Tushar Jimulia

My family is thankful to the PMO, the GOI, the HCI and the MEA for arranging the safe travel of my daughter back home to India under Vande Bharat. She has finished her institutional quarantine and is back home with the family. @AmitShah

@solimanibra92 @RazaMehmood @InvictaOrtho @bonesmith_ @traumaticum @centerofhip @neilorpen @sportsdoc2016 @ojedathies @itius Will need a reference to an endocrinologist

@RazaMehmood @InvictaOrtho @bonesmith_ @traumaticum @centerofhip @TJimulia @neilorpen @sportsdoc2016 @ojedathies @itius Actually it was low energy Fall from standing position

Hello #OrthoTwitter 👋 25 male, post RTA. PFN or DHS? It’s quite rare for me to see a fracture like this in a patient this young If PFN: What is the proper entry point ? @InvictaOrtho @bonesmith_ @traumaticum @centerofhip @TJimulia @neilorpen @sportsdoc2016 @ojedathies @itius

@solimanibra92 @InvictaOrtho @bonesmith_ @traumaticum @centerofhip @neilorpen @sportsdoc2016 @ojedathies @itius DHS plus anti rotation screw

@solimanibra92 @bonesmith_ @centerofhip @Davembmd @eric_novack @neilorpen @southNJscoli @sportsdoc2016 @Trauma_Pagaza Would clean and sanitise the groin and thigh. Also turn the patient to sanitise the back and buttocks. Carry on with surgery but I add IV Metronidazole for further prophylaxis. Drape in such a fashion so as to prevent further contamination.

Hello #OrthoTwitter Pt prepared for surgery,but before prep and draping after spinal anesthesia he developed sudden severe diarrhea contaminating the table and medial thigh WWYD? Best to use skeletal traction&delay until abdominal stability? @bonesmith_ @centerofhip @Davembmd

@shah_punwar @solimanibra92 @jointdocShields @ojedathies @EauClaireOrtho @FractureDoc @DrPhilSurface @DrShivabs Expected. Better for the patient and the family

@solimanibra92 @jointdocShields @ojedathies @EauClaireOrtho @FractureDoc @DrPhilSurface @DrShivabs @TJimulia Amputation I am afraid.

Hello #OrthoTwitter 34M, prior joint replacement for giant cell tumor, now with exposed tibial implant and purulence. Revision likely difficult. What would you do ? @jointdocShields @ojedathies @EauClaireOrtho @FractureDoc @DrPhilSurface @DrShivabs @TJimulia

@solimanibra92 @jointdocShields @ojedathies @EauClaireOrtho @FractureDoc @DrPhilSurface @DrShivabs Options are amputation or implant removal, aggressive debridement and knee arthrodesis. For knee arthrodesis, one would have to do bone lengthening and fusion using Ilizarov. For Ilizarov, you need a compliant patient who is ready for prolonged Fixator use

@solimanibra92 @InvictaOrtho @bonesmith_ @eric_novack @neilorpen @sportsdoc2016 @traumaticum @txsportsdoc OK.

@TJimulia @InvictaOrtho @bonesmith_ @eric_novack @neilorpen @sportsdoc2016 @traumaticum @txsportsdoc Also, I checked the extensor mechanism and he could do a straight leg raise

Hello #OrthoTwitter, 55 y/o M a femoral fracture treated 20 years ago. He presented after a fall 4 days ago for plate removal. He has had no knee flexion for the past 20 years (fixed in extension). Would you address the patella or leave it as is? @InvictaOrtho @bonesmith_

@solimanibra92 @InvictaOrtho @bonesmith_ @eric_novack @neilorpen @sportsdoc2016 @traumaticum @txsportsdoc The best time to fix a fracture when it is fresh. In this case, lack of flexion has not caused any obvious knee joint degeneration. The Quads appears to be stuck at the plate which has walked off the bone. So at the time of plate removal, a quads plasty may help restore some ROM

@TJimulia @InvictaOrtho @bonesmith_ @eric_novack @neilorpen @sportsdoc2016 @traumaticum @txsportsdoc What is the benefit of fixing the patella sir if you don't mind to ask ?

@bonesmith_ @northwoods1980 I agree with medialisation but the DHS has to be 145 degrees. The hip has to be put in valgus. Medialisation with 135 degree DHS leads to varus failure. This case appears to be medialised in AP only and not in the lateral view.

