open reduction

Dislocation

Epidemiology

 

Uncommon

- dancers

- athletes

 

Aetiology

 

Hyperdorsiflexion of the MTPJ

 

Pathology

 

MT head dislocates plantar

- may buttonhole through capsule

- can prevent closed reduction

 

Blocks to Reduction

 

1.  Sesamoids

2.  Conjoint tendon

3.  Intersesamoid Ligament

 

Monteggia

Paediatric Monteggia APPaediatric Monteggia Lateral

 

Definition

 

Fracture / plastic malformation of proximal ulna with dislocation of radial head

 

Xray

 

Radio-capitellar line disrupted

 

Lateral Condyle Fractures

Epidemiology

 

Average age 6 years

 

20% distal humeral fracture

- second most common elbow fracture after supracondylar

 

Mechanism

 

Pull Off 

- more common 

- fracture begins posterolateral metaphysis

- LCL, ECRL & ECRB attached to fragment

 

Push off

- varus force to extended EJ

 

Classification

 

Lis Franc

HistoryLis Franc

Jacques LisFranc De St-Martin (1790 - 1847)

General Surgeon in Napoleonic army

 

Mechanism

 

High energy

 

1.  Twisting / Abduction injury of forefoot

- original description is fall from horse with foot caught in stirrups

- MVA

 

2.  Axial Loading