Author: Dr. Tushar Mehta
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Septic Arthritis – Facts
Most commonly affected joints in descending order include : knee > hip > elbow > ankle >sternoclavicular joint Most common pathogens include : Staphylococcus species Staphylococcus aureus (most common, >50% cases) MRSA Staphylococcus epidermis Neisseria gonorrhea Most common organism in otherwise healthy sexually active adolescents and young adults Knee joint most commonly involved Streptococcus Salmonella…
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Origin of Bone Fractures
In the case of a slip, trip, or fall, the force of the impact on a bone physically deforms a pair of joined proteins, osteopontin and osteocalcin, and results in the formation of nanoscale holes. These holes, called dilatational bands, function as a natural defence mechanism, and help to prevent further damage to the surrounding…
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Child Syndrome
CHILD (congenital hemidysplasia with ichthyosiform erythroderma and limb defects) syndrome is a rare disorder characterized by birth defects of several organ systems, including the skin, viscera, musculoskeletal system, and central nervous system. The earliest description of the syndrome has been attributed to Otto Sachs in 1903. CHILD syndrome is caused by an X-linked dominant mutation…
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Denosumab
Denosumab is a RANK ligand (RANKL) inhibitor indicated for: Treatment of postmenopausal women with osteoporosis at high risk for fracture Mechanism of action: Denosumab binds to RANKL, a transmembrane or soluble protein essential for the formation, function, and survival of osteoclasts, the cells responsible for bone resorption. Denosumab prevents RANKL from activating its receptor, RANK,…
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Sickle Cell Disease – What an Orthopaedician should know !
Orthopaedic Manifestations of Sickle Cell Disease : Infections are common in Diaphysis Common organisms – Salmonella and Staph.aureus Patients present with Acute Bony Crisis due to Bony Infarcts , which is also referred to as Hand Foot Syndrome when extremities are involved , most frequent between the ages of 6 months – 2 years In…
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Orthopaedicians – Who are We ?
OVERVIEW : A humorous anaesthetic colleague recently repeated the following popular saying while an operating table was being repaired with a mallet: “typical orthopaedic surgeon—as strong as an ox but half as bright.” Making fun of orthopaedic surgeons is a popular pastime in operating theatres throughout the country. This pursuit has recently spread to the…
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Remodelling – Basics
Remodeling : Remodeling of a fracture or deformity is a process that is carried out more efficiently in the child than in the adult. A deformity corrects itself by asymmetrical appositional formation of new bone. Remodeling is influenced by a number of factors, including the following: 1. Age – The younger the age, the better…
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Orthopaedic Neurology Updates
Neurology Updates : 1. The most common peripheral nerve injury – radial nerve 2. Radial nerve , after getting injured has the best prognosis of recovery as it is predominantly a motor nerve and the muscles supplied by it are not involved in fine movements 3. Sequence of Prognosis after nerve injury = radial >…
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Sir Hugh Owen Thomas
Medical Legacy of Sir Hugh Owen Thomas : His contribution to British orthopaedics was manifold. In the treatment of fractures and tuberculosis he advocated rest, which should be ‘enforced, uninterrupted and prolonged’. In order to achieve this he created the so-called ‘Thomas Splint’, which would stabilise a fractured femur and prevent infection. He is also…
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Blood supply of scaphoid
Anatomically, the scaphoid may be divided into proximal, middle (termed the waist), and distal thirds. Most of the blood supply to the scaphoid enters distally. The proximal part of the scaphoid has no blood vessels entering it, depending instead on vessels that pierce the midportion. Fractures of the proximal third of the scaphoid account for…
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