Haemophilic Arthropathy

Excerpts from upcoming book, Orthopaedic Principles A Review 2nd edition Hemophilia, both classic/hemophilia A (factor VIII def) and hemophilia B (factor IX def) are characterised by recurrent spontaneous haemarthroses. Starts manifesting after child is ambulant and must be included in the DD of acute painful swelling of a single joint in young males as inadvertent […]

The Randomised Control Trial

Randomized control trial       Sujit Kumar Tripathy Asst Professor, Dept of Orthopaedics All India Institute of Medical Sciences, Bhubaneswar   A randomized controlled trial (RCT) is a specific type of scientific experiment, and it is considered as the gold standard for a clinical trial. These trails are often conducted to evaluate the efficacy and/or effectiveness of […]

C Reactive Protein

C Reactive Protein Rajesh Purushothaman, Assoc Professor of Orthopaedics, Medical College, Calicut, India   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 protein. […]

Tarsal Tunnel Syndrome

Tarsal Tunnel Syndrome Dr Rajesh Purushothaman, Associate Professor, Medical College, Kozhikode, India 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 standing. Pain may […]

Wound Ballistics

Wound Ballistics Dr Rajesh Purushothaman, Associate Professor, Medical College, Kozhikode, Kerala, India 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 come […]

Flail Chest

Flail Chest- A Review Rajesh Purushothaman, Associate Professor, Orthopaedics, Medical College, Calicut, Kerala, India Thoracic injury is the direct cause of 25% of deaths after trauma and is a contributory factor in another 25% of deaths. Most of these deaths are due to blunt thoracic trauma and flail chest can be a major component of […]

Impact Factor: Tool to analyze quality of Journal

Impact Factor: Tool to analyze quality of Journal  Impact factor as the name implies measures the impact of a particular journal on the readers, thereby making a particular journal more popular than other. Every author wants to publish his research in a journal which is read more and cited more often by others for further […]

Alendronate Induced Stress Fractures

Alendronate induced stress fractures Sujit Kumar Tripathy, M.S., DNB, MNAMS, Dip SICOT, MCH Student (Ortho) Teeside University, UK Saumitra Goyal, Postgraduate student (Orthopaedics), KMC, Manipal Introduction Alendronate, an inhibitor of bone resorption, was the first oral medication widely accepted for use in treatment of osteoporosis associated with high burden of low-energy fractures of the proximal […]

Knee Dislocation- Review

Knee Dislocations Traumatic knee dislocations are uncommon, account for <0.02% of all orthopaedic injuries. It commonly results in multidirectional instability due to involvement of stabilising soft tissues (usually a combination of disruption of Acl, Pcl, Mcl, Lcl. Knee dislocation can be acute (<3 wks) or chronic (>3 wks).It can be classified anatomically based on position […]

Deep Vein Thrombosis and Venous Thrombo Embolism

DVT (Deep vein Thrombosis) Factors that increases the risk of deep venous thrombosis as described by Virchow in 1856 include:        Stasis        Hypercoagulability        Endothelial Trauma Thrombi below the popliteal fossa usually do not embolize. 50% of thrombi at or above the popliteal fossa will embolize The risk of thrombosis increased with trauma such […]

Morrant Baker’s Cyst

MORRANT BAKER’S CYST (BAKER’S CYST) Aetiopathogenesis: • “A type of cyst which results from egress of fluid through a normal communication of a bursa (semimembranosus or medial gastrocnemius bursa) or caused by herniation of the synovial membrane through the joint capsule”- Mayerding and Van Denmark • Named after Baker (described it in 1877), though Adams […]

Adhesive Capsulitis(Frozen Shoulder)

Adhesive Capsulitis (Frozen Shoulder)   Adhesive capsulitis is characterized by painful, gradual loss of active and passive shoulder motion resulting from fibrosis and contracture of the joint capsule. Peri-arthritis scapulo-humeralewas the initial term suggested by Duplay The term Frozen shoulder was coined by Codman The term Adhesive Capsulitis, coined by Neviaser, is more precise as […]

Robotic Surgery and Computer Navigation in Orthopaedics

ROBOTIC SURGERY AND COMPUTER NAVIGATION IN ORTHOPAEDICS The term “Robot” is derived from the Polish word, “robota”, which means, “forced labour” and is used to describe a machine that carries out multiple tasks automatically or with a minimum of external impulse, especially one that is programmable Two systems for Robotic Surgery exist: 1)Autonomous 2) Haptic […]

Accessory Navicular

Accesory Navicular This anatomic variant consists of an accessory ossicle located at the medial edge of the navicular Accessory ossicles are derived from unfused ossification centers. 90% bilateral It is most commonly symptomatic in the 2nd decade of life and causes medial foot pain Symptomatic in <1% of patients. Classification Type I occurs primarily as […]

Flexor Tendon Injuries

FLEXOR TENDON INJURIES: PRINCIPLES OF MANAGEMENT   Flexor Tendon Zones(Verdan zones) •    Zone I extends from just distal to the insertion of the sublimis tendon to the site of insertion of the profundus tendon. •    Zone II is in the critical area of pulleys (Bunnell’s “no man’s land”) between the distal palmar crease and the […]

Glenohumeral Arthritis

GLENOHUMERAL ARTHRITIS  Aetiology: Osteoarthritis(associated with posterior glenoid wear) Rheumatoid arthritis( assoc. with central glenoid wear) Secondary degenerative joint disease -Repetitive and major trauma -End-stage AVN -Rotator cuff tear arthropathy -Arthritis associated with instability or surgery for instability Clinical Features: –        Pain and stiffness in the shoulder –        adduction and internal rotation deformity of the joint […]

Ultrasound Therapy

ULTRASONIC THERAPY   Ultrasound is an electromagnetic wave with frequencies above 20,000Hz For therapy the frequency of sound waves used are between 85kHz to 3MHz and delivered at intensities between 0 and 3W/sq.cm Production: When electrical energy is applied on piezoelectric crystals they produce vibration and mechanical deformity of their molecular structure. This phenomenon is […]

Tibial Plateau Fractures

Tibial Plateau Fracture Anatomical Pearls: The articular surface of the lateral tibial plateau is flat or slightly convex in relation to the medial tibial plateau that is concave, which provides greater congruity with the medial femoral condyle than on the lateral side. The lateral plateau is also higher than the medial plateau, accounting for the […]

Stem Cells in Orthopaedic Surgery

Stem Cells in Orthopaedic Surgery A stem cell is an ‘immature’ or undifferentiated cell which is capable of producing an identical daughter cell. Stem cells must have a capacity for self-renewal giving rise to more stem cells, and the ability to differentiate into tissues of various lineages under appropriate condition             They may be totipotent, pluripotent […]

Lisfranc Joint Injury

The Lisfranc joint complex has a relatively rigid medial column(1st, 2nd and 3rd tarsometatarsal joints) and a mobile lateral column…..