Subtrochanteric
Lateral femoral shaft
Stress fractures
Associated with long term bisphonate use
Black et al. NEJM 2020
- reduction of hip fracture risk v risk of atypical femur fracture
- 10 year period
Self limiting syndrome of unknown aetiology
- hip pain associated with osteoporosis of proximal femur
AVN
- AVN of the hip in pregnancy is rare but possible
- TOH tends to be diffuse on MRI, while AVN is localised
- extends to neck and metaphysis
- transient osteoporosis has normal bone scan
Rare
- M: F 3:1
Non-traumatic or traumatic condition of femoral head with bone death
20 - 50 yo (average 38)
- M: F 4:1
70-80% with AVN will progress within 1 year
Largely related to degree of displacement
Hawkins Type I
- 0% to 13%
Hawkins Type II
- 20% to 50%
- usually only patchy and not a problem (rarely collapses)
Flexion deformity PIPJ with
- MTPJ normal / simple
- MTPJ hyper-extended / complex
- DIPJ any position
- P1 may become subluxed or dislocated
Uncertain
Long second toe / MT
Hallux valgus
Tight shoes
Hyperextension of MTPJ and PIPJ / DIPJ flexion
- usually all toes affected
1. Complex hammer
- hammer toe with MTPJ extension
- hammer usually affects second toe
2. Curly toe
1. Painful Bunion / Hallux valgus
2. Metatarsalgia / MTPJ dislocation
3. Claw toes
Complain of pain with prolonged standing
Complain feet tire easily
Overall alignment
Heel raises
1. Persistent instability despite ORIF and LCL repair
2. Gross acute instability, not suitable for surgery
3. Delayed treatment > 4 weeks
Young men
FOOSH
- axial load, dorsiflexion and radial deviation
DISI occurs in ulna deviation
Type A Stable acute fracture
A1 Tubercle