Earliest sign of nerve recovery?

Tinels sign

What are the Autonomous zones of the hand?

Radial nerve- 1st web space
Median nerve- volar distal aspect of index finger
Ulnar nerve- ulnar aspect distal little finger

What are the DD of thickened nerves?

Hereditory sensory neuropathy ,

neurotic amyloidosis ,

dejerine sottas disease ,

refsums disease ,

leprosy.

Most common finger involved in Dupuytrens disease?

Ring finger

What are the possible origins of loose bodies?

1 - Osteo chondral
2 - chondral
3 - fibrous
4 - foreign body

Reverse hill sachs lesion is seen in?

seen in posterior dislocation - antero medial portion of head of humerus

Classification of Polio foot?

Peabodys classification

Commonest shoulder dislocation?

Anterior - Subcoracoid type

Hand shake cast in given in?

After closed reduction of acute posterior dislocation

Posterior dislocation commonly seen in?

epileptic patients , seizures , post electric shock -
Is most common Missed dislocation !

What is Hangmans fracture ?

Traumatic spondylolisthesis of axis due to fracture at pars inter articularis.
(levines classification)

Ullmans sign ?

seen in spondylolisthesis .line drawn upward from anterior surface of sacrum infront of the anterior inferior angle of last lumbar vertebrae.

Kohlers disease.

osteochondritis/AVN  of navicular bone.

1st radiological sign of TB spine?

Rarefaction of the vertebral body / end plates.

indications of epidural steroid in a Prolapsed Intervertebral disc disease?

-age <50
-specific signs for disc
-leg pain more than back pain
-single level prolapse

name of classification of sequelae of septic hip arthritis?

- Choi classification (After In Ho Choi : Pronounced In Ho Che)

whats is harmons procedure - ?

harmons procedure is done for sequel of septic arthritis of hip in which remnant of cartialage of head is re-positioned in the acetabulum by doing a longitudinal femoral osteotomy .

 

when is a neck fracture femur said to be a non union?

3 months post fracture if no signs of healing radiologically

 

AVN Femoral Head classification based on MRI only

-Schimuzu MRI grades for AVN hip

What procedures are included in Bhattachraya's Procedure for release of stiff elbow Joint?

Bhattacharyas proceedure - removal of capsular contracture , mobilising brachialis and triceps from lower humerus , restoration of trochlear pulley , minimal removal of bone block  and post operatively  - 25 mg hydrocortisone acetate + 25cc of hylase and compression bandage.

 

What are the stages of myositis ossificans?

- hot stage - immature stage -  when ectopic bones is soft fluffy and tender , trabeculaes are not extablished

cold - mature stage - non tender ,hard swelling . causing joint ROM obstruction and usually excision should be done at this stage.

 

when to say an exostosis has turned malignant ?

clinically - continued growth , sudden appearance of pain , sudden enlargement of the swelling

radiologically - stippled calcification of the cartialage cap , cap size > 1.5 cms on USG , loss of distinctive bone margin.

 

Classification of patellar instability

- based on 2 factors

1) patella alta - insall salvati index < 1.3

2) generalised joint laxity

 

Which has a better prognosis brachial artery of Politeal artery Injury?

-Brachial Artery Injury has better prognosis compared to popliteal artery Injury. Actually this question is an indirect way of asking which artery has better collateral circulation. Brachial artery has better collateral circulation than politeal artery. (Contributed by Mannu Bhatia. Question asked by Prof Dhall in Delhi)

 Why while reducing supracondylar fracture humerus we feel radial artery and not ulnar artery?

A. the Radial and ulna arteries communicate through the palmar arch and thus palpating anyone will give the status of circulation of the Hand. Since radial artery is more easily palpable against the distal radius, it is palpated. Another reason is that in supracondylar fractures the brachia artery is injured proximal to the bifurcation of radial and ulnar arteries and hence palpating the more palpable radial artery is followed.

(Contributed by Mannu Bhatia. Question asked by Prof Sudhir Kumar in UCMS, Delhi)

 How to manage a patient of Bilateral femur fracture?

Early Bilateral unreamed intramedullary nailing is described for these fractures with acceptable complication rates in uncomplicated cases.
These fractures are known to have high incidence of mortality ranging from 40% to 6% (much reduced in recent years with technilogical progress in medical management)
In cases that are complicated like, cases delayed by 48 hours, associated with chest trauma or head injury, high inflammatory markers or associated co-morbidities compunded with other multiple injuries. In these cases Principles of "Damage control Surgery" should be followed and external fixation should be used.

Although a definitive answer does not exists the above answer is framed form review of literature article [Stavlas P, Giannoudis PV. Bilateral femoral fractures: does intramedullary nailing increase systemic complications and mortality rates? Injury. 2009 Nov;40(11):1125-8.]

(Contributed by Mannu Bhatia, Delhi)

 

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