Average age 6 years
20% distal humeral fracture
- second most common elbow fracture after supracondylar
Pull Off
- more common
- fracture begins posterolateral metaphysis
- LCL, ECRL & ECRB attached to fragment
Push off
- varus force to extended EJ
Age 0 - 5
- Salter Harris I
Age 5 - 11
- Salter Harris II
III / IV rare
Great remodelling potential
- 80% growth of humerus from proximal physis
Shoulder ROM compensatory
Age
- even older adolescents do well
1: 3000
Group of inherited peripheral sensory & motor neuropathies
- includes Charcot Marie Tooth Disease
Hypertrophic vs Neuronal HMSN
I Hypertrophic CMT
II Neuronal CMT
III Infantile Hypertrophic Neuropathy - Dejerine-Sottas
Type I: Undisplaced avulsion fracture
Type II: Anterior portion displaced & hinged
Type IIIA: Displaced
Type IIIB: Displaced & Rotated
Idiopathic condition of the immature femoral capital epiphysis involving varying degrees of osteonecrosis
AKA
- Legg-Calve-Perthes disease
- coxa plana
Described in separate publications in 1912 by
- Legg (Boston)
- Calve (France)
- Perthes (Germany)
M: F 4:1
1 in 740 males
Pre-axial / great toe / 15%
Central / 2-4 MT / 5%
Post-axial / 5th MT / 80%
Type A - articulated
Type B - rudimentary
2 in 1000 births
- 30% positive FHx
- autosomal dominant
Associated MT anomalies common
- block MT / Y-shaped / T-shaped /wide head
STS composed of malignant lipoblasts
Common
- 10% of STS
- second only to MFH
Occurs almost exclusively in adults
Males age 40-60
Can be multiple origin -> examine patient
Rarely arise from lipoma
Malignant Fibrous Histiocytoma
Characterised by heterogenous population of pleomorphic spindle cells
- organised in a characteristic storiform or "starry night" pattern
Cell of origin unknown
- primitive mesenchymal cell
- allowing both features of a macrophage (hence histiocyte)
- and collagen producing cell (hence fibroblast)
Benign tumour of nerve & sheath tissue
Most common benign nerve sheath tumour
- associated with NF 1
- usually arises from small cutaneous nerves
1. Localised
- most common type
- usually solitary (90%) with no genetic association
- nil malignant transormation
Jacques LisFranc De St-Martin (1790 - 1847)
General Surgeon in Napoleonic army
High energy
1. Twisting / Abduction injury of forefoot
- original description is fall from horse with foot caught in stirrups
- MVA
2. Axial Loading