v3.5 Fusion Pro
Each topic hub organizes the core wiki topic with related cases, atlas images, indexed evidence, resources, and MCQs so users and search engines can move through a structured learning cluster.
Search fracture-specific terms and review structured fracture classifications inside a dedicated atlas index.
Cierny–Mader classifies adult osteomyelitis by anatomic type (I–IV) and host status (A/B/C). Type I: Medullary; Type II: Superficial; Type III: Localized (cortical sequestration wi...
A comprehensive systematic approach to interpreting hip radiographs, covering patient positioning, anatomical landmarks, key lines and angles, pathological patterns, and common hip...
Rotator cuff provides dynamic stability and elevation of shoulder. Tears: acute traumatic vs degenerative. Indications for repair: symptomatic full-thickness tear, acute traumatic...
Autoimmune symmetric polyarthritis causing synovitis and progressive joint destruction—typical deformities in the hand: ulnar drift at MCPs, swan‑neck and boutonnière deformities,...
Defined as knee stiffness after TKA, usually 10° extension loss. Incidence: 3–6% after TKA. Causes: poor rehab, malposition, infection, scar tissue formation. Management: early man...
PCL prevents posterior tibial translation; stronger than ACL. Mechanism: dashboard injury (posterior force on tibia), hyperflexion. Clinical: posterior sag sign, posterior drawer t...
Allman: Type I midshaft; Type II distal; Type III medial third. Neer distal clavicle: Type I stable; IIA/IIB unstable (CC ligaments disrupted); Type III intra-articular; V epiphyse...
Type A (compression): A1 wedge, A2 split, A3 incomplete burst, A4 complete burst. Type B (tension band): B1 posterior through bone/ligament, B2 posterior + anterior, B3 anterior hy...
High-energy injury with high risk of popliteal artery injury (10–40%). Urgent reduction and splinting; check pulses + ABI. If ABI
Comprehensive guide to knee arthroscopy covering indications, patient positioning, standard and accessory portals with anatomical landmarks, the 10-point systematic diagnostic exam...
Involves disruption of ≥2 major knee ligaments; often from high-energy trauma. Common patterns: ACL + PCL ± collateral injuries. Associated with vascular (popliteal artery) and ner...
AO 31-A: A1 simple, A2 comminuted, A3 reverse oblique. Implants: DHS for stable A1/A2, CMN for unstable A2/A3. TAD
Seddon: neuropraxia, axonotmesis, neurotmesis; Sunderland expands to 5 degrees based on structural disruption. Degree I: conduction block; II: axonal disruption intact endoneurium;...
Avulsion of extensor tendon at DIP joint; may involve bony fragment. Mechanism: sudden forced flexion of extended DIP (e.g., ball injury). Clinical: inability to extend DIP; distal...
A: stable (posterior arch intact). B: rotationally unstable, vertically stable (open-book APC or LC injuries). C: rotationally + vertically unstable (complete posterior disruption)...
Most common carpal instability; due to disruption of scapholunate ligament. Clinical: wrist pain, weakness, clicking; positive Watson’s test. Radiology: gap >3 mm (‘Terry Thomas si...
Type I: Nondisplaced — anterior humeral line intersects capitellum; treat in long arm cast. Type II: Displaced with posterior cortex intact (hinge) — often closed reduction & pinni...
Medial hinge disruption >2 mm, anatomic neck fracture, head-splitting → high AVN risk. Assists decision towards arthroplasty in ischemic patterns.
Most common carpal fracture, usually waist (70%). Blood supply retrograde to proximal pole → high risk of AVN. Clinical: anatomical snuffbox tenderness, pain on axial loading of th...
Type I: tip avulsion (rare, stable). Type II: base of dens (common, unstable, high nonunion). Type III: into C2 body (better healing).
Most common primary malignant tumor of bone (plasma cell dyscrasia). CRAB features: hyperCalcemia, Renal failure, Anemia, Bone lesions (lytic). X‑ray: punched‑out lytic lesions, di...
Lisfranc joint = tarsometatarsal articulation; key stabilizer = Lisfranc ligament (medial cuneiform to 2nd MT base). Mechanism: axial load with plantar flexion/twist. Diagnosis: wi...
A: total incongruity; B1: medial partial; B2: lateral partial; C1: divergent partial; C2: divergent complete. Any >2 mm displacement typically requires surgical fixation/arthrodesi...
BOAST 4 guidelines: antibiotics ASAP, tetanus, debridement, stabilization, soft tissue cover. Do not remove bone fragments unless grossly non-viable. Definitive cover within 72 h (...
Lodwick classification describes patterns of bone destruction on radiographs. Type I: geographic (IA sclerotic rim, IB sharp margin, IC ill-defined). Type II: moth-eaten destructio...
Correct deformities in **CAVE** order: **C**avus → **A**dductus → **V**arus → **E**quinus. Use **Ponseti casting** with abduction and supination around talar head; avoid pronation/...
Morphology (compression 1, burst 2, translation/rotation 3, distraction 4), Posterior ligamentous complex integrity (intact 0, indeterminate 2, disrupted 3), Neurologic status (int...
Type I: nondisplaced (A noncomminuted / B comminuted). Type II: displaced but stable (A/B). Type III: displaced and unstable (A/B). Type I conservative; II–III usually require fixa...
SLAP = Superior Labrum Anterior to Posterior tear at the biceps anchor; pain is deep, activity‑related, with mechanical clicking. Snyder classification I–IV (and extensions V–VII);...
ETC: definitive fixation within 24 h for stable patients. DCO: temporary stabilization in unstable patients; definitive fixation after stabilization. Second hit phenomenon: surgery...
SA (supination-adduction): lat avulsion → vertical medial fx. SER (supination-external rotation): ATFL → fibula at level → posterior → medial (most common). PA (pronation-abduction...
Biopsy should be performed only by definitive surgical team at referral center. Types: core needle (preferred), incisional, excisional. Incision along surgical approach, longitudin...
Tibia shaft → highest risk of compartment. Signs: pain out of proportion, stretch pain. ΔP
Salvage procedure for irretrievable failed TKA, chronic infection, tumor resection. Techniques: intramedullary nailing, external fixation (Ilizarov), compression plating. Indicatio...
Main bearing couples: Metal-on-Polyethylene (MoP), Metal-on-Metal (MoM), Ceramic-on-Ceramic (CoC), Ceramic-on-Polyethylene (CoP). MoP: gold standard; risk of wear/osteolysis; impro...
I: sprain; II: AC torn, CC intact; III: AC+CC torn with superior displacement. IV: posterior displacement; V: marked superior displacement; VI: inferior displacement (rare). I–II n...
Used for tibia/femur fractures with traction. Has pulleys, slings; allows elevation and adjustment. Complications: sores, stiffness, peroneal palsy.
Viable (hypertrophic/oligotrophic) vs non‑viable (atrophic, necrotic, defect, comminuted). Radiographic callus indicates biology; absence suggests poor biology. Guides treatment: s...
