Lateral Compression
LC-1: pubic rami fracture with sacral fracture
Operative v Nonoperative
Levy et al Arthroscopy 2009
- systematic Review
- improved outcomes with operative management
https://pubmed.ncbi.nlm.nih.gov/19341932/
Vicenti et al. Injury 2019
- systematic review
- two studies compare operative v nonoperative
Rockerbottom foot / Persian Slipper Foot
Uncommon
50% bilateral
Doesn't delay walking
- may present in toddler with callus under talus head
Congenital anomalies
- CNS disorders
- spina bifida & diastematomyelia ~10%
- arthrogryposis
- neurofibromatosis
1. Direct lateral blow to patella
- usually with knee partly flexed and quadriceps relaxed
2. Indirect low energy injury
Dominant arm of middle aged men
- between 40 and 60
Sudden dramatic event
- sporting / weightlifting injury
- resisting heavy extension load
Degenerative changes seen on histology
Complete
- retracted / rupture of lacertus fibrosis
- minimally retracted
Average age 6 years
20% distal humeral fracture
- second most common elbow fracture after supracondylar
Pull Off
- more common
- fracture begins posterolateral metaphysis
- LCL, ECRL & ECRB attached to fragment
Push off
- varus force to extended EJ
Primary
- 8 / 52 gestation radius & ulna
Secondary
- distal radius age 1
- distal ulna age 5
< 10: > 15o malalignment
> 10: > 10o malalignment
Type I: Undisplaced avulsion fracture
Type II: Anterior portion displaced & hinged
Type IIIA: Displaced
Type IIIB: Displaced & Rotated
Metatarsus varus
- adduction of the forefoot at the TMTJ
Intrauterine positional deformity / packaging defect
1:1000
- M = F
- bilateral in 50%
- 10% have CDH
Unclear
Theories
- intrauterine positioning defect
- prone nursing