Synonyms: Finger sweep test Finger test can be performed under Local anesthesia or General anesthesia in: Emergency department Bedside in wards Operation theaters Procedure: Area is infiltrated with local anesthetic A 2 cm test incision down to fascia is made in the suspected area The tissues are visually examined for:…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Skeletal Traction – Pin Insertion Sites
Site Point of insertion Direction Indications Olecranon (K-wire) 1.25 inches (3 cm) distal to olecranon tip – deep to subcutaneous border of upper ulna (avoids ulnar joint and open epiphysis) Medial to Lateral – At right angles to longitudinal axis of ulna (Avoids ulnar nerve) Supracondylar or Distal humerus fractures…
Clinical Skills and Approaches 
FARES method of Shoulder Reduction
Indication: Anterior shoulder dislocation Position of patient: Supine Position of physician: Standing on the side of the dislocated shoulder Steps: Physician holds the wrist of the patient with both the arms keeping elbow of the patient extended and forearm in neutral position Arm is slowly abducted in brief oscillating movement…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Appearance and Fusion of Ossification Centers
Upper end of humerus Mnemonic: HGL – 1,3,5 a. Head – by 1 year b. Greater tuberosity – by 3 years c. Lesser tuberosity – by 5 years All 3 centers fuse together by 6 years (1 year after the last center appears) Upper end of femur Mnemonic: HGL –…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Bruner’s Ten Rules of Pneumatic Tourniquet Use
APPLICATION: Apply only to a healthy limb or with caution to an unhealthy limb SIZE OF TOURNIQUET: Arm, 10 cm; leg, 15 cm or wider in large legs SITE OF APPLICATION: Upper arm; mid/upper thigh ideally PADDING: At least two layers of orthopaedic felt SKIN PREPARATION: Occlude to prevent soaking…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Mnemonic Approach to Elbow Xray – FOOL
Mnemonic: FOOLa. Fat padsb. Overt findings and outlinesc. Ossification centersd. Lines Fat pads The elbow joint has anterior and posterior fat pads which are extra-synovial but within the articular capsule. These are present as a radiolucent (black) line (compared to bone and surrounding soft tissues) in lateral X-rays. Normal finding:…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Lines and Angles in Orthopedics
Slipped Capital Femoral Epiphysis (SCFE) Southwick’s angle: Epiphyseal-shaft angle on lateral radiograph <30 degrees: mild 30-60 degrees: moderate >60 degrees: severe Klein’s line: Line drawn along superior border of femoral neck (AP x-ray) In SCFE: will intersect less of the femoral head or not at all Developmental Dysplasia of Hip…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
List of Osteochondritis of Different Bones
Osteochondritis of the capitulum of humerus (elbow): panner’s disease Osteochondritis of the lunate bone: keinbock’s disease Osteochondritis of the femoral head: perthe’s disease Osteochondritis of lateral part of medial femoral condyle: osteochondritis dissecans Osteochondritis of the tibial tubercle: osgood schlatter’s disease Osteochondritis of lower part of patella: sinding larsen johansson…