Tibial Plafond
Issues
Complex / high energy injuries
Management of soft tissues critical
- restore length with external fixation
- await for swelling to reduce
Restoration of alignment & joint surface imperative
Outcome guarded
Complex / high energy injuries
Management of soft tissues critical
- restore length with external fixation
- await for swelling to reduce
Restoration of alignment & joint surface imperative
Outcome guarded
Xray
AP in plane of scapula
- template glenoid
- most inferior screw is in thick bone of scapular axillary border
AP humerus
- size and fit of diaphyseal and metaphyseal humeral components
CT
1. Acute < 3/52
- single bundle
2. Chronic
- double bundle
Set up
- knee at 90 degrees on bolster
- x-ray getting lateral of knee
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)
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
Fibrous proliferative lesion in plantar fascia
Male, white, middle age
May arise in isolation
Association Dupuytren's Diathesis
- aka Lederhosen disease
Proliferative Fibroblastic lesion
- May resemble fibrosarcoma histologically
1. Persistent instability despite ORIF and LCL repair
2. Gross acute instability, not suitable for surgery
3. Delayed treatment > 4 weeks
S. aureus / Strept
- usually a history of trauma
< 20o sagittal
< 30o coronal
< 3 cm of shortening
Injury to ulnar collateral ligament of thumb MCPJ
Initial description
- chronic laxity of British gamekeeper's thumb's
- no specific trauma
- secondary to breaking pheasant's neck
Acute trauma
- snow ski
- ball games
Valgus / forced abduction
UCL