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Bone and Spine

Orthopedic health, conditions and treatment

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Hand and Upper Limb

Scapulothoracic Bursitis Causes and Treament

By Dr Arun Pal Singh

scapulothoracic bursitis bursa locations

Scapulothoracic bursitis is inflammation of the scapulothoracic bursae present between the scapula and rib cage. Symptomatic scapulothoracic bursitis is not very common. Another similar but different term used is scapulothoracic crepitus [snapping scapula] and it is important to highlight the difference. Scapulothoracic crepitus is referred to as thumping or popping sounds that occur with scapulothoracic […]

Filed Under: Hand and Upper Limb

Bursae Around Shoulder

By Dr Arun Pal Singh

bursae arund shoulder

There are 5-6 bursae around the shoulder. Bursae are the synovial fluid-filled sacs that are present between two surfaces that rub on motion. The purpose of the bursa is to reduce friction and protect the moving tissue. Often these are found at tendon-tendon and tendon-bone interfaces. There are five main bursae around shoulder. They include: […]

Filed Under: Hand and Upper Limb

Dorsal Digital Expansion or Extensor Expansion

By Dr Arun Pal Singh

Dorsal Digital Expansion

The term dorsal digital expansion refers to the small triangular aponeurosis covering the dorsum of the proximal phalanx with its base at the metacarpophalangeal joint. The main tendon of the extensor digitorum occupies the central part of the expansion and is separated from the metacarpophalangeal joint by a bursa. [Aponeurosis is a flat sheet or […]

Filed Under: Anatomy, Hand and Upper Limb

Anatomy of Muscles of Arm

By Dr Arun Pal Singh

Biceps muscle with both heads of origin

The region between the shoulder joint and the elbow joint is called the upper arm or arm. That between elbow and wrist is called forearm. Brachium and antebrachium are anatomical terms for arm and forearm respectively but are not used that commonly. Muscles of arm can be classified as that of a flexor compartment or […]

Filed Under: Anatomy, Hand and Upper Limb

Rolando Fracture – Presentation and Treatment

By Dr Arun Pal Singh

Rolando Fracture

Rolando fracture is a three-part intraarticular fracture-dislocation of the base of the thumb. This is an unstable injury that requires surgical reduction and fixation. It is named after Silvio Rolando, an Italian surgeon who described it first. Relevant Anatomy, Mechanism of Injury and Pathophysiology The carpometacarpal joint is between the base of thumb and trapezium […]

Filed Under: Hand and Upper Limb

Bennett Fracture Causes, Presentation and Treatment

By Dr Arun Pal Singh

Forces deforming Bennet fracture

Bennett fracture is an intraarticular fracture involving the base of the thumb and leading to a subluxation of the carpometacarpal joint. It was described initially by Edward Hallaran Bennett in the late nineteenth century. The fracture is inherently unstable and requires adequate reduction and immobilization or fixation. Carpometacarpal joint is critical for pinching and opposition […]

Filed Under: Hand and Upper Limb

Base of Thumb Fractures and Their Types

By Dr Arun Pal Singh

Rolando Fracture

Base of thumb fractures are the extra-articular and intraarticular fractures of base of first metacarpal bone. Thumb is a highly important and efficient digit that makes the human hand highly efficient. An unusable thumb could mean a loss of 40% of hand function. Relevant Anatomy [Read complete hand anatomy] Thumb consists of two phalanges and […]

Filed Under: Hand and Upper Limb

Thumb Injuries Types, Presentation and Treatment

By Dr Arun Pal Singh

Intra-articular Fracture of First Metacarpal Base With Subluxation Of First Metacarpophalangeal Joint

Thumb injuries or fractures and dislocations are one of the common hand injuries. The term thumb injury includes all the injuries from the carpometacarpal joint to the tip of the thumb. There are various types of thumb injuries that come under fractures and dislocations of thumb. Nailbed and fingertip injuries are discussed separately. Thumb is […]

Filed Under: Hand and Upper Limb

Skier’s thumb – Causes, Symptoms and Teatment

By Dr Arun Pal Singh

skier's thumb or gamekeeper's thumb

Terms Skier’s thumb and Gamekeeper’s thumb are used for injuries to the ulnar collateral ligament of first metacarpal joint. While Gamekeeper’s thumb was the older term, Skier’s thumb is used more commonly. Ulnar collateral ligament injury of the metacarpal joint was found earlier in people of Europe who wrung the neck of the game like […]

Filed Under: Hand and Upper Limb

Jersey Finger – Causes, Symptoms and Treatment

By Dr Arun Pal Singh

Jersey finger

Jersey finger refers to the avulsion of the flexor digitorum profundus tendon off of its insertion at the volar aspect of the distal phalanx due to forced hyperextension of the distal interphalangeal joint. It is a type of zone I tendon injury. It is also called a sweater finger or rugby finger and typically occurs […]

Filed Under: Hand and Upper Limb

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Do backpacks cause back pain children

Backpacks and Back Pain- Tips to Use Backpacks in Children?

Back pain in children is not that common and often may be associated with underlying disorders. However, recent evidence has suggested backpacks in school-going children to be a cause of back pain. Yes! backpacks and back pain could be related. The school going does involve carrying backpacks filled with books and materials and is continuing […]

Wrist arthrodesis

Wrist Arthrodesis – Indications and Procedure

Wrist arthrodesis is a salvage procedure to provide the patient with the pain-free immobile wrist in maximum functional position. Arthrodesis means the fusion of the bones. After arthrodesis or fusion, motion between worn joints is eliminated and so is the pain. As noted before, wrist joint is a salvage procedure. Because it needs to sacrifice motion, […]

Lysholm Knee Scoring Scale

Lysholm Knee Scoring Scale is used to  evaluate the outcomes of knee ligament surgery  in patients The first version of this was published in 1982. The present scale includes  8 items Limp Support Locking Instability Pain Swelling Stair climbing Squatting Apart from knee ligament injury, the score can be used for meniscal tears, knee cartilage […]

Schartzker classification of Tibial Plateau

Tibial Plateau Fractures

Tibial plateau fractures signify periarticular fractures of the proximal tibia frequently associated with soft tissue injuries. These fractures, being in load-bearing area affect knee alignment, stability, and motion. Appropriate treatment of these fractures is critical to minimize disability and reducing the risk of complications like posttraumatic arthritis. Most of these injuries are the motor vehicle–related […]

Plantar Fascia Anatomy

Plantar Fasciitis – Causes and Treatment

Plantar fasciitis is a common cause of heel pain and occurs due to degenerative changes at the insertion of the plantar fascia on calcaneal tuberosity. The plantar fascia is the most common cause of heel pain for which professional help is sought. A heel spur is commonly found in plantar fasciitis patients, but many asymptomatic […]

AP view of Intercondylar Fracture Distal Humerus

Distal Humerus Fracture- Types, Causes and Treatment

Distal humerus fractures or distal third humerus fractures are fractures of the distal part of the humerus. It is an umbrella term for a group of injuries that may occur. Namely, the following constitute distal humerus fractures Fractures of lateral epicondyle Fractures of medial epicondyle Condylar fractures – lateral or medial condyle Intercondylar fractures Capitellem […]

Acromial physes in relevance to os acromiale

Os Acromiale Causes, Symptoms and Treatment

Os acromiale is an accessory bone that results from an unfused center of ossification of the acromion of the scapula bone. The acromion is part of the scapula that extends laterally over the shoulder joint. It develops from 4 ossification centers. If one of the four ossification centers of the acromion fails to fuse, an […]

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