Advantages: Patient position: Supine with a roll under the knee to allow knee flexion Tourniquet: Not used unless required Incision: Superficial dissection: 1. Fascia is incised in line of incision & sharply dissected off the vastus lateralis muscle laterally to its inclusion with the iliotibial band, to expose the quadriceps…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
Blog 
Books to study for Orthopedics Residency
The experience of an orthopedic residency is intense, challenging, but also incredibly rewarding for those passionate about musculoskeletal health and surgery. He/she will be looking at patients in outpatient department, inpatient patients, preparing patients for surgery including fitness, assisting and performing surgeries, preparing and presenting multiple topics, journal clubs and…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Enchondroma vs Chondrosarcoma (low grade) : Mnemonic
Among cartilaginous tumors, 2 pathologies can be misleading when trying to reach a correct diagnosis: enchondroma (E), a benign tumor, and low-grade chondrosarcoma (LGC), which is a low-aggressivity malignancy. This can be a problem when deciding treatment because E only requires regular follow-up, but LGC needs surgical treatment. Mnemonic: ABCDE…
Surgical Skills 
Shoelace technique for Delayed Primary Closure
Indication: Delayed primary closure of fasciotomy wounds Sutures that can be used: Anchors: Staples (can apply 2 staples) or Metal clips Knotting pattern: The suture is attached to one side and passed through the incision to be attached on the opposite side, in a sequence that resembles a zigzag from…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Joint Lubrication Made Easy
Boundary lubrication A monolayer of lubricant molecule (lubricin) adsorbed on each surface (boundary) of the joint prevents direct cartilage to cartilage (articular) contact Fluid-film lubrication Cartilage surfaces are separated by a fluid film 1. Hydrodynamic lubrication: 2. Squeeze film lubrication: 2. Elastohydrodynamic lubrication: Combination of hydrodynamic and squeeze film Mixed…
Surgical Skills 
Biomechanics in MIPO (Minimally Invasive Plate Osteosynthesis)
1. Provides optimal environment for fracture healing: 2. Relative stability of fracture: 3. Acts as internal fixator: 4. Plate length and Number of screws in Bridge plate function: 5. Plate working length: References:
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Medial and Lateral Plantar Nerves
Origin: Tibial nerve (both medial and lateral plantar nerve) Similar to: Course and innervation: Medial plantar nerve Lateral plantar nerve Origin Larger branch of tibial nerve Smaller branch of tibial nerve Course Deep to abductor hallucis muscleBetween 1st and 2nd plantar layers Deep to abductor hallucis muscleBetween 1st and 2nd…
Clinical Skills and Approaches 
Clarke’s test
Synonyms: Patellofemoral grind test, Patella hold test, Zohler’s sign Tests for: Patellofemoral dysfunction Patient position: Lying down with knees extended and relaxed (heels on table) Technique: 1. Place the webspace of thumb on the upper pole of patella and push it inferiorly. 2. Ask the patient to contract his/her quadriceps…