Discover and read the best of Twitter Threads about #OrthoTwitter
Most recents (24)
A dream came true!! Our paper: "Neutrophil-derived catecholamines mediate negative stress effects on bone" is now published in @NatureComms 🎉
This work is a joint project from my group at @OrthoLabUlm & @MolPsySoUlm! A fantastic cross-discipline collaboration!
A thread:
This work is a joint project from my group at @OrthoLabUlm & @MolPsySoUlm! A fantastic cross-discipline collaboration!
A thread:
We found out earlier that chronic psychosocial stress during adulthood disturbs long bone growth and fracture healing in mice: doi.org/10.1073/pnas.1…
But the question was: what is the mechanism? We answered that in our latest study. Stress leads to catecholamine production ...
But the question was: what is the mechanism? We answered that in our latest study. Stress leads to catecholamine production ...
... in local immune cells in the bone marrow and the fracture callus. These catecholamines disturb endochondral ossification via the beta2-adrenoreceptor on chondrocyte-derived cells in mice. Most importantly, we could confirm this also in human samples:
Fracture patients...
Fracture patients...
A snapshot in time confounded by @TheNRMP match “algorithm”. The truth is #medicine is we have work to do in #genderequity - US physician workforce only 37% women. Rads 27%, Gen Surg 22%, #EM 👋🏼29%…@acepnow @WomenSurgeons @AmCollSurgeons @radiologyacr @EmergencyDocs @aawr_org… twitter.com/i/web/status/1…
@AAMCtoday stats on 2021 US physicians by % female. #pediatrics 65%, #orthopedics 5.9%. Note surgical sub speciality ($$$) higher male dominance, medical/primary care higher female…#orthotwitter @aap_peds @aaos1
New generation of US #doctors show progress, by @aamc study on residents and fellows, 47% total female, #gensurg 46%, #radiology still only 27%, #emed 39%…
Based on the @StanfordMed graphic, we can assume why progress for gensurg but why not for Rads…
Based on the @StanfordMed graphic, we can assume why progress for gensurg but why not for Rads…
I'll post these, even though theyre far from pretty. lots of reasons why this or that shouldve couldve wouldve. not something i enjoyed much. Cables doing their best where there was no tube to reconstruct. 85yo bone was dust. screw went into the best bit of the head. open to… twitter.com/i/web/status/1…
both vastus lat and glut med on the trochanter fragment. made getting past the lateral wall of tissue a huge PITA without defunctioning something big. managed tho. dozens of intermediate fragnment. only read was lateral distal trochanter to diaphysis. only had 10mm of overlap.
Let me take you on a journey... #orthotwitter
"no, the triceps tendon was not augmented, why do you ask?"
no problem, we'll revise it, this time with augmentation.
🧵I LOVE teaching medical students! This is how I teach someone to examine the bones of the wrist. Had to break it up… Now you know how to examine your friend when they fall over! #orthotwitter @orthoWOW @pride_ortho @OrthopodReg @Ortho_Cherry @orthogal21 @OrthoDiversity
The rest of the film! @BSSHand @BritOrthopaedic @BOMSA_UK @TheBMA @RCollEM @meets2023 @medicalwomenuk
My simple explanation of a wrist XRay… @RCRadiologists @RadiologyACR @RadiologySigns @radiology_rsna I resisted the urge to show laterals which confuse most people, and talk about DISI etc, but happy to do so if people are interested!
A thread 🧵
Very interesting case with a lot of teaching points
Elderly female with moderate hip pain - underwent right IA hip injection at OSH
#orthotwitter
Very interesting case with a lot of teaching points
Elderly female with moderate hip pain - underwent right IA hip injection at OSH
#orthotwitter
2 months later presented with worsening hip pain
X-rays show AVN with collapse -
- do not inject hips in elderly females - high risk of AVN with collapse
X-rays show AVN with collapse -
- do not inject hips in elderly females - high risk of AVN with collapse
Patient went on to get a THA at OSH. Intra-operatively could not get the cup to stick. Bail out was to cement a cementless cup. Chose blade type prosthesis - cracked the calcar, managed with cables
அனைவருக்கும் வணக்கம் , கொரோனா பாதிப்பிலிருந்து மீண்டு வந்த பின்பு பலருக்கும், பல வகையான உடல் உபாதைகள் ஏற்பட்டுள்ளது. இதை Post COVID syndrome/ Long COVID என்று அழைப்போம்.இதற்கு எலும்பியல் துறை மட்டும் விதிவிலக்கில்லை. *1/10 @DrVinoth_ortho #MedTwitter #COVID19
32 வயது ஆண், வலது இடுப்பில் 9 மாதமாக லேசாக வலி இருந்தது , ஆனால் கடந்த 3 வாரம் வலி மிகவும் அதிகமாக உள்ளது, கால்களை மடக்கி கீழ உட்கார முடியவில்லை என்றார்.
