Sports

Question 1

Partial cuff tear management

Answer 1

Disruption of rotator cable destabilizes the tendon and allows propagation of tear Bursal sided tears > 3mm or articular tears >7 mm thick= repair The articular surface of the rotator cuff has decreased vascularity and tensile strength compared to the bursal surface. Therefore, articular-sided partial RCTs are often due to degenerative tendinopathy in older patients and tensile failure in younger patients, particularly overhead throwing athletes. Bursal-sided tears are most commonly associated with extrinsic impingement of the acromion and the coracoacromial ligament.

Question 2

MPFL

Answer 2

femoral insertion site= Schottle’s point

Question 3

Circle of Hori

Answer 3

Lateral- medial

1. PLRI LCL complex
2. Perched ulna- Ant & post disruption. Incomplete posterolateral dislocation with ulna sitting on trochlea and radial head subluxated/ dislocated
3. complete dislocation
   
   1. posterior MCL disrupted
   2. entire MCL disrupted- unstable in varus, valgus, and rotation after reduction- Immobilize in 90^o flexion
   3. all soft tissue avulsed from distal humerus (flexor & extensor masses)- Grossly unstable even in flexion

Question 4

OCD (elbow)

Answer 4

1. adolescents >10 yo
2. typically capitellum of dominant arm
3. Classification
   
   1. intact cartilage +/- bony support
   2. Cartilage fx w/ bony collapse or displacement
   3. Loose bodies in joint
4. Treatment
   
   1. stable Type 1= immobilization
   2. Unstable 1 or 2= microfracture
   3. Large fragments= arthroscopic fixation
   4. Large uncontained lesions engaging w/ radial head= OATS
5. Panner’s disease= osteochondrosis of capitellum in kids < 10 yo
   
   1. self-limiting
      6.