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Bone and Spine

Orthopedic health, conditions and treatment

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Lower Limb

Fractures of Talus Bone

By Dr Arun Pal Singh

Lateral View of United Fracture of Talus In A Child

Fractures of the talus include a broad spectrum of injuries from occult fractures of the talar process to displaced talar neck fractures. Talar fractures are rare. But they could be difficult to treat and potentially devastating to overall foot function. Relevant Anatomy of Talus The talus is a uniquely-shaped bone divided into three anatomic regions […]

Filed Under: Foot Ankle

Neglected Hip Dislocation after Trauma

By Dr Arun Pal Singh

Anterior Dislocated Hip

Hip dislocation is a less common injury. Therefore, very little has been written about neglected traumatic hip dislocations. Most of the literature is in form of case reports only. The common causes of a neglected hip dislocation are the presence of a femoral shaft fracture that causes injury being missed. Delay in seeking health care, […]

Filed Under: Hip

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

By Dr Arun Pal Singh

Danis Weber Classification of Malleolar Fractures

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 […]

Filed Under: Foot Ankle

Ottawa Ankle Rules for Ankle Injury Radiography

By Dr Arun Pal Singh

Ottawa ankle rules

Ankle injuries are very common injuries and not all ankle injuries require x-ray evaluation. Ottawa ankle rules for ankle injury radiography is an attempt to answer when the x-rays should be done in cases of ankle injuries. Because the rule is sensitive and not specific, it provides a clear guide of which patients not to […]

Filed Under: Foot Ankle

Ankle Fractures and Dislocations Injuries

By Dr Arun Pal Singh

tillaux fracture

Ankle fractures are actually groups fractures involving different parts of the region – the distal tibia, distal fibula, talus, and calcaneus. More often they are referred to fractures involving malleoli, distal tibia, and fibula. But ankle fractures also include the fractures of talus and calcaneum along with above-mentioned injuries. The group also includes fracture pattern […]

Filed Under: Foot Ankle

Floating knee Injuries in Adults and Children

By Dr Arun Pal Singh

Fraser Classification of Floating Knee Injuries

Floating knee refers to the fracture of ipsilateral [same side] fractures of tibia and femur. This makes knee unattached to tibia or femur, therefore name floating knee is given. The word floating knee was introduced for the first time by McBryde in 1965. Floating knee injuries may include a combination of diaphyseal, metaphyseal, and intra-articular […]

Filed Under: Lower Limb

Pilon Fractures of Tibia – Presentation and Treatment

By Dr Arun Pal Singh

Classification of Pilon Fractures

Pilon fractures or plafond fracture are fractures of the distal part of tibia involving its articular surface at the ankle joint.  Pilon is a French word for pestle, an instrument used for crushing or pounding. Pilon fractures account for approximately 10% of tibial fractures. These fractures involve the dome of the distal tibial articular surface […]

Filed Under: Foot Ankle

Tibial Shaft Fractures

By Dr Arun Pal Singh

Transeverse Comminuted Fracture TIbia

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 […]

Filed Under: Lower Limb

Tibial Plateau Fractures

By Dr Arun Pal Singh

Schartzker classification of Tibial Plateau

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 […]

Filed Under: Knee

True and Apparent Leg Length Measurement

By Dr Arun Pal Singh

Leg Length Measurement with Tape

True and apparent leg length refer to limb lengths in absolute terms and in compensated forms. The limb length measurement is used to find leg length discrepancy if any. When there is a shortening of the limb, the body compensates by tilting the pelvis down, equinus position of the foot and flexion of the opposite […]

Filed Under: Lower Limb

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Greenstick Fractures and other fractures, Image credit: St Luke

Greenstick Fractures Presentation and Treatment

Greenstick fractures are incomplete fractures of long bones and are They are commonly mid-diaphyseal, affecting the forearm and lower leg. They are distinct from torus fractures. Greenstick fractures are incomplete fractures of long bones usually seen in young children, more commonly less than 10 years of age. They are commonly mid-diaphyseal and typically affect the forearm and lower leg. […]

Elbow arthrocentesis indications and procedure

Elbow Arthrocentesis or Elbow Joint Aspiration

Elbow arthrocentesis refers to puncture of the elbow joint and the aspiration of its synovial fluid. It is used for synovial fluid analysis to aid in diagnosis and also for therapeutic purposes. Analysis of the removed fluid helps to reach at its etiology. Anatomy of Elbow Joint Elbow region is the connecting region between arm […]

Child hand with amniotic band syndrome.

Amniotic Band Syndrome

Amniotic band syndrome is a rare disorder [but not hereditary] that entrapment of fetus in strands of amniotic tissue and causes a variety of different birth defects.  The severity of amniotic band syndrome can range from a single, isolated finding to multiple, disfiguring complications. It is advocated that it should be called a sequence, rather […]

Lab Study Profiles of Different Types of Rickets

Hypophosphatemic Rickets

Hypophosphatemic rickets is a hereditary form of rickets characterized by low serum phosphate levels and resistance to treatment with ultraviolet radiation or vitamin D ingestion. This disorder was initially called vitamin D resistant rickets, is now called hereditary hypophosphatemic rickets because the primary problem is phosphate wasting rather than true vitamin D resistance. [Read in […]

Anatomy of Brachial Plexus

Brachial Plexus Anatomy

The brachial plexus is a network of nerves formed by the anterior rami of the lower four cervical nerves and first thoracic nerve roots and proceeds through the neck, the axilla, and into the arm. The nerves coming out from this supply upper limb and shoulder girdle. Structure of Brachial Plexus The brachial plexus consists […]

qCT or quantitative computed tomography vertebra

Quantitative computed tomography or QCT

Quantitative computed tomography is a procedure which uses CT scan for quantitative assessment of the bones or bone mineral density. It is mainly used in osteoporotic patients.  By Osteoporosis is a skeletal disease, characterized by low bone mass and micro-architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. […]

Posteromedial tibial bowing

Posteromedial Tibial Bowing

Posteromedial tibial bowing is a type of tibial bowing is a congenital bowing of the tibia with the apex directed posteriorly and medially. The cause is mostly physiological and is often associated with a calcaneovalgus foot deformity. Two other types of tibial bowing are anteromedial bowing and anterolateral bowing. Anterolateral bowing occurs in neurofibromatosis and […]

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