xray

Types

Dystrophic or Metastatic

1.  Metastatic 

- hypercalcaemia / hyperphosphatemia

2.  Dystrophic 

- more common

- onto damaged connective tissue

- tendon / ligament / cartilage

- calcific tendonitis shoulder

- Pellegrini-Steida lesion MCL

Pathology

Deposited around chondrocytes & into avascular portion of CT

History

Jacques LisFranc De St-Martin (1790 - 1847)

General Surgeon in Napoleonic army

Mechanism

High energy

1.  Twisting / Abduction injury of forefoot

- original description is fall from horse with foot caught in stirrups

- MVA

2.  Axial Loading

Definition

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

Definition

Body Fracture

- fracture line exits inferior surface behind lateral process

- into posterior facet

- intra-articular body fracture

Neck Fracture

- fracture line exits inferior surface anterior to lateral process

- in front of sinus tarsi

- extra-articular neck fracture

Types

1.  Shear

2.  Crush

3.  Posterior Process

Metatarsal Fractures

Indications for Surgery

1.  Displacement > 4 mm

2.  Angulation > 10^o

3.  Intra-articular

Base of 5th Metatarsal

Classification

Zone 1

- avulsion 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

Definition

Chronic instability due to rupture of one or more parts of the lateral ligament

Anatomy

Progressive injury

1. Anterolateral capsule

2. ATFL

3. CFL

NHx

Can lead to ankle OA over time

Definition

Partial or complete rupture of one or parts of lateral ligaments of ankle

- common ankle sprain

Epidemiology

Lateral ligaments sprains are the most common ligamentous injuries of the human body

- account for approximately 15% of all athletic injuries

- it is estimated that there is one ankle inversion injury per day per 10,000 people

Most common young males

- average age 27

Definition

Painful prominence of lateral eminence of 5th metatarsal head 

Coughlin Classification 

Type I deformity 

- prominent lateral condyle 5th metatarsal head

- lateral condylectomy

Type II deformity 

- lateral bowing of 5th metatarsal

- chevron osteotomy

Epidemiology

More common in girls

High incidence of positive family history (75%)

Can be associated with mild CP

Pathology

Congruent joint

- 50% compared with 9% in adult HV

Metatarsus primus varus