ORTHO

Dr Shreya
Important tests

Image
identification

patientin

at tape
Ober'sTest
Iliotibial band
Modified Schober Adam'sforward Modified Allen's Test contracture
Test bending test
Ankylosing Tocheckthe patency of
spondylitis scoliosis doesnot palmararch beforeany
reduces or resolveon
arterial puncture
resolves bending
Postural Structura
scoliosis scoliosis
 pressonlateral
epicondy e

cozen'sTest
ThomasTest Thompsontest Phalen.se psatpunnggynffhhesTest Forlateralepicondylitis
Totest flexion calfcompression or Tenniselbow
deformity Simmond'sTest
ie Iliopsoas Toidentify a
musclecontracture R Counterforce
get brace

DurkanTest Golfer'selbow
Type I Partialtear most specifictestformedial medial
TYPE2 Complete23cm KUWADA
forAchillesTendontear nerve compression epicondyliti
Type complete 36cm
Type4 complete 6cm
 Tests forThoracicOutletObstruction

BAD
Barlow Ortolani RoosTest EAST Adson'sTest WrightTest Finkelstein'sTest
Adduction Abduction Elevated armabduction Overhead DeQuervain's
pignation Relocation stress test I farm abduction tenosynovitis
Developmental Dysplasia forneurogenicand i e Tendonsinflamm
resentation
vascularetiology 199 81 9
s mccneurogenic venous art AbPL EXPB
6months USG 6months XRAY cervicalrib SCV SCA
Extensor
Shenton'slinefrommedial
Abg Policis
partoffemoralcondyleto
inferioraspectofsuperior Longus Brevis
Pubicrami 46monthsPavlickHarness
Graf classification 6 10months Spica
Alpha angle:decreases 10months OpenReduction
Beta angle:increases Osteotomy
 LachmanTest1203011 Apley'sgrindingTest Thessaly'sTest McMurray's Test
TocheckACLintegrity pronerotation
Anteriordrawertest Meniscal Injury
flexion at90

10C MRI RRepair

Sportsinjury
Goldstandard
Arthroscopy resection
Valgus stress test:MCL nobloodSupply
Varus stress test:
O’Donogue triad:
Pivot shift test:Anterolateralcorner
MCL
Dial test:Posterolateralcornerofknee
ACL
Medial meniscus Makkke ACL
Nerve Injuries

CardTest PAD EgawaTest DAB BookTest Wartenberg sign

forPalmarinterossi add fordorsalinterossi abduction Tocheckfunctionof
AdductorPolicis Wartenbergsyndrome
flexioninsteadofabduction 1Dermat whitefloat
ofhairt
11 9 444
3,4 lumbricals Heterochromiairidi
Interossi a Nervecompressio
spiralgroove Ulnarnew
Radialnerve
Hypothenarmuscles ofsensorypart0
AdductorPolicisgraveyardoffering Radialnerve

E ME Ulnarnerve
 Lumbricals
Knucklebenderspl
unipennate Bipennate forclawhand
Adduction Abduction Origin-FDP tendon ulnar Mediann
1,2: UnipennateMedianN
3,4: Bipennate
Ulnar
nerve CockUPsplint
Function:flexion
MCP Radial
extension
nerve
interphalanges.palsy

Radial N palsy bestPrognosis

High (Axilla)-elbow
wrist fingerdrop sent
Low (spiral groove)- wristtfingerdroptsens.lu
PIN (Monteggia/Radial head)-fingerdrop
ApeThumbDeformity Pope'shand PenTest OKS ohNevinsign
Adductedthumb Oscherclaspdeformity Totest opposition AIN
Thenaratrophy pointingindex andabduction
Nerve Injuries and Compression
• Shoulder dislocation, Neck of humerus:Axillarynerve Deltoidabduction 1590
• Quadrangular space: ing ve T.Minor ER
Holstein Lewis #:radiant Yis'I finger Lat arm sensation
•
• Monteggia #:
drop sensloss skies
• Supracondylar #: v RadialN ulnarn ROTATOR CUFF TENDONS:
• Elbow dislocation:YEY Jemedian S raspinatous 10 15abduction
• Cubital tunnel, Guyon’s canal (hook of hamate #):
Ulnarnerve ITnfraspinators Externalrotation
• Wrist dislocation:Mediannerve
eresminor
• Carpal tunnel, Pronator syndrome:Mediannerve SabscapularisAdduction InternalRotatio
• Supinator syndrome:Radia new Empty can test Supraspinatous
• Cheralgia paraesthetica / Wartenberg syndrome:Sensorybranch Forgotten tendon, Lift off test:
• Meralgia paraesthetica:LatCutN of thighMcRobert OfRadialN Painful arc syndrome: 60 120
• Piriformis syndrome: position
•
•
É
Tarsal tunnel :Posterior
Neck of fibula fracture:common peronealnerve also in lithotomy

