Cubitus varus
Incidence
Occurs 10% of supracondylar humeral fractures
- varus malunion
Lateral condyle fracture
- AVN trochlea
Growth arrest of medial aspect physis
- rare
- post traumatic
operative management
Thigh Pain Uncemented Femur
Epidemiology
Ranges
- up to 4%
Clinical
Focal pain
- typically anterolateral thigh
- often tender
- corresponds to tip of stem
Aetiology
1. Instability
Types
- early
- late / failed bony ingrowth
Cause
- micromotion at distal stem
Hemophilia
Definition
Hereditary bleeding disorder due to defective and/or deficient factor VIII molecule
Inherited X-linked recessive disorder
- occurs almost solely in males
- female carriers usually asymptomatic
- 30% have no family history
Haemophilia A
FVIII deficiency
X-linked disorder
- 1:10 000
- all ethnic groups
Sinus Tarsi Syndrome
Anatomy
Osseous canal between talus and calcaneum
- interosseous talo-calcaneal ligament
- cervical ligament
- joint capsule
- nerve endings / arterial anastomoses
Aetiology
Flat foot / overpronation
Inversion / sprain
Pathology
Management
Non-Operative
Education regarding shoe wear
- extra wide / large toe box
Insoles
- longitudinal arch support
- pre MT dome for metatarsalgia
- podiatry to attend to callosities
Toe spacers
Analgesia
Operative
Indications
1. Continued pain and discomfort
2. Difficulties with shoe wear
Accessory Navicular
Incidence
1 - 2 %
Anatomy
Medial Aspect of foot
- proximal to navicular
- part of T posterior tendon
Usually will fuse with navicular (50%)
Issues
1. Probably not a cause of flat foot
- excising accessory navicular / rerouting / reattaching tibialis posterior
- will not help pes planus
2. Pain
- may fracture
Abductor tendon tears
Trochanteric Bursitis
Mechanism
Repetitive friction of iliotibial tract over GT
Aetiology
Overuse in athletes
Common post THR
May be associated with gluteus medius tears
Symptoms
Pain over upper lateral thigh with activity
- often related to hip flexion
Examination
Talar neck fractures
Epidemiology
Second most common hindfoot after calcaneal fractures
Aetiology
Aviators Astragalus
Fall from height
- hyper-dorsiflexion injury
- neck of talus strikes the anterior tibia
Anatomy
More than half surface covered by articular cartilage
- medial articular wall straight
- lateral articular wall curves posteriorly
Calcific tendonitis
Definition
Mid-substance calcification of the rotator cuff
- part of a metaplasia secondary to hypoxia
Aetiology
2 groups of patients