Terminologies Electrosurgery modalities Modality Electrode configuration Waveform Indications Remarks DC Electrocautery Patients with ICDs and pacemakers No current passes through patient (direct heat transference to tissue) AC Unaltered sine wave a. High voltage, Low ampere Can be tolerated in patients with pacemakers at low dosage Electrodessication Monoterminal Markedly damped Superficial…
Author: Dr. Sulabh Kumar Shrestha, MS Orthopedics

Orthopedic Examination Made Easy
Orthopedic examination is a fundamental aspect of assessing musculoskeletal conditions, injuries, and disorders. This comprehensive guide aims to provide healthcare professionals, students, and practitioners with a thorough understanding of the principles, techniques, and best practices involved in conducting orthopedic examinations. By examining the mechanics behind the tests, readers will gain…

Circumferential Periosteal Block (CPB)
Use: Alternative to hematoma block in reduction of distal radius and ulna fractures Advantage: Providing distance from the fracture hematoma (no theoretical risk of converting closed fracture into open fracture) Disadvantage: Risk of neurovascular injury on volar surface of forearm Local anesthetic and volume: 10–15 ml of 1 % plain lidocaine…

SCFE : Mnemonic Approach
Approach to a limping child General points Classification Management depends on 4 factors which can be remembered using the mnemonic SCFE. Stability and Severity a. Loder classification: b. Severity: Severity Southwick angle on frog-leg lateral view (Difference of head-shaft angle from normal side) Wilson slip % on AP or frog-leg…

Management of Skeletal Tuberculosis – Principles
Classification Stage/Type Pott’s spine (Kumar’s) Pott’s paraplegia (Tuli) Hip and Knee Hip (Shanmugasundaram) I Predestructive (Straightening, spasm, hyperemia) Negligible (Objective plantar extensor response or ankle clonus) Synovitis (ROM 75-100%/Haziness, rarefaction)– Hip: FAbER, Apparent lengthening Normal (C) II Early destructive (Diminished space, paradiscal erosion, K<10) Mild (Subjective neuro-deficit but walks with…

Clavicle Fractures : Last Minute Revision
1. 80-85% are mid-shaft fractures (other 10-15% are lateral 3rd and 5% are medial 3rd fractures) because of: 2. Deforming forces: 3. X-ray views: 4. Allman classification: Dameron and Rockwood classification for lateral 1/3 pediatric fractures: Type I: Mild strains of ligaments or periosteal tears Type II: Complete disruption of…

Perkin’s Timetable for Fracture Healing
One needs to understand the difference between bone union and consolidation first Union Consolidation Definition Partial/Incomplete repair Full/Complete repair Callus Calcified Ossified Attempted angulation Painful Painless Fracture line in X-ray Still visible Obliterated and crossed by bony trabeculae Full weight bearing Cannot be undertaken Can be undertaken Reference: Physiotherapy in…

Osteochondroma : Mnemonics
Features of Osteochondroma Mnemonic: Six “C” Commonest benign bone tumor Continue to grow until Closure of physis Cartilage cap (appears larger clinically than in X-ray) Continuous with native bone (cortex and medullary canal) Cane (pedunculated/stalked points away from joint and sessile/broad based have higher risk of malignant degeneration) Change (mutation)…