5 components a. Central aponeurosis It is triangular in shape with apex originating at the level of flexor retinaculum as a continuation of palmaris longus and thins and fans out distally. It has 3 dimensional fiber orientation: longitudinal, transverse and vertical 1. Longitudinal: Gives 4 pre-tendinous band (PTB) in the…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
PGMEE, MRCS, USMLE, MBBS, MD/MS
Rheumatoid hand
Ulnar drift or deviation of fingers Normal anatomical factors contributing to ulnar drift of fingers at MCP joint: Normal mechanical advantage of ulnar intrinsic muscles Asymmetry and ulnar slope of metacarpal heads of index and middle fingers Greater ulnar deviation permitted by radial collateral ligament when MCP joint is flexed…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Gout : Mnemonics
Urate Lowering Therapy (ULT) Mnemonic: 1, 2, 3, 4, 5, 6 Start Urate Lowering Therapy if: ≥1 subcutaneous tophi ≥2 flares per year ≥3 stage CKD with Serum uric acid (SUA) ≥ 9 mg/dl Other indications: Urate renal stone, Evidence of joint destruction in X-ray 4. ≥4 weeks to be…
Surgical Skills
Percutaneous Achilles Tenotomy for CTEV
Indications Cavus, Adductus and Varus are fully corrected but ankle dorsiflexion remains <10 degrees above neutral Adequate abduction: Best sign: Ability to palpate anterior process of the calcaneus as it abducts out from beneath the talus Abduction of approximately 60 degrees Neutral or slight valgus of os calcis Technique 1….
Clinical Skills and Approaches
Heel Pain : Mnemonic
Mnemonic: HEEL PAINS 1. Heel pad syndrome 2. Enthesopathy 3. Entrapment 4. Ligaments 5. Plantar fasciitis 6. Posterior tibial tendinopathy/tenosynovitis 7. Peroneal tendinopathy/tenosynovitis 8. Arthritis 9. Impingement 10. Neuroma 11. Spurs 12. Stress fracture 13. Sinus tarsi syndrome 14. Sever’s disease 15. S1 radiculopathy Condition Description Site of heel pain…
Surgical Skills
Hip Spica Cast
Acceptable angulation in Femoral Shaft Fractures Age Varus/Valgus (degrees) Anterior/Posterior (degrees) Shortening (mm) <2 yr 30 30 15 2-5 yr 15 20 20 6-10 yr 10 15 15 >10 yr 5 10 10 Reference: Rockwood and Wilkin’s Fractures in Children – Leg position for Hip Spica Application in Femur Shaft…
PGMEE, MRCS, USMLE, MBBS, MD/MS
CTEV Made Easy
CAVE deformities Mnemonic Deformity Site Components C Cavus Midfoot Plantar flexed 1st metatarsal A Adductus Forefoot (Tarsometatarsal joint) Medial displacement of navicular and cuboid along with talar neck and head; Calcaneus and distal calcaneal articulating surfaces adducted along V Varus Hindfoot (Subtalar joint) Calcaneum is adducted, plantar flexed and inverted…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Compartments, Muscles and Fasciotomy of the leg
Muscle Origin Insertion Action Innervation Anterior compartment 1. Tibialis anterior (TA) Superior 2/3 lateral surface of tibia Medial cuneiform, 1st metatarsal Dorsiflexion, foot inversion Deep peroneal nerve (L5) 2. Extensor digitorum longus (EDL) Superior 2/3 of fibula and interosseous membrane Middle and distal phalanx, lateral 4 toes Dorsiflexion, toe extension…