xrays

Metacarpal Fractures

Fractures

 

1.  Neck of 5th Metacarpal

2.  Metacarpal Shaft

3.  Metacarpal Head

4.  Base of Metacarpal Fracture Dislocations

5.  Base of Thumb Fractures / Bennett's / Rolanda

 

1.  Neck of 5th Metacarpal Fracture

 

Non operative Management

 

Accept 45o angulation

- will have finger extensor lag, but will recover

MCL Insufficiency

AetiologyTommy John Surgery

 

Throwing injury

- seen in the throwing athlete

- repetitive microtrauma / valgus stress

- develop laxity

 

History

 

Initially

- lose velocity / accuracy

 

Develop medial pain

 

40% ulna nerve symptoms

 

Background

Aetiology

 

Intrinsic

- inflammatory

- degenerative

 

Extrinsic

- traumatic

- spur

 

Epidemiology

 

F > 40

 

Associations 60% of cases  

- hypertension

- diabetes

- obese

- trauma 

- prior surgery

- steroids

 

Kienbock's Disease

Definition 

 

Avascular necrosis & subsequent disintegration of lunate

 

Aetiology

 

50-75% history of trauma

 

Occasionally seen in sickle cell / steroid use

 

Pathogenesis

 

Vascular Theory

 

Trauma disrupting vascularity

- single incident with disruption of blood supply

Gout

DefinitionElbow Gout

 

Heterogeneous group of diseases characterised by

- hyperuricaemia

- recurrent attacks of acute arthritis

 

Diagnosis confirmed by

- crystals of Monosodium Urate in synovial fluid

- tophi ("Porous stone") urate in soft tissues

- renal urate stones

 

Epidemiology

 

Adult men