Dynamization of intramedullary nail is the process of converting a static interlocking nail (provides better fixation & rotational control) to a dynamic locking nail (allows axial loading of fracture to stimulate bone healing). Dynamization converts a bridging mode of fixation to the splinting mode. Timing of Dynamization: Dynamization should be…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
Surgical Skills 
Eponychial Marsupialization for Chronic Paronychia
Chronic paronychia is an inflammatory recalcitrant disorder affecting the nail folds. It can be defined as an inflammation lasting for more than 6 weeks and involving one or more of the three nail folds (one proximal and two lateral). Surgical management is only indicated in cases of chronic paronychia, which…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Meniscal Tears on MRI
Meniscal tears are best seen on T1-weighted, gradient-echo and proton-density images. The menisci are low intensity on all sequences. Morphologies Meniscal tear morphology Description MRI appearance Horizontal Separates meniscus into superior (femoral) & inferior (tibial) fragments Primarily horizontal signal on sagittal images Vertical radial Splits central margin of meniscus Vertical…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Heel Pad Syndrome vs Plantar Fasciitis
Heel pad syndrome and plantar fasciitis both cause heel pain, but they affect different areas and have distinct characteristics. Further reading and differential diagnoses of heel pain: Heel Pain : Mnemonic Plantar Fasciitis Heel Pad Syndrome Definition Inflammation of the calcaneal origin of plantar fascia Traumatic irritation of the specialized…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Basilar Thumb or 1st CMCJ Osteoarthritis
Tips to remember this classification include: Eaton Stage Joint Subluxation Osteophyte Surgery I 1st CMCJ widened <1/3 No Volar Ligament Reconstruction II 1st CMCJ narrowed <1/3 <2 mm 1. Ligament reconstruction with tendon interposition (LRTI) 2. Single interposition 3. Suspensionplasty 4. Metacarpal osteotomy III 1st CMCJ severely narrowed ≥1/3 >2…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Scapular Dyskinesis
Definition: Abnormal scapular motion which may refer to – Causes: 1. Primary: Due to abnormalities arising in Scapulo-thoracic articulation, periscapular muscles and nerves 2. Secondary: Response to shoulder abnormalities Types: It is categorized into three main types based on the prominence of specific areas of the scapula during movement. Clinical…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Kambin’s Triangle or Prism
There is confusion regarding the borders of Kambin’s triangle across the literature. Kambin originally described the borders of this triangular working zone as: Though it was named as a “triangle” it was described with 4 borders with 2 triangles (in AP view and Lateral view) which gives a 3D structure…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Spinal Tumors Localization : Mnemonics
Intradural Intramedullary Spinal Tumors Mnemonic: I HEAL Intradural Extramedullary Spinal Tumors Mnemonic: MNM Extradural Spinal Tumors Lesions outside the thecal sac are categorized as extradural lesions. Remember that everything that isn’t in the thecal sac is extradural, including discs, bones, nerves, and blood vessels.