surgery

Periosteal Osteosarcoma

 

Definition

 

Intermediate grade chondroblastic osteosarcoma arising from surface of long bones

 

Epidemiology

 

Extremely rare

- 1% of all osteosarcomas

- 25% of surface osteosarcomas

 

Age 15-25

 

Location

 

Typically anterior proximal tibia

- diaphysis of major long bones

- humerus

 

Pathology

 

Greater trochanter pain syndrome

Greater trochanteric pain syndrome

 

Definition

 

Chronic lateral trochanteric pain

- abductor tendon tendonitis

- trochanteric bursitis

 

Epidemiology

 

Women 40 - 60 years old

 

Mechanism

 

? repetitive friction of iliotibial tract over GT

 

Symptoms

 

Pain over upper lateral thigh with activity

- often related to hip flexion

 

Tibial tubercle fractures

Epidemiology

 

Adolescent boys

 

Ossification

 

Proximal tibia / primary ossification centre

 

Tibial tuberosity / secondary ossification centre

- eventually merges with primary ossification centre

 

Ogden Classification

 

Type I - Tibial tuberosity ossification only

 

Facet Joint Dislocation

Definition

 

Facet joint dislocations secondary flexion distraction injury

 

Epidemiology

 

10%

 

Stages

 

1. Unifacet subluxation - interspinous process widening

2. Unifacet dislocation - 25% anterolisthesis

3. Bifacet dislocation - 50% anterolisthesis

4. Complete vertebral translation - 100% anterolisthesis

 

Unilateral Facet Joint Dislocation

 

Morton's Neuroma

Definition

 

Benign enlargement of the common digital branch

- usually 3rd webspace

 

Mortons Neuroma Common Site

 

Anatomy

 

Found at level of or just distal to MT heads

- deep to the deep transverse MT ligament

 

Epidemiology

 

Classically women between 40 and 60

Great toe dislocation

Epidemiology

 

Uncommon

- dancers

- athletes

 

Aetiology

 

Hyperdorsiflexion of the MTPJ

 

Pathology

 

MT head dislocates plantar

- may buttonhole through capsule

- can prevent closed reduction

 

Blocks to Reduction

 

1.  Sesamoids

2.  Conjoint tendon

3.  Intersesamoid Ligament