Atlanto-axial Rotatory Instability
Definition
Acute dislocation of the atlanto-axial facet joint
Present with acute torticollis
Etiology
Children
open reduction
Dislocation
Epidemiology
Uncommon
- dancers
- athletes
Aetiology
Hyperdorsiflexion of the MTPJ
Pathology
MT head dislocates plantar
- may buttonhole through capsule
- can prevent closed reduction
Blocks to Reduction
1. Sesamoids
2. Conjoint tendon
3. Intersesamoid Ligament
Monteggia
Definition
Fracture / plastic malformation of proximal ulna with dislocation of radial head
Xray
Radio-capitellar line disrupted
Lateral Condyle Fractures
Epidemiology
Average age 6 years
20% distal humeral fracture
- second most common elbow fracture after supracondylar
Mechanism
Pull Off
- more common
- fracture begins posterolateral metaphysis
- LCL, ECRL & ECRB attached to fragment
Push off
- varus force to extended EJ
Classification
Lis Franc
History
Jacques LisFranc De St-Martin (1790 - 1847)
General Surgeon in Napoleonic army
Mechanism
High energy
1. Twisting / Abduction injury of forefoot
- original description is fall from horse with foot caught in stirrups
- MVA
2. Axial Loading