techniques
Deltoid ligament injury
Etiology
Ankle sprain
- eversion / external rotation
Ankle fractures
Trochanteric Osteotomy
Types
1. Standard trochanteric osteotomy
2. Sliding trochanteric osteotomy
3. Extended trochanteric osteotomy
Standard Trochanteric osteotomy
Stems
Advantage
1. Reduce implant loosening
- offset load sharing to diaphysis
- 30% if > 70 mm
2. Restore optimal alignment
Indications
1. Using augments or bone grafting
2. Increased constraint
- VVS / hinge
Recurrent Posterior Instability
Definition
Patients usually complain of subluxation rather than dislocation
- rarely requires reduction
Different entity to acute posterior dislocation usually
Epidemiology
Rare
Aetiology
1. Ligamentous laxity > 50%
- commonly associated with MDI
- posterior only 20%
- posterior & inferior 20%
Multidirectional Instability
Definition
Instability in at least 2 planes
- postero-inferior
- antero-inferior
- antero-postero-inferior
Epidemiology
Recognised as a common problem
- often misdiagnosed
Most patients athletic
Distal Biceps Tendon Rupture
Epidemiology
Dominant arm of middle aged men
- between 40 and 60
Aetiology
Sudden dramatic event
- sporting / weightlifting injury
- resisting heavy extension load
Pathology
Degenerative changes seen on histology
Types
Complete
- retracted / rupture of lacertus fibrosis
- minimally retracted