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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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L3 Compression Fracture

Thoracolumbar Spine Injuries Presentation and Treatment

Thoracolumbar spine injuries refer to injuries of the thoracic and lumbar spine. Thoracic spine has 12 vertebrae from T1 to T12 whereas lumbar vertebrae are five in number are mostly caused by two-wheeler accidents. Injuries to both these regions are considered together because the pattern of injury and their treatment is similar. Thoracolumbar spine injuries are […]

neurogenic shock illustration

Neurogenic Shock Causes, Symptoms and Treatment

Neurogenic shock is a shock caused by autonomic dysregulation, mostly caused by spinal injuries resulting in loss of sympathetic tone and leading to low blood pressure, low heart rate and peripheral vasodilatation.

Medial Epicondyltis or Golfers elbow

Medial Epicondylitis or Golfers Elbow

Golfers elbow or medial epicondylitis is overuse tendinopathy that can be associated with golfing, racquet sports [most likely due to valgus stresses placed at medial epicondyle], throwing sports, bowlers, archers, and weightlifters. Just as lateral epicondyle is the site for the origin of wrist and hand extensors, medial epicondyle is the site for wrist and […]

Anatomy of Thoracic Outlet Syndrome

Thoracic Outlet Syndrome – Presentation and Treatment

Thoracic outlet syndrome is a group of disorders involving compression of neurovascular bundle passing between the anterior scalene and middle scalene muscles as they pass between the chest and upper extremity.  The structures that could be affected are the brachial plexus, the subclavian artery, and, rarely, the subclavian vein. Note: Subclavian vein, normally, does not […]

Different indices for patellar height measurement

Patellar Height Measurement – Insall Salvati, Blackburne-Peel and Caton-Deschamps Indices

Patellar height measurement becomes important in the diagnosis of patella alta and patella baja. Patella alta is a condition where the patella is high riding than its normal position. Patella baja refers to low lying position of the patella. Both conditions have been discussed separately. Measurement of patellar height can confirm or rule out the […]

Radius and Ulna Anatomy

Radius Bone Anatomy

The radius bone is the lateral [on side of thumb] and slightly shorter of the two forearm bones. It rotates to produce the motion supination and pronation of the forearm. Supination is the movement which allows you to turn your palms skyward in a flexed elbow and pronation causes it to face the ground [in […]

Transeverse Comminuted Fracture TIbia

Tibial Shaft Fractures

Tibial shaft fractures are often the result of the high-energy injury. Sometimes they can also be insidious in onset, such as stress fractures. Motor vehicles, snowmobiles, and motorcycles, as well as the growing popularity of extreme sports, contribute to the increasing occurrence of tibial shaft fractures. The tibia is currently the most commonly fractured long bone […]

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