arthritis
Talar Neck Complications
AVN
Largely related to degree of displacement
Incidence
Hawkins Type I
- 0% to 13%
Hawkins Type II
- 20% to 50%
- usually only patchy and not a problem (rarely collapses)
DRUJ Arthritis
Options
Darrach's
- distal ulna excision
- best for elderly RA patient
Bower's interpositional hemiarthoplasty
Technique
Rheumatoid Wrist
Epidemiology
Extremely common
- 90% by 10 years have wrist problems
Principles
Landsmeer 1961
- treat wrist at same time as treat fingers or will recur
Frequently combine procedures
- synovectomy
- tendon transfer
- ulna procedure
Rheumatoid Arthritis
Issues
Rotator cuff
- often deficient
Bone stock
- often deficient
Glenoid
- often posterior version
Management
Options
1. TSR
Indications
- cuff intact
ACJ Osteoarthritis
Aetiology
Post-traumatic (type III clavicle fractures)
Idiopathic
4 patterns
1. OA with osteophytes
- contribute to impingement
2. Osteolysis with resorption & gross osteoporosis