Younger patients (from 20 to 50 years of age) – high-energy vehicular trauma or falls from significant heights, Older patients (from 60 to 80 years of age) – low-energy falls and concomitant osteoporosis Posterior column: Quadrilateral surface, Posterior wall and dome, Ischial tuberosity, Greater/lesser sciatic notches Anterior column: ilium (gluteus medius tubercle), Anterior wall and dome, Iliopectineal eminence, Lateral superior…
Mayo definition, ≥62 mm in women and ≥66 mm in men Bone deficiencies are mostly filled by the cup itself Reduction of the need for bone-grafting Possible normalization of the hip center of rotation Disadvantages : May ream away posterior wall, column, Screws required, May raise hip centre of rotation, High rate of dislocation Contraindicated in Pelvic discontinuity, Unstable cup,…
Posterior wall of the acetabulum – most common Indications for operative intervention are Hip instability demonstrated on EUA, Hip incongruency due to intra-articular fragments, Fractures involving >50% of the posterior wall Dynamic fluoroscopic stress testing under general anaesthesia should be the preferred method for the determination of hip stability status after posterior wall fractures of the acetabulum Kocher Langenbock Approach…
Diarthrodial joint, AP stability is provided by acromioclavicular ligaments and coronal plane stability by trapezoid and conoid coracoclavicular ligaments Mechanism of injury is by fall onto the lateral aspect of the shoulder Rockwoods classification is used for AC joint injuries Types I to III are treated nonoperatively Types IV to VI require surgical management
Lisfranc injury is a tarsometatarsal fracture dislocation characterized by traumatic disruption between the articulation of the medial cuneiform and base of the second metatarsal Easily missed on radiographs May take form of purely ligamentous injuries or fracture-dislocations Hardcastle & Myerson classification For stable injuries treat non operatively with POP Operative management : closed reduction and percutaneous pinning or open reduction…
Acute inflammation of single joint, less than 2 weeks of duration Common causes include infectious arthritis, crystal diseases, AVN, infectious mononucleosis etc Establishing chronology of events is important in narrowing down diagnosis Physical examination of joint gives great insight about the nature of the problem whether is it intra-articular or extra-articular disease CBC, ESR, CRP, Uric acid can give us…
