A) Epidemiology: B) Mechanism of Injury: C) Classifications: a. Milch: Fracture line based – b. Jakob and Weiss: Displacement and articular congruency based – Modified Weiss classification: No need for arthrogram1. Type I: <2 mm displacement2. Type II: 2-4 mm displacement 3. Type III: >4 mm displacement (displacement of >4…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Forearm muscles : Tricks to remember
Anterior Forearm (Compartment) Muscles Total muscles: 8 (4 superficial + 1 intermediate + 3 deep) Mnemonic: Do it yourself as shown in the figure below! Place your thenar/hypothenar eminence over medial epicondyle and fan out 5 fingers with thumb resting below the 4 fingers. The 4 fingers represent superficial flexors…
Clinical Skills and Approaches 
Pathological reflexes – Variations of Babinski
Normally, the pathological reflexes are not evident because they are suppressed by cerebrum at brainstem or spinal cord level by 6 months of age. Importance: Up-going (dorsiflexion) toe can be elicited at various sites and all indicated Upper Motor Neuron (UMN) lesion. Use a blunt-pointed object like fingernail or tip…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Summary of Clinical Tests and Signs in Orthopedics
Adson’s test: for thoracic outlet syndrome Allen’s test: for testing patency of radial and ulnar arteries Alli’s test: for DDH Anvil test: for testing tenderness of the spine Ape thumb: for median nerve injury Apley’s grinding test: for meniscus injury Apprehension test: for recurrent dislocation of the shoulder Barlow’s test:…
Clinical Skills and Approaches 
Trendelenburg test or sign
Method: The patient is then asked to stand on one leg and bend the opposite knee to 90° without flexing the hip. This action eliminates the role of hip flexors as they play a role in pelvic stability and may affect the Trendelenburg sign. The test is then repeated by…
Clinical Skills and Approaches 
Bryant’s triangle (Examination of Hip)
Synonyms: Iliofemoral triangle Position: The patient lies supine with the pelvis square, and the limbs in identical position. Points of the Bryant’s triangle: The Bryant’s triangle is a right angled formed by: Anterior Superior Iliac Spine (ASIS) Tip of Greater trochanter Junction of perpendiculars from the 2 points above (1st draw…
Clinical Skills and Approaches 
Examination of Gait
Definitions Gait: Gait is the cyclical pattern of musculoskeletal motion that carries the body forwards. It involves a cyclic loss and regaining of balance by a shift of the line of gravity in relation to the center of gravity. Normal gait is smooth, symmetrical and ergonomically economical. Gait cycle: The…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Salmonella Osteomyelitis in Sickle Cell Disease
Sickle Cell Disease (SCD) is a hereditary disorder of hemoglobin synthesis caused by a mutation in the globin gene that changes the sixth amino acid from glutamic acid to valine resulting in abnormal sickling (rigid, inflexibled and sickle-shaped) of Red Blood Cells (RBCs) under low oxygen conditions. Sickle cell anemia…