How do you feel about our website?
Great   Indifferent

Blog Archive

When Your Knee Becomes More of a Liability than an Asset Jun 25th, 2020

You may enjoy hiking, biking, running, along with many other activities in which your knees play a vital role. But what happens when your knees begin to cause you pain and discomfort? Many of those activities that you used to enjoy may feel like a distant memory. At University of...

Reasons You Shouldn’t Ignore Joint Pain May 27th, 2020

As you get older, your joints may suffer some normal wear-and-tear that triggers a slight discomfort. However, if you're dealing with pain in your joints that doesn't go away, or it's accompanied by other symptoms, it may be time to seek medical attention. This is where Dr. Nabil Ebraheim at...

6 Tips for Preparing for Spine Surgery Apr 23rd, 2020

Back pain can originate from a number of different conditions, many of which can decrease your mobility. It’s possible you’ve tried treatment after treatment with minimal or no relief and are now facing the real possibility of surgery. If you’re at that point, there are some things you need to...

Your Daily Routine May Be Putting You at Risk for Carpal Tunnel Syndrome Mar 16th, 2020

Carpal tunnel syndrome is a common condition caused by repetitive motion of the hand and wrist. It can seem to come on suddenly, causing chronic pain and discomfort. However, the syndrome actually builds up over a period of time, and it may be linked to things you do in your...

Why Hip Replacement Surgery Has an Incredibly High Satisfaction Rate Feb 1st, 2020

Many people just like you, who have suffered from chronic pain and decreased mobility from years of wear and tear on their hip, are raving about hip replacement surgery. And why, you ask? There are many reasons, including new advances in surgical procedures and long-lasting prosthetic hip replacements. Dr. Nabil...

Ignoring a Hairline Fracture May Lead to a More Serious Fracture (and More Pain!) Jan 7th, 2020

When it comes to protecting itself, your body is fairly good at letting you know when something’s wrong. And pain is usually the messaging tool of choice, thanks to your extensive nervous system. But all too often, you ignore the messaging and carry on because life is busy and you...

5 Tips to Help Speed Your Recovery Following Knee Replacement Surgery Dec 9th, 2019

Your knees are arguably the hardest-working joints in your body, as they provide support, mobility, and range of motion, allowing you to easily navigate your life. So when wear-and-tear, arthritis, or injury compromise your knee, making it more of a liability than an asset, it’s likely time for knee replacement...

Coracobrachialis Muscle Anatomy Dec 3rd, 2019

https://youtu.be/LURWl2Q585E   The coracobrachialis muscle arises from the tip of the coracoid process. The coracobrachialis lies lateral to the pectoralis minor muscle. Close to the origin of the coracobrachialis is the origin of the coracoclavicular ligaments. The conoid ligament is medial and the trapezoid ligament is lateral. The coracobrachialis muscle...

Q Angle of the Knee Sep 19th, 2019

  A well-functioning knee is important for mobility. The knee must be able to support the weight of the body during activities such as walking or running. A normal alignment of the knee is important for its function. The Q-angle of the knee provides useful information about the alignment of...

Motions of the Thumb Sep 6th, 2019

  The motions of the thumb are complex and are often difficult to visualize, as multiple joints and planes are involved. The motions are crucial to the overall function of the hand, with amputation of the thumb resulting in 40% impairment. Amputation has also been cited as causing 22% disability...

Subscapularis Muscle Tear Aug 30th, 2019

The subscapularis muscle is a large muscle that originates on the anterior surface of the scapula and lies in front of the shoulder. The subscapularis muscle tendon inserts into the lesser tuberosity of the humerus. The subscapularis muscle provides about 50% of the total cuff strength. The subscapularis muscle inserts...

Knee Dislocations Aug 23rd, 2019

Dislocation of the knee is a serious problem. It should be recognized and managed appropriately early. Knee dislocation is considered an orthopedic emergency. It is important to recognize the dislocation, and do reduction and perform serial neurovascular exam before the reduction and after the reduction. Approximately 50% of knee dislocations...

Brown Sequard Syndrome (BSS) Aug 16th, 2019

Brown-Sequard Syndrome results from an injury to one half of the spinal cord as seen in penetrating injuries. The spinothalamic tract fibers cross the midline below the level of the lesion resulting in contralateral loss of pain and temperature sensation. The posterior column and the corticospinal tracts carry vibration, position,...

Supracondylar Fracture of the Humerus in Children Aug 9th, 2019

  The age is between 4-10 years. The injury is caused by a fall onto an outstretched hand. The majority of the fractures are extension type fractures. Type III is a displaced fracture, and it carries a high incidence of neurovascular deficit and compartment syndrome. Compartment syndrome may not develop...

