CP is a permanent disorder of movement and posture
- non-progressive
- brain injury before the age of two years
Strict definition excludes familial & progressive congenital problems & those acquired in childhood as a result of head injuries
2-3 per 1000 live births
Higher in
Up to 8% patients with ACL reconstruction will have recurrent instability and graft failure
- increased with surgical inexperience
1. Be inadequate from the start
- inadequate tension
- poor tunnel placement
Self limiting syndrome of unknown aetiology
- hip pain associated with osteoporosis of proximal femur
AVN
- AVN of the hip in pregnancy is rare but possible
- TOH tends to be diffuse on MRI, while AVN is localised
- extends to neck and metaphysis
- transient osteoporosis has normal bone scan
Rare
- M: F 3:1
Non-traumatic or traumatic condition of femoral head with bone death
20 - 50 yo (average 38)
- M: F 4:1
70-80% with AVN will progress within 1 year
Second most common hindfoot after calcaneal fractures
Aviators Astragalus
Fall from height
- hyper-dorsiflexion injury
- neck of talus strikes the anterior tibia
More than half surface covered by articular cartilage
- medial articular wall straight
- lateral articular wall curves posteriorly
Mallet
- DIP flexed
- MTP / PIPJ neutral
Hammer
- PIP flexion
- DIPJ neutral / extended
Simple - MTP not involved
Complex - MTP hyper-extended
Claw
- PIPJ and DIPJ flexed
- MTPJ hyperextended
Curly toe
- PIP and DIP flexion
Flexion deformity of DIPJ
Usually in 2nd toe
- Long second MT
- Constrictive footwear
Pain over
- tip of toe
- over dorsum of DIP joint
May be corn on tip of toe
Fixed or flexible
Flexion deformity PIPJ with
- MTPJ normal / simple
- MTPJ hyper-extended / complex
- DIPJ any position
- P1 may become subluxed or dislocated
Uncertain
Long second toe / MT
Hallux valgus
Tight shoes
Ulna drift & volar dislocation
Ulna Drift / Ulna Dislocation
1. Physiological
S. aureus / Strept
- usually a history of trauma