பரிசோதனை செய்தததில் இடுப்பு எலும்பு மூட்டு சிறிது தூரம் தான் அசைக்க முடிந்தது. *2/10
பரிசோதனை செய்தததில் இடுப்பு எலும்பு மூட்டு சிறிது தூரம் தான் அசைக்க முடிந்தது. *2/10
Xray பரிசோதனையில் இடுப்பு எலும்பின் தலை பகுதி அழிந்து, உருளையாக இருக்கும் பகுதி ,வடிவம் மாறியது தெரிய வந்தது.
MRI பரிசோதனையில் இடுப்பு மூட்டு முழுவதும் சிதைந்து இருந்தது. *3/10
MRI பரிசோதனையில் இடுப்பு மூட்டு முழுவதும் சிதைந்து இருந்தது. *3/10
How can one reduce the risk of knee #osteoarthritis?
1. Knee osteoarthritis (OA) causes knee pain. It limits mobility, hampers physical activity and contributes to sedentary lifestyle, which in turn, increases the risk of obesity, diabetes, hypertension, heart attack and stroke.
1. Knee osteoarthritis (OA) causes knee pain. It limits mobility, hampers physical activity and contributes to sedentary lifestyle, which in turn, increases the risk of obesity, diabetes, hypertension, heart attack and stroke.
2. Who are at risk of developing knee OA?
*Non-modifiable risk factors:
Female gender and older age
*#obesity: Increases the risk of knee OA three-times. It also accelerates the progression of disease.
#MedTwitter #orthotwitter #orthopedics
*Non-modifiable risk factors:
Female gender and older age
*#obesity: Increases the risk of knee OA three-times. It also accelerates the progression of disease.
#MedTwitter #orthotwitter #orthopedics
3. Knee injury: Traumatic joint injury is a major risk factor for osteoarthritis, particularly at the #knee (i.e. meniscal damage, anterior cruciate ligament rupture, or direct articular cartilage injury). Ref: doi.org/10.1097%2FBOR.…
Dear all postgraduate orthopedic residents...
1st lesson of Orthopedics from my teacher I learnt....
There is nothing called cellulitis in an infant unless there is a wound.
It is osteomyelitis, unless proven otherwise.
#orthotwitter
1st lesson of Orthopedics from my teacher I learnt....
There is nothing called cellulitis in an infant unless there is a wound.
It is osteomyelitis, unless proven otherwise.
#orthotwitter
Pt from NICU with swelling and tenderness below knee. Diagnosed as cellulitis and some oral antibiotics given.
Xray was not informative.
The baby was home with a pus point formed in upper tibia, got an I & D by a local doc.
Xray was not informative.
The baby was home with a pus point formed in upper tibia, got an I & D by a local doc.
At 1 mo, the pt has a recent onset distal tibial swelling and redness, impending to burst. No fever. TLC 24000. ESR 110. CRP 26.
If you're a medical student pursuing #ortho, you will almost certainly end up doing #awayrotations...
For M3s, that process is right around the corner!
But for us M4s, aways are over, and now I have nothing but time on my hands 😌
So let's do a thread on away applications 🧵1/
For M3s, that process is right around the corner!
But for us M4s, aways are over, and now I have nothing but time on my hands 😌
So let's do a thread on away applications 🧵1/
🦴When do you apply for aways?
Typically, you will be applying in the Spring of your 3rd year.
Of the places I applied, the earliest an application opened was in February and the latest was in May, but the majority of programs open applications in March - April. 2/
Typically, you will be applying in the Spring of your 3rd year.
Of the places I applied, the earliest an application opened was in February and the latest was in May, but the majority of programs open applications in March - April. 2/
🦴A quick note for M2s!
The timing of away apps is why I tell M2s interested in ortho that they should aim to do an ortho rotation by Jan/Feb at the latest when scheduling their M3 year.
Ideally, you should know if ortho is definitely for you before you apply for aways. 3/
The timing of away apps is why I tell M2s interested in ortho that they should aim to do an ortho rotation by Jan/Feb at the latest when scheduling their M3 year.
