Roughly one center appears per year from the age of 1 year to 7 years, anti-clockwise in right hand and clock-wise in left hand looking from the anterior surface, i.e. from ulnar side to radial side. Pisiform, being a sesamoid bone it gets left behind and only develops years later. capitate: 1-3 months hamate:…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
Clinical Skills and Approaches 
Tests for Knee Ligaments
Anterior Cruciate Ligament (ACL) Lacchman’s test It is performed with the patient supine and the knee flexed 20–30°. The examiner grasps the distal femur (from lateral side) with one hand and the proximal tibia with the other hand (from medial side). The lower leg is given a brisk forward tug…
Emergency Medicine 
Ligament Tests for Ankle Injuries
Anterior Drawer Test Assesses: Anterior talofibular ligament (ATFL) Position: Knee joint in flexion and ankle in 10-15 degrees plantar flexion Maneuver: The examiner exerts a downward force on the tibia while simultaneously attempting to “lift up” the foot while grasping behind the heel. Interpretation: A significant difference from the unaffected…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Salter Harris Classification for Physeal Fracture: Mnemonic
In children, the growth plate (physis) is a zone of cartilate situated between the epiphysis and the metaphysis of long bones. Cartilage is weaker than bone and thus is a common site of fracture. The Salter-Harris classification consists of 5 different types of growth plate fractures based on the location…
Emergency Medicine 
Ottawa Foot, Ankle and Knee rules – Mnemonic
Ottawa Ankle and Foot Rules Mnemonic: 44-55-66-PM Patients need an X-ray only if: 4: Unable to do 4 steps immediately AND4: Unable to do 4 steps at Emergency Department OR 5: Has pain at the base of 5th metatarsal5: Has pain at the 5caphoid (Navicular) OR 6: Tenderness in 6…
Emergency Medicine 
Log Rolling Maneuver : Steps
Step 1: Rescuer 1 stabilizes head and neck in neutral position without applying traction. He/she should grasp the patient’s shoulders at the neck and gently position the patient’s head betweeen the forearms. Another rescuer should apply a semirigid extrication collar. Even with the collar in place, Rescuer 1 must maintain…
Emergency Medicine 
Open fractures : Mnemonics
Gustilo Anderson Classification Mnemonics:1. Parameters: ABCD’S (Area, Bone, Circulation, Dirt, Soft tissue)2. Classification: I, II, III then A, B, C Progression for grade I to III C implies a higher degree of energy involved in the injury, higher soft tissue and bone damage, and higher potential for complications. Type I:…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Approach to Low Back Pain
Definition of Low Back Pain Low back pain (LBP) is defined as pain, muscle tension or stiffness localized below the costal margin and above the inferior gluteal folds, with or without leg pain (sciatica). “Diagnostic triage” after excluding non-spinal causes of low back pain classifies LBP into 3 broad categories:…