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Bone and Spine

Orthopedic health, conditions and treatment

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Lower Limb

Bicycle Seat Neuropathy or Cyclist Syndrome

By Dr Arun Pal Singh

Bicycle Seat Neuropathy or Cyclist Syndrome

Bicycle seat neuropathy is recurrent perineal numbness in a cyclist after prolonged cycling and carries the risk of impotence in the long run if unchecked. It is also known as pudendal neuralgia or pudendal nerve entrapment syndrome [In stricter sense, Pudendal nerve entrapment could be due to other causes as well.] The injuries and symptoms […]

Filed Under: Lower Limb

Accessory Navicular Bone Syndrome

By Dr Arun Pal Singh

Accessory Navicular bone

Accessory navicular bone or os tibiale externum, or os naviculare accessorium, is a large accessory ossicle [small bone] that can be present adjacent to the medial side of the navicular bone. The tibialis posterior tendon which normally inserts on the navicular attached to the ossicle when present. An accessory navicular bone is present in 10-12% of the population and first appears in adolescence. […]

Filed Under: Foot Ankle

Surgical Approaches to Hip and Proximal Femur

By Dr Arun Pal Singh

Watson jones approach of hip

For surgery, the hip can be approached by many surgical approaches. The choice of particular approach is based on the procedure and need for exposure of a particular part, associated shaft or acetabular fixation and the preference of the surgeon. There are numerous approaches and some are modifications of original approaches. Most of the approaches […]

Filed Under: Lower Limb

Posterior Cruciate Ligament injury or PCL Injury

By Dr Arun Pal Singh

posterior cruciate ligament injury

Posterior cruciate ligament injury or PCL injury is less common than the anterior cruciate ligament injury.  A posterior cruciate ligament tear may result in disability ranging from no impairment to severe impairment. The primary function of the PCL is to prevent posterior translation of the tibia on the femur. The posterior cruciate ligament is also important […]

Filed Under: Knee

Calcaneus Fracture – Causes, Presentation and Treatment

By Dr Arun Pal Singh

Anatomy of Calcaneus

Calcaneus fracture or os calcis represent 2% of all fractures seen in adults. The os calcis is the most frequently fractured tarsal bone and accounts for more than 60% of tarsal fractures. Calcaneus is the bone that forms the heel. Calcaneus fractures are most commonly seen in young men. Extra-articular fractures account for 30% of […]

Filed Under: Foot Ankle, Trauma

Genu Recurvatum or Knee Hyperextension

By Dr Arun Pal Singh

Genu Recurvatum in a child

Genu recurvatum is a deformity in the knee  where the knee angulates backwards because of hyperextension occurs in the tibiofemoral joint [the knee goes further into extension beyond the neutral] Genu recurvatum is also called knee hyperextension and back knee. Depending upon hyperextension, the recurvatum could be mild, moderate or severe. The normal range of motion of the knee joint is from […]

Filed Under: Knee

Anterior Cruciate Ligament Injury or ACL Injury

By Dr Arun Pal Singh

anterior cruciate ligament injury

Anterior cruciate ligament injury is a very common injury of the knee. It may occur in isolation or along with other soft tissue or bony injury of the knee. Anterior cruciate ligament injury or ACL injury most commonly results from a low velocity, noncontact deceleration injuries or pivoting injuries and contact injuries with a rotational […]

Filed Under: Knee

Trochlear Dysplasia of Femur

By Dr Arun Pal Singh

trochlear bump measurement

Trochlear dysplasia refers to a pathologic alteration in the shape of the femoral trochlea. Trochlea is also called facies patellaris, intercondylar groove, or intercondylar sulcus. Normal trochlea is sufficiently concave to guide and retain the patella throughout the normal range of movement. However trochlear dysplasia may cause the groove to be shallower than normal or […]

Filed Under: Knee

Patellar Translation or TT TG Distance

By Dr Arun Pal Singh

Calculation of Tibial Tuberosity - Trochlear Groove Distance

Patellar translation is the distance between tibial tubercle and trochlear groove and is also called TT-TG distance. It is measured on CT or MRI by overlapping or superimposing axial images of the femoral condyles and tibial tuberosity. The measurements are used to quantify patellar instability. The position of the tibial tubercle is crucial for the inferolateral force […]

Filed Under: Knee

Patellar Instability – Causes, Presentation and Treatment

By Dr Arun Pal Singh

Patella ligament stabilizers

Patellar instability or Patellofemoral instability is a frequent cause of symptoms of anterior knee pain and episodes of mechanical instability. It is also called patellar subluxation syndrome. There is a difference between symptoms of instability and patellar dislocation, though the former may cause the latter to happen. The term can denote a sign on physical examination or […]

Filed Under: Knee

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Attachments on foot - plantar surface

Anatomy of Metatarsal Bones and Phalanges

Metatarsal Bones or Metatarsus There are five metatarsal bones in the foot which are numbered from medial to lateral side. Common Features of Metatarsal Bones Each metatarsal bone is a miniature long bone and has following parts Base Base is the proximal end of metatarsal bone and articulates with tarsal bones. It is set obliquely […]

Knee Effusion

Knee Effusion [Water On Knee] – Causes and Treatment

Knee effusion or swelling of the knee occurs when excess fluid accumulates in or around the knee joint. It is also called water on the knee in a colloquial manner. A synovial joint has a small amount of fluid called synovial fluid that has many functions including lubrication while joint movement. A joint effusion means […]

Sprengel Deformity

Sprengel Deformity – Congenital High Scapula

Sprengel deformity is a congenital condition where the scapula is small and located higher than its normal position because of its failure to descend to its position. There could also be scapular winging and presence of omovertebral bone 30-50%]. Omovertebral bone is an anomalous bone connecting the elevated scapula to the cervical spine. It is […]

Burst Fracture

Thoracolumbar Burst Fractures

Burst fractures are defined as vertebral fracture with the failure of the anterior and middle column. The fractures are unstable as there is involvement of two columns, anterior and middle, out of three columns of the spine. Burst fractures are caused by axial loading with flexion and can be considered as high energy compression fractures […]

Danis Weber Classification of Malleolar Fractures

Malleolar Fractures of Ankle- Bimalleolar Fractures, Trimalleolar Fractures and Other Injuries

Malleolar fractures are types of ankle injuries which include fractures malleolar regions of tibia and fibula [medial and posterior malleoli arise from the tibia, distal end of the fibula is called lateral malleolus]  and/or associated ligaments. They are intraarticular injuries because the malleoli form part of the ankle joint. These fractures are frequently associated with […]

Inlet outlet views of pelvic fractures

Pelvic Fractures- Presentation and Treatment

Pelvic fractures and soft tissue injuries break the continuity of pelvic ring. Most pelvic fractures are stable and occur with a low-energy mechanism of injury. However pelvic fractures can be unstable. These unstable fractures are usually a result of high energy trauma and are associated with injuries to surrounding viscera, vessels and nerves and are […]

atlas vertebra

Surgery in Spinal Tuberculosis

Surgery in spinal tuberculosis is considered in the patients where the disease is not responding to the drug treatment, rest and other conservative measures. The aims of treatment of tuberculosis of the spine are: Control and cure of the existing ac­tive systemic and local infection and prevent its further spread. Achieving the stability of the […]

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