surgical management

Mallet Toe

Definition

 

Flexion deformity of DIPJ 

 

Aetiology

 

Usually in 2nd toe

- Long second MT

- Constrictive footwear

 

Clinical

 

Pain over

- tip of toe

- over dorsum of DIP joint

 

May be corn on tip of toe 

 

Fixed or flexible

 

Management

 

Hammer Toe

Definition 

 

Flexion deformity PIPJ with

- MTPJ normal / simple

- MTPJ hyper-extended / complex

- DIPJ any position

- P1 may become subluxed or dislocated

 

Aetiology

 

Uncertain

 

Long second toe / MT

Hallux valgus

Tight shoes

 

Examination

 

Non union

Scaphoid Non union xrayScaphoid Nonunion Xray 2

 

NHx

 

Convincing association with development of osteoarthritis

- arthritic changes beginning at radial styloid

- progress to scaphocapitate & capitolunate 

 

Coronoid Process Fracture

BackgroundClassification Coronoid Fractures

 

The coronoid is the most important portion of ulno-humeral articulation

 

Reasons

1.  Provides anterior buttress

2.  Anterior capsule and brachialis attach to coronoid

2.  Anterior band of the MCL attaches to it

- distally and medially on sublime tubercle

Replants

Replant 4 FingersReplant 4 fingers post

 

Definition

 

Replant

- reattachment of body part that has been completely severed

 

Revascularisation of incomplete Amputation

Fibrous Dysplasia

Definition

 

Developmental hamartoma in which areas of the skeleton fail to mature normally

- remain indefinitely as immature, poorly mineralized trabeculae

 

Pathology

 

Hamartoma of bone and fibrous tissue

 

McCune - Albright's Syndrome

 

Rare triad of

 

1.  Fibrous Dysplasia