Atlanto-axial instability
Definition
Loss of ligamentous stability between atlas and axis
Can cause impingement of the spinal cord
Etiology
Loss of ligamentous stability between atlas and axis
Can cause impingement of the spinal cord
Ulna drift & volar dislocation
Ulna Drift / Ulna Dislocation
1. Physiological
Extremely common
- 90% by 10 years have wrist problems
Landsmeer 1961
- treat wrist at same time as treat fingers or will recur
Frequently combine procedures
- synovectomy
- tendon transfer
- ulna procedure
Rotator cuff
- often deficient
Bone stock
- often deficient
Glenoid
- often posterior version
1. TSR
Indications
- cuff intact
1987 American College of Rheumatology
Need 4/7 (MAX RANS)
1. Morning Stiffness
2. Arthritis of 3 areas > 6/52
3. Xray changes
4. Rh factor
5. Arthritis of Hand > 6/52
6. Nodules
7. Symmetric Arthritis > 6/52