Posterior Labral Tear Shoulder Instability Aug 2nd, 2019

  Posterior labral tear could mean posterior instability, which is usually diagnosed by the Jerk test or the Kim test. The lesion is sometimes called a Reverse Bankart Lesion. The lesion is usually seen on the MRI. When there is an avulsion of the posterior inferior labrum, and the lesion...

Pigmented Villonodular Synovitis Jul 26th, 2019

  Pigmented villonodular synovitis is sometimes called PVNS. PVNS is a slow growing, benign, reactive synovial proliferation characterized by proliferation of pigment laden histiocytes and giant cells. PVNS occurs in the middle age, and it can be localized or diffuse. Localized occurs predominantly in the anterior knee (classic) and will...

Ankle Fractures, Minimally Invasive Fixation Jul 19th, 2019

  Candidates for percutaneous fixation of ankle fractures are immunosuppressed patients, patients with severe soft tissue compromise, patients with diabetes, elderly patients, and patients with peripheral vascular disease. These patients may be candidates, especially if reduction of the fracture can be obtained in a closed fashion. Precise anatomic reduction of...

Profunda Femoris Artery Jul 12th, 2019

  The profunda femoris artery is the main blood supply of the thigh. The profunda femoris artery arises from the posterolateral aspect of the femoral artery about 4cm below the inguinal ligament. It goes medially behind the femoral artery. The profunda femoris artery crosses the pectineus muscle, and the adductor...

Femoral Triangle Jul 4th, 2019

The femoral triangle is a superficial triangular space located on the anterior aspect of the thigh just inferior to the inguinal ligament. The boundaries of the femoral triangle include the lateral border, the medial border, and the base. The lateral border is formed by the medial border of the Sartorius...

Herpetic Whitlow Jun 28th, 2019

  Herpetic whitlow occurs from the herpes simplex virus. It is a self-limited disease, and it often involves the tip of the fingers. It occurs due to contact with oral or tracheal secretions and from self-inoculation. Herpetic whitlow is seen in dentists, respiratory therapists, anesthesiologists, and toddlers (children who suck...

Paronychia Jun 21st, 2019

Paronychia can be acute or chronic. It is an infection of the nail fold. It is a common hand infection, usually affecting a single digit. The nail fold will be tender, red, and swollen. It will sometimes be fluctuant with pus. It can happen from injury or trauma in the...

June 14, 2019 | Nabil Ebraheim, M.D The reverse pivot shift test helps to diagnose acute or Jun 14th, 2019

  The reverse pivot shift test helps to diagnose acute or chronic posterolateral instability of the knee. A significantly positive reverse pivot shift test suggests that the PCL, the LCL, the arcuate complex, and the popliteal fibular ligament are all torn. The reverse pivot shift test begins with the patient...

Pivot Shift Test Jun 7th, 2019

  The anterior cruciate ligament is located in the front of the knee. Rupture of the anterior cruciate ligament (ACL) is a condition commonly seen in sports usually due to a non-contact pivoting injury. The Pivot Shift test is a specific test for ACL deficient knee (ACL injury). Pivot shift...

Ankle Fractures Danis Weber Classification May 31st, 2019

  Ankle Fractures Danis Weber Classification This classification is based on the level of fibular fracture. Fibular fracture that is more proximal indicates an increased risk of syndesmotic disruption and ankle instability. Type A is an internal rotation and adduction injury. It is a fracture of the fibula below the...

Osteomyelitis Bone Infection May 24th, 2019

  Osteomyelitis Bone Infection Osteomyelitis is an infection of the bone. It may be an incurable disease. Usually bacteria causes infection in the bone. Staph aureus is the most common organism in adults. Leukocytes are attracted to the area and secrete enzymes in attempt to kill the bacteria. Blood flow...

Painful Gait, Antalgic Gait May 17th, 2019

  A patient with antalgic gait does not want to spend time on the affected leg due to the pain. The patient wants to get their weight off the affected extremity. With antalgic gait, there is an abnormal shortened stance phase on one of their steps. The swing phase is...

Froment’s Sign May 10th, 2019

The Froment’s Sign occurs due to weakness of the adductor pollicis muscle, which occurs when the patient has an ulnar nerve palsy. The adductor pollicis muscle has two heads: the transverse head and the oblique head. The transverse head originates from the anterior body of the third metacarpal. The oblique...

