Tuberosity avulsions
Tuberosity fractures
Definition
screw
Arthroscopic Screw in Situ
Medial femoral condyle
Technique
Arthroscope in lateral portal
Clear fat pad
Ensure can see entire dimensions of OCD
If fragment is displaced, reduce and pin with accessory K wire
Management
Deformity
Varus / extension / external rotation
Options
Intertrochanteric
Base of Neck
Subcapital
Osteotomy
Valgus / flexion / internal rotation
Intertrochanteric / Southwick
Technique
- biplanar
- valgising / flexion / internal rotation
Background
Definition
Displacement of proximal femoral epiphysis in the immature hip
- due to imbalance of mechanical and endocrine factors
Epidemiology
Age Peak Incidence : M 12-14; F 11-13; Slight downward trend due to earlier maturation of children
L hip > R
10 / 100 000
Bilateral SUFE
No endocrine abnormality
- 20% at time of of diagnosis
- another 20% during diagnosis
- up to 60% with long term follow up
Fracture
Epidemiology
Young men
Aetiology
FOOSH
- axial load, dorsiflexion and radial deviation
DISI occurs in ulna deviation
Herbert Classification
Type A Stable acute fracture
A1 Tubercle
SNAC
Definition
Scaphoid non union advanced collapse
Diagnosis
Xray / CT
- non union of scaphoid
- radio-scaphoid OA
Operative Options
Clavicle Fractures
Mechanism
Usually a direct blow
- less commonly a fall on the outstretched hand
RTA / sporting accidents commonest causes
Can be pathological as a result of radionecrosis
- eg following radiotherapy for breast cancer.
Incidence
Fractures of the clavicle are common