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Bone and Spine

Orthopedic health, conditions and treatment

Procedures

Radioscapholunate Arthrodesis – Indications and Procedure

By Dr Arun Pal Singh

radioscapholunate arthrodesis

Radioscapholunate arthrodesis is a type of partial arthrodesis of the wrist which preserves some of the motion in the wrist joint. It is based on the observation that most activities of daily living can be accomplished with wrist motion in the range of 10° flexion, 35° extension, 10° radial deviation, and 15° ulnar deviation. Wrist […]

Filed Under: Procedures

Four Corner Arthrodesis [Fusion] of the Wrist

By Dr Arun Pal Singh

Four Corner Arthrodesis

Four corner arthrodesis involves excision of scaphoid and fusion of the remaining wrist bones in neutral alignment. It is motion preserving limited arthrodesis and provides pain relief and improved grip strength. This four corner arthrodesis is based on the principle that the radiolunate articulation is often spared from degenerative changes from conditions. Indications SLAC wrist […]

Filed Under: Procedures

Skeletal Survey or Bone Survey – Indications and Uses

By Dr Arun Pal Singh

Babygram or skeletal survey in congenital rubella syndrome

A skeletal survey is a series of x-rays which are done to view the entire skeleton, performed systematically to cover the entire skeleton or the anatomic regions as per clinical indications. Different clinical indications may demand a different set of x-rays. In the case of child abuse, which is a common indication, the local health […]

Filed Under: Procedures

Laminoplasty – Indications and Procedure

By Dr Arun Pal Singh

laminoplasty diagram

Laminoplasty is a process of increasing the space available for the spinal cord by reconstruction of the laminar arch via a posterior approach. It is done by hinging or opening the lamina to allow access to the canal and may include augmentation or reconstruction of the spinal canal. Laminectomy is just removal of the lamina […]

Filed Under: Procedures, Spine

Jackson Table System for Spine Surgeries

By Dr Arun Pal Singh

An image of jackson table

What is the Jackson Table System for Spine Surgeries Jackson table is a specially designed table to be used in spine surgeries. It can be used to perform a  perform a variety of spinal surgeries in supine, prone, lateral positions in a safe manner. Two of the peculiar features of Jackson table are No central […]

Filed Under: Procedures, Spine

Dynamization of Nail- Principle and Procedure

By Dr Arun Pal Singh

Mechanism of Dynamization when locking is done through dynamic slots. With loading, the screw allows play and bone fragments get approximated

What is Dynamization of nail? Dynamization of nail is the process of converting a static interlock nail to dynamic nail by removing screw of the proximal static hole [read further for explanation]. Interlock nail is a common surgery in orthopedics. It is most commonly used for fracture of femur  [read further for explanation]nd fracture of […]

Filed Under: Procedures

Ganglion Impar Block

By Dr Arun Pal Singh

Various approaches to ganglion impar

The ganglion impar is a  sacrococcygeal ganglion, also called ganglion of Wather. It is a retroperitoneal structure located at the level of the sacrococcygeal junction. It is the final terminus of sympathetic chains formed by the fusion of both the chains. Therefore, the ganglion impar block is used in patients with the pain in pelvic […]

Filed Under: Procedures

Digital Block Procedure – Indications and Techniques

By Dr Arun Pal Singh

Webspace Digital Block

Digital nerve blocks are used for numbing digits [fingers, toes] for a procedure on the digits. Injury and infection are the two most common reasons for surgical procedures of digits. The digital block is generally effective for procedures distal to metatarsal or metacarpal heads. Relevant anatomy Each digit is innervated by 4 digital nerves – […]

Filed Under: Procedures

Trigger Point Injection Procedure

By Dr Arun Pal Singh

The fingers compress muscle for needle insertion

Trigger point injections are used as a treatment modality for inactivating trigger points to provide prompt relief. Trigger points are palpable painful nodules in the taut band of muscle fibers. Trigger points are also called myofascial trigger points as they are seen in myofascial pain syndrome, a painful muscle disorder. [Read more on myofascial pain […]

Filed Under: Procedures

Intrarticular Methylene Blue Injection Procedure

By Dr Arun Pal Singh

Methylene blue injection in elbow

Methylene blue injection is an easy and safe way to rule out or confirm breakage of the joint capsule when there is an injury near or around the joint,  thus establishing or ruling out the presence of open joint injury. Open joint injuries consist of are skin and soft-tissue injuries which communicate with the joint. It […]

Filed Under: Procedures

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tillaux fracture

Ankle Fractures and Dislocations Injuries

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 […]

muscle power grading

Muscle Power Grading

Muscle power grading is a frequent and important part of the neurological examination. The neurological examination consists of sensory and motor examination. Muscle power grading is part of motor system examination. Before muscle power grading is done, limbs or trunk are examined for the tone of the muscles, the bulk of the muscles. The limbs […]

atlanto occipital fusion

Atlanto-occipital Fusion

Atlanto-occipital fusion or Occipitalization of atlas [C1]is the most common congenital abnormality of the upper cervical spine. It means partial or complete congenital fusion between the atlas and the base of the occiput. Other names for atlanto-occipital fusion are occipitalization, occipitocervical Synostosis, assimilation of Atlas The severity ranges from a complete bony fusion to a […]

Erb's Palsy

Erb’s Palsy Causes, Presentation and Treatment

Erb’s Palsy is also called brachial palsy or Erb Duchenne palsy and it occurs due to injury to the upper group of the arm’s main nerves, specifically of the upper trunk [C5–C6 nerves] Depending on the severity of the injury can either resolve on its own over a period or leave residual weakness. Relevant Anatomy […]

Various approaches to ganglion impar

Ganglion Impar Block

The ganglion impar is a  sacrococcygeal ganglion, also called ganglion of Wather. It is a retroperitoneal structure located at the level of the sacrococcygeal junction. It is the final terminus of sympathetic chains formed by the fusion of both the chains. Therefore, the ganglion impar block is used in patients with the pain in pelvic […]

x-ray machine

Radiographs in Orthopedics

Radiographs are also called or roentgenographs named after the discoverer of X-rays, Wilhelm Röntgen. Radiographs are produced by transmitting X-rays through a patient.  Rontgen discovered X-rays in 1895 and received the first Nobel Prize in Physics for their discovery in 1901. In the conventional film-screen radiography, an X-ray machine tube generates a beam of X-rays, aimed […]

ACR guidelines for imaging of rib fracture

ACR Guidelines For Imaging of Rib Fracture

Rib fracture is the most common thoracic injury. It is found in 10% of all traumatic injuries and  40% of cases of blunt trauma. 5th to 9th ribs are most commonly involved probably due to the protection offered by shoulder girdle to upper ribs and mobility of lower ribs. Isolated rib fractures have relatively low […]

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