Bedside Clinics in ORTHOPEDICS
Bedside Clinics in ORTHOPEDICS
SECOND EDITION
Upendra Kumar D Ortho (PMCH, Patna) DNB Ortho (DDUH, Dehi)
Government Medical College Bettiah, Bihar, India
Forewords
DK Taneja
Anil K Jain
VK Sinha
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Bedside Clinics in Orthopedics
First Edition: 2017
Second Edition: 2021
9789390020669
Printed at
Aayush Kumar Sinha MS (Ortho) Consultant Orthopedic Surgeon Hitech Emergency Hospital Patna, Bihar, India | Deepak Kumar MS (Ortho) Assistant Professor Jan Nayak Karpoori Thakur Medical College and Hospital (JNKTMCH) Madhepura, Bihar, India | ||
Ajay Rajput DNB (Ortho) Lecturer Department of Orthopedics University of Medical Sciences Etawah, Uttar Pradesh, India | DK Taneja D (Ortho) MS (Ortho) FAMS Medical Director and Senior Consultant Arihant Hospital and Research Center Indore, Madhya Pradesh, India | ||
Anand Shankar MS (Ortho) Assistant Professor Department of Trauma and Orthopedics Indira Gandhi Institute of Medical Sciences (IGIMS) Patna, Bihar, India | Gitika Khanna MD (Patho) In-charge CIO Lab, Safdarjung Hospital New Delhi, India | ||
Anurag Sharma DNB (Ortho) Consultant Orthopedic Surgeon Cygnus and Brahmshakti Hospital New Delhi, India | Govind Ballav Joshi DNB (Ortho) D (Ortho) Consultant Orthopedic Surgeon Balaji Action Hospital New Delhi, India | ||
Arnab Sinha DNB (Ortho) Consultant Orthopedic Surgeon Patna, Bihar, India | John Mukhopadhyay MCh (Ortho) (Liverpool) Director Department of Orthopedics and Joint Replacement Paras HMRI Hospital Patna, Bihar, India | ||
Ashwini Gaurav MS (Ortho) Assistant Professor Department of Orthopedics Netaji Subhas Medical College and Hospital (NSMCH) Patna, Bihar, India | Khuswant Rathore DNB (Ortho) Assistant Professor Department of Orthopedics NIMS University Jaipur, Rajasthan, India | ||
Chandan Sekhar DNB (Ortho) D (Ortho) Consultant Orthopedic Surgeon Kumar Hospital Patna, Bihar, India | Kirti Gehlot DNB (Radiodiagnosis) Assistant Professor Department of Radiology Safdarjung Hospital New Delhi, India | ||
Kumar Kaushik MS (Ortho) Senior Resident Department of Orthopedics Shrikrishna Medical College and Hospital (SKMCH) Muzaffarpur, Bihar, India | Sanjay Keshkar MS (Ortho) Professor and Head Department of Orthopedics ESIC Medical College and Hospital Kolkata, West Bengal, India | ||
NA Khan MS (Ortho) Consultant Orthopedic Surgeon Universal Hospital and Research Center Bettiah, Bihar, India | Sant Prakash Gautam BPO MPO Consultant Prosthetists and Orthotics Dr S Mishra National Rehabilitation University Lucknow, Uttar Pradesh, India | ||
Naman Wahel MS (Ortho) Assistant Professor Department of Orthopedics SP Medical College and PBM Group of Hospitals Bikaner, Rajasthan, India | Shailendra Gupta MS (Ortho) Senior Specialist and Head Department of Orthopedics ESI Hospital Rohini, New Delhi, India | ||
Naresh Chandra MS (Ortho) Senior Specialist and Head Department of Orthopedics Guru Govind Singh Hospital New Delhi, India | Shailendra Khare MS (Ortho) Consultant Orthopedic Surgeon Safdarjung Hospital New Delhi, India | ||
Oswald Anand DNB (Ortho) Consultant Orthopedic Surgeon Panacea Ortho Clinic Bettiah, Bihar, India | Surjit Kumar BPO Consultant Prosthetists and Orthotics Artificial Limbs and Rehab Center Patna, Bihar, India | ||
Piyush Kumar Singh DNB (Ortho) D (Ortho) Consultant Orthopedic Surgeon Felix Hospital Noida, Uttar Pradesh, India | Tarun Solanki MS (Ortho) Consultant Orthopedic Surgeon KBR Hospital Kashipur, Uttarakhand, India | ||
Preeti Goyal Varshney MD DNB (Anesthesia) Assistant Professor Department of Anesthesiology Lady Hardinge Medical College and Hospital, New Delhi, India | VK Sinha Professor and Head Department of Orthopedics Patna Medical College and Hospital Patna, Bihar, India |
The practical examination is a clinical examination starting from bedside manners to history taking, eliciting clinical signs and making a clinical differential diagnosis. Unfortunately, all these aspects are very much lacking in the present setup of the training. After 3 years, when students face senior examiners who ask basic questions on clinical examinations, the students start fumbling. In spite of the fact that the student has good theoretical knowledge.
