clinical photo
Morton's Neuroma
Definition
Benign enlargement of the common digital branch
- usually 3rd webspace
Anatomy
Found at level of or just distal to MT heads
- deep to the deep transverse MT ligament
Epidemiology
Classically women between 40 and 60
Nail Bed Lacerations
Subungual haematoma
Management
- < 50% of nail bed -> Decompress with needle
- > 50% -> remove nail and repair bed
Nail bed lacerations
Options
1. > 50% nail lost
- will get hook nail
- ablate nail bed
Quadriceps Tendon Rupture
Epidemiology
Usually occurs in patients over 60
- due to decreased vascularity & collagen weakness
Younger patient on steroids / growth hormone
Occasionally occurs in young athlete with excessive contracture
Aetiology
Often preceded by quadriceps tendinosis
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
Compartment Syndromes
1. Antebrachial Compartment Syndrome
Aetiology
Supracondylar fracture of humerus
Both bone forearm fractures
Examination
Osteoarthritis
Epidemiology
Male & Females > 60 years
- X-ray evidence of OA
Symptomatic
- 25% females
- 15% males
Affected joints
Base thumb
PIPJ / Bouchard's nodes
DIPJ / Heberden's nodes
Inflammatory Arthritis
Conditions
Acro-osteolysis
SLE
Scleroderma
Psoriasis
Acro-osteolysis
Definition
Absorption of distal tuft of phalanx
DDx
Psoriasis
Scleroderma / Raynauds
Frost Bite
Hyperparathyroidism
Diabetes
Vasculitis
Leprosy
RA rarely
Gout
Valgus TKR
Definition
A valgus knee has a tibiofemoral angle of > 10o
Causes
Inflammatory
- RA
Pes Planus
Definition
No good definition
- flexible flat foot
- medial longitudinal arch of foot in weight-bearing is in contact with ground or closer to ground than 'normal'
Epidemiology
Common
- almost always bilateral
- strong familial tendency
Aetiology
Physiological
All infants have flat feet