1. PIPJ Synovitis
- synovectomy via dorsomedial approach
2. Flexor tenosynovitis
- may cause trigger finger
- trial HCLA
- remove synovits but don't release A1 pulley
- will worsen ulna drift
3. DIPJ
- rarely affects
Extremely common
- 90% by 10 years have wrist problems
Landsmeer 1961
- treat wrist at same time as treat fingers or will recur
Frequently combine procedures
- synovectomy
- tendon transfer
- ulna procedure
Failure of fusion of adjacent ossification centers
Incidence 3%
Bilateral in 60%
4 ossification centers present in acromion
- pre-acromion
- mesoacromion
- metaacromion
- basiacromion
Male & Females > 60 years
- X-ray evidence of OA
Symptomatic
- 25% females
- 15% males
Base thumb
PIPJ / Bouchard's nodes
DIPJ / Heberden's nodes
Congenital fibrous, cartilaginous or bony connection of 2 or more tarsal bones
- due to failure of segmentation
Peroneal Spastic Flat Foot
- tarsal coalition
- tarsal pain
- reduced STJ motion
- rigid pes planus
- peroneal muscle spasm / tightness
Present in 6% of population
- symptomatic in 1% of population
Bilateral in 50%
Clinical diagnosis
- based on a sclerotomal distribution of motor &/or sensory symptoms or signs
Caused by impingement of exiting nerve roots
- HNP
- zygo-apophyseal / facet joint hypertrophy
- neuro-central joint hypertrophy
May be acute or chronic
M>F
Peak age 50-54
C7 > C6