The Bone School

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

Usually lateral femoral condyle

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

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

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

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

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

Issues

Femur

Multiplanar deformity

- worsend by previous surgery

- may require osteotomy

Acetabulum

Dysplasia often present

- not as severe as in DDH

LLD

Can be significant

Abductors

Have been short for long time

- difficult to restore length

Definition

Minimal trauma fracture

- secondary to osteoporosis

- wedge fractures

Epidemiology

F > M

More common in elderly patients

Uncommon in men < 75

- look for alternative diagnosis

DDx

Renal failure

Malignancy - metastasis

Infection

Clinically

Can present with pain

Definition

Chronic, non metabolic bone disorder

Characterised by increased bone resorption, bone formation and remodelling

Epidemiology

Rare < 40

1 – 3 % population over 60

M > F

Aetiology

Unknown

Paramyxovirus implicated

- measles

- RSV

- canine distemper virus

Electron Microscope

Definition

A fixed equinus deformity of the forefoot in relation to the hindfoot 

- resulting in an abnormally high arch that fails to flatten with weight bearing

- deformity may be forefoot, hindfoot or combination

Aetiology