aetiology

Thigh Pain Uncemented Femur

Epidemiology

 

Ranges

- up to 4%

 

Clinical

 

Focal pain

- typically anterolateral thigh

- often tender

- corresponds to tip of stem

 

Aetiology

 

1.  Instability

 

Types

- early

- late / failed bony ingrowth

 

Cause

- micromotion at distal stem

Dislocation

Epidemiology

 

Uncommon

- dancers

- athletes

 

Aetiology

 

Hyperdorsiflexion of the MTPJ

 

Pathology

 

MT head dislocates plantar

- may buttonhole through capsule

- can prevent closed reduction

 

Blocks to Reduction

 

1.  Sesamoids

2.  Conjoint tendon

3.  Intersesamoid Ligament

 

Paget's Disease

Definition

 

Chronic, non metabolic bone disorder

Characterised by increased bone resorption, bone formation and remodelling

 

Epidemiology

 

Rare < 40

1 – 3 % population over 60

M > F

 

Aetiology

 

Unknown

 

Paramyxovirus implicated

- measles

- RSV

- canine distemper virus

 

Electron Microscope

Posterolateral Rotatory Instability

Definition

 

Radius rotates externally in relation to the ulna

- posterior displacement of the radial head relative to the capitellum

- in flexion

 

Posterolateral rotatory Instability

 

Anatomy LCL

 

LCL Elbow

 

MCL Insufficiency

AetiologyTommy John Surgery

 

Throwing injury

- seen in the throwing athlete

- repetitive microtrauma / valgus stress

- develop laxity

 

History

 

Initially

- lose velocity / accuracy

 

Develop medial pain

 

40% ulna nerve symptoms

 

Background

Definition

 

A fixed equinus deformity of the forefoot in relation to the hindfoot 

- resulting in an abnormally high arch that fails to flatten with weight bearing

- deformity may be forefoot, hindfoot or combination

 

Foot CavusFoot Cavovarus

 

Aetiology

 

Background

Aetiology

 

Intrinsic

- inflammatory

- degenerative

 

Extrinsic

- traumatic

- spur

 

Epidemiology

 

F > 40

 

Associations 60% of cases  

- hypertension

- diabetes

- obese

- trauma 

- prior surgery

- steroids

 

Sinus Tarsi Syndrome

Anatomy

 

Osseous canal between talus and calcaneum

- interosseous talo-calcaneal ligament

- cervical ligament

- joint capsule

- nerve endings / arterial anastomoses

 

Sinus Tarsi

 

Aetiology

 

Flat foot / overpronation

Inversion / sprain

 

Pathology

 

Background

DefinitionHallux Valgus Severe

 

Bunion

- medial prominence of head of 1st MT

 

Hallux Valgus

- medial deviation 1st MT

- lateral deviation of great toe

 

Anatomy

 

Metatarsal head

- has 2 grooves separating ridge (cristae)

 

Tibial Nonunion

Definitions

 

Delayed union

- difficult to define

 

Nonunion

- US FDA

- 9/12 since injury

- 3 consecutive months with no signs union

- when the fracture has not healed in what you would expect to be a normal time period

 

Types

 

A.  Hypertrophic

- abundant callous

- adequate blood supply, insufficient stability

 

Syndicate content