more →Definition Scapular dyskinesia is defined as observable alterations in the static position of scapula or abnormal patterns of motion of scapula during coupled scapulohumeral movements in relation to the thorax. Introduction Due to inhibition or disorganization of activation patterns of…
Read more →Anatomy Ulnar nerve is a branch of medial cord of brachial plexus which arises from C8 and T1 ventral rami. It lies between the axillary artery and vein. It lies posteromedial to the brachial artery. In the arm at the…
Read more →INTRODUCTION It is important to have a systemic plan for the examination of knee arrive at the correct diagnosis, to identify its impact on the patient, to understand the patients’ needs and concerns and then to formulate a treatment plan…
Read more →Anatomy •The average dimension of Acromioclavicular joint is 9mm superoinferiorly and 19mm anteroposteriorly. Joint is straight and vertical in 30% of population and in 70% the joint is oblique downwards and medially. •Articular cartilage of clavicle end becomes fibrocartilaginous after…
Read more →Extra-articular fracture involving proximal humerus proximal to the bicipital tuberosity. Usually a physeal injury either Salter-Harris I or II. 1% of pediatric fractures and 5-10% of pediatric elbow injuries. Major concerns are vascularity of proximal fragment, risk of growth arrest…
Read more →Partial articular, coronal plane fractures of the posterior part of femoral condyles are called Hoffa fractures. It was first described by Albert Hoffa; a German surgeon in 1904. They are rare and account for less than 1% of distal femoral fractures.…
Read more →The definition of Triage is to draw or choose after examination. It is the process of sorting patients depending on the severity of injury and the prioritization of treatment. Triage was introduced by Baron Dominique Jean Larrey (1766-1842), Surgeon to…
Read more →Biologic alternatives to bone graft can be classified into cell based or molecule based. Bone Morphogenic Proteins (BMPs) are a group of molecules that works by inducing the mesenchymal stem cells to differentiate into bone forming cell lines that form…
Read more →The aim of examination in patients with a musculoskeletal swelling is to identify the exact location, size, anatomical extent, biological nature and the effects of the swelling and to plan its treatment. Method of treatment depends on the nature of…
Read more →About 10-25% of patients with low back pain have SIJ as the primary source of pain. During pregnancy, 20-80% of pregnant women develop low back pain in the region of SIJ. Examination of sacroiliac joint (SIJ) is generally not given due importance. This…
Read more →Surgical suture is a medical device used to approximate body tissues after an injury or surgery or to ligate blood vessels. Sutures must be easy to handle; have high tensile strength and should permit secure holding of the knot. It should be biocompatible, nontoxic…
Read more →Introduction Radial head fractures are seen in 20% of elbow fractures. It may involve the radial head, radial neck or both. It may either be an isolated injury or associated with other fractures or ligamentous injury. Treatment depends on the type…
Read more →A presentation I have given 2 years back uploaded in slideshare. http://www.slideshare.net/orthoprinciples/acl-graft-fixation-options?ref=http://orthopaedicprinciples.com/2013/06/graft-fixation-options-in-acl-reconstruction/
Read more →A presentation I made recently posted in slideshare http://www.slideshare.net/orthoprinciples/alternative-bearing-surfaces-2?ref=http://orthopaedicprinciples.com/2013/06/bearing-surfaces-in-hip-arthroplasty/
Read more →Screw is a cylinder with spiral threads running on its outer surface. It converts torsional forces into compression. The primary functional objective in the design of a screw is to dissipate and distribute the mechanical load. Thread design should maximise initial contact,…
Read more →Introduction Introduce yourself Get consent of patient or the parent for examination. Note down the name, age, sex, race and occupation of the patient. Adequately expose the patient. Make sure that external genitalia is adequately covered and the patient is comfortable and…
Read more →According to Dobyns carpal instability is “a carpal injury in which loss of normal alignment of the carpus occurs early or late”. It is symptomatic due to carpal malalignment under physiologic loads. Scapholunate dissociation (SLD) is the most common carpal…
Read more →Epidemiology Account for 3-4% of all fractures. Second most common fracture of the upper limb after distal radius fractures. Most commonly missed fracture in the body. Highest incidence seen between 20-30 years of age. Male female ratio is 2:1. Anatomy…
Read more →Isolated capitellar fractures are rare. It accounts for only 1% of all elbow fractures and 3-4% of distal humeral fractures. These fractures are almost exclusively seen in those older than 12 years of age. The annual incidence is reported to…
Read more →Coronoid fractures were once thought to be inconsequential. But they have been recognised to be of great importance as minor incongruity of the anteromedial facet have been shown to lead to elbow arthrosis and in presence of other fractures and…
Read more →Tears of the superior labrum were first reported by Andrews in 1984. The term Superior Labrum Anterior and Posterior (SLAP) was coined by Snyder in 1990 to describe injuries of the superior labrum and biceps anchor. It may be associated…
Read more →Major Points Ceramic on ceramic articulation has 200 times less wear than metal on polyethylene coupling. Improvements in taper technology, ceramic quality, quality control has lead to greater confidence among surgeons. Ceramics are biologically inert Two types of ceramics available…
Read more →Labrum increases the stability of hip, increases the surface area for weight bearing and provides proprioception. It increases stability by deepening the acetabulum and also by acting as a seal to maintain negative intra-articular pressure. Acetabular labral tears are associated…
Read more →When a child is born, it has 10-15 degrees of physiological genu varum, 5 degree internal tibial torsion and external rotation contracture of the hip. It reaches the maximum by about 9-12 months. This usually gets corrected to neutral by…
Read more →Osteoporosis is a systemic bone disease, characterized by low bone density and micro-architectural deterioration of bone that lead to increased bone fragility and increased risk of fractures. It is the most common metabolic bone disease. In those aged more than…
Read more →Robert Kienbock; a Viennese radiologist described 16 cases of avascular necrosis of lunate in 1910. Similar changes of lunate in anatomical specimen was reported by Peste in 1843, but Kienbock’s report was the first clinical report. Etiology The cause of…
Read more →Introduction The term tarsal tunnel syndrome was described by Keck in 1962. It is characterised by burning pain in medial aspect of ankle and foot and paraesthesia along the distribution of medial and lateral plantar nerves, which is aggravated by…
Read more →Ballistics is the study of motion of projectiles. It is done under 3 headings. Interior ballistics- Study of motion of bullets inside the barrel of the gun. Exterior ballistics- Study of motion of bullets in the air once it has…
Read more →Main Points Skeleton is the third most common site for metastasis. Metastatic disease is the most common malignancy of bone. Portends high morbidity and limited survival. Seen in areas with hemopoetic marrow. Classified as lytic, sclerotic and mixed. Metastasis is…
Read more →Introduction and Definition Giant cell rich tumors can be classified according to their site of origin; bone, soft tissue, synovium or tendon sheath. Those that arise from synovium, tendon sheath or bursa are now classified into localized (nodular tenosynovitis) or…
Read more →Synovial chondromatosis is a rare, self-limited and benign condition characterized by metaplasia of synovial lining of a joint, tendon sheath or bursa; leading to the formation of multiple cartilaginous loose bodies. It is also called articular chondrosis or synovial chondrosis.…
Read more →CRP is a protein secreted by liver into the circulation. It is named so because it was first identified by its ability to interact with capsular polypeptide of pneumococcus by Tillet and Francis in 1930. It is a 224 aminoacid…
Read more →Surgical Anatomy The distal radius has metaphyseal flare and three articular surfaces: scaphoid fossa, lunate fossa and the sigmoid notch. The dorsal and radial cortices are thin and the volar and ulnar cortices are thick: this explains the greater incidence…
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