Ulna collateral ligament
Definition
Injury to ulnar collateral ligament of thumb MCPJ
Interferes with pinch grip and grasp and thumb is ineffective as a post
MRI
Hoffa fracture
Definition
Coronal plane fracture of distal femoral condyle
- intra-articular
- often only attachment is posterior capsule
Epidemiology
Rare
Mechanism
Usually a severe valgus trauma
Xray
Hangman's / C2 Fracture
Definition
Bilateral Pars Fracture C2
- traumatic axis spondylolisthesis
NHx
Neurological injury uncommon
- fragments separate and decompress
Different to judicial hanging where spinal cord is severed
Xray
Occipital Condyle Fractures
Epidemiology
Rare
- unilateral
- bilateral
Mechanism
Compression
Lateral Compression
Rotation
Clinical
Skull base pain
Cock Robin
Cranial nerve injury
Classification Anderson & Montesano
Type I
Impaction of a condyle
Facet Joint Dislocation
Definition
Facet joint dislocations secondary flexion distraction injury
Epidemiology
10%
Stages
1. Unifacet subluxation - interspinous process widening
2. Unifacet dislocation - 25% anterolisthesis
3. Bifacet dislocation - 50% anterolisthesis
4. Complete vertebral translation - 100% anterolisthesis
Unilateral Facet Joint Dislocation
Burst Fractures
Definition
Burst fractures
- injury to anterior and middle columns +/- posterior column
Mechanism
Vertical compression
Epidemiology
10% cervical fractures
Most commonly C5/6
Pathology
Anterior & middle columns fail
- if severe, posterior ligament complex fails
Crush Fractures
Definition
Minimal trauma fracture
- secondary to osteoporosis
- wedge fractures
Epidemiology
F > M
More common in elderly patients
Uncommon in men < 75
- look for alternative diagnosis
DDx
Renal failure
Malignancy - metastasis
Infection
Clinically
Can present with pain
Sportsman's Hernia
Definition
Groin pain in athletes
- secondary to tear in external oblique fascia
Epidemiology
Sports with aggressive adduction
- hockey / soccer
Pathology
Tears in external oblique fascia
- tend to be central
- around spermatic cord and ilioinguinal nerve
- pain may be from nerve entrapment
DDx
Adductor Longus Tear
MCL Insufficiency
Aetiology
Throwing injury
- seen in the throwing athlete
- repetitive microtrauma / valgus stress
- develop laxity
History
Initially
- lose velocity / accuracy
Develop medial pain
40% ulna nerve symptoms
Quadriceps Rupture
Epidemiology
Usually occurs in patients over 60
- due to decreased vascularity & collagen weakness
Younger patient on steroids / growth hormone
Occasionally occurs in young athlete with excessive contracture
Aetiology
Often preceded by quadriceps tendinosis