Minimal trauma fracture
- secondary to osteoporosis
- wedge fractures
F > M
More common in elderly patients
Uncommon in men < 75
- look for alternative diagnosis
Renal failure
Malignancy - metastasis
Infection
Can present with pain
Isolated posterior ligament injuries
- PLL / Posterior interspinous ligament / Paraspinal muscles
Excludes fracture / dislocation / HNP
MVA
Sport
Hyperflexion injuries
Large spectrum clinical presentation
- neck ache
- nausea & vomiting
- headache
- visual symptoms
Non-union
- arrest of progression to union at fracture site
- > 6-9 /12
- no visible progressive signs of healing for at least three consecutive months
- individualise for each fracture
- when the surgeon believes the fracture has little or no chance to heal
Delayed union
- failure of fracture to unite within expected time
- still may spontaneously unite
Transient disturbance of spinal cord function
- +/- vertebral column injury
- no pathological changes in spinal cord
Rapid change in velocity following trauma
- football / ice hockey
Congenitally narrow spinal cord
Hypermobility
Hereditary bleeding disorder due to defective and/or deficient factor VIII molecule
Inherited X-linked recessive disorder
- occurs almost solely in males
- female carriers usually asymptomatic
- 30% have no family history
FVIII deficiency
X-linked disorder
- 1:10 000
- all ethnic groups
Groin pain in athletes
- secondary to tear in external oblique fascia
Sports with aggressive adduction
- hockey / soccer
Tears in external oblique fascia
- tend to be central
- around spermatic cord and ilioinguinal nerve
- pain may be from nerve entrapment
Adductor Longus Tear
Radius rotates externally in relation to the ulna
- posterior displacement of the radial head relative to the capitellum
- in flexion
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
Bunion
- medial prominence of head of 1st MT
Hallux Valgus
- medial deviation 1st MT
- lateral deviation of great toe
Metatarsal head
- has 2 grooves separating ridge (cristae)
Biological response to particulate matter
- characterised by periprosthetic osteolysis
- stimulated by wear debris
- debris gains access to any area accessible by fluid
1. Wear
Mechanisms of wear