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Bone and Spine

Orthopedic health, conditions and treatment

  • General Ortho
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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

Classification of Anesthetic Agents

By Dr Arun Pal Singh

classification of anesthetic agents

There are many different anesthetic agents available and the user may vary depending on the site of the procedure, type of anesthesia [local versus spinal] and duration of anesthesia sought. In addition to this patient’s allergy profile needs to be taken into account. Lidocaine is the most commonly used anesthetic and belongs to the amide […]

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

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Different zones where ulnar nerve compression can occur in Guyon canal

Ulnar Tunnel Syndrome Features and Treatment

Ulnar tunnel syndrome is neuropathy [disease or dysfunction of nerve] of the ulnar nerve caused by compression in Guyon’s canal or the ulnar canal or ulnar tunnel. Guyon’s canal is a longitudinal space in the wrist which allows passage of the ulnar artery and ulnar nerve into the hand.  Guyon was a French Urologist who […]

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 […]

Lateral Dislocation of Elbow

Elbow Dislocation – Presentation & Treatment

Acute elbow dislocation in adults occurs at the ulnohumeral joint.  Elbow dislocation can be pure dislocation or associated with fractures of surrounding bones. Elbow is a very important part of upper limb function and plays a very important role in the positioning of the hand for grip and prehension. Various day to activities and recreational […]

CT of Spine Injuries D4-D5

Spinal Cord Injury Presentation and Treatment

Spinal cord injury is a term used for the spectrum of insults to the spinal cord which results in either temporary or permanent loss of function of the affected area of the cord. Spinal cord works to relay motor and sensory signals to the peripheral organs. Therefore the function affected are sensation, proprioception, the activity […]

anterior knee pain scale

Anterior Knee Pain Scale- Use and Limitations

The anterior knee pain scale is a patient-reported assessment of symptoms and functional limitations in patellofemoral disorders. It was first published in 1993 by Kujala et al. The questions on the Kujala questionnaire add to total of100 points. Anterior knee pain results in significant symptoms and activity limitations. The anterior knee pain scale is a […]

Discography in Lateral position Image

Lumbar Discography – Indications, Procedure and Inference

Lumbar discography is an invasive diagnostic procedure that involves, instillation of iodinated contrast into the nucleus pulposus after inserting a needle under fluoroscopy. This procedure is done with an aim to get information on the morphology and integrity nucleus pulposus, vertebral endplates and annulus fibrosus. In addition to this, the measured contrast injection allows determination […]

complications of fractures

What are Complications of Fractures

Fractures treatment in modern times allows most of the fractures to heal without a problem. But complications of fractures do occur sometimes which may affect management and outcome. Complications of fractures can be acute or chronic. Acute complications of fractures are mostly due to initial injury and generally as a result of the initial trauma […]

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