Te raisingsplint
cpngff.fi dpiflexionofankl Supraspinatous
scapularnerve
supra
Stepparge Slapping
gait Infraspinatous

58 7 is su8 8 18isnerve
Important hands and fingers

rayersign Swanneck SED Dip Heberden'snodules Canavel'ssign suppurativetenos fits

abeticcheiroarthropathy flexion atDIP Pip Bouchardnodules otherinfectionofhand Felon pulp
Paronychia nail
showsTabletopsign Extension atPIP v15Boutonniere's to fp

5778
AYLINIUM entrapment
contractu
Steiner'slesion
trapped Triggerfinger
AddPolicis contracture at A1Pulley of
thumbs flexortendon
amekeeper'sskier's Baseball Malletfinger RugbyJerseyfinger
vulsionatulnarcollaterallig extensortendonrupture flexortendonrupture
Fractures
NONUNION: FLUTS DEFORMITIES:
Tibia • Gunstock deformity:cubitus
femme
ulna varus
1849
d
• Dinner-fork:colle's

MALUNION:
ofhunger Fai 3 • Garden-spade:
• Fish-tail:Distalhummithal Dinnerfork
• Haglund deformity

triin qq.q.ru
• Madelung59
Type
SE a9iaiawiisY e
Characteristics GUSTILO ANDERSON CLASSIFIC
s
I Puncture wound < 1 cm + Minimal soft tissue
IOC for AVN: damage
MRI II Laceration >1 cm but <10 cm + Moderate soft tissue
Sites for AVN: damage
1 Headoffemur me III A Laceration > 10 cm + Extensive soft tissue damage /
2Talus body contamination
3Scaphoid ProxPole Segmental/ comminuted fractures
III B Periosteal stripping and bone exposure
Primary bone healing: No callus III C Vascular injury requiring repair
Secondary bone healing: Callus +plate
Antibiotics, Debridement
Callus earliest:
Delayed union:
3weeks External fixator foropen
Non-union: 9
6months fractures
months except IC
HIP X-RAYS APPROACH

crescentsign femurdislocated Anterior

RIF Steroids upwards dislocatio
ofhip
Lisson's manerve
injured
Femoral

FICATSTAGING OFAVN
Limehghening
shfortening
FABER
FADIR
Posteriordislocation
ofhip
menerveinvolved Sciatic FABER:
TB Synovitis
FADIR: Septic arthritis
TB hip arthritis Iliotibial band contracture
Posterior dislocation Anterior dislocation
SHOULDER DISLOCATIONS

998 8 7 d aÉ
anteroinferior
labrum humerus
fgf
fyfffff.sk bulbsign

MC type:anteriorshoulderdislocation
Limb attitude:abduction ER
MC nerve:Axillary
nerve formanagement
Modified Kocher’s:
TESTS: ofanteriordislocation
T
Ruler touched acromion and lateral epicondyleHamilton's RACTION
E
Difficulty touching opposite shoulderDugas
A
Increased girthcanaway
M Foration
 crushinjury

me
Yai's
SCFE Thruston
HollandSign
A above
eg
If
egSCH
R Crt k wire
 UPPER LIMB FRACTURES
CMpulls
up undisplaced
miffed anaphase

faffffiffy Gartlandclassification

alunionbecauseof 3Pointretention
oppositeforce
Henial
arteryinjury
HolsteinLewis LCH nonunion SCH malunion compartmentsyndrome
spiralgroove Cubitusvalgus
EssexLopresti
Radiad fitted Tardyulnarnerve common in children
palsy cubitusvarus Maissoneur's
Neer classification: Milch classification:
proximalhumerus LCH Posteromedial displacement
clavicle Extension type
MC at birth, MC overall Terrible triad of elbow: Dunlop smith traction
Medial 2/3-lateral 1/3 Elbow dislocation Baumann angle
FIGURE OF 8 bandage Radial head # 3 point maintained
Arm by side lifting shoulder Coronoid # CR + K-wire
 GRIMUS

Monteggia Galleazi 5thbhfa.supal

ightstick Greenstick TorusBuckle Superior ulna Inferior radius
mpletecortical unicortical Nobreach only # + radial head # + radio-ulnar
ofulna ofradiusulna bendingofcortex dislocation dislocation
inchildren atthesiteofinjury 1stMetacarpal
pe Injury Piedmont #
inchildren
2part
3M