Reiter's Syndrome May 3rd, 2019

    Reiter’s Syndrome is a type of reactive arthritis that happens as a reaction to a bacterial infection in the body. It is characterized by urethritis, conjunctivitis, and join arthritis. Urethritis is inflammation of the urethra with the most common symptom being painful or difficult urination. Conjunctivitis is inflammation...

Pronator Teres Syndrome Apr 26th, 2019

Pronator teres syndrome is a compression of the median nerve at the level of the elbow which occurs more in females. In the forearm, the median nerve runs between the two heads of the pronator teres muscle, and it lies between the flexor digitorum superficialis and flexor digitorum profundus muscles....

DVT & Virchow's Triad Apr 19th, 2019

There are three factors that are thought to contribute to deep venous thrombosis: endothelial injury, venous stasis, and hypercoagulability. Deep venous thrombosis or blood clots form in the deep veins usually in the legs. Although deep venous thrombosis (DVT) predominantly occurs within the deep veins in the legs, it may...

Serratus Anterior Muscle Apr 12th, 2019

  The serratus anterior muscle originates on the superolateral surface of the upper 8 or 9 ribs. The muscle inserts into the medial border on the anterior side of the scapula. The serratus anterior muscle is divided into three parts: serratus anterior superior, serratus anterior intermediate, and serratus anterior inferior....

Spinal Cord Injury Apr 5th, 2019

  A patient was involved in a motor vehicle accident, and the patient is unable to move all four extremities. We will start the examination with applying the ABC’s for trauma patients: Airway, Breathing and ventilation, Circulation and hemorrhage control, Disability evaluation, Exposure/Environmental control. Because the patient cannot move their...

Tests for Examination of the Knee Mar 29th, 2019

There are multiple tests for examination of the knee. Tests include the McMurray’s test, the Lachman’s test, the pivot shift test, the reverse pivot shift test, the posterior drawer test, the dial test, the valgus stress test, and the Varus stress test. The McMurray’s test is a knee examination test...

Fractures of the Calcaneus Mar 22nd, 2019

Fractures of the calcaneus could be open or closed. Open fractures can be a big problem. The primary fracture line is caused by an axial load injury. The primary fracture line goes from anterolateral to posteromedial. The primary fracture line divides the calcaneus into two main fragments. A superomedial fragment...

Tibial Pilon Fracture Mar 15th, 2019

  Tibial pilon fractures are high energy axial load injuries. Soft tissue injuries are bad; they can be open or closed fractures. The ankle joint and the metaphysis of the tibia are usually involved. There is no immediate open reduction and internal fixation (because the soft tissue is usually bad)....

Distal Femur Fracture- Supracondylar Femur Fracture Mar 8th, 2019

Supracondylar femur fractures can occur in young patients due to high energy trauma and when it occurs in older patients; it usually occurs due to low energy trauma such as a fall (osteoporotic bone). When you see a supracondylar fracture of the distal femur involving the joint, you need to...

Anatomical Snuff Box Mar 1st, 2019

The anatomical snuff box is a small, triangular depression located on the dorsoradial aspect of the wrist. People use this space for placing and then sniffing the powered tobacco or “snuff”. This is how the “snuff box” got its name. It is triangular in shape and the base is proximal....

Compartment Syndrome Feb 22nd, 2019

  Compartment syndrome is an increased pressure in a closed space or a compartment which will result in decreased perfusion and ischemia to the muscles and nerves. Compartment syndrome is an increased pressure in a closed space or a compartment which will result in decreased perfusion and ischemia to the...

Medial Collateral Ligament Injuries Feb 15th, 2019

The medial collateral ligament is one of four major ligaments of the knee. The medial collateral ligament extends from the medial epicondyle of the femur to below the medial condyle of the tibia. The MCL is a static stabilizer composed of superficial (primary) and deep (secondary) portions that are restraints...

Protein S/Protein C Deficiency & Factor V Leiden Feb 8th, 2019

The risk of avascular necrosis (AVN) and pulmonary embolism (PE) is increased by having an inherited thrombophilia. This includes protein S or protein C deficiency and Factor V Leiden mutation. Protein S and protein C work on the anticoagulation cascade. Protein C, in addition to thrombomodulin which is found in...

Ankylosing Spondylitis & The Spine Feb 1st, 2019

There really are a lot of problems when you deal with a patient that has ankylosing spondylitis and has spine trauma or the sudden onset of neck or back pain. If we don’t pay attention to the ankylosing spondylitis patient with a spine trauma, then the outcome is not going...

