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

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