epidemiology

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

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

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

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

Epidemiology

6 /100 000

- second most common dislocation after shoulder

Mechanism

FOOSH

Goal

Epidemiology

Most common form of shoulder instability

- young males 

- M:F = 2:1

Aetiology

Indirect ER and abduction moment on arm

- disruption of anterior stabilisers

History

Initial injury

- severe pain in shoulder

Epidemiology

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

- 40^o anterior angulation in sagittal plane

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

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)

Epidemiology

50% rheumatoid patients have elbow pathology

- 80% also have shoulder pathology

- 90% hand and wrist

Always consider entire upper limb