Don’t Marry Too Soon DRILL Choose the correct drill bit Insert the drill bit correctly in the chuck Tighten the chuck sufficiently Start the drill home perpendicular to the surface Maintain adequate pressure Maintain the proper direction Irrigation with normal saline should be commenced simultaneously with drilling Keep the drill…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Pedicle Screw Insertion Simplified
Anatomy of Vertebral Pedicle Width (narrowest transverse diameter): Narrowest at T4-T5 (4-5 mm) Above and below this level, the width gradually increases to almost double at T1 and T11 (8 mm) Narrowest for lumbar at L2 (two for tiny; 2 X 3 = 6 mm) Increases gradually to L5 (5…
Clinical Skills and Approaches 
Ober’s Test
Tensor fascial latae (TFL) originates from the anterior superior iliac spine (ASIS) outer surface, outer lip of anterior iliac crest and deep surface of fascia latae, continues down in thigh as Iliotibial band (ITB) and inserts to the ipsilateral Gerdy’s tubercle. TFL plays role in flexion, medial rotation and abduction…
Clinical Skills and Approaches 
Thomas Test and Staheli Test
Thomas test Synonym: Hip flexion contracture test, Iliacus test, Iliopsoas test Fixed flexion deformity of the hip and anterior pelvic tilt leads to a compensatory hyperlordosis of the lumbar spine to restore the body’s center of gravity. Compensatory hyperlordosis can mask the fixed flexion deformity of hip. Thomas test: With…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Nerve Conduction Study (NCS) and Electromyography (EMG) : Mnemonic Approach
Nerve Conduction Study (NCS) In the Nerve conduction study, assessment must be done for ABCDEFGH. Action potential Amplitude Measures the height of response in millivolts (mV) for motor nerve and microvolts (μV) for sensory nerve Indicates quantity of axons contributing to action potential Block of conduction CMAP on proximal stimulation…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Boutonniere and Swan neck Deformity – Pathophysiology
Understanding of the Boutonniere and Swan neck deformity requires clear concept of the finger extensor apparatus, which has been discussed here. The extrinsic extensor tendons trifurcate giving a central slip which attaches to the middle phalanx base and two lateral slips which join with lateral band (formed by intrinsic muscles…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Juvenile Idiopathic Arthritis (JIA) : Mnemonic Approach
Synonym: Juvenile Rheumatoid Arthritis (JIA) Diagnosis of JIA Mnemonic: One Six Sixteen (1, 6, 16) 1: Inflammation of atleast 1 joint (joint involvement: knee > wrist/hand > ankle > hip > c-spine) 6: Lasting for atleast 6 weeks 16: Onset before 16 years age In order to confirm the diagnosis,…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Singh Index for Osteoporosis – Simplified
Pattern of bone loss in Osteoporosis Trabecular bone responds faster to metabolic changes due to greater surface are compared to cortical bone. Non-weight bearing (secondary trabeculae) are lost first. Weight bearing (primary trabeculae) may appear prominent due to loss of other trabeculae and may also become thickened due to compensatory…