Today was one of those surgeries that stays with you not just for the technical challenge, but for what it teaches you as a growing orthopedic surgeon. Our patient was a 30-year-old male with painful AVN of the femoral head, years after an acetabular fracture that had been treated with…
Author: Dr. Sulabh Kumar Shrestha, MS Orthopedics
When Locking Screws Refuse to Budge – Techniques for Removing Jammed or Stripped Screws
Written on August 10, 2025 And once again, today’s case reminded me that removing orthopedic implants can be more challenging than inserting them – especially when faced with a stubborn, stripped or jammed locking screw. We operated on a 25-year-old female with a united distal radius fracture, aiming to remove…
Obstacles to reduction in Developmental Dysplasia of Hip (DDH)
Extra-articular obstacles: Secondary muscle shortening due to hip in subluxed/dislocated position Intra-articular obstacles: Results in decreased volume of the acetabulum
Tonnis and IHDI (International Hip Dysplasia Institute) Classification for DDH
IHDI method is a new radiographic classification of the severity of hip dislocation in DDH. It is based on the location of the midpoint of superior part of ossified metaphysis (H-point) relative to acetabulum. In contrast to Tonnis classification method, IHDI method: Tonnis classification: It is assessed according to the…
Mohr Syndrome (OFD2): An Orthopedic Insight from a Rare Case
Introduction Mohr syndrome, or Orofaciodigital syndrome type II (OFD2), represents a very rare genetic disorder in which there is a triad of craniofacial anomalies, oral malformations, and digital deformities. While classic findings such as lobulated tongue, cleft palate, and broad nasal root mainly remain in the domain of pediatricians and…
When Fixing Bones Meets Nerves: A Lesson from the Cubital Tunnel
Date of writing: June 17, 2025 Day 3 of my pre-fellowship was unlike the others – not because I scrubbed in for an arthroplasty or a hip case (there weren’t any today), but because I witnessed firsthand how a routine trauma case can spiral into an anatomical and surgical challenge….
A New Chapter: Beginning My Fellowship Journey at B&B Hospital
I will be sharing my fellowship journey from my journal here. The posts will be backdated and hopefully I will catchup eventually. Dated: July 15, 2025 As I begin this fellowship training in Hip, Pelvi-Acetabulum, and Arthroplasty at B&B Hospital for one year, I felt like taking a step back…
Bhandari’s Paradox : Patient’s expectation vs Surgeon’s choice (THR vs HRA)
In displaced femoral neck fractures in elderly, the two main treatment options are – Hemiarthroplasty (HRA) which is quicker, with a lower risk of dislocation and Total hip arthroplasty (THA) which provides superior long-term function and durability. Despite evidence favoring THA in many cases, actual surgical practices often lean heavily…