Colles: extra-articular, dorsal tilt; Smith: extra-articular, volar tilt; Barton: intra-articular rim fracture. Clinical deformities: dinner-fork (Colles), garden-spade (Smith). St...
Comprehensive guide to orthopaedic screws covering screw anatomy and geometry, cortical and cancellous screws, lag screws and the lag technique, locking screws, cannulated screws,...
Malunion = fracture healing in unacceptable position (angulation, rotation, shortening, translation). Nonunion = failure of fracture to heal in expected time (9 months with no sign...
Classification guides treatment by considering fracture location, implant stability, and bone stock. THA femur: **Vancouver** (A: trochanteric; B1: around stem-stable; B2: around s...
CSM is progressive spinal cord dysfunction due to degenerative stenosis (disc osteophyte complex, ligamentum flavum hypertrophy, OPLL). Symptoms: hand clumsiness, gait imbalance, L...
Tension‑stress effect: gradual distraction (≈1 mm/day in 4 steps) after corticotomy induces regenerate bone and soft‑tissue adaptation. Circular fixator with tensioned wires permit...
Indications: medial compartment OA with varus deformity in young active patients. Goal: shift weight-bearing axis laterally to unload medial compartment. Techniques: lateral closin...
Indications: femoral shaft fractures, temporary stabilization. Provides traction + splintage. Structure: proximal ring, side bars, distal crossbar. Complications: sores, nerve pals...
SC joint dislocations: anterior (more common, often stable after reduction) vs posterior (rare but life‑threatening due to mediastinal compression). Posterior dislocation red flags...
Occurs in ages 3–6; risk of late valgus (Cozen phenomenon) due to asymmetric overgrowth. Usually metaphyseal greenstick/complete fractures from low‑energy mechanisms (trampoline, s...
Rockwood I–VI classification based on AC/CC ligament disruption and clavicle displacement. I–II: non-op (sling, rehab). III: controversial; IV–VI: surgery. Surgical options: hook p...
CT: excellent for cortical bone, 3D recon. MRI: excellent for marrow, soft tissue, ligaments, cartilage. CT indications: complex fractures (pelvis, acetabulum, calcaneus). MRI indi...
Types I–V: nondisplaced to highly comminuted/segmental by number/configuration of fragments. Most require IM nailing; higher types have longer healing and alignment challenges.
Detailed guide to hip labral tears covering anatomy, Seldes/Czerny classification, clinical tests, MR arthrography, arthroscopic repair vs debridement vs reconstruction, and outcom...
Benign osteoblastic tumor
Zone 1: lateral to foramina (alar) — low neuro risk. Zone 2: through foramina — higher L5/S1 root risk. Zone 3: medial to foramina (central canal) — highest cauda equina risk.
External (periosteal) vs internal (endosteal) callus; bridging and uniting fragments. Primary (contact) healing has minimal/no callus under rigid stability; secondary healing forms...
Hyperextension of PIP with flexion of DIP joint. Caused by RA (most common), trauma, chronic mallet finger, spasticity. Clinical: finger looks like swan neck, loss of grip strength...
Gold standard for young active patients with ACL-deficient knee. Grafts: Bone–Patellar Tendon–Bone (BTB), Hamstring (STG), Quadriceps tendon, Allograft. Tunnel drilling: transtibia...
Idiopathic avascular necrosis of capital femoral epiphysis in 4–8‑year‑olds (boys > girls). Radiographic **Waldenström stages**: Initial, Fragmentation, Re‑ossification, Healed. **...
Expansile blood-filled benign tumor in children/young adults. Common sites: metaphysis of long bones, spine posterior elements. X-ray: blow-out lesion with thin shell, septations....
TFCC stabilizes the distal radioulnar joint and dissipates ulnar‑sided load. Palpable 'fovea sign', ulnar grind, and DRUJ shift test support diagnosis. MRI useful; wrist arthroscop...
Types: hypovolemic (hemorrhagic), distributive (septic, neurogenic), cardiogenic, obstructive. Initial approach: ATLS (Airway with C‑spine, Breathing, Circulation, Disability, Expo...
Most common cause of adult acquired flatfoot; due to PTT degeneration/rupture. Stages I–IV (Johnson & Strom classification). Clinical: medial ankle pain, progressive collapse of me...
Distal radial shaft fracture with distal radioulnar joint (DRUJ) disruption. Unstable pattern: ORIF radius and stabilize DRUJ.
Physis has zonal architecture; hypertrophic zone is weakest and fails in most injuries. Salter–Harris I–V (Slip, Above, Lower, Through, Rammed) with Ogden’s extension (VI–IX). Aim...
Physeal separation of medial clavicle mimics SCJ dislocation — the physis is weaker than ligaments in children. Posterior displacement threatens mediastinal structures — requires u...
HO = abnormal bone formation in periarticular soft tissues after surgery or trauma. Incidence after THA: 20–50%; clinically significant in 5–10%. Risk factors: male sex, hypertroph...
High‑energy axial load injures distal tibial plafond with severe soft‑tissue compromise. Standard of care is staged protocol: **span → scan → settle → ORIF**. Restore length and al...
Comprehensive guide to anterior cruciate ligament injury covering anatomy, biomechanics, clinical diagnosis including Lachman and pivot shift tests, graft selection, fixation metho...
Indications: end-stage OA, RA, post-traumatic arthritis with pain and disability. Contraindications: active infection, severe vascular disease, extensor mechanism dysfunction. Impl...
Comprehensive guide to Kirschner wire (K-wire) principles in orthopaedic surgery covering wire properties and sizes, biomechanical principles of fixation, insertion techniques, cli...
Overuse injury of patellar tendon, common in jumping athletes (basketball, volleyball). Pain localized to inferior pole of patella; worse with jumping, squatting, stairs. Histology...
I: anterior radial head dislocation (ulna angulated anterior). II: posterior; III: lateral; IV: both bones fractured with radial head dislocation. ORIF ulna restores radial head re...
APC I–III: progressive symphysis/SI disruption (III complete). LC I–III: sacral compression → crescent fx → windswept (bilateral). VS: vertical shear; CM: combined mechanisms.
Grade 0: minimal; 1: superficial abrasions/contusions; 2: deep contaminated abrasions, muscle contusion; 3: extensive crush, compartment risk. Higher grades predict complications a...
Common alloys: 316L stainless, cobalt‑chrome, titanium (Ti‑6Al‑4V). Corrosion mechanisms: fretting at modular junctions, crevice under plates, galvanic with dissimilar metals. Clin...
Pes planus (flatfoot) is a deformity characterized by loss or reduction of the medial longitudinal arch of the foot, resulting in hindfoot valgus, forefoot abduction, and altered b...
First-line treatment is ATT with rest and bracing per Tuli’s 'middle path'. Surgical indications: neurological deficit not improving, instability/deformity, large abscess, severe p...
