trigger finger

Usually patient come with c/o trigger finger. They say that there finger hjas become stiff now and when they try to extend it , it suddenly become streight with a trigger like fashion.
there may be some amount of pain on movements .
Treatment is :
1. analgesics and manipulation in early stage.
2. steroid injection if physiotherapy is not usefull.
3. Surgery is last option, it can be done under local anesthesia. Some time one or two cm. incision can be taken for resection.

coccydynia

pain occuring on prolong sitting .
usually common in female
history of injury may be there.
recurrence common.
treatment is mainly suppportive.
avoid prolong sitting on hard surface.
if necessary than use ring shape cushion.
analgesics line NSAID can help.
use Sitz bath, ie to sit in a pot with warm water.
try to avoid straining at coccyx by avoiding constipation.

non union fracture femur

this patient was a 30 year old male with h/o RTA. he sustained closed fracture femur . patient was treated( else where) with k nail and encirclage wires.. One month after surgery encirclage were removed . when he came after 6 months of surgery at over centre he was not able to walk.His knee was completely stiff. This was his x ray picture. His CRP was negative and ESR was 30. there was 4 cm shrtening of lower limb.

patient was explined for illizarove fixator but he refused in favour of exchange nailing and bone grafting.

We have operated him doing exchange nailing and bone grafting.MUA done for knee stiffness and we got 30 degree of movement. Patient was kept on CPM after 15 days and he got upto 90 degree rom.

At 1 month follow up patient was walking full weight bearing .5 cm shoe raise was given to him.There was no pain at fracture site. X ray wae showing callus formation.

cubitus varus

recurrent dislocation of shoulder

are you having recurrent dislocation of shoulder. Arthroscopy has good treatment for it.Usually these patients have difficulty in overhead activties like combing, painting walls, playing badminton, or throwing ball.
how we treat it? it require arthroscopic surgery . you do not have to take bed rest and there will be only three puncture holes so no bigger scar marks. Your shoulder is kept in shoulder immobiliser for 3 weekss and after that range of motion exercises is started.
you can ask if some metal part will remain inside? Answer is yes. But it is of 3 mm size and called as suture anchors.
it is made up of titaium.

recurrent dislocation of shoulder

are you having recurrent dislocation of shoulder. Arthroscopy has good treatment for it.

septic hip treated conservatively.

Septic hip in child usually lead to stiffness of joint, deformities and instability. These patients are usually treated with antibiotics and surgical treatment. But results are varying from almost normal hip to severe disability. We are presenting a case which was treated with only medication without any surgical procedure but has shown a remarkable recovery and patient at present is full functional with no disability.
Our patient was a 12 year female who was presented to us with hip pain with no constitutional symptoms. Hip pain was since 1 week and patient was not able to walk due to that.
After x ray and MRI and detail clinical examination we reached at conclusion that she was having septic hip with MRI was showing marrow edema and fluid in joint. We plan to drain it but could not get anesthetic fitness due to breathlessness. Patient received 6 week iv antibiotics followed by 6 week oral antibiotics and bed rest.
After her pain was subside and she was stated partial weight bearing followed by full weight bearing.
At present after 2 year of follow-up she was having normal gait pattern with no functional disability.
We here want to emphasize that femoral head in children has remarkable growth potential and good healing power.

want to know about ACL surgery

well if you are planning to go through ACL reconstruction , you may have lot of thing going in your mind. I am trying to help you by telling some of the facts.
1. It should be done only if you have problem in walking. It may possible that your MRI showing ACL tear but you do not have any symptoms at all. Always remember MRI can be misleading. ACL surgery will treat instability. So if you have instability in walking than only go through this surgery.
2. it's result are depend on the doctor who is operating . Arthroscopic surgery has better result.
3. Usually hospitallisation is of 3 days.
4.No bed rest require, you can walk on next day of surgery .
5.You have to walk with crutches for three weeks.
6. There would be knee brace for 6 weeks.
7. You can start sports after 6 to 9 months.

reading one article per day

well, in todays fast changing world it is never sufficient to read text books only.Every month we have some new implant and technique coming. Concepts are changing every day. I think you should develpoe a habbit of reading one new paper per day. It is difficult to attend all seminar during residency as time is not there, but try to attend as many as possible.Increase discussion among your collegues. Remember getting passed in MS is very easy. Every body some day ormother will pass exam but to pass it with knowedge is important. So read as much as possible in your second year, and in third year you can concentrate in exam.