surgical technique

Psoas Avulsion

Ileum Fracture

ASIS Avulsion

Sartorius

AIIS Avulsion

Rectus femoris

Schatzker Classification

I.  Lateral Spilt 

- seen in young patient

- lateral meniscus can be incarcerated in fracture

II.  Lateral Split Depression

- often seen in young patients with high energy injuries

- vary in severity

Issues

Complex / high energy injuries

Management of soft tissues critical

- restore length with external fixation

- await for swelling to reduce

Restoration of alignment & joint surface imperative

Outcome guarded

1.  Templating

Xray

AP in plane of scapula

- template glenoid 

- most inferior screw is in thick bone of scapular axillary border

AP humerus

- size and fit of diaphyseal and metaphyseal humeral components

CT

Definition

Humeral Avulsion of Glenohumeral Ligament

Incidence

Bokor et al JBJS Br 1999

- 514 cases surgical treatment traumatic instability

- incidence 7.5%

- 25% associated SSC tear

- likelihood of HAGL if no Bankart or MDI 27%

Indication

1.  Acute < 3/52

- single bundle

2.  Chronic

- double bundle

Technique Single Bundle

Set up

- knee at 90 degrees on bolster

- x-ray getting lateral of knee

Causes

Most common

- fascia lata on greater trochanter

- iliopsoas on lesser trochanter

1.  Intra-articular structures

- labrum

- ligamentum Teres

- loose bodies

- synovial chondromatosis

- osteochondoma

2.  Extra-articular structures

- fascia lata on greater trochanter (common) 

Epidemiology

Second most common  hindfoot after calcaneal fractures

Aetiology

Aviators Astragalus

Fall from height

- hyper-dorsiflexion injury

- neck of talus strikes the anterior tibia

Anatomy

More than half surface covered by articular cartilage

- medial articular wall straight

- lateral articular wall curves posteriorly

Definition

Fibrous proliferative lesion in plantar fascia

Epidemiology

Male, white, middle age

May arise in isolation

Association Dupuytren's Diathesis

- aka Lederhosen disease

Pathology

Proliferative Fibroblastic lesion

- May resemble fibrosarcoma histologically

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