Calcaneal fracture is treated by both open reduction and closed reduction technique, we are going to show you both surgeries in video format, open reduction is shown in form of animations where we do plating and go through lateral approach. Watch out the open reduction of calcaneum below on you-tube in animation form below.

Now see the video of closed reduction of comminuted fracture of calcaneum with  articular depression by one of the great surgeons of India Dr Anurag Shukla (M.S Orthopedic, M.Ch from U.K). While doing this surgery we come to know a very important fact which may be seen sometime. On seeing the X-Ray from lateral projection articular surface seems to be normal but x-ray from medial projection showed significant articular depression, thus both projections showed different pictures. This fact becomes very important when we used to do plating in calcaneum, we almost go through lateral approach, which can be misleading as we have shown from x-ray that’s
why we did surgery again after seeing x – ray from medial projection.

Steps of closed reduction include, first we reduced the fracture with the help of fracture reducing forceps, then we applied K-Wire so as to give temporary fixation to the calcaneam pieces. After that we permanently fixed the fracture with cancellous screw. In order to give immobilization to the ankle joint we need to fix it by external fixators. In order to do it we inserted k-wire in all metatarsals, calcaneum and tibia bone. Watch out the surgery below on you-tube.

Dr Anurag Shukla is one of the best orthopedic surgeons of India, he is gold medalist too, he has completed his M.Ch (ortho) from United Kingdom. He has written a book for the welfare of students preparing for Post Graduation Examination in India his book is ACROSS   -A COMPLETE REVIEW OF SHORT SUBJECTS published by Jaypee publishers you can buy this book at ifibeam.com.

What is bohler’s angle? Read at wikipedia

Common sites for sport injuries are shoulder, elbow, wrist, hip, knee, ankle and foot. Incidence of sports injuries among all orthopaedics injuries accounts to be around 10%.

Recently in comming months India is going to organise Common Wealth Games 2010 in New Delhi, so you will come to know some injuries, since more and more people are choosing sports as their career so sports injuries are rising, so is the sports medicine field.

We are going to talk about some common sports and injuries seen in them.

CRICKET
1. You must be knowing Sachin Tendulkar suffering from Tennis Elbow
2. Mallet injury it takes place when a fielder tries to catch ball, and ball hits the tip of finger(causes forced flexion) which leads to rupture of terminal slip so active extension fails at DIP. Treatment includes immbolization of both DIP and PIP in full extension with dorsal splint for 2 weeks then splint only DIP in slight hyperextension for another 4-8 weeks. In high incidence of mallet fingers avulsion fracture is reported.

3. Carpal Tunnel Syndrome it can also occurs due to repetative movement at wrist joint, seen during batting or bowling.
4. Other hand injuries are Baseball Finger, Jersey Thumb.
5. Cricket ball may hit face or eye in those players not wearing helmets and cause severe injuries.
6. Ankle Sprain can occur while running between wickets.
7. Even there is possibility of March (fracture of 2nd & 3rd metatarsal bones) and Jones fracture (fracture of 5th metatarsal bone).
8. Rotator cuff injuries, shoulder dislocation can happen in bowlers.

FOOTBALL
1. Most common is knee ligament injuries like Anterior Cruciate Ligament injury or Posterior Cruciate Ligament injury.
2. Meniscal tears.
3. Fracture of patella.
4. Strain in calf musclces, trunk muscles and sprain in hamstring muscles.

HOCKEY
1. same as football, there are some chances of fractures of tibia,when hit by hockey stick.

ATHELETS
1. Jumpers Knee is common in them, which takes place due to patellar tendinitis, it is also common in basket ball players. Blood flow to tendons is less so causing difficult self healing.

CYCLIST
1. Clavicle fracture can occur due to fall from cycle.
2. Chondromalacia is very common among cyclists.
3. Back Ache
4. Colle’s Fracture

TENNIS
1. Tennis Elbow

GOLF
1. Golfer’s Elbow

CANOEISTS
1. Wrist Extensors Tenosynovitis.

CAR RACING
1. Whiplash injury
2. Dashboard injury or posterior dislocation of hip joint ( this is emergency).
3. Anything can fracture in case of accident, like rib fracture, head injuries, spine injury etc.

BOXING and WRESTLING
Any thing can break up no comments

WEIGHT LIFTING
1. bicipital tendinitis

General Principles of Treatment of Sports Injuries.

1. Give complete rest to the injured limb.
2. Give the ice therapy.
3. Do compression bandaging.
4. Elevate the injured limb.
5. Prescribe painkillers.
6. Heat, straps and supports should be given.

Watch out the video below on common sports injuries and their basic principles in treatment by Dr Jayant Bajpai.

Dr Jayant Bajpai is the renowned orthopaedic surgen of India, he is has done his MBBS from KGMC (lucknow), B. Sc from University of Jhonston (USA), F.A.C.S.
He has been awarded Chitiksha Sikh. Ratna Award from Government of Uttar Pradesh, National Humanitarian Award of I.M.A.
He has been presidential appointee to executive board of NIOH and National Handicapped Board.
He has around five international and fourty seven national publications till today.
This great surgeon was born on 18 november 1944 and presently working at Era’s Lucknow Medical College and Hospital.