Scheuermann disease: rigid structural kyphosis with ≥3 adjacent vertebrae wedged ≥5° and Schmorl nodes. Post‑TB kyphosis is angular with short apex, often severe and progressive in...
The unhappy triad (O'Donoghue triad) is a combined knee injury involving the ACL, MCL, and medial meniscus, classically caused by a valgus contact force on a planted foot. Modern e...
Cobb angle measures curve magnitude; progression risk relates to age, Risser stage, menarchal status, and curve size. Bracing indicated for skeletally immature curves 25–40° with d...
A: infra-syndesmotic; B: at syndesmosis; C: supra-syndesmotic (Maisonneuve possible). Instability rises from A→C; C requires ORIF with syndesmotic fixation.
Types I–VIII: extra- vs intra-articular, DRUJ involvement, and ulnar styloid fracture. Intra-articular (III–VIII) have higher arthritis risk; often require ORIF.
Indications: end-stage hip OA, AVN, RA, ankylosing spondylitis, fracture neck femur (elderly). Contraindications: active infection, severe medical comorbidity, poor bone stock with...
Periosteal reactions are one of the most underrated signs on a plain X-ray. One look at the pattern tells you whether you're dealing with something benign and slow — or aggre...
Biopsy is critical for diagnosis but must follow strict oncological principles. Plan biopsy with final surgery in mind; incision should be longitudinal and in line with resection....
Primary driver of late osteolysis and aseptic loosening in TKA. Wear modes: adhesive/abrasive; delamination & pitting with high contact stress/oxidation in older PE. Risk factors:...
Functional elbow arc ≈ 30–130° flexion and 50°/50° pronation–supination (Morrey). Common causes: trauma, HO, prolonged immobilization, intra‑articular fracture, infection. Initial...
High medial longitudinal arch with hindfoot varus and forefoot equinus/abduction. Etiology: neuromuscular disorders (CMT disease most common), trauma, idiopathic. Clinical: lateral...
Neuropathic osteoarthropathy due to sensory/autonomic neuropathy—diabetes most common cause. Eichenholtz stages: I (fragmentation), II (coalescence), III (remodeling). Sanders–Fryk...
Gold standard for adult diaphyseal femur. Reaming adds biology + bigger nail. Supine position, piriformis/trochanteric entry. Complications: fat embolism, malrotation, knee pain.
Comprehensive guide to femoroacetabular impingement (FAI) covering cam, pincer, and mixed morphologies, alpha angle measurement, Tönnis grading, clinical assessment, conservative a...
Comprehensive guide to subacromial impingement syndrome covering Neer staging, Bigliani acromial morphology, clinical tests, conservative management, subacromial decompression and...
Comprehensive guide to lumbar disc herniation covering disc anatomy and pathology, morphological classification (protrusion, extrusion, sequestration), dermatomal levels, clinical...
Transverse, comminuted (stellate), polar avulsion, vertical; AO: 34-A extra-articular pole, 34-C transverse/comminuted. Displacement/extensor disruption → ORIF; minimal displacemen...
Implants classified by degree of constraint: CR (least) → PS → CCK → Hinged (most). CR retains PCL; PS substitutes with cam-post. Constrained implants indicated for instability or...
AO: 42-A simple, 42-B wedge, 42-C complex/segmental. Closed soft tissues graded by Oestern–Tscherne; open injuries by Gustilo (I–IIIC). Guides fixation strategy and antibiotics/cov...
Non-invasive traction in children. Types: Gallows (
Stable: intact posteromedial buttress; Unstable: posteromedial comminution, reverse obliquity, subtrochanteric extension. Stable → DHS; Unstable → cephalomedullary nail/fixed-angle...
Incidence rising with aging population and expanding TKA volumes. Common sites: distal femur (supracondylar), tibia (around keel/stem), patella (resurfaced patella). Classification...
Origin: supraspinous fossa; insertion: superior facet of greater tuberosity; innervation: suprascapular nerve (C5–6). Action: initiates abduction, contributes to humeral head depre...
Fibroproliferative disorder of palmar fascia causing fixed flexion deformity of fingers. Risk factors: male, >40 years, northern European descent, diabetes, alcoholism, smoking. Co...
Phases: inflammatory (days 1–7), proliferative (days 3–21), remodeling (weeks–months). Intrinsic (tenocyte) vs extrinsic (synovial/paratenon) healing; adhesion formation from extri...
Most common compressive neuropathy; due to compression of median nerve at carpal tunnel. Symptoms: nocturnal paresthesias, hand clumsiness, thenar atrophy. Tests: Phalen’s, Tinel’s...
Trigger finger: stenosing tenosynovitis of flexor tendon sheath (A1 pulley). Symptoms: painful clicking/locking of finger; risk in diabetics, RA. De Quervain: stenosing tenosynovit...
Second most common osteoarticular TB after spine; insidious monoarthritis progressing through stages. Typical deformity: flexion, adduction, external rotation; muscle spasm and nig...
Locally aggressive benign tumor in skeletally mature adults (20–40 yrs). Campanacci classification: Grade I (latent), II (active), III (aggressive with soft tissue extension). X-ra...
I: 10 cm/high-energy or extensive damage. IIIa: adequate coverage; IIIb: periosteal stripping, needs flap; IIIc: arterial injury requiring repair. Higher grade → higher infection/n...
High‑grade intramedullary osteosarcoma affects metaphyses of long bones in adolescents (distal femur, proximal tibia, proximal humerus). Workup: **X‑rays**, **MRI with contrast** o...
Bone allografts used for structural reconstruction after tumor resection. Sources: cadaveric donors; stored in bone banks (fresh-frozen, freeze-dried). Indications: intercalary def...
Congenital variant where meniscus is thickened and disk-shaped. Most common in lateral meniscus (incidence 1–3%). Clinical: snapping, pain, locking in children/young adults. Imagin...
Controversial: to resurface or not during TKA. Resurfacing: reduces anterior knee pain, avoids secondary resurfacing procedures. Non-resurfacing: avoids patellar complications (fra...
I: tip avulsion; II: 50% height. II–III indicate elbow instability, commonly part of terrible triad → fixation required.
Causes: congenital anomalies (Down syndrome), os odontoideum, trauma, and rheumatoid arthritis with transverse ligament incompetence. Measure atlantodental interval (ADI): >3 mm in...
Pediatric equivalent of ACL tear — bony avulsion of tibial eminence. Meyers–McKeever Types I–III (and IV comminuted) guide management. Type I: cast in extension; II–III/IV: arthros...
Autosomal dominant **FGFR3** mutation → rhizomelic limb shortening with normal trunk, macrocephaly. Neonates risk **foramen magnum stenosis** and central apnea; screen in infancy....
I: incomplete/valgus impacted; II: complete, nondisplaced. III: complete, partially displaced (varus); IV: complete, fully displaced. I–II stable → fixation; III–IV unstable → arth...
PSI uses preop MRI/CT to fabricate custom cutting jigs. Goal: improve accuracy, reduce OR time/inventory; evidence shows marginal accuracy gains without clear functional benefit. L...
