Joideep Phadnis

@generalorthomd @robgraymd @CE_HandSurg @ansokmd @FixnBones @NuelleSportsMD @OrthoCurryMD @txsportsdoc @SSittonMD @Gnomelover1970 @shouldergeek @kevinfarmermd @OrthoThompson @MDMillerMDUVA No need for imaging in an acute injury where the hook test confirms complete rupture. This is 90% of the time. Mri mainly useful for the others e.g when there is a suspicion of a short head tear or hook test is equivocal - usually a tear with almost no retraction.

How often do you get MRI for distal biceps rupture? And how do you decide? @robgraymd @CE_HandSurg @ansokmd @FixnBones @NuelleSportsMD @OrthoCurryMD @txsportsdoc @SSittonMD @Gnomelover1970 @shouldergeek @kevinfarmermd @OrthoThompson @MDMillerMDUVA #orthotwitter

@Gnomelover1970 @traumaticum @drrogervanriet @rish_parmar Yep - just talking about this specific case - small coronoid minimally displaced not contributing to the instability significantly imo

@lbowfixr @traumaticum @drrogervanriet @rish_parmar It depends on the coronoid. Sometimes it’s a big piece that you can lock in and then you don’t always need to do the ligaments. In this one coronoid tiny and fixing it did not return congruence and so you had to do the ligaments.

Interesting elbow today. @Gnomelover1970 has made me paranoid about the medial coronoid facet and I’ve spent way too much time deliberating the biomechanics of the pMCL. But this was an eye opener @drrogervanriet @lbowfixr @rish_parmar #orthotwitter osteosynthesis.org/13002310-pmri-…

@Helen7physio @bessconference Love that - v jealous

Is it weird that I’m really satisfied with my scapula keyring?! #shouldergeek #shoulderphysio #bess2023 @bessconference

@JSanchezSotelo Fantastic elbow course and a real priveledge to work alongside some of the best elbow teachers in the world.

Thank you to our Faculty and Delegates #IACES 2023 #elbow

@kangsta77 @OR_UK @Gnomelover1970 @CameronLackey3 @CambridgeOrtho1 Showed this pic to my 9 year old daughter and she asked how I knew boris Johnson and the new prime mister guy😂😂😂

On our way to #LSM2023 @OR_UK Bio, psycho, social Who is which? 🤔 @Gnomelover1970 @CameronLackey3

@sdouglas80 Incredible standard

Almost footballing perfection from Man City in that first half.

@sdouglas80 Almost….I think they gave the ball away three times

@northwoods1980 Would be interesting to know how many baseplates with a tiny radiographic gap don’t fail

I need some help on this reverse. Each one separated by about 12 months. Any technical reason visible?

@sdouglas80 Great composure to hit top bins in injury time. This team is a breath of fresh air

Mac Allister penalty in the 99th minute wins it for Brighton Not quite as late as Bruno's on the same ground in 2020 (100th minute)

@AshwanthRamesh Yes - it means the knot ends up on the lateral side

@lbowfixr recently read your paper on suture fixation for olecranon fractures. Just wondering the first suture is a transverse grasping stitch starting medial side of triceps then passing it through the ulna bone tunnel and continuing on the lateral edge of triceps?

@hpsinghjk1 Surgery - unstable ulnohuneral joint

18 year old young man, wants to take up professional golf, fell on golf course ⛳️, options of management? Conservative or operative?

@traumaticum Get on and do it IMO. Evidence may suggest leaving till the morning is ok but no pulse and likely neuro deficit despite pink hand is likely to evolve further. Different if it presents at midnight but these almost always come in early evening.

Weather is getting warmer... can you tell?! Gartland IV with brachialis buttonholing. Closed. Pink warm hand, cap refill 2sec. 7yo kid zonked out by paramedics for transport (helicopter ride!) Neuro status AWOL. its 21:00. What's your game plan? #orthotwitter

@centerofhip This is one where I position prone - you’re directly looking at the reduction. No tension from the flexors and allows easy reduction then just fire the screw downwards. Really makes it easy. Imaging also a breeze

Diagnosis? 12 yr old lad, severe pain left elbow after he fell of his bike. Management? #orthotwitter

@sdouglas80 😮wow - didn’t know this was afoot

This Barcelona/referees story getting bigger and bigger

@Gnomelover1970 Here’s another Lee! I’ve treated two and seen a few more via other people - they all look the same but have variable marginal comminution +\- a coronoid fx where the trochlea engages over it. Interesting to consider the mechanism….

Like buses, can’t remember ever seeing an isolated medial trochlea fracture. Now two come at once.

@dave_cloke @Gnomelover1970 Good idea 👍. One of the situations where a prone position works well. A couple of windows in front and behind flexors works but osteotomy would have given you a panoramic view. Blood supply to that fragment is v tenuous and comes from the medial epicondyle via one vessel.

@lbowfixr @Gnomelover1970 Approach? I went pistero medial and did medial epicondyle osteotomy

Things are not always as they seem…. @Gnomelover1970 @lbowfixr - punchline in thread

@dave_cloke @Gnomelover1970 Also it tends to get locked on the coronoid so u have to lever it off

@lbowfixr @Gnomelover1970