techniques

Etiology

Ankle sprain

- eversion / external rotation

Ankle fractures

Types

1.  Standard trochanteric osteotomy

2.  Sliding trochanteric osteotomy

3.  Extended trochanteric osteotomy

Standard Trochanteric osteotomy

Epidemiology

Adolescent boys

Ossification

Proximal tibia / primary ossification centre

Tibial tuberosity / secondary ossification centre

- eventually merges with primary ossification centre

Ogden Classification

Type I - Tibial tuberosity ossification only

Definition

Present with pain but not instability

Types

Traumatic

Degenerative

Different treatment algorithms for each

History

Ulna side wrist pain

- may be worse with rotation

- opening doors and jars

History of trauma

Examination

Local tenderness DRUJ

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

Surgical Options

1.  Open antero-lateral approach 

Large / Massive Cuff Tear

2.  Deltopectoral approach

Large Subscapularis tear

3.  Arthroscopic Assisted Mini-open

Indication

- Small / Moderate Cuff Tear < 3cm

- no retraction

Technique

- arthroscopic SAD

Definition

Stenosing tenosynovitis of the first dorsal compartment of wrist

Epidemiology

Most are middle aged women

Aetiology

Repetitive thumb movements

- abduction & extension

- combined with RD & UD movements

Any mechanical irritation

- foreign body

- prominent bony surface

- restricted fascial compartment

Anatomy

Largest and most powerful rotator cuff

- arises coastal border of scapula

- superior 2/3 tendon inserts into LT

- inferior 1/3 inserts into proximal humerus

Action

- IR (with T major, P major, Lat Dorsi)

- part of force couplet depressing humeral head

Incidence