AO 33 classification. Locking plate vs retrograde nail. Principles: joint first, then shaft. Complications: nonunion, malalignment, stiffness.
Syme's amputation is a through-ankle amputation in which the foot is removed while preserving the heel pad and distal tibia-fibula, allowing end-bearing ambulation. Originally desc...
Raised intracompartmental pressure → ischemia/necrosis. Causes: tibia/forearm fractures, crush injury, reperfusion, tight casts. Early signs: pain out of proportion, pain on passiv...
Brachial plexus consists of Roots (C5–T1), Trunks (upper, middle, lower), Divisions (each trunk splits into anterior/posterior), Cords (lateral, posterior, medial), and terminal Br...
Excess PTH causes cortical bone loss via RANKL-mediated osteoclast activation; classic radiology: subperiosteal resorption, salt‑and‑pepper skull, brown tumors. Primary (adenoma),...
0: none; I: small butterfly; II: larger butterfly with ≥50% cortical contact. III:
Detailed review of superior labrum anterior to posterior (SLAP) tears covering Snyder classification Types I–IV and further subtypes, clinical diagnosis, MR arthrography, biceps te...
Defective mineralization: osteoid in adults (osteomalacia) vs physis in children (rickets). Etiologies: Vit D deficiency/resistance, phosphate deficiency (tumor‑induced, hereditary...
Spectrum: acetabular dysplasia to frank dislocation. Risk factors: breech, female, family history, oligohydramnios. Clinical: Ortolani & Barlow tests in neonates; Galeazzi sign, li...
Score based on skeletal/soft tissue injury, ischemia, shock, age. Ischemia >6 h doubles points. MESS ≥7 → amputation likely. Adjunct tool; not absolute.
Indications: isolated unicompartmental OA with intact ligaments and correctable deformity. Contraindications: inflammatory arthritis, fixed deformity, ACL deficiency. Advantages: s...
Meniscus vital for load transmission, shock absorption, joint stability. Repair preferred when possible (red-red, red-white tears, vertical longitudinal). Meniscectomy indicated fo...
Gartland I–III (± IV for multidirectional instability). Complications to watch: **brachial artery injury**, **median/anterior interosseous nerve palsy**, **compartment syndrome**,...
Symptomatic nonunion: pain, cosmetic deformity, scapular dyskinesis, and weakness. Standard treatment: compression plating + autogenous iliac crest bone graft for atrophic nonunion...
Limb salvage is preferred over amputation when margins can be obtained and function preserved. Endoprostheses replace resected bone segment, especially around knee and proximal hum...
Loder classification: **Stable** (able to walk, even with aids) vs **Unstable** (non‑ambulatory) — strongest predictor of AVN. Typical patient: obese adolescent (boys > girls), end...
Malunion = fracture healed in unacceptable alignment causing functional, cosmetic, or biomechanical issues. Decision to correct depends on symptoms, joint at risk, magnitude/plane...
Patellar instability often due to MPFL rupture after lateral patellar dislocation. Risk factors: trochlear dysplasia, patella alta, increased TT-TG distance. Clinical: recurrent di...
Used after wide resection of distal femur/proximal tibia tumors. Modular systems allow intraoperative flexibility and immediate stability. Expandable designs used in children to ac...
I split lateral; II split+depression; III pure depression; IV medial; V bicondylar; VI metaphyseal-diaphyseal dissociation. Severity ↑ from I→VI; medial/bicondylar often need dual...
Neer classification (parts displaced >1 cm or >45°): guides management. Non‑operative for minimally displaced; ORIF (locking plate) for displaced 2–3 part; hemiarthroplasty/RSA for...
Supraspinatus most commonly torn; tears progress from partial to full‑thickness and can propagate posteriorly/anteriorly. Painful arc, night pain, and weakness on specific tests (J...
Indications: rheumatoid arthritis, post-traumatic arthritis, complex distal humerus fractures in elderly, tumor resection. Implant types: linked (semi-constrained), unlinked (requi...
I lateral split, II split+depression, III depression, IV medial, V bicondylar, VI dissociation. Surgical principle: elevate, graft, raft screws, plate. Complications: compartment s...
Lenke classification guides fusion levels using curve type, lumbar modifier, and sagittal modifier. Bracing is effective in skeletally immature (Risser 0–2) with 25–40° curves when...
Recurrent instability may follow failed Bankart repair. Causes: capsulolabral failure, glenoid bone loss, engaging Hill-Sachs. Workup: MRI, CT for bone loss quantification. Revisio...
Diagnosis uses consensus criteria (MSIS/ICM) combining major and minor criteria. Classify by timing: early (24 mo) — guides biofilm maturity and strategy. Treatment options: DAIR (...
Load sharing vs load bearing; absolute vs relative stability; primary vs secondary healing. Plates: compression (DCP/LCP in compression) vs bridging (relative stability); working l...
Avascular necrosis of lunate; affects young adults, more in men. Risk factors: negative ulnar variance, trauma, vascular anomalies. Lichtman staging I–IV guides management. Symptom...
Idiopathic avascular necrosis of femoral head in children 4–10 yrs. More common in boys; often unilateral. Clinical: limp, hip/knee pain, limited abduction/internal rotation. Imagi...
Define CRPS — Budapest Criteria with common etiologies and pathoanatomy. List key classifications or staging systems used in exams. Clinical features and focused examination; speci...
Bone-conserving alternative to THA; resurfaces femoral head with metal cap. Indicated in young, active patients with OA, good bone stock, large femoral head size. Advantages: bone...
ISS: anatomical score using AIS; 1–75; >15 = major trauma. RTS: physiological score (GCS, SBP, RR);
I: nondisplaced posterior facet; II: two-part; III: three-part; IV: comminuted (>3 parts). Type correlates with outcome; II–III often ORIF; IV has poorest prognosis.
PCL resists posterior tibial translation. Mechanism: dashboard injury, fall on flexed knee with foot plantarflexed. Clinical: posterior sag sign, posterior drawer test, quadriceps...
Define Boutonnière & Swan Neck with common etiologies and pathoanatomy. List key classifications or staging systems used in exams. Clinical features and focused examination; specia...
Second most common primary malignant bone tumor in adults. Occurs age 40–70 yrs; M > F. Common sites: pelvis, femur, shoulder girdle, ribs. Variants: conventional, clear cell, mese...
Most common primary malignant bone tumor in adolescents (after myeloma overall). Sites: metaphysis of long bones—distal femur, proximal tibia, proximal humerus. X‑ray: sunburst per...
Early detection with Barlow/Ortolani; ultrasound (Graf) guides treatment under 6 months. Pavlik harness is first‑line for reducible dislocation under ~6 months; avoid excessive ext...
Tennis elbow = lateral epicondylitis (ECRB tendon origin degeneration). Golfer’s elbow = medial epicondylitis (flexor-pronator origin). Clinical: pain, tenderness, weakness o...
