diagnosis

Lunate - triquetal instability

 

Etiology

 

FOOSH

Rare

 

Patho-anatomy

 

Intrinsic Extrinsic

Lunate-triquetal ligament

- C shaped

- volar / dorsal / membranous

- volar component strongest

 

Dorsal radiocarpal ligament

 

Palmar radio-triquetral ligament

Patella Baja

Patella Baja

 

Aetiology

 

Congenital

 

Acquired

- trauma

- post ACL reconstruction / TKR

- chronic quadriceps rupture

 

Issues

 

Decreases ROM

Associated with early OA of the PFJ

 

Diagnosis

 

Blackburne-Peel ratio at 30 degrees flexion

 

Cuboid Fractures

Types

 

1.  Capsular avulsions

 

2.  Body / Nutcracker fracture

 

Nutcracker fracture

 

Epidemiology

- rare

 

Mechanism

- forced eversion / abduction of forefoot

- cuboid crushed between 4th and 5th MT and calaneum

 

Pathology

- displaced cuboid fracture with subluxation of tarsus

DIC

Definition

 

Disseminated Intravascular Coagulation

 

Pathology

 

Results from excessive activation of either extrinsic or intrinsic coagulation pathway

- multiple small clots 

- consumptive coagulopathy

 

1.  Excessive Extrinsic Activation

 

Secondary to extensive cellular destruction

- thromboplastins +++ released into circulation

Necrotising Fasciitis

Definition

 

Infection of skin and subcutaneous tissue

- spreads across fascial planes

- many microbes can be responsible

 

Types

 

Type 1 Polymicrobial

 

Type 2 Monomicrobial

 

Aetiology

 

Group A Beta Hemolytic Strep (S. pyogenes)

- most common cause monomicrobial

 

S. Aureus / MRSA

 

Vibrio

Paget's Disease

Definition

 

Chronic, non metabolic bone disorder

Characterised by increased bone resorption, bone formation and remodelling

 

Epidemiology

 

Rare < 40

1 – 3 % population over 60

M > F

 

Aetiology

 

Unknown

 

Paramyxovirus implicated

- measles

- RSV

- canine distemper virus

 

Electron Microscope

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