incidence

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

Definition

CP is a permanent disorder of movement and posture 

- non-progressive 

- brain injury before the age of two years

Strict definition excludes familial & progressive congenital problems & those acquired in childhood as a result of head injuries

Incidence

2-3 per 1000 live births

Higher in 

Incidence

Up to 8% patients with ACL reconstruction will have recurrent instability and graft failure

- increased with surgical inexperience

Graft can

1.  Be inadequate from the start

- inadequate tension

- poor tunnel placement

Pathogenesis

Virchow's Triad

1. Venous stasis

2. Hypercoagulability

3. Endothelial damage

Starts as platelet nidus at valves

- thrombogenic materials elaborated by platelets

- leads to development of fibrin thrombus

- thrombus grows

Thrombus may 

- detach as embolus

- be completely dissolved / recanalise

- organise with valve incompetence

Definition

Self limiting syndrome of unknown aetiology

- hip pain associated with osteoporosis of proximal femur 

DDx

AVN

- AVN of the hip in pregnancy is rare but possible

- TOH tends to be diffuse on MRI, while AVN is localised

- extends to neck and metaphysis

- transient osteoporosis has normal bone scan

Incidence

Rare

- M: F 3:1

AVN  

Largely related to degree of displacement

Incidence

Hawkins Type I

- 0% to 13% 

Hawkins Type II 

- 20% to 50% 

- usually only patchy and not a problem (rarely collapses)

Types

Dorsal

- most common

Volar

Causes

1.  Acute traumatic peripheral tear TFCC with DRUJ dislocation

- usually major trauma

- dorsal or volar

2A.  Distal radial fracture

Clinical

Pain & Stiffness

- often more pain than FT tears

Bursal side tears more painful than articular

Articular side more common

May see in young patient overhead throwing

Examination

Painful arc

Impingement signs

No weakness

- function good

Incidence

10% of elbow tendonitis

Aetiology

Overuse injury

- poor swing in golf

- poor throwing technique

- overuse of topspin in tennis

- occupational (repetitive hammering / screwing)

Some patients also have lateral epicondylitis

Examination

Tenderness CFO

Stimulate pain

- flexion of WJ with fingers resisting

Incidence

Lateral : Medial 9:1

Epidemiology

4th & 5th decades

- M = F

- 75% dominant arm 

50% of regular tennis players

- especially > 2 hrs / week

Aetiology

Insertion pathology / Enthesopathy

Over-extension of the elbow with supination / pronation

Anatomy

Lateral epicondyle

- anconeus from posterior face

- ECRB and EDC from anterior face (CEO)