Common indications: aseptic loosening, PJI, instability, stiffness, polyethylene wear, periprosthetic fracture, malalignment. Workup: exclude infection (ESR/CRP ± aspiration); quan...
Deforming forces: flex-abd-ER proximal; add distal. Implant: CMN gold standard. Reduction aids: Schanz, cerclage, clamps. Entry point crucial (piriformis/trochanteric). Complicatio...
Type I: Through physis only (slip) — good prognosis; often in younger children. Type II: Through physis and metaphysis (Thurston–Holland fragment) — most common; good prognosis. Ty...
Indicated for skeletally immature patients undergoing limb-salvage near a growth plate (e.g., distal femur/proximal tibia). Designs: minimally invasive magnetically driven expander...
Idiopathic or secondary; painful stiffness with capsular pattern (ER most limited). Stages: painful freezing → frozen → thawing; natural history 1–3 years. Nonopera...
Zones: reserve (resting), proliferative, hypertrophic (maturation, degeneration, provisional calcification). Regulation: Ihh/PTHrP feedback loop, GH/IGF‑1 axis, local factors (TGF‑...
ACL is critical stabilizer against anterior translation and rotational instability. Mechanism: non-contact pivoting injury; pop and immediate swelling (hemarthrosis). Clinical: Lac...
Red‑red (peripheral) zone heals best; red‑white intermediate; white‑white avascular. Vertical longitudinal (bucket handle) tears in young → repair; complex/degenerative tears in ol...
33-A: extra-articular; 33-B: partial articular (e.g., Hoffa = B3); 33-C: complete articular. Articular types require anatomic joint reduction; fixation usually with locking plates...
UKA: isolated compartment OA, intact ACL/collaterals, correctible deformity; faster recovery, more natural kinematics. TKA: multicompartment disease, inflammatory arthritis, signif...
Accounts for ~20% of TKA revisions. Types: extension instability, flexion instability, mid-flexion instability, recurvatum. Causes: ligament imbalance, component malposition, polye...
Trunnionosis = corrosion/wear at head–neck modular junction of THA. Mechanism: fretting + crevice corrosion, leading to metal ion release. Clinical: unexplained pain, swelling, adv...
Indicated for cuff tear arthropathy, pseudoparalysis, massive irreparable cuff tears. Developed by Grammont: medialized & lowered center of rotation. Deltoid substitutes for defici...
Concept: balance early fixation vs systemic insult. ETC = early total care in stable patients; DCO = staged for unstable. Indicators for DCO: ISS >40, hypothermia, acidosis, coagul...
Formation markers: bone‑specific ALP, osteocalcin, P1NP. Resorption markers: CTX (C‑telopeptide), NTX, TRAP‑5b. Uses: monitoring therapy in osteoporosis and metabolic bone disease,...
Pyogenic: acute pain, fever, rapid neuro deficit; disc involvement early. TB: insidious course, night sweats, cold abscess, vertebral collapse, gibbus deformity. MRI: pyogenic—disc...
Zone I: tuberosity avulsion (pseudo-Jones) — usually heals conservatively. Zone II: Jones fracture at metaphyseal–diaphyseal junction — watershed area, higher nonunion → screw fixa...
Assess stability and neurology with TLICS; Load Sharing Classification (McCormack) predicts need for anterior support. High load‑sharing score (≥7) → consider anterior column recon...
Metals: stainless steel (316L), cobalt‑chrome, titanium alloys; differences in modulus, corrosion resistance, MRI artifacts. Polymers: UHMWPE (arthroplasty bearings), PMMA (bone ce...
OI due to COL1A1/2 defects; **Sillence I–IV** (classic) with expanded types V–VII; severity ranges from mild to perinatal lethal. Clinical: **blue sclerae**, dentinogenesis imperfe...
Cubital Tunnel Syndrome (CuTS) is the second most common upper-limb compression neuropathy and results from compression of the ulnar nerve at the elbow, most commonly within the cu...
Mallet: extensor tendon avulsion at DIP → inability to extend. Jersey: FDP avulsion at DIP → inability to flex. Mallet mechanism: forced DIP flexion; Jersey: forced DIP e...
Heterotopic ossification in muscle after trauma or neurological injury. Common sites: quadriceps, brachialis, adductors. Symptoms: painful swelling → hard mass, ↓ROM. Radiology: pe...
THA: cementless acetabular components standard; femoral fixation cemented (elderly) vs cementless (younger). TKA: tibial components commonly cemented; cementless options increasing...
Benign proliferative synovial lesion; localized or diffuse type. Common in knee (80%) and hip; presents with pain, swelling, recurrent effusion. MRI: low-signal intensity on T2 due...
Level selection balances wound healing potential, prosthetic energy cost, and function. Upper limb: transmetacarpal, wrist disarticulation, trans‑radial, elbow disarticulation, tra...
Most common malignant tumor of bone overall. Primary sources: breast, prostate, lung, kidney, thyroid. Lesions: breast (mixed), prostate (blastic), lung/kidney/thyroid (lytic). Sit...
Achilles tendon is most frequently injured tendon; common in athletes and middle-aged weekend warriors. Tendinopathy: degenerative process due to overuse, poor vascularity, fluoroq...
Comprehensive guide to floating joint injuries covering floating knee (Fraser classification, ipsilateral femur and tibia fractures), floating elbow (ipsilateral humerus and forear...
A lytic bone lesion on X-ray should be approached systematically using five steps: patient age (the single most powerful clue — under 20 favours benign lesions, over 40 mandates ex...
Primary neurapraxia occurs in ~10–15% closed fractures; most recover spontaneously by 3–4 months. Immediate exploration for open fractures, vascular injury, high‑energy with suspec...
Risk high in hip/knee arthroplasty, hip fracture surgery, pelvic/acetabular trauma, prolonged immobility. Options: LMWH, DOACs (apixaban/rivaroxaban), aspirin (selected low‑risk ar...
Wiltse etiologic types: I dysplastic, II isthmic (IIA lytic, IIB elongated pars, IIC acute pars), III degenerative, IV traumatic (other than pars), V pathologic, VI iatrogenic. Mey...
Posterior elbow dislocation + radial head fracture + coronoid tip fracture. Requires concentric reduction, radial head fixation/replacement, coronoid/LCCL repair.
Incidence 1–3% after primary THA; higher in revision. Risk factors: posterior approach, malpositioned cup (anteversion 25°, inclination >60°). Patient factors: neuromuscular diseas...
Tendon-to-bone fixation is the process of securely attaching a tendon or ligament graft to bone using devices such as bone tunnels, suture anchors, interference screws, cortical bu...
Degenerative fasciosis (not true 'itis') of the plantar fascia origin at the medial calcaneal tubercle due to repetitive micro‑trauma. Classic history: sharp 'first‑step' pain on a...
Classically 24–72 h after long‑bone/pelvic fractures or IM reaming; triad: hypoxemia, neurological signs, petechiae. Diagnosis is clinical; supported by Gurd’s criteria (1 major +...
