treatment
Metacarpal
Fractures
1. Neck of 5th Metacarpal
2. Metacarpal Shaft
3. Metacarpal Head
4. Base of Metacarpal Fracture Dislocations
5. MCPJ dislocations
1. Neck of 5th Metacarpal Fracture
Non operative Management
Accept 45o angulation
- will have finger extensor lag, but will recover
Transient synovitis / Septic arthritis
Clinically
Unwell / irritable
Fever
Not feeding
Unable to weight bear / limp
Knee pain
Examination
Fever
Limited / painful ROM
Hip held flexed and externally rotated
- maximises volume of capsule
Lab tests
WCC > 12 000
ESR > 40
CRP > 10
Blood cultures
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
Heterotopic ossification
Definition
Pathological bone formation in soft tissues
Epidemiology
In elbow
- 3% of trauma
- 89% if head injury + trauma
Types
Completely different
1. Myosisitis Ossificans Circumscripta
- post traumatic
- more common
- recognised as a consequence of neurological injury
Knee Plica
Aetiology
Knee forms from 3 separate compartments
Plica represents normal embryonic synovial septum that persists into adult life
Epidemiology
20% of knees have medial patellar plica at arthroscopy
Symptomatic plicae much less common 1-2%
Mean age 14
Types
1. Infrapatellar (ligamentum mucosum)
Calcific tendonitis
Definition
Mid-substance calcification of the rotator cuff
- part of a metaplasia secondary to hypoxia
Aetiology
2 groups of patients