techniques

Etiology

Ankle sprain

- eversion / external rotation

Ankle fractures

A. Radiocarpal Dislocation

Pathology

Children < 6

- entire distal humerus physis is displaced

Xray

Distal physis not ossified < 1 year

- may be a difficult diagnosis

Types

1.  Standard trochanteric osteotomy

2.  Sliding trochanteric osteotomy

3.  Extended trochanteric osteotomy

Standard Trochanteric osteotomy

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

Issues

1.  More common recently

- more high level sport

2.  High risk of reinjuring knee from instability

- can suffer permanent severe chondral and meniscal damage

3.  Risk of physeal arrest high if bone block across physis

- risk is growth arrest with ACL reconstruction

Epidemiology

Hemarthrosis

- 60% children have ACL tear

Definition

Present with pain but not instability

Types

Traumatic

Degenerative

Different treatment algorithms for each

History

Ulna side wrist pain

- may be worse with rotation

- opening doors and jars

History of trauma

Examination

Local tenderness DRUJ

Advantage

1.  Reduce implant loosening

- offset load sharing to diaphysis

- 30% if > 70 mm

2. Restore optimal alignment

Indications

1.  Using augments or bone grafting

2.  Increased constraint 

- VVS / hinge