Extra-pelvic blood vessels
Femoral Artery
MCFA
LCFA
Profunda Femoris
Obturator artery
Intrapelvic vessels
External iliac artery and vein
Obturator artery
Superior and inferior gluteal
Anatomy
- anterior division of common iliacs / L5-S1
Clin Orthop 1989
- 38 patients treated with DXRT without surgery
- most breast cancer
- developed scoring system
- predicts post DXRT fracture risk in preDXRT long bones
- risk of fracture within 6 months
- irradiated without fixation
Four risk factors
Multi-ligament knee injury (MLKI)
- 2 or more ligaments disrupted
Knee dislocation
- ACL + PCL + one of collaterals
High energy (MVA)
Low energy (sport)
- low energy has 5% arterial injury
Pigmented Villo-Nodular Synovitis
- benign inflammatory process that arises in synovial tissues
- contains significant amounts of hemosiderin
Age: 20 - 50
Sex: M > F
A. Diffuse
- throughout joint synovium
- more difficult to treat / excise fully
I. Lateral Spilt
- seen in young patient
- lateral meniscus can be incarcerated in fracture
II. Lateral Split Depression
- often seen in young patients with high energy injuries
- vary in severity
Fracture below lesser trochanter / proximal 5 cm femur
Young patients / high velocity injuries
Old patients / osteoporosis
CP is a permanent disorder of movement and posture
- non-progressive
- brain injury before the age of two years
Strict definition excludes familial & progressive congenital problems & those acquired in childhood as a result of head injuries
2-3 per 1000 live births
Higher in
Most common site for skeletal TB
- usually haematogenous spread
- can be direct from lung
1. Peridiscal (50%) - originating in metaphyseal region
2. Central - high incidence of vertebral collapse
3. Anterior - instability less common with less bony destruction
Affects multiple contiguous vertebrae
Young men in 20's and 30's
High energy injuries
- fall from heights
- MVA
Injury progresses from radial to ulna
- usually disruption proximal row either side of lunate
1. Capitate usually displaces dorsally initially
- volar lunate dislocation is end stage
90% respond
- very important
- 6 - 12 months minimum before offering surgery
1. Stretches
- quads stretches
- ITB
- lateral retinaculum