fracture

Background

 total shoulder arthroplast allPoly Glenoid

 

Indications

 

RA 

OA 

AVN 

 

Contra-indications

 

Infection

Charcot

Paralysis of deltoid

Torn rotator cuff

Insufficient glenoid bone stock

 

Tibial Stress Fractures

EpidemiologyTibial Stress Fracture

 

Athletic / high impact exercises

 

Aetiology

 

First described in ballet dancers (Burrows 1956)

- tension side of bone / lateral side

- progression to complete fracture has been well documented in athletes

 

Signs

 

Point tenderness

- lateral aspect of tibia

 

Over time develop bony lump

 

Uncemented Femur

GoalTHR Uncemented

 

Initial press fit

- implant geometry fits the cortical bone in the proximal femur

- good initial mechanical stability

 

Biological fixation for success

- good press fit

- minimal micromotion

- bony or fibrous tissue ingrowth or ongrowth

 

Non union

Scaphoid Non union xrayScaphoid Nonunion Xray 2

 

NHx

 

Convincing association with development of osteoarthritis

- arthritic changes beginning at radial styloid

- progress to scaphocapitate & capitolunate 

 

Coronoid Process Fracture

BackgroundClassification Coronoid Fractures

 

The coronoid is the most important portion of ulno-humeral articulation

 

Reasons

1.  Provides anterior buttress

2.  Anterior capsule and brachialis attach to coronoid

2.  Anterior band of the MCL attaches to it

- distally and medially on sublime tubercle

Distal Radius Fracture

Epidemiology

 

2 groups

 

1.  Elderly

- low velocity injury

- osteoporotic

- need to start bisphosphonates

 

2.  Young patients

- high velocity injury

 

Anatomy

 

Distal Radius Angles

- radial volar tilt 11°

- radial inclination  22°

- radius is 11 mm longer than ulna 

- ulna variance 2mm positive on average