epidemiology

Background

Bilateral Hip AVN Xray

 

Definition

 

Non-traumatic or traumatic condition of femoral head with bone death

 

Epidemiology

 

20 - 50 yo (average 38)

- M: F 4:1

 

NHx  

 

70-80% with AVN will progress within 1 year

 

Talar Neck Fracture

Epidemiology

 

Second most common  hindfoot after calcaneal fractures

 

Aetiology

 

Aviators Astragalus

 

Fall from height

- hyper-dorsiflexion injury

- neck of talus strikes the anterior tibia

 

Anatomy

 

More than half surface covered by articular cartilage

- medial articular wall straight

- lateral articular wall curves posteriorly

Os Trigonum FHL Impingement

Posterior Ankle Impingement

 

Epidemiology

 

Repetitive plantar flexion

- soccer players, ballet dancers

 

Cause

 

Os trigonum

FHL stenosing tenosynovitis

Soft tissue mass

 

Os Trigonum

 

Secondary centre of ossification of talus

- lateral to groove for FHL

- 2-7% of normal feet

- impinges against plafond with forced PF

Plantar Fibromatosis

Definition

 

Fibrous proliferative lesion in plantar fascia

 

Epidemiology

 

Male, white, middle age

 

May arise in isolation

 

Association Dupuytren's Diathesis

- aka Lederhosen disease

 

Pathology

 

Proliferative Fibroblastic lesion

- May resemble fibrosarcoma histologically

 

Distal Humerus Fractures

EpidemiologyDistal Humeral Fracture

 

2 groups

- young patient with high velocity injury

- older patient with comminuted, osteoporotic fracture

 

In the second group fixation can be very difficult

 

Anatomy

 

Hinged Joint

- trochlea axis is centre of rotation

- 40o anterior angulation in sagittal plane

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)