Category: Orthopedics

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In this article, we will discuss the Barton’s Fracture. So, let’s get started.

Barton’s Fracture

It is an intra-articular fracture of the distal radius. Here, the fracture extends from the articular surface of the radius to either its anterior or posterior cortices. The small distal fragment gets displaced and carries with it, the carpals. Depending upon the displacement, there is volar Barton’s Fracture (anterior type) and a dorsal Barton’s Fracture (posterior type). Treatment is closed reduction and a plaster cast. Open reduction and internal fixation with plate is required in those cases where closed reduction fails. It may be considered as a primary choice of treatment in young adults with significantly displaced fractures.

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In this article, we will discuss various Causes of Spinal Cord Compression. So, let’s get started.

Causes

Extradural compression (involvement of vertebral bodies and intervertebral disc): It comprises 80% of cases of compression

A. Vertebral bodies

  • Trauma (fracture-dislocation), whiplash injury
  • Metastatic carcinoma (e.g. breast, bronchus, prostate, lymphoma, thyroid)
  • Myeloma
  • Tuberculosis

B. Disc lesion

  • Intervertebral disc prolapse
  • Trauma

C. Inflammatory

  • Epidural abscess
  • Cold abscess
  • Granuloma
  • Arachnoiditis

D. Epidural hemorrhage

Intradural extramedullary compression: It constitutes 15% of cases of compression

  • Tumors, e.g. meningioma, neurofibroma, ependymoma, metastasis, lymphoma, leukemia.
  • Subdural abscess

Intradural intramedullary: It constitutes 5% of the cases of compression

  • Tumors, e.g. glioma, ependymoma, metastasis.
  • Hematomyelia

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In this article, we will discuss the various Stages of Osteosarcoma. So, let’s get started.

Firstly, we will grade the tumor (cancer) in terms of histopathology (cancerous cells).

GX: The tumor grade cannot be identified

G1: The cancer cells are well differentiated (low-grade)

G2: The cancer cells are moderately differentiated (high-grade)

G3: The cancer cells are poorly differentiated (high-grade)

Stages

Stage IA: The tumor is low grade or cannot be graded and the size is 8 cm or smaller. It has not spread to any lymph node or other parts of the body.

Stage IB: The tumor is low grade or cannot be graded and the size of the tumor is larger than 8 cm or there are more than 1 separate tumors in the primary bone site. It has not spread to any lymph node or other parts of the body.

Stage IIA: The tumor is high-grade and the size is 8 cm or smaller. It has not spread to any lymph node or to other parts of the body.

Stage IIB: The tumor is high-grade and the size is larger than 8 cm. It has not spread to any lymph node or to other parts of the body.

Stage III: There are multiple high-grade tumors in the primary bone site, but has not spread to any lymph nodes or to other parts of the body.

Stage IVA: The tumor is of any size or grade and has spread to the lung(s).

Stage IVB: The tumor is of any size or grade and has spread to the lymph nodes or the tumor is of any size or grade and has spread to another bone or organ besides the lung.

(There are no stage grouping for primary bone cancer in the spine or pelvis)

Original and primary source: AJCC Cancer Staging Manual, Eighth Edition (2017), published by Springer International Publishing

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In this article, we will discuss about Salter-Harris Classification. So, let’s get started.

Salter-Harris Classification

It was proposed in the year 1963 by Salter and Harris and is widely used to describe and classify physeal fractures.

Type I or Straight across, in this the fracture line runs across the growth plate.

Type II or Above, in this the fracture line runs through the growth plate and includes a portion of metaphysis.

Type III or Lower, in this the fracture line runs through the growth plate and exits through the epiphysis into a joint.

Type IV or Transverse, in this the fracture line runs through the metaphysis, growth plate, and epiphysis.

Type V or Ruined, it is a crush type injury that does not displace the growth plate but damages it by direct compression or compressive force.

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In this article, we will discuss about the Symptoms of Syringomyelia. So, let’s gets started.

Symptoms

Symptoms of the spinal cord and corresponding nerve damage depend upon the location, size, and extent of the Syrinx (fluid-filled cyst) and is usually exacerbates when the syrinx puts pressure on the spinal cord. The symptoms develop slowly overtime and action such as coughing or straining triggers/increases the symptoms. Following are the symptoms of Syringomyelia:

Pain

Progressive weakness of the upper and lower extremities

Stiffness or tightness in the back (thoracic/lumbar), shoulders, cervical, arms or legs

Impaired sensation to pain, temperature (hot/cold) in the hands

Facial pain and numbness and/or headache

Numbness or tingling sensation on upper or lower extremities

Impaired balance along with gait (walking) abnormalities

Urinary or rectal incontinence

Sexual dysfunction

The curvature of the spine or Scoliosis (present as classical or only sign in children)