BADO classification: Monteggia

 n n

Colle's Smith Barton's Chauffer's TerryThomassign spilledteacupsi

orsal displaterment Intraarticular Hutchinson's Increased icapitate inline
displacement Radiocarpal Radiostyloid scaphoidlunate lunateslippedon
ofdistalendofradius dislocation Brachioradialis spacedueto Lunate
Extraarticularfracture avulsion scapholunate dislocation
dislocation

Colles’: FOOSH in extension

Deformity:
Dinnetftion
Smith: FOOSH in
Deformity: Gardenspade
landshakingcast Glassholdingcast cylindricalcast Hanging U slabcast
Scaphoid Patellar M
IfPronation
p c NII caneasilybemissed seen in skylineview
hence nonunionandAVN
Palmarflexion Dorsiflexion
R.TLffghband
Ulnardeviation Radialdeviation
Skylineview
power Biparty Olecranon, Patella # : Tension
Patella
aistraciiiiiii.in
LOWER LIMB FRACTURES

99k
a

umper Segond Pott's Cotton's Pillon's Talus Lover's Calcaneal

Lateralaspectof Bimalleolar Trimaneolar Intraarticular
ftp efial tibia oflateral Aviator fracture Bohler:decrease
capsularligament 487T Classification: Gissane:increas

avulsion Hawkin's

Schatzker classification: Jumper #:sacrum

Tibialfractures Denis classification:sacrum
Judet and letournel:
ar
Young and Burgess:
 Pathological VS Stress fractures:

Boneisabnormal Bone is normal

MccOsteoporosis Stressis abnormal
Painproceedsthe
fracture
ne's
MirelScore forPathological
Chopart Lisfranc
Inter
tarsaldislocation Torsometatarsal
dislocation

Pseudogene's
altavulsion of
Peroneusbrevis
DANIS- WEBER:
OTTAWA RULES:: 98 xrayinankletraumaImcATFLteaffspfa.hr's
FRACTURE PROXIMAL FEMUR
NOF management:
>65yrs:Hemiarthroplasty
<65yrs, <3weeks:
<65yrs,>3weeks:
A entedosteotomy

Proximalfemoral Dynamichip
More age nail screw
More trauma
More pain
More shortening
More ER >45 degrees
Evan classification PartialHR THR
PIPKIN, GARDEN
MALUNION: Coxa vara onlyfemoralhead femoralhead
Neckoffemur acetabulum
eadstononunion Intratrochantericfemur preferred in
osteoarthritis
Thompson m Bipolar
 SPINE FRACTURES

urst Jefferson
ourParts ofatlas
table asspinalcord
notinvolved
Clayshoveler's Burst Hangman's Carrotstick
Rettopusion
CtspinousProcess C2Cssubluxation Ankylosingspondylite
I Axialloadingand
subluxation

SCIWORA:spinalcordinjurywithoutradiographicabnormalities obvious
seen in children
LogRoll 10CMRI
 SKULL XRAYS-PATTERN APPROACH

SaltandPepperskull subperiosteal Multiple myeloma Geographiclytic

lesions vertebraplan
smalllyticlesions resorptiononradial Punchedoutlesions withbevelledmargins in LCH
d LCH skinrash
scuff splenomegaly
hepato

lossoflaminadura
Yperpy 1PTH D t adenoma
2PTHd t CKD
aget'sdiseasecottonwool osteoporosis Haironendsturgewebersundrome
Skull
Hypoff.ggfmmiiaa Tramtrackskull
lyticphase
Neurocutaneous syn
Portwinestain
congenitalglaucoma
 15

normal s slip

Spondylolisthesis

sign
Phemister’s triad:
14 15Disc Prolapse Pottspine Periarticular osteopenia
Paradiscal involvement
is
Erosions
Yersingime
10C CE MRI Reduced joint space
IndicationforBiopsy
DrugresistanceNeurological involvement
• Bony ankylosis:TB • Babcock Triangle:TB
hip
9
• Fibrous ankylosis: knee • Fairbank triangle:congenitalcoxavara Trendelenberg
• Ward triangle:Osteoporosis
gait
 cloaca
sm MG
Ithffampangflamaquestrum
goodprognostic
sign
Baker'scyst
m.in9fs fmfkffijon Brodie's Abscess rupture occursbetween
subacuteosteomyelitis semimembranosus and
no subacutefeatures of medialgastrochimus
inflammation DVTlike condition

