Background
Anatomy / Biochemistry
Constituents of cartilage
Extracellular matrix (proteogylcans + collagen + water) + chondrocytes
Extracellular matrix (proteogylcans + collagen + water) + chondrocytes
National Spinal Cord Injury Statistical Center (2021) Facts and figures at a glance
- road traffic accident 40%
- falls 30%
- sports 10%
Chen et al Arch Phys Med Rehab 2016
- 80% male
- cervical (60%), thoracic (30%), lumbar (10%)
Congenital Talipes Equinovarus
Congenital abnormality of the foot characterised by
- hindfoot equinus & varus
- forefoot Adduction
- midfoot Supination
Latin: talus - ankle / pes - foot / equinus - horse like
Foot
- pipe stem calf
- short wide foot
- small heel
- curved lateral border
Host
Wound
Operating room environment
Antibiotics
Operative technique
Post operative
Immunocompromised
RA (0.9 v 2.2%)
Psoriasis
DM (6%)
Poor nutrition
Obesity
UTI
Prednisone
Previous operation
Previous infection
Age
To produce sufficient thrombin to rapidly convert soluble fibrinogen into insoluble mass of fibrin
Coagulation cascade must be localised & limited to site of tissue injury
1. Immediate Control of Blood Loss
Vascular Phase
- damage to blood vessel triggers reflex vasoconstriction
Platelet phase
Palmar Fibromatosis
AD with variable penetration
Murrell's Theory of Pathogenesis
1. Microvascular ischaemia
Accumulation of calcium salts in the soft tissues
- Dystrophic or Metastatic
Different from bone formation
- calcification is typically amorphous calcium crystals
- ossification has bone organic matrix (Osteoid) & cells
Dystrophic
Metastatic
A fixed equinus deformity of the forefoot in relation to the hindfoot
- resulting in an abnormally high arch that fails to flatten with weight bearing
- deformity may be forefoot, hindfoot or combination
Intrinsic
- inflammatory
- degenerative
Extrinsic
- traumatic
- spur
F > 40
Associations 60% of cases
- hypertension
- diabetes
- obese
- trauma
- prior surgery
- steroids