instability

Atlas / C1 Fractures

3 types

 

1. Posterior Arch

 

Mechanism

- axial compression with hyperextension

 

Associations

- 50% incidence other C1/2 fracture

- i.e. ondontoid fracture

 

Management

- stable

- soft / philadelphia collar

 

2. Isolated lateral mass fracture

 

Mechanism

- asymmetrical axial compression / lateral bend

Background

Definition

Dislocated Patella

 

Repeated dislocation of patella with minimal trauma

- 15-20% of paediatric acute patella dislocations

- more common girls 

- often bilateral

 

Dislocation occurs unexpectedly when quadriceps contracted with knee in flexion 

 

Direction

 

Management

Non-operativePatella Instability MPFL and TTT AP

 

Results

 

90% respond 

- very important

- 6 - 12 months minimum before offering surgery

 

Physiotherapy

 

1.  Stretches

- quads stretches

- ITB

- lateral retinaculum