treatment

 Articular process fracture

Natural history

Superior articular process fracture

- potentially unstable

Inferior articular process fracture

- thought to be more stable

CT scan

Definition

Loss of ligamentous stability between atlas and axis

Can cause impingement of the spinal cord

Etiology

Cause

Movement of iliopsoas tendon over femoral head / iliofemoral ridge / iliofemoral ligament

Can be seen following THA with cup impingement

Symptoms

Audible or palpable snap in the groin

Hip moves

- from flexed / abducted / externally rotated position

- to extended / internally rotated position

Incidence

10% of the population - usually painless

 Fractures

1.  Neck of 5th Metacarpal

2.  Metacarpal Shaft

3.  Metacarpal Head

4.  Base of Metacarpal Fracture Dislocations

5.  MCPJ dislocations

1.  Neck of 5th Metacarpal Fracture

Non operative Management

Accept 45^o angulation

- will have finger extensor lag, but will recover

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

Definition

Pathological bone formation in soft tissues

Epidemiology

In elbow

- 3% of trauma

- 89% if head injury + trauma

Types

Completely different

1.  Myosisitis Ossificans Circumscripta

- post traumatic

- more common

- recognised as a consequence of neurological injury

Aetiology

Knee forms from 3 separate compartments

Plica represents normal embryonic synovial septum that persists into adult life

Epidemiology

20% of knees have medial patellar plica at arthroscopy

Symptomatic plicae much less common 1-2%

Mean age 14

Types

1.  Infrapatellar (ligamentum mucosum) 

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

Classification

Pre-axial / great toe / 15%

Central / 2-4 MT / 5%

Post-axial / 5th MT / 80%

Type A - articulated

Type B - rudimentary 

Epidemiology

2 in 1000 births

- 30% positive FHx

- autosomal dominant

Associated MT anomalies common

- block MT / Y-shaped / T-shaped /wide head

Treatment

Condition

Strange scapular tumour

- typically bilateral 

- occurs in lat dorsi

Complain of lump which appears around scapula

Imaging

Looks like muscle on CT

Behaviour

Benign

Histology

Shows marked amount of elastin