Standard: cefazolin within 60 min before incision (2 g; 3 g if >120 kg). Add vancomycin if MRSA colonized/high prevalence or severe β‑lactam allergy; start 120 min pre‑incision due...
Flexion of PIP joint with hyperextension of DIP joint. Caused by central slip rupture of extensor tendon at PIP. Mechanism: forceful blow, RA, laceration. Clinical: inability to ex...
AFO: ankle-foot support in drop foot, CP, polio. KAFO: supports knee in quadriceps paralysis, SCI. Types: rigid, hinged, leaf-spring (AFO); locked, drop lock, offset (KAFO). Goals:...
SLAP = Superior Labrum Anterior to Posterior tear involving biceps anchor. Mechanism: overhead throwing, fall on outstretched hand. Types I–IV (Snyder classification). Clinical: pa...
Cartilage defects cause pain, swelling, mechanical symptoms; poor intrinsic healing. ACI: two-stage procedure — harvest cartilage → culture chondrocytes → reimplant under periostea...
The pisiform is a sesamoid bone located within the flexor carpi ulnaris (FCU) tendon on the medial side of the wrist, articulating with the triquetrum at the pisiotriquetral joint....
Caused by recurrent hemarthrosis in hemophilia A/B leading to synovitis, cartilage loss, and arthritis. Target joints: knee, ankle, elbow—recurrent bleeds produce synovial hypertro...
Stage before biopsy: define lesion (X‑ray/MRI) and search for primaries (CT CAP, bone scan/PET). Adult common cause is metastasis (BLT KP) or myeloma; in children, benign lesions (...
Second most common malignant bone tumor in children/adolescents after osteosarcoma. Characterized by t(11;22) → EWS-FLI1 translocation. Common sites: diaphysis of long bones, pelvi...
Perineural fibrosis of the common plantar digital nerve—classically in the 3rd webspace—causing burning plantar forefoot pain. Provocative tests: web‑space compression, Mulder’s cl...
Simultaneous fracture of radius and ulna compromises pronation-supination. Adults: ORIF with plating is gold standard; children: closed reduction & casting. Principle: restore leng...
Apophysitis of tibial tubercle in adolescents due to repetitive traction from quadriceps. Common in athletic boys (10–15 yrs). Clinical: pain, swelling, prominent tender tibial tub...
Surgical emergency: cartilage can be destroyed within 24–48 hours; prompt drainage + antibiotics is critical. Children: hematogenous origin common; hip/knee frequent; Staphylococcu...
Periprosthetic osteolysis = bone loss from wear particle-induced inflammation. Detected on radiographs as radiolucencies, cystic defects; CT useful for mapping, MRI (MARS) for soft...
Lewis–Rorabeck and Su classifications guide treatment; stability of the femoral component is the key decision point. Stable TKA → fixation (locking plate or retrograde nail if inte...
Degenerative stenosis from disc bulge, facet arthrosis, and ligamentum flavum hypertrophy causes neurogenic claudication. MRI confirms stenosis; correlate with walking tolerance an...
Failure of mineralization at the growth plate → metaphyseal cupping, fraying, and splaying with genu varum/valgum. Differentiate **nutritional vitamin D deficiency** from **X‑linke...
Ilizarov fixator allows bone transport for segmental loss. Principle: distraction osteogenesis by gradual tension on callus. Indications: infected nonunion, bone loss, deformity co...
Second most common compression neuropathy after CTS; affects ulnar nerve at elbow. Symptoms: paresthesias in ulnar digits, weakness of intrinsic hand muscles. Tests: Tinel’s at elb...
Developmental fibro‑osseous lesion replacing normal bone with fibrous tissue. Types: monostotic (70%), polyostotic; associated with McCune–Albright (café‑au‑lait, endocrine). X‑ray...
Includes quadriceps tendon rupture, patellar fracture, patellar tendon rupture, patellar component failure. Risk factors: previous surgery, patellar resurfacing, malalignment, ster...
Type I: 50° (most vertical → highest shear). Higher angle = higher shear → instability, nonunion risk; stronger fixation needed.
Malignant tumors of mesenchymal origin; >50 histological subtypes. Enneking staging: based on grade (low/high), compartment (intra/extra), metastasis (I–III). Presentation: painles...
Milch Type I: Fracture line lateral to trochlear groove (through capitellum–trochlear junction) — more stable. Milch Type II: Fracture line extends into trochlea — less stable (ris...
Type I: Transepiphyseal (with/without dislocation) — highest AVN risk. Type II: Transcervical (through the neck). Type III: Cervicotrochanteric (basicervical). Type IV: Intertrocha...
A: acute stable (A1 tubercle, A2 nondisplaced waist). B: acute unstable (B1 distal oblique, B2 displaced waist, B3 proximal pole, B4 comminuted, B5 perilunate). C: delayed union; D...
T- or Y-shaped intra-articular fractures of the distal humerus. Most common in young adults (high energy) and elderly osteoporotic (low energy). Require anatomic articular reductio...
Relapse often due to **brace non‑compliance**; dynamic supination is common in toddlers. Initial management is **re‑casting** following Ponseti principles; evaluate for residual eq...
Lateral deviation of great toe with medial eminence (bunion). Risk factors: female gender, footwear, ligamentous laxity, pes planus. Clinical: pain, callosities, overlapping toes....
SSI prevention bundle: preop optimization (glucose, smoking cessation), skin prep with alcohol‑chlorhexidine, timed antibiotic prophylaxis, normothermia, OR traffic control. Sepsis...
Hawkins classification I–IV based on displacement/dislocation. AVN risk increases with stage: I 90%. Urgent reduction and fixation critical to preserve talar blood supply. Fixation...
Type I: Minimally displaced avulsion. Type II: Hinge of posterior fibers intact (anterior lift) — may reduce closed; fixation if interposed tissue. Type III: Completely displaced f...
Traction apophysitis at inferior pole of patella in adolescents. Similar mechanism to Osgood–Schlatter but at patellar origin of tendon. Clinical: localized pain at inferior patell...
Indications: displaced transverse fractures with intact extensor. Principle: converts tensile quadriceps force into compression at fracture site. Technique: 2 parallel K-wires + fi...
Used for segmental bone loss after tumor resection or non-oncologic massive defects (failed revision arthroplasty, periprosthetic fractures). Common sites: distal femur replacement...
Bone scan = radionuclide (Tc-99m MDP) uptake proportional to osteoblastic activity. Highly sensitive for metastasis, stress fractures, infection, AVN. PET (FDG-PET): measures metab...
Biologic response to wear particles (polyethylene > metal/cement) drives periprosthetic osteolysis via macrophage cytokine cascade. Risk factors: conventional PE, thin liners, mala...
AVN = ischemic necrosis of femoral head → collapse and arthritis. Risk factors: steroids, alcohol, trauma, sickle cell, Gaucher’s, idiopathic. Ficat staging I–IV; ARCO integrates i...
