Synonym: Adult onset tibial tubercle exostoses History: Pain over anterior surface of upper tibia Pain during running, jumping, squatting, kneeling and descending stairs Usually no history of trauma, anterior knee pain or Osgood-Schlatter disease Physical examination: Tenderness over hypertrophic tibial tubercle Quadriceps tightness (Ely’s test) X-rays: AP, lateral and tangential…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Swan neck deformity vs Boutonniere deformity
Alterations in the relationships between the balanced extrinsic and intrinsic musculature of the hand due to trauma or secondary to the effects of systemic disease may cause the development of functional deformities such as a boutonnière or swan-neck deformity. Swan-neck deformity Boutonniere deformity Deformity PIPJ Hyperextension PIPJ Flexion DIPJ Flexion…
Surgical Skills 
Volar V-Y advancement flap for fingertip amputations
Indications Contraindications Advantages Disadvantage Tension (maximum tension occurs in mid portion of the defect) especially with large defects Blood supply of flap Oblique terminal branches of the digital arteries arising from the trifurcation of distal interphalangeal joint (a subcutaneous pedicle flap) Technique References:
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Osteoid Osteoma : Mnemonic
Epidemiology and Clinical features Mnemonic: LMNOP Lower extremity predilection (proximal femur > tibial diaphysis) Male predilection (2:1 to 3:1) Night pain relieved by NSAIDs (absent in osteoblastoma) Osteogenic benign tumor Prostaglandins (PGE2) and Cyclooxygenase (COX1 and 2) release by nidus (explains night pain and response to NSAIDs) 3 Concentric layers…
Emergency Medicine 
Conus Medullaris Syndrome vs Cauda Equina Syndrome : Anatomical basis and Mnemonic
Definitions Condition Vertebral level of injury Neurological level of injury ISNCI level of injury Conus Medullaris Syndrome (CMS) T12-L2 T12-S5 T11 Cauda Equina Syndrome (CES) L3-L5 L3-S5 L2 Anatomy The spinal cord ends as a tapered structure called the conus medullaris at the level of L2–L3 disc in the neonate…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Pirani Score and Dimeglio Classification for Clubfoot Assessment
Pirani socre Pirani score for assessment of clubfoot (CTEV) consists of 6 parameters (3 each in midfoot and hindfoot) which is scored as 0, 0.5 or 1 with a maximum possible score of 6. The parameters can be remembered using the mnemonic: PER TOM Posterior crease Empty heel Rigid equinus…
Surgical Skills 
Krackow Suture Technique
The Krackow technique is a continuous locking loop suture technique commonly used in tendon repair. The classic Krackow stitch involves 3 or more locking loops placed along each side of the ligament or tendon. Starting point: 1 cm from the tendon end Suture pitch: 5 mm (space the loops 5…
Surgical Skills 
DIY Vac Dressing for Wounds
Pre-requisites for Vac Dressing Components of Vac Dressing 1. Pump for Negative Pressure: In a study, 3 closed suction drainage systems were studied – Davol Reliavac 400 Evacuator, Jackson-Pratt Closed Wound Suction Drainage System, and Snyder Hemovac 400. In all three systems, maximal negative pressures (-71 to -175 mm Hg)…