ORIF

Clavicle Fractures

Clavicle Fracture Displaced

Mechanism

 

Usually a direct blow 

- less commonly a fall on the outstretched hand

 

RTA / sporting accidents commonest causes

 

Can be pathological as a result of radionecrosis

- eg following radiotherapy for breast cancer.  

 

Incidence

 

Fractures of the clavicle are common

Os Acromiale

Definition 

 

Failure of fusion of adjacent ossification centers

 

Epidemiology

 

Incidence 3%

 

Bilateral in 60%

 

Anatomy

 

4 ossification centers present in acromion

- pre-acromion

- mesoacromion

- metaacromion

- basiacromion

 

Olecranon Fracture

Definition

 

Intra-articular proximal ulna fracture

 

Anatomy

 

Articulates with trochlea

- may have a central bare area

 

Triceps insertion

- via broad aponeurosis which blends with anconeus and CEO

 

Management

 

Non operative Management

 

Undisplaced fracture

- need to ensure triceps mechanism is intact

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

OCD

DefinitionTalus OCD MRI Coronal

 

Fracture talus through articular cartilage into subchondral bone

- 2° force transmitted from distal tibia

 

Osteochondritis dissecans v osteochondral fracture

 

Epidemiology

 

6% ankle sprains

Average age = 25 

M > F

 

Location

 

Navicular fractures

Types

 

1.  Dorsal lip fracture / Tuberosity fracture

- avulsion fractures

- most common

- beware avulsion T post

 

2.  Body fracture

 

3.  Stress Fractures

 

Body Fractures

 

Types

 

A.  Transverse fracture in coronal plane

B.  Transverse from dorsolateral to plantarmedial

C.  Central or lateral comminution