osteoarthritis

Managment

Proximal Tibio-fibular fusion

Vumedi Proximal Tibio-fibular fusion

Epidemiology

Much less common than hip and knee OA
Patients tend to be younger

Condensing Osteitis

Epidemiology

- seen in women over 40

Xray

- sclerotic and overgrown

CT

Definition

OA of the scapho-trapezium-trapezoidal joints

Epidemiology

50% patients with CMC OA have STT OA

F > M

Xray

Management

Non-operative Management

Natural history

Return to Sport

Shelbourne et al. Am J Sports Med 1999

- 133 patients with isolated PCL injuries followed for mean of 5 years

- 1/2 returned to sport at same level of play

- 1/3 returned to sport at lower level of play

https://pubmed.ncbi.nlm.nih.gov/10352760/

Agolley et al. Bone Joint J 2017

Acute management

Resuscitation

EMST

Neurovascular assessment

Investigations - exclude Pipkin, NOF

Emergent reduction / skeletal stabilisation

Assess stability

Re-evaluate sciatic nerve

Insertion Femoral Steinman Pin

Indications

- displaced acetabular fracture

Schatzker Classification

I.  Lateral Spilt 

- seen in young patient

- lateral meniscus can be incarcerated in fracture

II.  Lateral Split Depression

- often seen in young patients with high energy injuries

- vary in severity

Bristow

Concept

Non-anatomical bony block 

- transfer of coracoid process through subscapularis

- dynamic anteroinferior musculotendinous sling

- provides subscapularis tenodesis

- preventing lower portion from displacing proximally as arm abducted

- when shoulder in vulnerable position abduction and ER

DDx

OA

Psoriasis

CREST (scleroderma)

RA (rare form)

Other seronegative arthropathies

Hyperparathyroidism

Reactive arthropathy

Gout