results
Cruciate ligament ganglion
Location
- 85 intra-articular ganglions
- 49 ACL, 16 PCL
- 12 from anterior horn meniscus, 3 posterior horn meniscus
- 3 from fat pad
Cruciate ligament ganglion
Technique
Surgical technique PDF using trans-septal portal
Atlanto-axial instability
Definition
Loss of ligamentous stability between atlas and axis
Can cause impingement of the spinal cord
Etiology
Atlanto-axial Rotatory Instability
Definition
Acute dislocation of the atlanto-axial facet joint
Present with acute torticollis
Etiology
Children
Vertical Shear
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
Internal snapping hip
Cause
Movement of iliopsoas tendon over femoral head / iliofemoral ridge / iliofemoral ligament
Pectoralis Major Tears
Epidemiology
Middle age men
Steroids / Growth Hormone
Aetiology
Usually occurs in gym
Bench Press
Clinical
Significant bruising in the acute phase
In chronic setting, ask patient to adduct against hip / resistance
Fixation
Definition
Garden 1 / 2
Algorithm
ORIF
- ~ 15% displacement rate with non operative management
- increased risk of non union
- reduced hospital in patient stays
Options
Cannulated screws
DHS + derotation screw
3 cannulated screws
Central Cord Syndrome
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
Perthes
Issues
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