@northwoods1980 Old school; SHS collapse with medialisation of the shaft. Frequently will heal. A central position of the screw in the head is pivotal to longevity of the construct. It only has to endure 3 months or so.

Patient is massive. But, curious how others would interpret this.

@medflutter_ @OrthopodReg @generalorthomd @ojedathies @Ortho_FL Very odd place for implant failure. Maybe to do with the implant quality.

History Of Short Pfn One Month Back! Implant Failure. What leads To this? And Further Plan? Expert opinion needed. @OrthopodReg @generalorthomd @ojedathies @Ortho_FL

@SECTOR_RES0123 Delhi government gives 9000 per month. Even during AAP government. Why did he not change it? How much is he claiming from the government? Let him clarify all this and make his claims public. How much was spent by the tax payer on his treatment in London?

@blitzkreigm @sonalbhutra @MTPHereToHelp You are in media. Why not rally all your friends in the media and make videos of how traffic police behave and interview senior traffic personnel? Make documentaries. Air them. Use your contacts otherwise most of us will vent on X to no avail. And back to square one.

@MTPHereToHelp there has to be a fair grievance redressal mechanism for fines levied by traffic policemen. Share-cabs, two wheelers create a mess, and they’re not fined. Confronted a cop at Worli Naka on this, and he’s taken a picture of my car for violation.

@airlinerslive National Express?

✈️ "This was the cheapest way for me to get home." 👇 18-year-old Jordon Cox avoided expensive UK rail fares by taking a 1,017-mile diversion. Faced with a £47 train ticket from Sheffield to his home in Essex, he discovered it was cheaper to fly. He travelled by bus to East Midlands Airport, flew to Berlin for a seven-hour layover, and then returned to London Stansted. The entire European journey cost him just £44.07, which included airport transfers, two Ryanair flights, and even lunch in Germany. A direct train journey with lunch would have cost £51.79. UK rail fares have historically been among the highest in Europe, leading passengers to find other travel options. Cox documented the trip to highlight this difference in pricing. Writing for MoneySavingExpert, he stated, "I know that flying is not very environmentally friendly and I won't do this every time I travel, however this was the cheapest way for me to get home." 🛫

@shah_punwar Spin out of poly?

A couple of years later, knee not looking happy 😳 #periprostheticfracture

@shah_punwar Good result.

Thanks to all who engaged with the last post. Really interesting that no obvious consensus. Had I been treating then I think likely a nail/plate combo but not involved until much later in the story. Here’s what was done. Comments welcome. #periprostheticfracture

@Dr_KD_MS Very good practice of AO principle. Life is movement, movement is life. 👌🏽

60 yrs old female with fracture humerus Shaft. It is 9th Post operative day. Happy to see the shoulder movement. #PMCH

@dr_manish_ydv @Dr_Shiv_kumar_ @DocPriyamMD @daoo100 @ChShafiullah15 @bluebook2109 @albertoortegana @farhadparv27723 @SameerYogi14 @shakilED @esanum Perthes disease. A Varus derotation Osteotomy may help

Young boy with progressive limp and mild hip pain for 3 months. Diagnosis ❓ Treatment ❓ #MedX #MedTwitter

@shah_punwar Lag screws and bicolumnar plating

How are we fixing this one? Looks straightforward 🧐 #periprostheticfracture #knee

@richapintoi Strict action should also be taken against previous administration, MCGM officers for allowing this to happen. Public must maintain pressure on the elected officials to persevere with these actions. Problem of course is corruption.

Around 200 illegal hawkers and unauthorised extended structures on footpaths along Irla Road in Andheri (West) were demolished yesterday. Irla Road connects Swami Vivekanand Road and Gulmohar Road and also serves as an access route to Dr R. N. Cooper Hospital. It had witnessed massive unauthorised extensions on footpaths and the setting up of stalls by illegal hawkers.

@pratikorho Would discuss options with the patient. THR v/s fixation. And go with the patient. If the patient lets me decide, would push towards a THR

Neck of femur fracture in 55 year old gentleman, Pauwel type 2 Mild Comminuted ! Did DHS with CC Screw. #medtwitter #medx #orthotwitter #orthox #fracture