Simple Bone Cyst
A simple bone cyst is a solitary cavity containing clear fluid
- originating in the metaphysis of growing children
- adjacent to the metaphyseal aspect of the growth plate.
Unknown pathological origin
Metaphyseal Enchondroma
Arise from the metaphyseal cortex of long bones
- most common in the proximal humerus
Difficult to DDx from Chondrosarcoma
Masses of cartilage nestling in a shallow crater in the periphery of the cortex
Don't ossify
- remain as immature cartilage
Definition
Infection of bone 2° blood-borne bacteria
Most common children
- peak 10 years
True haematogenous OM rare in adults
- usually involves spine
M: F 2:1
Most common femur & tibia
Jacques LisFranc De St-Martin (1790 - 1847)
General Surgeon in Napoleonic army
High energy
1. Twisting / Abduction injury of forefoot
- original description is fall from horse with foot caught in stirrups
- MVA
2. Axial Loading
Body Fracture
- fracture line exits inferior surface behind lateral process
- into posterior facet
- intra-articular body fracture
Neck Fracture
- fracture line exits inferior surface anterior to lateral process
- in front of sinus tarsi
- extra-articular neck fracture
1. Shear
2. Crush
3. Posterior Process
3 Sesamoids may be present in great toe
- 2 almost always present on plantar aspect of MTPJ
- 1 may be present on plantar aspect of IPJ
MTPJ sesamoids most important
- embedded in FHB tendons
- held together by intersesamoid ligament & plantar plate
- each side of crista / inter-sesamoid ridge
- articulate with plantar facets of 1st MT
Tibial usually larger than fibula
A. Ankle Fracture
Types
- Weber A 4%
- Weber C 33%
- Displaced large posterior malleolar
Any OA develops in first 2 years
Causes
- articular damage at time of injury
- non anatomical reconstruction
- complications i.e. infection
A: Alignment
B: Bony
C: Canal
D: Disc
S: Soft tissues
1. Correct deformity
2. Restore stability
3. Decompress neural elements if required
Advantage
- defines level of conus
- may need anterior rather than posterior surgery if lesion above conus
Forward slip of one vertebra relative to inferior one
Wiltse "DID TIP"
Dysplastic
Isthmic
Degenerate
Traumatic
Iatrogenic
Pathological
Congenital Dysplasia of Upper Sacrum
- occurs at L5-S1
Spondylolithesis caused by
- facet joint degeneration
- no pars or dysplastic pathology
- disc space usually preserved
Most common at L4/5 level
More common in elderly females
- F: M = 5:1
Diabetics