Acuteosteomyelitis
me metaphysis

sc aimnenainfection
 BONE TUMORS EXTRA-EDGE
MC bone tumor:
MC primary bone metastaffultiple
tumor: myeloma
MC benign bone tumor: osteochondroma
MC true benign bone tumor:osteoid osteoma
Most chemo-radio sensitive:Ewing's
sarcoma Physaliferous
Most chemo-radio resistant:Osteosarcoma
MC radiation induced tumor:Osteosarcoma Ph
MC mets:Osteosarcoma us
MC bone to bone mets: Clivalchordoma cells
Ewing sarcoma
CD99/mic2:Ewing's sarcoma 11 22 cleft MY
p53/RB/INK4/CDK4/MDM2Osteosarcoma
Chromothrypsis Osteosarcoma
stiff fificans
Osteosarcoma denseperiph
H3-G34W
40
Denosumab role:
hazycenter
GCT
USP 6 rearrangement: Fluid-fluid levels on MRI:
ABC
EXT1/EXT2:Exostosis
BRACHURY marker:
noraomalsijoint airus
Egg
 INSTRUMENTS
corticalscre
cancellous
screw
Buffing
Bonenibbler Bonecutter osteotome Periosteal
elevator forceps
Herbert screw:
scaphf

I estrum
wire SteinmanPin Denhampin
2mm forskeletaltraction Distraction
railroadexternal ex.se
osteogenesis
ffafff
at fixato 11mIf9dY'sRin9
forth 49k
SPLINTS AND TRACTIONS: EXTRA-EDGE

gifica
ramersplint Thomas splint BBsplint Gallow'straction Bryanttraction
oremergency forshaftoffemur skeletaltraction forchild 22Years 10kg
PreviouslyusedforTB forupto20kg

Traction

YaL's p
 Halo'svest 4Postcollar SOMI ASHE brace Taylorbrace Ikhbucklesplin
Sternooccipito anteriorspinal MaxPagesurge
mandibularimmobilize hyperextension tendonreleas

crutchfield tongs
velpeaudressing Figure of 8 Dunlop smith traction cervical spinetraction
cromioclavicular condylarhumerus
Supra
dislocation
 Minerva cast Milwaukeebrace Bostonbrace Charleston
moused brace
mosteffective
hence not
worn 24 7
scoliosis
Cobb's angle
High-Yield

Klein'sline

Tiggnovan

creased Talonavicular Talo biotalar 0 ars

ch Calcaneo calcanea joint
cuboidal PerthesDisease SCFE
nite's angle 4 8Years 8 14 Years
preferred
Kites method Ponseti method now AVNvariantin obese
At birth Manipulation by
preferred
Manipulation and cast
children B Fixation
mother
Change of Every 2 weeks Weekly DennisBrownSplint
cast
Correction C-A-V-E C-AV-E toughest tocorrect Equinus
order
Fulcrum Calcaneocuboid Head of talus me residual deformity
joint adduction
Duration 6 - 9 months 6 - 8 weeks
PEDIATRIC ORTHOPEDICS EXTRA-EDGE

in

completelyfused Sprengeldeformity congenitaltorticollis RadialRayAnomaly Cleidocranial

c spine highrisingscapula birthinjury VACTER L dysplasia
Hematoma toScm Fanconianemia x ray
Fibrosedhematoma Thrombocytopenia Hypoplastic

Klippel Feilsyndrome I Lhead cabsentradius clavicle

low neck C Lchin Holtoramsyndrome
ASD RRA
i
OSTEOCHONDRITIS EXTRA-EDGE

KohlerJersey keinbach's sever'sdisease Frieberg

steochondritis of Osteochondritis Fused2nd Osgood Schlatter
navicularbone oflunate ffffff.gg metatarsalhead Adolescents
Fragmented
tibialtuberosity
HIGH-YIELD
BONE FORMATION:
ALP
Osteocalcin
Osteonectin
BONE RESORPTION:
Hydroxyproline
Hydroxylysine
Deoxypridinoline SACHFoot
TRAP
1 anklecushioned Popeyesign Belowknee
Telopeptide
4 Tearoflong amputation
JaipurFoot Movement not headofbiceps 2bones
allowssquatting and allowed tendon
flexion Trendentenberggait
No man’s land in flexor tendon Sx:
PAIN ON PASSIVE STRETCH:
zone gmean
earliestsignof compartment syndrome aminimus
Muscle mc: last pulselessness paralysis e superior
MASSAGE:
P itis ossificans
MC muscle:Brachialis
Fasciotomywhen pressure30mm
Pulled
elf years
nerve
gluteal
Greater
trochanter
Petechiae, dyspnea, confusion: a
Patellar clunk syndrome:Femoral fE.mil i
m
mgueitension
Axialtraction in extende
Order of replant of an amputated finger:
vein pronationposition
PEDICLE screws through pediciesbone Eth
go Is p artery nerve
R flexion supination