Ossification of the posterior longitudinal ligament (OPLL)
Heterotopic ossification of the posterior longitudinal ligament
2:1 Male:Female
More common in Japanese and East Asian populations
Ranges
- up to 4%
Focal pain
- typically anterolateral thigh
- often tender
- corresponds to tip of stem
1. Instability
Types
- early
- late / failed bony ingrowth
Cause
- micromotion at distal stem
Hereditary bleeding disorder due to defective and/or deficient factor VIII molecule
Inherited X-linked recessive disorder
- occurs almost solely in males
- female carriers usually asymptomatic
- 30% have no family history
FVIII deficiency
X-linked disorder
- 1:10 000
- all ethnic groups
Osseous canal between talus and calcaneum
- interosseous talo-calcaneal ligament
- cervical ligament
- joint capsule
- nerve endings / arterial anastomoses
Flat foot / overpronation
Inversion / sprain
Education regarding shoe wear
- extra wide / large toe box
Insoles
- longitudinal arch support
- pre MT dome for metatarsalgia
- podiatry to attend to callosities
Toe spacers
Analgesia
1. Continued pain and discomfort
2. Difficulties with shoe wear
1 - 2 %
Medial Aspect of foot
- proximal to navicular
- part of T posterior tendon
Usually will fuse with navicular (50%)
1. Probably not a cause of flat foot
- excising accessory navicular / rerouting / reattaching tibialis posterior
- will not help pes planus
2. Pain
- may fracture
Repetitive friction of iliotibial tract over GT
Overuse in athletes
Common post THR
May be associated with gluteus medius tears
Pain over upper lateral thigh with activity
- often related to hip flexion
Second most common hindfoot after calcaneal fractures
Aviators Astragalus
Fall from height
- hyper-dorsiflexion injury
- neck of talus strikes the anterior tibia
More than half surface covered by articular cartilage
- medial articular wall straight
- lateral articular wall curves posteriorly
Mid-substance calcification of the rotator cuff
- part of a metaplasia secondary to hypoxia
2 groups of patients
Adolescents & young adults
Usually between 12 - 21 years
Throwing athletes / gymnasts
Little Leaguer's Elbow
- combination of capitellar OCD and MCL injury
- a repetitive throwing injury / seen in pitchers
1. Trauma & Overuse
Common throwing sports / gymnastics