hanumantha@gravitysoft.in – Page 16 – MBJ Clinic – Bone & Joint : Orthopedic Clinic

Hindfoot Arthritis

Nonsurgical management of hindfoot arthritis includes oral anti-inflammatories, steroid injections, and bracing Progressive condition, hindfoot arthritis typically requires arthrodesis Patient with prior calcaneum fracture need special attention while doing subtalar arthrodesis Maintain height subtalar joint area with graft Isolated talonavicular arthritis typically occurs in the setting of rheumatoid arthritis or Mueller-Weiss disease Subtalar and talonavicular arthrodeses typically done for adult-acquired…

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Hip Displacement in Cerebral Palsy

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Cerebral palsy have a 30% risk of hip displacement Displacement leads to nonconcentric which ends up with degenerative and painful hip Hip surveillance is effective for detecting and managing hip displacement in CP Prevention of dislocation: Adductor/psoas muscle lengthening , Femoral osteotomy , Injections of botulinum toxin Surgical reconstruction successfully reduces these hips and improves quality-of-life scores Indications for THR…

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Humeral Shaft Fractures

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Treatment with closed reduction and coaptation splinting followed by conversion to a fracture brace results in union in 70% to 80% of cases. Obesity, medical comorbidities, inadequate splintage can all lead to delayed union or nonunion Slightly higher rates of healing with plate fixation and reduced shoulder problems 32.5%pts secondary surgeries needed in nailing Non-union is more common with simple…

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Infection after TKR

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The optimum 90 day cut off values are 6,130 cells/µL for WBCs ; 39.8 mg/L for CRP; 39.5 mm/hour for ESR; 79.5% for PMN percentage Beware of High false-negative rates Prevalence of suspected culture-negative PJI – 22%. Fluorescence in Situ Hybridization (FISH) is a rapid, reliable and feasible technique Prevent infection by managing host factors such as malnutrition, obesity, smoking,…

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Intercondylar Fractures of Humerus

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DH resembles a triangle, with the medial & lateral columns making up the sides and the trochlea forming the base Reconstruction of the premorbid anatomy of the trochlea is crucial to restoration of motion and stability AO and Riseborough & Radin’s Classification commonly used Lambotte, in the first decade of the 20th century, was one of the first to describe…

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Internal Impingement of the Shoulder

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Pathologic contact between margin of posterior glenoid and posterior rotator cuff tendons Affects overhead athletes, Arm in full external rotation and abduction of at least 90°. Associated Pathologic Conditions include Increased glenohumeral external rotation, Increased humeral head and glenoid retroversion, Anterior capsular laxity, Posterior capsular contracture, Partial and full-thickness rotator cuff tears, Anterior and posterior capsular injury, Labral tears, glenoid…

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