Atlanto-axial instability
Definition
Loss of ligamentous stability between atlas and axis
Can cause impingement of the spinal cord
Etiology
xray
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
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
March Fracture
Definition
Insufficiency fracture
- secondary to exceeding fatigue threshold
- usually of second or third MT shaft
Epidemiology
Onset of new and very intense / strenuous physical activity
- i.e. new army recruits / dancers
Women with postmenopausal osteoporosis
Association
Cavus feet
History
Distal Humeral Physeal Separation
Pathology
Children < 6
- entire distal humerus physis is displaced
Xray
Distal physis not ossified < 1 year
- may be a difficult diagnosis
Osteoblastoma
Epidemiology
Uncommon
< 1% Primary bone tumour
Young boys
- second decade
Location
Similar to OO
Spine 30%
- especially posterior elements
Long bones 35%
Clinical
Back or limb pain
- pain less severe than OO
Brailsford Disease
Definition
Adult form
- 45 year old females
- more severe than Kohler's
Symptoms
Intense pain +/- oedema & inflammation
- often pronounced limp
- marked flat foot with prominant navicular
Radiology
Navicular narrowed
- lateral part dense, sclerotic & thin
- occasional fracture line
Background
Definition
Congenital Talipes Equinovarus
Congenital abnormality of the foot characterised by
- hindfoot equinus & varus
- forefoot Adduction
- midfoot Supination
Latin: talus - ankle / pes - foot / equinus - horse like
Clinical
Foot
- pipe stem calf
- short wide foot
- small heel
- curved lateral border
Background
Definition
Fracture distal to articular surface & proximal to intertrochanteric region
Epidemiology
On average 4 years younger than intertrochanteric fracture
One year mortality as high as 36%
Only 1/3 will return to pre-fracture living environment
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