Rolando Fracture

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

Rolando Fracture

It is a three part or comminuted intra-articular fracture through the base of first metacarpal bone. It was described by Silvio Ronaldo in the year 1910. The fracture consists of three distinct fragments; typically T- or Y- shaped. The volar fragment remains attached to the carpometacarpal joint, while the main dorsal fragment subluxes or dislocates dorsally and radially due to the unopposed pull of the abductor pollicis longus muscle.

Mechanism of Injury

It is usually an axial blow to a partially flexed metacarpal, such as a fistfight.

Treatment

Treatment includes reduction with tension band wiring technique (it is a technique in which fracture fragments are transfixed by Kirschner wire) accompanied by external fixation.

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Physical Findings of Pneumonia

In this article, we will discuss the Physical Findings of Pneumonia. So, let’s get started.

Physical Findings

  • Fever or hypothermia, tachycardia, and arterial gas desaturation
  • An increased respiratory rate and use of accessory muscles of respiration
  • Palpation reveals increased or decreased vocal fremitus (pleural effusion)
  • Percussion reveals dull percussion note on the area involved
  • Auscultation reveals crackles, bronchial breath sounds. A pleural rub may be heard over the area involved.

10 MCQs on Orthopedics (Part-VII)

In this article, we will solve 10 MCQs on Orthopedics (Part-VII). So, let’s get started.

Questions and Answers

Q1. Gallow’s traction is given for fracture of:

A. Femur

B. Tibia

C. Humerus

D. Spine

Q2. Who is acclaimed world wide for total joint replacement?

A. Paul Brand

B. John Charnley

C. Paul Harrington

D. Huckstep

Q3. Ossification in fetus starts in:

A. 1 week of intrauterine life

B. 3rd week of intrauterine life

C. 5th week of intrauterine life

D. 5th month of intrauterine life

Q4. In psoriatic arthroplasty the characteristic joint involved is:

A. Proximal interphalangeal joint

B. Distal interphalangeal joint

C. Metacarpophalangeal joint

D. Wrist joint

Q5. Aseptic loosening in cemented total hip replacement, occurs as a result of hypersensitivity response to:

A. Titanium debris

B. High density polythene debris

C. N N- Dimethytryptamine (DMT)

D. Free radicals

Q6. Slipped femoral epiphysis is commonly seen in the:

A. 1st decade

B. 2nd decade

C. 3rd decade

D. 4th decade

Q7. A therapist reviews the surgical report of a patient that sustained extensive burns in a fire. The report indicates that at the time of primary excision cadaver skin was utilised to close the wound. This type of graft is termed as/an:

A. Allograft

B. Autograft

C. Heterograft

D. Xenograft

Q8. Rocker bottom foot results from:

A. Congenital vertical talus

B. Poliomyelitis

C. Club foot over correction

D. Both A and C

Q9. Coxa vara is found in:

A. Perthe’s disease

B. Tuberculosis

C. Rickets

D. Rheumatoid arthritis

Q10. A patient presented with claw hand, after supracondylar fracture was reduced and plaster applied. The diagnosis is:

A. Median nerve injury

B. Volkmann’s ischemic contracture

C. Ulnar nerve injury

D. Dupuytren’s contracture

E. Both B and C

Answers: 1 (A), 2 (B), 3 (C), 4 (B), 5 (C), 6 (B), 7 (A), 8 (D), 9 (A), 10 (E).

Clinical Presentations of Pituitary Apoplexy

In this article, we will discuss the Clinical Presentations of Pituitary Apoplexy. So, let’s get started.

Signs and Symptoms

  • Headache, sudden and severe retro-orbital and frontal pain
  • Decreased visual acquity and visual field defects
  • Opthalmoplegia, ptosis, and pupilary defects
  • Nausea, vomiting, headache, alteration in the level of consciousness, e.g. lethargy, stupor, and coma
  • Hemiplegia
  • Acute adrenal insufficiency
  • Gonadal dysfunction
  • Diabetes insipidus
  • Hypofunction of thyroid
  • Fever, anosmia, CSF rhinorrhea, and facial pain, respiratory and cardiac rhythm disturbances

Structure involved/compressed

  • Sudden enlargement of tumor mass
  • Optic nerve
  • The III,IV, and VI cranial nerve compression
  • Meningeal irritation (disruption of dura or leakage of blood into subarachnoid space)
  • Internal carotid artery
  • Compression of corticotrophs (loss of ACTH)
  • Compression of gonadotrophs (loss of LH, FSH)
  • Compression of pituitary stalk
  • Compression of thyrotrophs
  • Nonspecific, noncompressive

WHO Classification of Acute Myeloid Leukemia

In this article, we will discuss the WHO Classification of Acute Myeloid Leukemia (AML). So, let’s get started.

Classification

The WHO has modified FAB classification of acute myeloid leukemia by reducing the number of blasts required for diagnosis from 30 to 20% and incorporated molecular, morphologic and clinical features.

(1) AML with recurrent cytogenetic translocations

AML with t(8;21) (q22;q22); AML1 (CBFα)/ETO

Acute promyelocytic leukemia [AML with t(15;17) (q22;q12) and variants; PML/RARα]

AML with abnormal bone marrow eosinophils [inv (16) (p13;q22) or t(16;16) (p13;q22) CBFβ/MYH1]

AML with 11q23 (MLL) abnormalities

(2) AML with multilineage dysplasia

With prior myelodysplastic syndrome

Without prior myelodysplastic syndrome

(3) AML and myelodysplastic syndrome, therapy related

Alkylating agent-related

Topoisomerase type II-related

Other types

(4) AML not otherwise categorised

AML minimally differentiated

AML without maturation

AML with maturation

Acute myelomonocytic leukemia

Acute monocytic leukemia

Acute erythroid leukemia

Acute megakaryocytic leukemia

Acute basophilic leukemia

Acute panmyelosis with myelofibrosis

Myeloid sarcoma