background
Background
Epidemiology
National Spinal Cord Injury Statistical Center (2021) Facts and figures at a glance
- road traffic accident 40%
- falls 30%
- sports 10%
Chen et al Arch Phys Med Rehab 2016
- 80% male
- cervical (60%), thoracic (30%), lumbar (10%)
Background
Definition
Congenital Talipes Equinovarus
Congenital abnormality of the foot characterised by
- hindfoot equinus & varus
- forefoot Adduction
- midfoot Supination
Latin: talus - ankle / pes - foot / equinus - horse like
Clinical
Foot
- pipe stem calf
- short wide foot
- small heel
- curved lateral border
Background
Issues
Host
Wound
Operating room environment
Antibiotics
Operative technique
Post operative
Host
Immunocompromised
RA (0.9 v 2.2%)
Psoriasis
DM (6%)
Poor nutrition
Obesity
UTI
Prednisone
Previous operation
Previous infection
Age
Background
Aim of Coagulation
To produce sufficient thrombin to rapidly convert soluble fibrinogen into insoluble mass of fibrin
Coagulation cascade must be localised & limited to site of tissue injury
Three phases
1. Immediate Control of Blood Loss
Vascular Phase
- damage to blood vessel triggers reflex vasoconstriction
Platelet phase
Background
Definition ![Dupuytrens](/sites/default/files/Upper Limb/Dupuytrens.JPG)
Palmar Fibromatosis
Aetiology
AD with variable penetration
Pathogenesis
Murrell's Theory of Pathogenesis
1. Microvascular ischaemia
Background
Definition
Accumulation of calcium salts in the soft tissues
- Dystrophic or Metastatic
Different from bone formation
- calcification is typically amorphous calcium crystals
- ossification has bone organic matrix (Osteoid) & cells
Types
Dystrophic
Metastatic
Dystrophic
Background
Definition
A fixed equinus deformity of the forefoot in relation to the hindfoot
- resulting in an abnormally high arch that fails to flatten with weight bearing
- deformity may be forefoot, hindfoot or combination
Aetiology
Background
Aetiology
Intrinsic
- inflammatory
- degenerative
Extrinsic
- traumatic
- spur
Epidemiology
F > 40
Associations 60% of cases
- hypertension
- diabetes
- obese
- trauma
- prior surgery
- steroids