The incidence of THA dislocation is: Primary THA: 1-2% Revision THA: 5-7% Mnemonic: WHAT caused the total hip arthroplasty dislocation? Wear Types: Volumetric wear: proportional to r2 (diameter of head) Linear wear (related to penetration of femoral head into liner): smaller heads have higher linear wear Adhesive wear (most important):…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
Surgical Skills 
Zancolli-Lasso Procedure
Based on the preoperative clinical examination, the decision on which donor superficialis (FDS) tendon to use is made (commonly FDS middle finger is used). Transverse incision is made at the level of the distal palmer crease. Care should be taken to avoid the neurovascular bundles and the flexor tendons must…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Scaphoid Fractures : Rule of 70s
70% of blood supply of scaphoid is by dorsal branch of radial artery 70% of scaphoid bones have arterial foramina through out their length 70% of carpal fractures are scaphoid fractures 70% of scaphoid fractures occur through the waist 70% of scaphoid fractures are detected on initial radiographs 70% proximal…
Blog 
L-PRF for Chronic Wounds
L-PRF (Leukocyte-platelet rich fibrin) is a second generation platelet reach concentrate where autologous platelets and leukocytes are present in a 3D fibrin mesh which is used as a scaffold by surrounding host cells and which slowly releases growth factors and glycoproteins (≥ 7 days). It is processed without the anticoagulant,…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Diagnosis of Spinal Instability (White & Panjabi) : Mnemonic
Mnemonic: Remember 4 D common to all + 3 D for C-spine and 1 D for L-spine Diagnosis requires: Score >4 Denis column disruption: Anterior column destroyed or unable to function (2 points) Posterior column destroyed or unable to function (2 points) Deformity: Will have a maximum score of 4…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Scheurmann’s Disease : Mnemonic
Mnemonic: Remember “S” for Scheurmann Structural kyphosis (sagittal deformity) of thoracic or thoracolumbar spine Skeletally immature sons (0.4-10% of adolescents between 10-14 years; onset with prepubertal growth spurt; M:F = 2-7:1) Strong hereditary (genetic) predisposition and Several theories: Scheurmann’s vertebral epiphyseal disturbance theory Schmorl’s nodes (herniation of disc material into…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Tendon Transfer Principles : Mnemonic
Tendon transfer is the use of the power of a functioning muscle unit to activate a non-functioning nerve/muscle/tendon unit. The transferred tendon remains attached to its parent muscle with an intact neurovascular pedicle. Mnemonic: SEACOAST-1 a. Synergistic: act together to produce a single composite movement (facilitate each other). e.g. b….
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Tourniquet Paralysis Syndrome
Synonym: Pressure paralysis Mechanism: Direct extrinsic pressure (displacement of ranvier node) or axonal hypoxia on the nerves beneath the tourniquet and are related to the cuff pressure and duration of application.\ It is different from post tourniquet syndrome which caused due to combined effect of muscle ischemia, edema and microvascular…