Types I–V: rim (anterior/posterior), transverse, and complex intra-articular patterns. Large articular fragments or instability need ORIF; small rim fractures stable may be non-op.
Thickened lateral fascia lata from iliac crest to Gerdy’s tubercle; receives fibers from TFL and gluteus maximus. Functions: lateral knee stabilization, assists hip abduction and k...
Avulsion of flexor digitorum profundus (FDP) tendon from distal phalanx. Mechanism: forced extension of DIP during active flexion (grabbing opponent’s jersey). Clinical: inability...
Surgical approaches: posterior, anterolateral, direct anterior, transtrochanteric. Posterior: excellent exposure, preserves abductors, higher dislocation risk. Anterolateral: stabl...
Common site of osteoarticular TB after spine and hip; presents with chronic monoarthritis. Phemister triad on X‑ray: peri‑articular osteopenia, marginal erosions, gradual joint‑spa...
Congenital or developmental deformity due to premature closure of ulnar volar physis of distal radius. More common in adolescent females; associated with Léri-Weill dyschondrosteos...
Common cause of anterior knee pain in young adults, esp. females (‘runner’s knee’). Etiology: maltracking due to Q-angle increase, muscle imbalance, overuse. Clinical: diffuse ante...
Common in young females; often after acute lateral dislocation. Risk factors: trochlear dysplasia, patella alta, increased TT-TG distance, ligamentous laxity. Clinical: recurrent d...
Menisci are fibrocartilaginous structures aiding load transmission, stability, and lubrication. Types: longitudinal, horizontal, radial, flap, bucket handle, complex. Clinical: joi...
Three arches: medial & lateral longitudinal, and transverse (anterior/posterior). Keystone bones: talus (medial longitudinal), cuboid (lateral), intermediate cuneiform (transverse)...
Classification based on position of foot + force direction. Common: Supination-External Rotation (SER), Supination-Adduction (SA), Pronation-Abduction (PA), Pronation-External Rota...
First‑time dislocation: non-op unless loose bodies/osteochondral fracture or gross instability. Recurrent instability → MPFL reconstruction; address bony factors (TT‑TG distance, t...
Most common cause of late arthroplasty failure. Pathophysiology: particle-induced macrophage activation → cytokine release → osteolysis. Risk factors: polyethylene wear, malalignme...
Most common primary malignant bone tumor in adults (median age ~65 yrs). Neoplastic proliferation of plasma cells → monoclonal immunoglobulin production. Classical CRAB features: h...
Second most common primary malignant bone tumor after osteosarcoma, usually >40 years. Common sites: pelvis, femur, humerus, ribs. Graded histologically (I–III); dedifferentiated a...
Common in elderly and overhead athletes; supraspinatus most often torn. Clinical: pain, weakness in abduction/external rotation, night pain. Tests: Jobe’s, drop arm, external rotat...
Entrapment neuropathy of the posterior tibial nerve under the flexor retinaculum behind the medial malleolus. Symptoms: burning dysesthesia/paresthesia in plantar foot, worse at ni...
Recurrent hemarthroses → synovial hypertrophy → cartilage damage and arthropathy (ankle, knee, elbow). Evaluation: bleeding history, factor levels/inhibitors, US/MRI for synovitis...
Gait cycle: stance (~60%) and swing (~40%); double support ~20% of cycle. Rocker phases: heel rocker, ankle rocker, forefoot rocker enable forward progression. Determinants reduce...
Radial head and neck fractures are common elbow injuries caused most often by a fall on an outstretched hand that transmits axial force through the forearm to the elbow. In adults,...
Absolute CP >30 mmHg indicates fasciotomy. ΔP = DBP – CP; if <30 mmHg, fasciotomy indicated. Interpret with clinical signs.
Garden I–II = non-displaced, III–IV = displaced. Pauwels I 50° vertical shear. Young = urgent reduction + fixation (CS/DHS). Elderly = arthroplasty if displaced. Complications: AVN...
Elementary: PW, PC, AW, AC, Transverse. Associated: PC+PW, Trans+PW, T-type, AC+PHT, Both-column. Views: Judet + CT 3D. Approaches: KL (post), Ilioinguinal/Stoppa (ant). Goal: anat...
Follow ATLS with careful immobilization; CT is first‑line imaging for suspected injury. AO Subaxial classification guides stability and surgical approach; assess disco‑ligamentous...
Computer-assisted surgery (CAS) improves component alignment in TKA/THA. Techniques: imageless and CT-based navigation. Benefits: improved mechanical axis alignment, reduced outlie...
Definition: fracture adjacent to fixation device or prosthesis. Differentiate peri-implant vs periprosthetic. Causes: stress risers, osteopenia, trauma. Management: depends on impl...
Type I: 3 mm and/or angulation (disc injury) — traction/halo or surgery. Type IIa: flexion–distraction variant (marked angulation). Type III: with C2–3 facet dislocation — unstable...
Widened physes with cupping and fraying at metaphysis; generalized osteopenia. Rachitic rosary at costochondral junction; Harrison’s sulcus due to diaphragmatic pull. Looser’s zone...
Robotics assists bone preparation and implant positioning (mostly semi-active systems). Potential: improved accuracy, reproducibility, individualized alignment strategies. Limitati...
Elementary: posterior wall/column, anterior wall/column, transverse. Associated: posterior column+wall, transverse+posterior wall, T-shaped, anterior column/posterior hemitransvers...
Enhanced recovery protocols (ERAS) enable same-day/next-day discharge in selected patients. Selection: ASA I–II, motivated, good support, no major comorbidities or bleeding risks....
Tillaux: Anterolateral epiphyseal avulsion (SH-III) during asymmetric physeal closure — intra-articular; >2 mm step needs fixation. Triplane: Multi-planar SH-IV variant (sagittal e...
Sanders classification: based on CT coronal posterior facet fractures. Essex-Lopresti: tongue vs joint depression patterns. Operative indications: displacement >2 mm, malalignment,...
Early complications: dislocation, infection, nerve injury, DVT/PE. Late complications: aseptic loosening, periprosthetic fracture, heterotopic ossification, osteolysis, implant wea...
Radial shaft fracture with disruption of the distal radioulnar joint (DRUJ). Occurs in middle to distal third radius fracture. Requires ORIF of radius and stabilization of DRUJ. Ca...
Tarsal navicular: body, tuberosity, and stress fractures; critical for medial column length and talonavicular congruity. Cuboid: 'nutcracker' fracture from forefoot abduction; late...
1st metatarsal fractures affect medial column; greater functional impact. 5th metatarsal: distinguish avulsion (zone 1), Jones (zone 2), and diaphyseal stress (zone 3). Multiple me...
Localized malignant proliferation of plasma cells in bone or soft tissue without systemic myeloma. Common in vertebrae, pelvis, ribs, femur. Symptoms: pain, swelling, pathological...
Hemiarthroplasty: isolated humeral head disease (e.g., AVN, head-splitting fracture). Anatomic TSA: primary OA, RA, post-traumatic arthritis with intact rotator cuff. Reverse TSA:...
