causes

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

 

Whiplash

Definition

 

Isolated posterior ligament injuries

- PLL / Posterior interspinous ligament / Paraspinal muscles

 

Excludes fracture / dislocation / HNP

 

Aetiology

 

MVA

Sport

Hyperflexion injuries

 

Symptoms

 

Large spectrum clinical presentation

- neck ache 

- nausea & vomiting 

- headache 

- visual symptoms

Non Union

Definition

 

Non-union

- arrest of progression to union at fracture site 

- > 6-9 /12

- no visible progressive signs of healing for at least three consecutive months

- individualise for each fracture

- when the surgeon believes the fracture has little or no chance to heal

 

Delayed union

- failure of fracture to unite within expected time

- still may spontaneously unite

 

Burners & Stingers

Definition

 

Neurological pain in arm after injury in sport

- usually due to brachial plexus injury

 

Epidemiology

 

Contact sports

- ice hockey

- rugby

- american football

- basketball

 

Pathology

 

Brachial plexus injury

Cervical nerve root injury

 

Aetiology

 

Traction injury

- hit onto shoulder

Instability

Types of Instability

 

1.  AP Instability

2.  Varus Valgus Instability

3.  Global Instability

4. Frank Dislocation

 

TKR Dislocation APTKR Dislocation Lateral

 

Background

Definition

Dislocated Patella

 

Repeated dislocation of patella with minimal trauma

- 15-20% of paediatric acute patella dislocations

- more common girls 

- often bilateral

 

Dislocation occurs unexpectedly when quadriceps contracted with knee in flexion 

 

Direction

 

Snapping Hip

Causes

 

Most common

- fascia lata on greater trochanter

- iliopsoas on lesser trochanter

 

1.  Intra-articular structures

- labrum

- ligamentum Teres

- loose bodies

- synovial chondromatosis

- osteochondoma

 

2.  Extra-articular structures

- fascia lata on greater trochanter (common) 

Complex Ankle Sprain

Definition

 

Simple sprain 

- injury to ATFL

- will almost always get better in 6-8/52

 

Complex sprain 

- associated injury

- suspect if patient slow to recover 

- diagnose most things on MRI

 

Symptoms

 

Instability

- clinical diagnosis 

- most will get better with appropriate physio

 

Winged Scapula

 

Classification

 

Primary

 

Due to scapulothoracic articulation disorder

 

1.  Neurological Origin

 

A.  Spinal Accessory Nerve / Trapezius palsy

B.  Long Thoracic Nerve /  Serratus Anterior palsy

C.  Dorsal Scapular Nerve / Rhomboids palsy (rare)

 

2.  Osseous Origin

 

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