aetiology

De Quervain Syndrome

Definition

 

Stenosing tenosynovitis of the first dorsal compartment of wrist

 

Epidemiology

 

Most are middle aged women

 

Aetiology

 

Repetitive thumb movements

- abduction & extension

- combined with RD & UD movements

 

Any mechanical irritation

- foreign body

- prominent bony surface

- restricted fascial compartment

SLAC Wrist

Definition

SLAC Wrist

 

Scapho-lunate advanced collapse

- caused by malalignment of scaphoid on radius

- due to scapholunate disruption

 

Most common cause of wrist OA

 

Pathology

 

1.  Radio-scaphoid degenerative changes

- from abnormal flexion of scaphoid

Winged Scapula

 

Classification

 

Primary

 

Due to scapulothoracic articulation disorder

 

1.  Neurological Origin

 

A.  Spinal Accessory Nerve / Trapezius palsy

B.  Long Thoracic Nerve /  Serratus Anterior palsy

C.  Dorsal Scapular Nerve / Rhomboids palsy (rare)

 

2.  Osseous Origin

 

Posterior Instability

Definition

 

Patients usually complain of subluxation rather than dislocation

- rarely requires reduction

 

Different entity to acute posterior dislocation usually

 

Epidemiology

 

Rare

 

Aetiology

 

1.  Ligamentous laxity > 50%

- commonly associated with MDI

- posterior only 20%

- posterior & inferior 20%

Capitellar OCD

Epidemiology

 

Adolescents & young adults

 

Usually between 12 - 21 years 

 

Throwing athletes / gymnasts

 

Little Leaguer's Elbow

- combination of capitellar OCD and MCL injury

- a repetitive throwing injury / seen in pitchers

 

Aetiology

 

1.  Trauma & Overuse

 

Common throwing sports / gymnastics

Lateral Epicondylitis / Tennis Elbow

Incidence

 

Lateral : Medial 9:1

 

Epidemiology

 

4th & 5th decades

- M = F

- 75% dominant arm 

 

50% of regular tennis players

- especially > 2 hrs / week

 

Aetiology

 

Insertion pathology / Enthesopathy

 

Over-extension of the elbow with supination / pronation

 

Anatomy

 

Lateral epicondyle

- anconeus from posterior face

- ECRB and EDC from anterior face (CEO)