Atlanto-axial instability
Definition
Loss of ligamentous stability between atlas and axis
Can cause impingement of the spinal cord
Etiology
Loss of ligamentous stability between atlas and axis
Can cause impingement of the spinal cord
Injury to ulnar collateral ligament of thumb MCPJ
Interferes with pinch grip and grasp and thumb is ineffective as a post
Coronal plane fracture of distal femoral condyle
- intra-articular
- often only attachment is posterior capsule
Rare
Usually a severe valgus trauma
Insufficiency fracture
- secondary to exceeding fatigue threshold
- usually of second or third MT shaft
Onset of new and very intense / strenuous physical activity
- i.e. new army recruits / dancers
Women with postmenopausal osteoporosis
Cavus feet
Children < 6
- entire distal humerus physis is displaced
Distal physis not ossified < 1 year
- may be a difficult diagnosis
Uncommon
< 1% Primary bone tumour
Young boys
- second decade
Similar to OO
Spine 30%
- especially posterior elements
Long bones 35%
Back or limb pain
- pain less severe than OO
Adult form
- 45 year old females
- more severe than Kohler's
Intense pain +/- oedema & inflammation
- often pronounced limp
- marked flat foot with prominant navicular
Navicular narrowed
- lateral part dense, sclerotic & thin
- occasional fracture line
Congenital Talipes Equinovarus
Congenital abnormality of the foot characterised by
- hindfoot equinus & varus
- forefoot Adduction
- midfoot Supination
Latin: talus - ankle / pes - foot / equinus - horse like
Foot
- pipe stem calf
- short wide foot
- small heel
- curved lateral border
Fracture distal to articular surface & proximal to intertrochanteric region
On average 4 years younger than intertrochanteric fracture
One year mortality as high as 36%
Only 1/3 will return to pre-fracture living environment
Bilateral Pars Fracture C2
- traumatic axis spondylolisthesis
Neurological injury uncommon
- fragments separate and decompress
Different to judicial hanging where spinal cord is severed