Talar head fractures
Epidemiology
< 10% of all talus fractures
Rare and often missed
Types
treatment
Internal snapping hip
Cause
Movement of iliopsoas tendon over femoral head / iliofemoral ridge / iliofemoral ligament
Metacarpal
Fractures
1. Neck of 5th Metacarpal
2. Metacarpal Shaft
3. Metacarpal Head
4. Base of Metacarpal Fracture Dislocations
5. MCPJ dislocations
1. Neck of 5th Metacarpal Fracture
Non operative Management
Accept 45o angulation
- will have finger extensor lag, but will recover
Facet Joint Dislocation
Definition
Facet joint dislocations secondary flexion distraction injury
Epidemiology
10%
Stages
1. Unifacet subluxation - interspinous process widening
2. Unifacet dislocation - 25% anterolisthesis
3. Bifacet dislocation - 50% anterolisthesis
4. Complete vertebral translation - 100% anterolisthesis
Unilateral Facet Joint Dislocation
Heterotopic ossification
Definition
Pathological bone formation in soft tissues
Epidemiology
In elbow
- 3% of trauma
- 89% if head injury + trauma
Types
Completely different
1. Myosisitis Ossificans Circumscripta
- post traumatic
- more common
- recognised as a consequence of neurological injury
Knee Plica
Aetiology
Knee forms from 3 separate compartments
Plica represents normal embryonic synovial septum that persists into adult life
Epidemiology
20% of knees have medial patellar plica at arthroscopy
Symptomatic plicae much less common 1-2%
Mean age 14
Types
1. Infrapatellar (ligamentum mucosum)
Calcific tendonitis
Definition
Mid-substance calcification of the rotator cuff
- part of a metaplasia secondary to hypoxia
Aetiology
2 groups of patients
Os Acromiale
Definition
Failure of fusion of adjacent ossification centers
Epidemiology
Incidence 3%
Bilateral in 60%
Anatomy
4 ossification centers present in acromion
- pre-acromion
- mesoacromion
- metaacromion
- basiacromion