Cervical Myelopathy Jan 25th, 2019

Cervical spine myelopathy can occur due to compression of the cervical spinal cord at the cervical spine level. Cervical spine myelopathy is caused by spondylosis, cervical stenosis, cervical disc herniation, tumors, or ossification of the posterior longitudinal ligament (OPLL). OPLL can occur more in people of Asian ancestry. C4-C6 is...

Jersey Finger Jan 18th, 2019

Jersey finger is an avulsion of the flexor digitorum profundus from its insertion at the base of the distal phalanx. The injury zone occurs in Zone I which is located from the insertion of the flexor digitorum superficialis distally. The ring finger is affected in about 75% of the patients....

Bunionette Jan 11th, 2019

Bunionette is also called “Tailor’s Bunion”. It is a prominence usually at the lateral part of the fifth metatarsal head. Pain can result from the bursitis. Bursitis can happen because of rubbing of the fifth metatarsal head prominence against the shoes. The patient will have a widened forefoot and may...

Quadratus Femoris Jan 4th, 2019

  The quadratus femoris muscle originates from the lateral margin of the ischial tuberosity. It inserts into the quadrate tubercle on the intertrochanteric crest between the greater and lesser trochanter. The quadratus femoris is one of the six external rotators of the hip. It also helps adduct the thigh. It...

ACL Tears- Radiological Diagnosis Dec 28th, 2018

The Anterior Cruciate Ligament (ACL) is a strong band of tissue in the center of the knee that prevents anterior translation of the tibia on the femur. The mechanism of injury to the ACL is usually a noncontact, pivoting injury. As the ACL tears, the patient feels a “POP” and...

Clinical Examination of Shoulder & Rotator Cuff Dec 21st, 2018

There are multiple tests that are used for clinical evaluation of the subacromial impingement and cuff pathology. In the Neer’s Test, the patient should be standing or sitting upright. The examiner will passively elevate the pronated arm of the patient above the level of the shoulder. Pain at the anterolateral...

Extensor Carpi Radialis Longus Muscle Dec 14th, 2018

The ECRL originates from the lower third of the lateral supracondylar ridge of the humerus. The ECRL inserts at the back of the base of the second metacarpal bone. The ECRL acts for extension and abduction of the hand at the wrist joint. This means extension and radial deviation of...

Capitellum Fracture Dec 7th, 2018

Be aware of coronal shear fracture of the capitellum that includes the capitellum and part of the trochlea. The coronal shear fracture involves the capitellum and extends medially to include part of the trochlea. You will see a double arc on the lateral x-rays. One arc represents the capitellum, and...

Hemoglobin A1c Tests That Orthopedic Surgeons Should Think About Nov 30th, 2018

Hemoglobin A1c is a test that measures the amount of glucose attached to the hemoglobin. The test tells us the average level of blood sugar (glucose) of the patient over the last 2-3 months. The normal range of Hemoglobin A1c is between 4% and 5.6%. When the level is 6.5%...

Ewing's Sarcoma Nov 23rd, 2018

  There are some characteristics for Ewing’s Sarcoma that will help us in remembering this malignant bone tumor. Ewing’s Sarcoma occurs more in males between the ages of 5-30 years old. Ewing’s Sarcoma occurs in the diaphysis of bone about 50% of the time. It occurs mostly in the femur,...

Aspiration of Joints-Tests That Orthopedic Surgeons Should Think About Nov 16th, 2018

When you inject steroids into a joint, it is better to aspirate the joint first to see the color of the fluid. You do not want to inject steroids when the patient has infection. Aspiration and analysis of joint fluid is the best method for diagnosis of possible infection. Aspirate...

Winking Owl Sign & Beyond Nov 9th, 2018

An absent pedicle in the AP view of the spine is a sign of a metastatic tumor to the spine that affects the pedicle. This is usually called the “winking owl” sign. It means that the pedicle is absent or destroyed due to the metastatic tumor. The tumor extends from...

Neck Pain: Causes and Treatment Dec 30th, 2016

  The neck is composed of seven bones, called vertebrae that Begin in the upper torso and end at the base of the skull (Figure 2).   With the help of muscles and ligaments, the neck provides stability to the spine and allows motion.  The neck has two other very...

Orthopaedic Surgeon First Hand Dec 9th, 2014

We begin to search the internet to find definitions or "key" phrases.  We stumble across the definition of a surgeon: A person who has been trained/educated in the diagnosis of pre-operative, operative and post-operative treatments relating to the musculoskeletal system.  But yet we find ourselves not fully understanding what it...