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…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
First Cuts, First Concerns: Avoiding the Sciatic Trap
Dated: July 15, 2025 So here we go – not quite Day 1, but definitely the beginning of something new. With two weeks of overlap before the official August 1 start, I reached B&B Hospital at 7:30 AM – early, eager, and quietly absorbing everything around me. As I waited…
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…
Safe Surgical Dislocation of Hip
Surgical Principles Relevant Course of MFCA Surgical Technique 1. Position: Lateral decubitus 2. Incision and approach: Traditional Kocher-Langebeck (KL) approach or Gibson interval (more anterior interval with posterior retraction of gluteus maximus muscle without violating it) 3. Trochanteric (Digastric slide) osteotomy: 4. Exposure: 5. Z-shaped Capsulotomy: 6. Hip Dislocation: 7….
Boyd (Posterolateral) Approach to Elbow
Indications: Skin incision: Begin the incision just posterior to the lateral epicondyle and lateral to the triceps tendon, and continue the incision distally to the lateral tip of the olecranon and then down the subcutaneous border of the ulna to the junction of its proximal and middle thirds or as…