techniques

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

 

TFCC tears

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

 

Stems

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

 

Perilunate dislocations

Epidemiology

 

Young men in 20's and 30's

 

Aetiology

 

High energy injuries

- fall from heights

- MVA

 

Mayfield Classification

 

Injury progresses from radial to ulna

- usually disruption proximal row either side of lunate

 

1.  Capitate usually displaces dorsally initially

- volar lunate dislocation is end stage