Glenoid fractures
Definition
posterior
Approach
Options
Direct Lateral - transgluteal
Postero-lateral (AKA posterior) - release short external rotators
Direct Anterior
Results
Gait / outcomes
Meermans et al Bone Joint J 2017
- systematic review of 42 studies comparing Direct Anterior / Posterior / Lateral
Shoulder
Approaches
Anterior
Anterolateral
Posterior
Anterior Approach / Deltopectoral
Indications
- shoulder stabilization
- arthroplasty
- fracture fixation
Approach
Position
- beach chair
- upper body elevated 30- 40o / reduces venous pressure and bleeding
Hip
Approaches
Anterior
Anterolateral
Lateral
Posterior
Medial
Anterior Approach / Smith Peterson
Indications
- neonatal hip sepsis
- open reduction hip DDH
Techique
Position
- supine
- sandbag under buttock
- free drape leg
Landmarks
Knee
Approaches
Medial Parapatellar
Medial
Lateral
Posterior
Modified Posterior
Medial Parapatellar Approach
Indications
Synovectomy
Patellectomy
TKR
Technique
Hip Dislocation
Incidence
Young men
Posterior / Anterior 9:1
Aetiology
High velocity injury
- head direction at impact decides direction of dislocation
Anterior Dislocation
Externally rotated & abducted leg
- flexion = inferior dislocation
Mass Behind Knee
DDx
Baker's Cyst
Popliteal Anerysm
Soft tissue sarcoma
Osteosarcoma / Parosteal OS
Hemangioma / AVM
Note:
Always do xray for calcification
A Bakers cyst / aneurysm can be calcified
Monteggia
Definition
Fracture / plastic malformation of proximal ulna with dislocation of radial head
Xray
Radio-capitellar line disrupted