techniques

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%

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