Ideally, you should know if ortho is definitely for you before you apply for aways. 3/
Today outpatient had at least 7 patients with #Diabetes presenting with various Ortho conditions .
I am listing some common Ortho conditions which present in diabetic patients . Some may present only as Ortho pathology & alert about possibility of underlying undetected diabetes
I am listing some common Ortho conditions which present in diabetic patients . Some may present only as Ortho pathology & alert about possibility of underlying undetected diabetes
1. Trigger finger : the incidence is 3-4 times higher & also can involve multiple digits
2. Carpal tunnel syndrome : the incidence is ten times more , can involve both hands & depends on duration of diabetes too
2. Carpal tunnel syndrome : the incidence is ten times more , can involve both hands & depends on duration of diabetes too
3. Dupuytren’s contracture: the incidents is 3 times higher & related to diabetes duration & its control too
4. Frozen shoulder with adhesive capsulitis: incidence is 4 times higher , resolution is less predictable & prolonged
4. Frozen shoulder with adhesive capsulitis: incidence is 4 times higher , resolution is less predictable & prolonged
3 most common deficiencies I see in Ortho patients are
Calcium, Vitamin D and Vitamin B12 , especially in vegetarians . I have listed some foods specifically for them .
These are by no means an exhaustive list but can be incorporated easily in your daily diet
Calcium, Vitamin D and Vitamin B12 , especially in vegetarians . I have listed some foods specifically for them .
These are by no means an exhaustive list but can be incorporated easily in your daily diet
Calcium:
Ragi , spinach , curd , methi leaves , moong sprouts , peanuts , Rajma , paneer , milk , til seeds , orange, bindi, drumstick , almonds , soya
Ragi , spinach , curd , methi leaves , moong sprouts , peanuts , Rajma , paneer , milk , til seeds , orange, bindi, drumstick , almonds , soya
Vitamin D
Milk products including curd , cheese , butter, soya milk , fortified foods, supplements if very deficient and of course sunshine around noon
Egg yolk& mushrooms if you consume them
Milk products including curd , cheese , butter, soya milk , fortified foods, supplements if very deficient and of course sunshine around noon
Egg yolk& mushrooms if you consume them
Cerclage wires got a good wrap in 2022. Several conference presentations, a couple of posters and abstracts, and now here's a mini literature collection for @DrMarecek and myself to bath in the next time the topic comes up #orthotwitter
osteosynthesis.org/42003807-commi…
osteosynthesis.org/42003807-commi…
pubmed.ncbi.nlm.nih.gov/35618854/
pubmed.ncbi.nlm.nih.gov/34510127/
pubmed.ncbi.nlm.nih.gov/34825927/
pubmed.ncbi.nlm.nih.gov/34435729/
pubmed.ncbi.nlm.nih.gov/32918572/
pubmed.ncbi.nlm.nih.gov/35377073/
pubmed.ncbi.nlm.nih.gov/34510127/
pubmed.ncbi.nlm.nih.gov/34825927/
pubmed.ncbi.nlm.nih.gov/34435729/
pubmed.ncbi.nlm.nih.gov/32918572/
pubmed.ncbi.nlm.nih.gov/35377073/
just an aside, i was honestly a bit skeptical whether people would follow links to off-site content, and looking at the 30 odd likes on this tweet i was thinking "well there you go, not much interest/engagement". huh.. was i wrong, i just looked at site stats ~600 click-throughs!
அனைவருக்கும் வணக்கம், ஒருவயதிற்கு குறைவாக உள்ள குழந்தைகளுக்கு தொடை பகுதியில் தான் தடுப்பூசிகள் போடப்படும், அப்போது ஒரு சில சமயம் அரிதிலும் அரிதாக எதிர்வினைகள் ஏற்படலாம். @DrVinoth_ortho #orthotwitter #MedTwitter *1/8
கடந்த வாரம், பிறந்து 18 நாட்கள் ஆன குழந்தையை ,அவரது பெற்றோர்கள் 15 நாட்கள் தொடர் காய்ச்சல் மற்றும் இடது தொடையில் ஏற்ப்பட்ட வீக்கம் காரணமாக மருத்துவமனை அழைத்து வந்தனர் .*2/8
குழந்தைக்கு பிறந்தவுடன் HbsAg தடுப்பூசி இடது தொடையில் அருகில் உள்ள மருத்துவமனையில் செலுத்தியுள்ளனர், பின்பு லேசான காய்ச்சல் மற்றும் தொடையில் வீக்கம் ஏற்பட்டுள்ளது. அதன் பின் காய்ச்சல் இல்லை. ஆனால் வீக்கம் குறையவில்லை, மீண்டும் காய்ச்சல் தொடர்ந்து ஏற்பட்டுள்ளது.*3/8
Sequence of Kapandji intrafocal pinning for a case of distal radius fracture with intra-articular extension.
