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What is an Avulsion Fracture?

Avulsion FractureAn avulsion fracture occurs when some soft tissue (either a tendon or a ligament) is subjected to an excessive sudden force. A good way to think of this is to imagine a rope that has been nailed onto a plaster wall being pulled on very hard. If everything is solid enough, nothing bad will happen.  It might be that the rope is the weakest link and will break - meaning a tendo...
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What is Kohler’s Disease?

Kohler's Disease Kohler's Disease  is an uncommon condition that affects the inner aspect of the mid-foot. It is part of a group of conditions called avascular necrosis disorders.  This is Latin for 'bone death due to lack of blood supply'. It occurs between 5 and 9 years of age, mostly in boys.Kohler's disease refers to bone death in the Navicular bone.  After the blood supply is lost, the...
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Dancer’s fracture: The outside of my foot hurts when I land from dance jumps?

What is a 'Dancer's Fracture'?A dancer's fracture is a spiral fracture of the 5th metatarsal neck (the bone just behind the base of the little toe).  This type of fracture generally results from landing with an inverted or 'sickled' foot and from falling off of pointe/demi pointe over the little toe.The cause of these mis-steps is usually weakness and / or fatigue in the peroneal muscles...
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What is Haglund’s Deformity? What is the bump on the back of my heel?

Haglund's DeformityHaglund’s deformity is characterized by a bony bump on the back of the heel bone that can become painful when irritated by footwear. When pain occurs, it is usually located in the skin or a soft tissue sac of fluid that forms over the bony bump.  This sac is called a bursa and inflammation of it is referred to as bursitis. The original bony bump seems to develop secondary ...
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What is Paget’s Disease of Bone?

Paget's disease of BonePaget's disease of the bone is a long term condition that causes excessive growth of bone which causes them to both thicken and weaken. Commonly affected sites include the skull, spine, pelvis and the long bones of the upper arms and legs. Paget’s disease is uncommonly diagnosed in people aged below 40 years. At 40, the incidence is ~3%.  At 80 years of age, this rises...
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What is Femoral Anteversion? What is tibial torsion?

Tibial TorsionInternal Tibial Torsion is an inward twist of the long shin bone - as if you held the knee end in place and screwed the tibia inwards at the ankle. Some degree of tibial torsion is normal in babies and young children.  Often a large part of the twist has 'unfurled' by age 1 and the majority by age 6. Around 10% will have the inward rotation last into skeletal maturity and there...
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What is Metatarsus Adductus?

What is Metatarsus Adductus ?Metatarsus adductus is an inward curving of the foot, shown in the picture opposite. It is present at birth but may not be noticed by a casual observer.  Metatarsus adductus is caused by the restricted position of the baby within the uterus. It is considered mild if the foot can be pushed back beyond 'normal' when assessing the condition.It is moderate if the...
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Is W Sitting bad for my child?

Is W sitting bad for my child ? Yes - Sitting in the W position (shown in the diagram opposite) is likely to be harmful to a child.  It is normal for some 'twist' to be present in the long bone of the thigh in children. This is called femoral anteversion and naturally unfurls as the child ages.  This natural straightening of the leg can be impaired if the hip muscles are stretched excessively.   ...
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What can I do to help prevent Deep Vein Thrombosis? Should I use compression socks when Flying?

We are frequently asked by patients if they should use compression socks when flying.  The answer is ... maybe.  Let's first look at the underlying rationale behind the idea.Finding yourself immobile for an extended period of time has the potential to cause serious health issues.   Air travel gets singled out as a cause more often due to the  long periods of inactivity, cramped seating and a ten...
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What are these bumps on my toes? What are digital bursae?

What is a Bursa?A bursa is a fluid filled sac that occurs beneath the skin (plural = bursae). It is different to a blister that forms between the skin layers.  Anywhere that one hard structure of the body (namely bone) rubs repetitively against a soft part (often skin or tendon) a bursa will form.  Some bursae are 'anatomical' meaning everyone has one there, like the trochanteric bursa discu...
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