Clay-shovelers
Clay-shoveler's
Definition
Spinous process avulsion
- typically C7
- can be seen in thoracic spine
Mechanism
Spinous process avulsion secondary to ligamentum nuchae
Spinous process avulsion
- typically C7
- can be seen in thoracic spine
Spinous process avulsion secondary to ligamentum nuchae
Subscapularis failure
Rotator cuff failure
Instability
Infection
Periprosthetic fracture
Aseptic loosening
Neurological injury
Parada et al. J Should Elbow Surg 2021
- 2224 aTSA complication rate 11%, revision rate 5.6%
RA
OA
AVN
Infection
Charcot
Paralysis of deltoid
Torn rotator cuff
Insufficient glenoid bone stock
Metaphyseal
Extra-articular
Femur
Multiplanar deformity
- worsend by previous surgery
- may require osteotomy
Acetabulum
Dysplasia often present
- not as severe as in DDH
LLD
Can be significant
Abductors
Have been short for long time
- difficult to restore length
Chronic, non metabolic bone disorder
Characterised by increased bone resorption, bone formation and remodelling
Rare < 40
1 – 3 % population over 60
M > F
Unknown
Paramyxovirus implicated
- measles
- RSV
- canine distemper virus
Electron Microscope
Direct blow
- most common
Indirect
- forced knee flexion with foot fixed / maximally contracted quadriceps
1. Vertical
2. Transverse
Position
- patient supine on radiolucent table
- place ECG lead and artery clip over centre of femoral head
- useful to put II ipsilateral to leg, and place knee on cassette
Athletic / high impact exercises
First described in ballet dancers (Burrows 1956)
- tension side of bone / lateral side
- progression to complete fracture has been well documented in athletes
Point tenderness
- lateral aspect of tibia
Over time develop bony lump
Fracture which extends between the trochanters of the proximal femur
- lower limit is inferior border of lesser tuberosity
Extra capsular / well vascularized
The key to stability is the posteromedial cortex