Osgood Schlatter Disease of the Adolescent knee

Osgood Schlatter disease is the osteochondritis of the tibial tuberosity occurring in adolescent knees.
It causes pain and mild swelling just below the knee joint over the prominence in the front of the upper leg.
Patients complain of difficulty in running activities.
It is a developmental affection of the tibial tuberosity apophysis, and settles with completion of growth maturity, and fusion of the apophysis.
In severe case, patients may be offered splintage in the form of brace or plaster cast.
For those not responding to conservative trials, needling of the lesion triggers the cure.

Shoulder Injuries and Disorders- Frozen Shoulder

Frozen shoulder or the technical name Adhesive Capsulitis of Shoulder, mostly seen in middle aged women and diabetics, causes global loss of shoulder movements in all directions.
Usually a self limiting disease, but the prolonged disease course causes much disability.
Early cases should be managed by a course of physiotherapy.
In non- responding patients, manipulation under anesthesia after injecting and inflating the shoulder joint capsule with saline is an alternative.
Prolonged supervised physiotherapy is almost always necessary.

Shoulder Injuries and Disorders- Impingement Syndrome

Shoulder impingement syndrome causes limitation of shoulder movements in one or more directions, but never complete global loss of movements.
Also known as a "Painful arc syndrome"; when the arm is taken overhead in the window cleaning position, patient catches pain. Pain is reproduced on every attempt to do this manoeuvre.
The patholy lies in the reduction of space for the free excursion of the rotator cuff tendons mainly Supraspinatus, beneath the acromion process.
This may occur due to inflammation of tendon itself, due to thickening of acromion process of shoulder blade (scapula); or due to repetitive stress injuries of the rotator cuff.
Treatment of this disorder is mostly conservative.
Most patients respond to suitable modification of activity or local steroid infiltration.
In patients who are resistant to conservative trials, decompression of the sub-acromial space may be performed surgically (Acromioplasty).

Shoulder Injuries & Disorders : Acromioclavicular Joint Injuries

AC Joint injuries are common due to fall on out-stretched hand. They have significant impact in overhead activities and sports.
Patients with AC joint injuries have been classified into six types, with severity ranging from simple sprain to complete destruction of all supporting ligaments and marked displacement of the collar bone from its normal position.
Not all patients with AC joint injury need surgery.
Most patients wherein the AC joint remains even in partial contact may be managed by a sling support. For more severe injuries, a reconstruction of ligaments may be taken immediately after the injury or at a later date.

Collar Bone fracture : Is operation necessary ??

Collar bone (Clavicle) fracture occurs commonly due to indirect forces with fall on the out-stretched hand.
Most comon area of fractur is at the junction of inner 2/3 and outer 1/3. However, at times, the fracture occurs more outwards and closer to the shoulder joint. The latter presents a technically challenging scenario.

Most collar bone fractures can be treated without surgery. Usually a cuff and collar sing is provided for pain relief, and exercises are started after 4 weeks.
In certain situations, wherein the vascular or neural structures are in jeopardy due to pressure by fracture fragments, operation may be required. Surgery is also indicated in fractures occurring close to the shoulder joint.

With greater emphasis on cosmetic appearance, surgery is often demanded by young girls, who do not want a fracture bump. In such cases, a plate may be used with minimum surgical scar.