pathology

Definition

Unstable injuries

Complete disruption of both the anterior and posterior ring

5 - 20% of pelvic fractures

Mechanism

Axial load

Motor vehicle accident

Fall from height

Pathology

Anterior ring

Epidemiology

Uncommon

< 1% Primary bone tumour

Young boys

- second decade

Location

Similar to OO

Spine 30%

- especially posterior elements

Long bones 35%

Clinical

Back or limb pain

- pain less severe than OO

Condensing Osteitis

Epidemiology

- seen in women over 40

Xray

- sclerotic and overgrown

CT

Definition

Rockerbottom foot / Persian Slipper Foot

Epidemiology

Uncommon

50% bilateral

Doesn't delay walking

- may present in toddler with callus under talus head

Associations

Congenital anomalies

- CNS disorders

- spina bifida & diastematomyelia ~10%

- arthrogryposis

- neurofibromatosis 

Epidemiology

Rare

Types

Medial

- 80%

- calcaneum dislocated medially

Lateral

- 20%

- higher energy injury

Epidemiology

Most common pattern cord injury

Hyper-extension injury in middle aged man with osteoarthritic spine

Usually C3/4 and C4/5

Mechanism

Most common type / in older patient with pre-existing spondylosis / OPLL

- hyperextension injury

- compression of the cord

- anteriorly by osteophytes

- posteriorly by infolded ligamentum flavum

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

Anatomy

Fascicles of long, spiraling bundles

- tenocytes & Type I collagen

- synovial cells & fibroblasts present

Endotenon 

- surrounds the individual collagen bundles

Epitenon

- fine fibrous outer layer, highly cellular, continuous with endotenon

- contains most of the blood vessels & capillaries

Definition

Palmar Fibromatosis 

Aetiology

AD with variable penetration

Pathogenesis

Murrell's Theory of Pathogenesis

1. Microvascular ischaemia