The tibia is the main weight-bearing bone of the lower leg, so a tibial fracture is more serious than a broken fibula. There’s not much tissue around the tibia, and therefore not as much blood supply to the bone. Consequently, it takes longer to heal.

The method of treatment and the time to complete healing comes down to where the bone was broken,  whether near the ankle, or in the mid-portion, or close to the knee joint. Each location has its own problems that we deal in different manner. Ideally, we do not want to operate on a tibial fracture. You prefer to set it in place, brace it, and allow it to heal. Generally, the more limited the blood supply, the greater the healing time.

If you are in playground or in market, you saw your friend met and accident and got his fractured at lower end of legs, read here how to splint a fracture of lower leg.

Some times we are forced to operate the patient so to internally fix the fracture, following video helps to demonstrate how to perform the surgery for fracture of lower end of tibia and fibula.

After giving general anaesthesia to patient, we try to reduce the fracture with fracture reducing forcep without giving any incision, we can see the correct alignment of bones under X-Rays in O.T.

With the help of driller we drill K-Wire so that fracture is temporarily reduced and stablised. Now we will give small incision so that we can elevate the periosteum of bone so that implant or plate can properly set over the bone.

In the video below we are trying to fix the fibula first and fix it with reconstruction plate, which is screwed to bone with cancellous screw, you may need the help of bone holding forceps during reducing fibula fractures.

After fixing fibula we move to fix tibia and fix it with lower tibial metaphyseal plate and cancellous screws, give stitches and bandage is applied.

This fantastic surgery has been done by great orthopaedician from Lucknow Dr O. P. Gupta M. S (ortho. from K.G.M.C Luknow) and working as an Associate Proffessor at Era’s Lucknow Medical College and Hospital. For any kind of orthopaedic surgery can call him at 09450871300 and 09307773920. This surgery was assisted by Dr Deepak Chaudhary and Dr Yasir Ali Khan( P.G Students).

Generally there are no symptoms related to ganglion, however sometimes they become painful.

Treatment of ganglion is simple aspiration of cyst through needle, you can see some gelly like material comming out from ganglion is the video below which shows how to aspirate a ganglion, this gelly like material is hallmark of ganglion. After doing aspiration, we need to inject hylase or methy prednisolone in the cyst so that it may not reoccur. If it re occurs surgical excision is the treatment.

Guttate Psoriasis is generally found in young age group, below is the picture of guttate psoriasis lesions as captured by us, this is a young male, this child applied some steroid over the lesion, due to which linear atrophic scars are seen over the limbs seen in second photograph

see another photograph below where child has applied steroid over months so linear atrophic scars are formed

Treatment of Psoriasis

Psoriasis treament is divided into 2 categories 1. Topical therapy and 2. Systemic therapy.

Topical therapy includes application of Coal tar with Ultra violet exposure, application of anthralin in 0.1 to 1% concentration, and vitamin D 3 analogues.

Systemic therapy methotrexate 10-15 mg per week, psoralens accompanied by PUVA therapy, retinoids and cyclosporines.

You can read complete information on psoriasis from wikipedia

Diagnosis of psoriasis is made after performing Auspitz’s sign see how to perform Auspitz’s sign in Psoriasis.

You can watch out the video demonstration of Auspitz’s Sign on youtube done by us below

• Pigmenting fixed drug eruption
• Generalized or multiple fixed drug eruption
• Linear fixed drug eruption
• Wandering fixed drug eruption
• Nonpigmenting fixed drug eruption
• Bullous fixed drug eruption
• Eczematous fixed drug eruption
• Urticarial fixed drug eruption
• Erythema dyschromicum perstans–like fixed drug eruption
• Vulvitis
• Oral
• Psoriasiform

read about pathophysiology of fixed drugs reaction, drugs causing it and also see more pictures at emedicine.medscape.com

Its higher incidence is seen in school going childrens, sexually active people, or those whose immune system is weak.

Molluscum Contagiosum is characterised by Henderson Peterson bodies or Molluscum bodies, these are basically inclusion bodies made of nuclear or cytoplasmic aggregates usually proteins, they typically represent sites of viral multiplication in our body usually capsid protein.

Molluscum contagiosum lesions are flesh-colored, dome-shaped, and pearly in appearance often 1–5 millimeters in diameter, with a dimpled center, known as umblicated lesions, lesions not painful, but they may itch or become irritated. Picking or scratching the lesions may lead to further infection this process is known as autoinoculation.

Virus is present at the head of the lesion, so just removing the Handerson Peterson body treats the infection, this concept is being utilised below

Home Remedy For Molluscum Contagiosum

Take a 26 gauze sterilized needle, and 30 % trichloroacetic acid (TCA), gloves and make patient lie on couch in supine position.

With the help of needle just remove Molluscum Bodies, as shown in video below on youtube, after that apply 30 %  trichloroacetic acid on the tip of area where molluscum contagiosum lesion was present.

To fill TCA in needle, just dip the needle in acetic acid solution it will ascend up due to capillary action. Now watch the video below on youtube.
T

There are other treatments also for molluscum contagiosum read here at wikipedia.