– See: Intercondylar Eminence Frx – Discussion: – avulsion frx of tibial tuberosity along w/ a Salter Harris type-III frx of proximal tibial physis; – need to distinguish tibial tubercle avulsion from Osgood-Schlatter disease (which has no physeal involvement); – where as Osgood Schlatter disease involves … Read more
Discussion: – pathogenesis – vascular interruption: – blood supply to femoral head – specific inciting causes – natural history – diff dx: – synovitis; – Idiopathic Transient Osteoporosis of the Hip – femoral neck stress frx – metastatic disease – trochanteric bursitis: – ref: Avascular necrosis of the femoral head presenting as trochanteric bursitis. – … Read more
– Discussion: – local or Split compression frx have centrally depressed fragments; – AVN is diagnosed when serial X-ray show a gradual shrinking of the eleveated fragments until a defect remains; – surgically elevated articular fragments always are avascular; – fortunately most elevated frags regain vascularity before they … Read more
– fingings may include osteopenia at frx site & absence of callus; – potential for healing is significantly diminished; – these require bone grafting & enhanced fixation; – Treatment: – fracture ends of atrophic non union may need to be opened & debrided; – typically these … Read more
– See: – Occipital-Atlanto-Axial Anomalies: – Anatomy of C1 / C2 – Discussion: – more common children, since the pediatric occipital condyles are small and almost horizontal & lack inherent stability; – this injury is usually but not invariably fatal 2nd to respiratory arrest caused by injury … Read more
– See: Nerve Entrapment – Discussion: – cubital tunnel serves as major contraint for the ulnar nerve as it passes behind elbow; – the syndrome occurs most commonly between 30 to 60 years, and is exceptionally uncommon in children under 15 years; – inciting events: … Read more
– Discussion: – note carrying angle of the elbow (for cubitus valgus); – r/o subluxation: – palpate the nerve in the cubital tunnel and note its mobility; – it is essential to know whether ulnar nerve subluxation is present; – motor … Read more
– Discussion: – in the presence of H.O. the nerve should be placed in the subcutaneous position, since H.O. forms between muscle layers; – sub-muscular transposition (or subQ transposition) is also indicated to relieve tension following ulnar nerve repairs; – is often indicated in revision cubital tunnel surgery; … Read more
– Discussion: – demonstrates intra-articular extension of frx – degree of comminution of posterior facet; – calcaneocuboid joint; – impingement of lateral border of calcaneus on lateral malleolus and entrapment of tendons or nerves can be demonstrated; – latter is best seen … Read more
– Discussion: – decreased neck shaft angle from defect in ossification of femoral neck; – it is bilateral in 1/3 to 1/2 of cases; – it can be congenital (noted at birth & differenitated from CDH by MRI), developmental (AD-progressive), or acquired (trauma, LCP, SCFE) – Differential Dx: … Read more