#orthotwitter #Orthopedics #handsurgery #congenitalhand
#orthotwitter #Orthopedics #handsurgery #congenitalhand
The first wire is passed from the dorsum for correcting the dorsal tilt of the ulnar volar fragment.
The second wires is used to hold and correct the radial tilt of the styloid fragment. It is applied from the radial direction.
Our technique of managing Camapanacci grade 3 giant cell tumor of distal radius. Whole of the distal radius is excised, the ulna is transferred to the gap and a radioscapholunate fusion is done. This retains some amount of motion in the wrist. #orthotwitter
This is an illustration of the same. The ulnar artery connections are maintained while transposing the ulna. #Orthopedics #handsurgery #congenitalhand
This is a representative radiograph if the same. #giantcelltumor
1/When it comes to brachial plexus pathology, you shouldn’t have to wing it! A #tweetorial to help you figure out #brachialplexus injuries
#medtwitter #meded #neurosurgery #orthotwitter #orthopedics #neurorad #radres #medstudent #FOAMed #FOAMrad #spine #radiology #neurotwitter
#medtwitter #meded #neurosurgery #orthotwitter #orthopedics #neurorad #radres #medstudent #FOAMed #FOAMrad #spine #radiology #neurotwitter
2/When it comes to brachial plexus injuries, the most important distinction to make is whether it is a pre or post ganglionic injury. Pre ganglionic injuries are nerve root avulsions from the spinal cord and cannot be repaired, while most post ganglionic injuries can be repaired
3/It’s like repairing a house. If there’s a structural flaw at the beginning, before you’ve even built it, you won’t even try to build it, you’ll just scrap the design (preganglionic). But if there’s damage after the house is built, you can salvage it w/repair (postganglionic)
1/Ready for some heavy lifting? My second #tweetorial on the BRACHIAL PLEXUS! This time we cover how the #brachialplexus looks on #MRI.
#medtwitter #meded #neurosurgery #orthotwitter #orthopedics #neurorad #radres #medstudent #FOAMed #FOAMrad #spine #radiology #neurotwitter
#medtwitter #meded #neurosurgery #orthotwitter #orthopedics #neurorad #radres #medstudent #FOAMed #FOAMrad #spine #radiology #neurotwitter
2/Brachial plexus is how the cervical nerves reach the arm. In the coronal plane, it looks like a slide, guiding nerves downward. Bc nerves are traveling laterally, sagittal MRI plane is our plane of choice to cut the nerves in cross section & see down the barrel of the nerves
3/But it’s more than a slide, it’s a complex highway, w/nerves joining & dividing—like highway off ramps & on ramps. If you want to know more about this intrinsic anatomy, see my first brachial plexus tweetorial here:
1/Raise your hand if you’re confused by the BRACHIAL PLEXUS! I could never quite remember or understand it—but now I do & I’ll show you how
A #tweetorial on #brachialplexus #anatomy!
#medtwitter #meded #neurosurgery #orthotwitter #orthopedics #neurorad #radres #medstudent #FOAMed
A #tweetorial on #brachialplexus #anatomy!
#medtwitter #meded #neurosurgery #orthotwitter #orthopedics #neurorad #radres #medstudent #FOAMed
2/Everyone has a mnemonic to remember brachial plexus anatomy. I’m a radiologist, so I remember one about Rad Techs. But just remembering the names & their order isn’t enough. That is just the starting point--let’s really understand it
3/From the mnemonic, we start with the roots—the cervical nerve roots. I remember which roots make up the brachial plexus by remembering that it supplies the hand. You have 5 fingers on your hand so we start with C5 & we take 5 nerve roots (C5-T1).