Indicated in isolated medial/lateral compartment OA with intact ligaments. Advantages: smaller incision, bone preservation, faster rehab, more natural kinematics. Contraindications...
Definition (WHO): low bone mass with microarchitectural deterioration → fragility fractures; T‑score ≤ −2.5 on DEXA. Common sites: vertebral compression, hip (femoral neck/intertro...
Subacute osteomyelitis presenting as a localized lytic lesion with sclerotic rim (usually metaphyseal). Typical organisms: Staphylococcus aureus; culture may be negative. Symptoms:...
Spectrum: cellulitis, abscess, septic arthritis, osteomyelitis. Principles: Early recognition, debridement, targeted antibiotics, stabilization, soft‑tissue cover. Diagnosis algori...
Degenerative osteoarthritis of the 1st MTP joint causing dorsal osteophytes, stiffness, and pain—especially with push‑off. Coughlin–Shurnas clinical–radiographic grading guides tre...
Injury to ulnar collateral ligament (UCL) of thumb MCP joint. Mechanism: valgus stress from fall on abducted thumb (ski pole). Clinical: pain, swelling, instability at MCP; Stener...
Fix if fragment >25–30% of tibial plafond, >2 mm displacement, syndesmotic instability, or posterolateral fragment involving PITFL. CT-based morphology guides approach: posterolate...
Compression: anterior column only — usually stable. Burst: anterior + middle columns — unstable, canal compromise risk. Flexion-distraction (Chance): posterior tension failure — un...
Most common acute dislocation of knee; lateral displacement of patella. Mechanism: valgus stress + external rotation with knee flexion. Clinical: sudden giving way, patella displac...
Most common indication: displaced femoral neck fracture in elderly. Types: unipolar (Austin-Moore, Thompson) vs bipolar prostheses. Advantages: shorter surgery, less blood loss vs...
I: inferior to fovea (non–weight-bearing); II: superior to fovea (weight-bearing). III: I/II with femoral neck fracture; IV: I/II with acetabular fracture. II–IV worse prognosis; u...
Oncologic principles: accurate diagnosis, staging (MRI, PET/CT), biopsy planning, and **wide margins**. Indications: resectable tumors with adequate soft-tissue coverage and neurov...
High-grade soft tissue sarcoma, often near large joints of extremities (knee, ankle). Affects adolescents and young adults (15–40 years). Histology: biphasic (epithelial + spindle...
O’Brien Angulation: I (60°). Displacement/translation also matters; >3 mm or severe angulation predicts need for reduction/fixation. Metaizeau (elastic stable intramedullary nailin...
Type I: Anterior radial head dislocation with anterior angulated ulnar fracture — most common in children. Type II: Posterior/posterolateral dislocation; Type III: Lateral/anterior...
Cartilage repair technique for focal chondral defects
Wrist arthrodesis: gold standard for pain relief in advanced wrist arthritis; provides stability but sacrifices motion. Wrist arthroplasty: motion-preserving alternative for low-de...
Perilunate dislocations and fracture-dislocations are high-energy carpal injuries in which the lunate loses its normal articulation with the surrounding carpal bones — the capitate...
Enchondroma: intramedullary cartilage tumor, common in hand phalanges. Osteochondroma: cartilage-capped exophytic lesion from metaphysis. Syndromes: Ollier, Maffucci (enchondroma);...
Benign: slow, well circumscribed, no metastasis. Malignant: rapid, infiltrative, metastasis. Histology: benign differentiated; malignant atypia, mitoses, necrosis. Radiology: benig...
41-A extra-articular; 41-B partial articular; 41-C complete articular. Complements/updates Schatzker with alphanumeric consistency across regions.
Maisonneuve injury = proximal fibular fracture + syndesmotic disruption + medial injury (deltoid/medial malleolus). Mechanism: external rotation with pronation. Examine entire fibu...
Commonest source of dissatisfaction after TKA. Includes anterior knee pain, maltracking, subluxation/dislocation, fracture, loosening of patellar component. Risk factors: malrotati...
Pathologic varus from disordered endochondral growth of medial proximal tibial physis; early walkers/obesity risk. **Langenskiöld stages I–VI** describe progressive physeal/epiphys...
Both indicated for isolated medial compartment OA in younger active patients. HTO: joint-preserving, shifts weight-bearing axis, delays arthroplasty. UKA: joint-replacing, preserve...
Goal: prevent surgical site infections (SSI). Airflow: laminar, HEPA, positive pressure. Staff: gown, glove, mask, restrict movement. Instruments: autoclave, ETO, H2O2 plasma. Preo...
Types: uniplanar, biplanar, circular. Biomechanics: stiffness ↑ with larger pins, more pins, wider spread, closer frame. Indications: open fractures, polytrauma, infected nonunion,...
TUBS (Traumatic, Unidirectional, Bankart, Surgery) vs AMBRI (Atraumatic, Multidirectional, Bilateral, Rehab, Inferior capsular shift). Glenoid bone loss >20–25% → Latarjet (coracoi...
ATLS: binder early for unstable pelvis; hemorrhage control is priority. Tile A stable, B rotationally unstable, C rot + vertical unstable. Hemorrhage control: binder, ex-fix, C-cla...
Autograft is gold standard: osteogenic + osteoinductive + osteoconductive (iliac crest). Allograft provides scaffold (osteoconductive) ± growth factors; immune & disease transmissi...
Phases: inflammation → soft callus (cartilage) → hard callus (woven bone) → remodeling (lamellar). Primary (direct) vs secondary (indirect) healing; absolute vs relative stability...
Most common: midshaft fractures; assess displacement, shortening, comminution, skin tenting, neurovascular status. Nonoperative for minimally displaced; operative indications inclu...
I: no dislocation; II: subtalar dislocation; III: subtalar + tibiotalar; IV: plus talonavicular. AVN risk escalates I→IV; displaced types require urgent reduction and fixation.
Buckle/Torus: Compression failure of cortex (metaphyseal) — stable; treat with short immobilization/splint. Plastic Bowing: Microfracture without discrete break; persistent deformi...
Focal disorder of accelerated bone turnover: osteoclastic resorption followed by disorganized osteoblastic formation → enlarged, weak, vascular bone. Common sites: pelvis, spine, f...
Focal subchondral bone necrosis leading to cartilage instability. Common site: lateral aspect of medial femoral condyle. Clinical: pain, swelling, catching, locking in adolescents....
Indication: simple, non-comminuted transverse olecranon fractures (AO 21-B1) with intact dorsal cortex. Principle: converts triceps tensile force into compression at the articular...
Terrible triad = posterior elbow dislocation + radial head fracture + coronoid fracture. Highly unstable pattern, requires surgical fixation of all components. Goal: concentric red...
HIV patients prone to bacterial (Staph aureus), mycobacterial (TB), fungal infections. Salmonella is a classic cause of osteomyelitis in HIV, especially with sickle cell disease. C...