In order to bridge this gap, I have been conducting the special course for postgraduate students. It has become very popular and largely students have very much benefited. Dr Upendra Kumar also attended my course, and at present, he is my youngest faculty member too. What we teach and what all is discussed, has been trying to compile very systematically in a book form.
It is a very good effort by a young orthopedic surgeon. It is commendable indeed. After going through the book, I feel that it will prove very handy and useful. It covers all aspects of the examination, and it will help students to clear their practical examination in a single attempt. In the first phase of the book, Bedside Clinics in Orthopedics is in your hand, and its Clinical Methods and Cases unit will be available very soon.
DK Taneja
D (Ortho) MS (Ortho) FAMS
Medical Director and Senior Consultant
Arihant Hospital and Research Centre, Indore
Ex-Dean and CEO, MGM Medical College, Indore
Ex-Professor and Head, Department of Orthopedics
Mahatma Gandhi Memorial Medical College
Indore, Madhya Pradesh, India
Past President, Indian Orthopaedic Association
Past Secretary General, Orthopaedic Association of SAARC Nations
Secretary, Orthopaedic Research and Education Foundation, India
Secretary General, World Orthopaedic Concern
Foreword
I am extremely happy to write the foreword of Bedside Clinics in Orthopedics. I have known Upendra Kumar, when he used to attend postgraduate courses for his DNB training. His questions used to reflect the confusion in the mind of orthopedic trainees on getting variable responses to the same question. The practical training in orthopedics includes day-to-day patient care procedures, performed in ward/outpatient/operation theater. It is quite common to get a variable answer to the same question in ward round, practical examinations and viva voce. Through this book, he has tried to crystallize the answers to such practical training issues.
Orthopedics as a subject has grown exponentially. The trainee not only has to learn theoretical knowledge, but also to acquire psychomotor skills with a clear understanding of its rationale. There exists a lacuna in the current educational resource material on practical training subjects. The learning resources on the subjects of clinical/practical importance are not being updated and available as one book. The author has attempted to fill the vacuum.
The book is divided into eight sections—Ward Round, Instruments and Implants, Orthopedic Radiographs and Review of Imaging Modalities, Table of Orthosis and Prosthesis, Bone, Joint Model and Specimen, Orthopedic Surgical Approaches, Review of Orthopedic Surgeries, and Orthopedic Imaging and Operation Theater Principles. Each section has been broken into multiple subject titles, and each subject title is given a theoretical knowledge, practical application with rationale. This format will not only improve the understanding of practical procedures performed day-to-day by orthopedic trainees, but also improve the treatment outcomes.
I am sure this book will not only be useful to all orthopedic trainees, but will also be a guide for practicing orthopedic surgeons.
Anil K Jain
MS MAMS FAMS FRCS (England)
Director Professor and Head
Department of Orthopedics
University College of Medical Sciences and Guru Teg Bahadur Hospital
New Delhi, India
Past President, Indian Orthopaedics Association
Ex- Editor, Indian Journal of Orthopaedics
Deputy Editor, Journal Bone and Joint Surgery (AM)
Visiting Professor
The Tamil Nadu Dr MGR Medical University
Chennai, Tamil Nadu, India
Foreword
I am feeling privileged again that I am writing the foreword material for 2nd edition of a well established book Bedside Clinics in Orthopedics written by Dr Upendra Kumar. I also feel pride my student is working behalf of me as I had dreamed long back. The present edition of the book contains all viva-voce material for postgraduate practical examination. Hardly any corner is kept untouched from ward round to table viva-voce. This edition adds common surgical procedures and orthopedic imaging along with all revised previous materials. The honour to orthopedic legends is also shown at the proper places in this edition.
