nonoperative

Flexor Pulley Ruptures

Anatomy

 

5 Annular pulleys

3 Cruciate pulleys

 

Pathology

 

A1 and A5 expendable

 

Loss of other annular pulleys can lead to bowstringing

- A2 & A4 +/- A3

 

Aetiology

 

Rock climbers

- usually when slipping

 

May hear or feel a pop

 

Develop swelling / tenderness / pain

 

Bowstringing

Distal Biceps Tendon Rupture

Epidemiology

 

Dominant arm of middle aged men

- between 40 and 60

 

Aetiology

 

Sudden dramatic event

- sporting / weightlifting injury

- resisting heavy extension load

 

Pathology

 

Degenerative changes seen on histology

 

Types

 

Complete

- retracted / rupture of lacertus fibrosis

- minimally retracted

Lateral Condyle Fractures

Epidemiology

 

Average age 6 years

 

20% distal humeral fracture

- second most common elbow fracture after supracondylar

 

Mechanism

 

Pull Off 

- more common 

- fracture begins posterolateral metaphysis

- LCL, ECRL & ECRB attached to fragment

 

Push off

- varus force to extended EJ

 

Classification

 

Metatarsus Adductus

Definition

 

Metatarsus varus

- adduction of the forefoot at the TMTJ

 

Intrauterine positional deformity / packaging defect

 

Epidemiology

 

1:1000

- M = F 

- bilateral in 50%

- 10% have CDH

 

Aetiology

 

Unclear

 

Theories

- intrauterine positioning defect

- prone nursing