அனைவருக்கும் வணக்கம், பல பதிவுகளில் ஆதாரமற்ற பாரம்பரிய மருத்துவமுறையினால் ஏற்படும் தீமைகள் பற்றி சொல்லியிருக்கிறேன். கடந்த வாரம் 14 வயது சிறுவன் , காய்ச்சல் மற்றும் வலது தொடை பகுதியில் வீக்கம் ஏற்பட்டு மருத்துவமனை வந்திருந்தார்.1/7
இரண்டு வாரம் முன்பு கிரிக்கெட் பந்து மூலம் தொடையில் அடிபட்டு வீக்கம் ஏற்பட்டதால் அருகில் உள்ள பாரம்பரிய வைத்தியரிடம் சென்று எண்ணெய் மஸாஜ் மற்றும் மஞ்சள் பத்து போட்டுக்கொண்டுள்ளார் . அதன் பின்பு 12 நாட்கள் ஆகியும் வீக்கம் குறையவில்லை.2/7
2 நாட்களாக காய்ச்சல் மற்றும் அதிக உடல் சோர்வு ஏற்பட்டதால் , அவரது தந்தை மருத்துவமனை அழைத்து வந்தார், தொடை பகுதியில் வீக்கம் அதிகமாக இருந்தது, தொடை மிகவும் சூடாக இருந்தது (inflammation), இரத்த பரிசோதனையில் வெள்ளை அணுக்கள் 20,000 மேல் இருந்தது.3/7
It's time for a new and updated #orthotwitter thread on ANKLE ARTHRITIS!
A 🧵*....
*This will be as inclusive but brief. This may not include everything but will provide an overview of this topic. These slides are mine.
@AOFAS @AAOS1 #MedTwitter @MedTweetorials
1/?
A 🧵*....
*This will be as inclusive but brief. This may not include everything but will provide an overview of this topic. These slides are mine.
@AOFAS @AAOS1 #MedTwitter @MedTweetorials
1/?
The Ankle Joint is composed of three bones:
-Tibia
-Fibula
-Talus
There is cartilage between each articulation.
2/?
-Tibia
-Fibula
-Talus
There is cartilage between each articulation.
2/?
When the diagnosis of ankle arthritis is brought up, it is referencing the CARTILAGE LOSS between the TALUS and the TIBIA.
Here are some basic science facts surrounding this phenomena:
3/?
Here are some basic science facts surrounding this phenomena:
3/?
I've got 2 patients in orbit with concomitant fibula fractures (PLC injuries) in context of tibial plateau fracture. PLC anatomy does my head in, so heres a list of what im reading. If anyone has some tips on management of these, please chime in! #orthotwitter
pubmed.ncbi.nlm.nih.gov/27620470/
pubmed.ncbi.nlm.nih.gov/26535398/
pubmed.ncbi.nlm.nih.gov/33392754/
pubmed.ncbi.nlm.nih.gov/12540438/
pubmed.ncbi.nlm.nih.gov/26535398/
pubmed.ncbi.nlm.nih.gov/33392754/
pubmed.ncbi.nlm.nih.gov/12540438/
and whilst i agree neck injuries heal (and rarely need to be actively managed) im concerned about these 2 specific cases in that the PLC is identifiably disrupted as a descrete structure/complex, and a posterolateral instabilty ist quite likely (though not testable at present)
Short thread on knee osteoarthritis (OA) and total knee replacements (TKR)
Spoiler, OA does NOT always lead to you needing a TKR.
Keep being active, whatever your preferred activity!
If you do end up needing a TKR they can be fantastic and you can return to being active
Spoiler, OA does NOT always lead to you needing a TKR.
Keep being active, whatever your preferred activity!
If you do end up needing a TKR they can be fantastic and you can return to being active
Knee OA is very common. Approximately 1 in 5 adults >45 y/o in England have knee OA.
cks.nice.org.uk/topics/osteoar…
cks.nice.org.uk/topics/osteoar…
Exercise should be a core treatment for knee OA
Try to lose weight
Stop smoking
Discussed pain relief with your GP
Consider an injection
If none of above helping over a reasonable period of time (months not weeks) consider surgery
nice.org.uk/guidance/cg177…
Try to lose weight
Stop smoking
Discussed pain relief with your GP
Consider an injection
If none of above helping over a reasonable period of time (months not weeks) consider surgery
nice.org.uk/guidance/cg177…
3 o‘clock in the morning… best team best time! I think it was @generalorthomd who mentioned dynamic closure of fasciotomy wounds? Can’t remember, but this is my „running-suture“ technique which I promised to get a pic/video of #orthotwitter
For clarification, this differs from shoelace dermatotraction (pic below) in that theres only one strand which doesn’t cross. As a technical side note - i avoid stapling the skin edges directly, and anchor the suture back from the wound edge. Skin edges break down easily I think