Being a teacher and examiner in orthopedics for many years I think this book will complete the lacunae of orthopedics in clinical study. I want to say for all postgraduates to increase one more true friend in his shelf in the form of this book. It will be helpful for you, especially in those stressful nights that is about to come.
VK Sinha
D (Ortho) MS (Ortho) PhD (Ortho)
Professor and Head
Department of Orthopedics
Patna Medical College
Patna, Bihar, India
Preface to the Second Edition
After the great success of the first edition of Bedside Clinics in Orthopedics, its second edition is in your hand now. As per communication with teachers and postgraduate students, we have tried to make this unique in many ways. After launching of this book in IOACON Kochi, I personally visited many universities and orthopedic institutions and tried to gather the feedbacks of teachers, residents and students regarding content of this book. Side-by-side we discussed about the means we can make it more useful and systematic.
After this marathon efforts firstly we eradicated its factual and printing errors. Glorious history of some Indian orthopedicians with their contribution is recognized at proper place. We have dedicated a special section for common orthopedic procedures which are commonly asked nowadays in postgraduate examinations. In radiograph section, new chapters for regional orthopedic conditions and principle of orthopedic imaging have been added. In bone and joints section the unuseful details of joints are removed and materials are concised. Surgical approaches are attached with typical surgical photographs depicting the use of that particular approach. As per demand of students, many old photographs are expanded for more clarity. Newer tables and charts are added in almost all sections.
Again, I would like to convey my thanks to our all teachers, seniors and friends who have contributed in this edition specially Dr Kirti Gehlot and Dr Preeti Goyal Varshney. I hope the present edition will satisfy the hunger of orthopedic aspirants.
Please share your opinions at upenorthopmch@gmail.com
Upendra Kumar
Preface to the First Edition
Rightly said, the most of the useful and valuable things have been invented in difficult and demanding situations. In the same manner, the cornerstone of this book has been laid down during those harsh conditions when orthopedic postgraduates (DNB) students were not getting success even after their 2nd or 3rd attempts of their practical examinations in different parts of the country.
By discussing these issues with Dr DK Taneja (Indore), Dr VK Goyal (New Delhi) and Dr VK Sinha (Patna); we started to construct a treatise that can guide our DNBs, masters and diploma students in proper direction and lighten the pathway of success. The preparation of this book is also influenced by Orthopaedic Research and Education Foundation (OREF), India, established by Dr B Mukhopadhyay. This foundation is working continuously for orthopedic education for postgraduates throughout the country. We have prepared the book not for commercial purposes, but also as contribution in the field of orthopedics.
The book stands up to the mark, which is informative, illustrative, comprehensive and with sufficient content. Although the facts included in the book are obtained from various sources, hence, we are thankful to all orthopedic personnel and publishers throughout the globe, who have given their direct or indirect contribution in this regard. Hence, please do not look this issue as copyright, but treat it as your contribution if any.
The present edition contains ward round and tables, instruments and implants, orthopedic radiographs, orthosis and prosthesis, bone, joint model and specimen, surgical approaches along with principle of operation theater and sterilization, and glorious history of orthopedics. We are coming soon with its clinical version including history taking, clinical methods, long and short cases and important viva voce questions. Although this is clinical notes, hence students are requested to always go through standard textbooks.
Despite of meticulous corrections, there might be possibility of human error. Useful critics and suggestions are always invited from teachers, seniors, colleagues and juniors to make it more productive and fruitful. This is also a time to remember the living legends of orthopedics of India such as Drs Shailendra Bhattacharya (Kolkata), Surendra Mohan Tuli (Delhi), GS Kulkarni (Miraj), and Hardash Singh Sandhu (Amritsar). Our generation is fortunate to have such great orthopedicians.
In the last, I express my heartiest gratitude to the Chairman (Dr John Mukhopadhyay) and Secretary (Dr DK Taneja) of OREF, who always provided a back support on this project. I also thank my colleagues of Patna Medical College, Patna, Bihar, India, and Deen Dayal Upadhyay Hospital, New Delhi, for their constant support and supply of material for this cause.
Finally, I offer this book to the young buds of orthopedic world with a big salute to my all teachers throughout the country.
Upendra Kumar