1/878. Palmar (displaced) fracture of the proximal index metacarpal.A patient sustained a fracture of the ulnar side of the proximal end of the second metacarpal. The fragment was completely displaced into the palmar soft tissues. Open reduction was necessary.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/878. Dislocation of the first metatarsophalangeal joint with fracture of fibular sesamoid. A case report.Dorsal dislocations of the first metatarsophalangeal joint are classified by Jahss into two types. In Type 1, the hallux with the intact intersesamoid ligament dislocates dorsally over the metatarsal head. Such cases in the literature have been irreducible by closed manipulation. In Type 2 the hallux is dislocated dorsally with rupture of the intersesamoid ligament, resulting in wide separation of the sesamoids (Type 2A) or a transverse fracture of one or both sesamoids (Type 2B). The importance in classifying these injuries allows one to predict whether closed reduction will be successful as in Type 2. The patient reported had a fracture of the fibular sesamoid in addition to dislocation of the hallux. The clinical findings were consistent with Type 1 injury, including an intact intersesamoid ligament, but the radiographs showed, in addition to the dislocation, that there was a fracture of the fibular sesamoid. Reduction was achieved surgically through a dorsal approach. Although such injuries have been unreported previously, Type 1 injuries may be associated with a fracture of the fibular sesamoid but without rupture of intersesamoid ligament, so the injury reported is classified as Type 1A.- - - - - - - - - - ranking = 1.6keywords = fracture (Clic here for more details about this article) |
3/878. AAEM case report 33: costoclavicular mass syndrome. American association of Electrodiagnostic medicine.A true costoclavicular mass syndrome associated with a brachial plexopathy is rare. We report the occurrence of a severe brachial plexopathy as a late complication of a displaced midclavicular fracture. An exuberant callus associated with the clavicular fracture acted as a mass lesion to compress the brachial plexus within the costoclavicular space (i.e., between the clavicle and the first rib). The clinical features and the electrodiagnostic findings in this patient were crucial in suggesting the diagnosis, which was subsequently confirmed by radiographic studies and surgical exploration. Surgical excision of the hyperabundant callus and freeing of the entrapped brachial plexus resulted in marked improvement of the patient's neurological symptoms. Recognition of this uncommon complication of a clavicular fracture is important for the timely diagnosis of this treatable problem.- - - - - - - - - - ranking = 0.6keywords = fracture (Clic here for more details about this article) |
4/878. Annular ligament reconstruction in chronic posttraumatic radial head dislocation in children.Traumatic radial head dislocation without an associated fracture is an unusual injury in children. Occasionally, the diagnosis is missed or the injury is not treated acutely, leading to chronic radial head dislocation. The recommended treatment has been controversial, ranging from benign neglect to surgical reconstruction. This case report and review of the literature describes treatment indications and options, as well as potential risks and benefits for conservative and surgical approaches.- - - - - - - - - - ranking = 0.2keywords = fracture (Clic here for more details about this article) |
5/878. Fracture-dislocations of the sacrum. Report of three cases.The pattern of fracture-dislocation of the upper part of the sacrum is demonstrated in three patients. The fracture line followed the segmental form of the sacrum and was usually caused by a posterior force against the pelvis which had been locked by hip flexion and knee extension. Fractures of the lumbar transverse processes also occurred, presumably from avulsion by the quadratus lumborum muscle. The damage to the sacral plexus found in all three cases recovered after several months. Radiographs of the injury are difficult to obtain in severely injured patients but oblique views of the sacrum help to determine the extent of the forward dislocation.- - - - - - - - - - ranking = 0.4keywords = fracture (Clic here for more details about this article) |
6/878. osteotomy for malunion of a talar neck fracture: a case report.A malunion of the talar neck after a Hawkins type II fracture/dislocation of the talar neck occurred in a 34-year-old man after nonoperative treatment. Rigid varus deformity of the forefoot was a source of severe pain and disability in this patient. We describe our surgical technique for osteotomy of the talar neck with insertion of a tricortical iliac crest bone graft to correct the deformity. At follow-up (56 months), the patient had consistent relief of pain and was employed at his preinjury job doing heavy labor. The score on the American Orthopaedic foot and ankle Society ankle-Hindfoot Scale improved from 11 points, preoperatively, to 85 points, postoperatively. Radiographs showed maintenance in the position of the osteotomy and no evidence of avascular necrosis in the talar body. Evidence of arthrosis of the talonavicular joint was apparent radiographically, but the patient did not complain of symptoms referable to this area.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
7/878. Fracture-dislocation of the dorsal spine.A patient with fracture-dislocation of D9 on D8 had considerable posterolateral displacement. The neurologic injolvement of his left leg proved to be progressive. Treatment consisted of posterior decompression, exploration, open reduction and stabilization by means of Harrington rods, and fusion. All neurologic findings resolved completely. Final evaluation 18 months later showed a good and serviceable spine with no residual neurologic deficits. In my opinion, the treatment used in this case under given circumstances represented a reasonable modality of therapy.- - - - - - - - - - ranking = 0.2keywords = fracture (Clic here for more details about this article) |
8/878. Salvage of the head of the radius after fracture-dislocation of the elbow. A case report.We describe a patient with a Mason type-III fracture of the head of the radius associated with traumatic dislocation of the elbow. The radial head was intact throughout its circumference despite being completely detached from the shaft and devoid of any soft-tissue attachments. Severe comminution of the radial neck prevented reconstruction by internal fixation and precluded prosthetic replacement of the head. The head was fixed to the shaft with a tricortical iliac-crest bone graft which replaced the neck. Two years later, the patient had a stable elbow with flexion from 10 degrees to 130 degrees. Radiologically, the head of the radius appeared to be viable and the bone graft had incorporated.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
9/878. Injury to the first rib synchondrosis in a rugby footballer.Injuries to the first rib synchondrosis are uncommon in sport. The potential for serious complications following posterior displacement is similar to that seen with posterior sternoclavicular joint dislocation. Clinical examination and plain radiography may not provide a definitive diagnosis. Computerised tomography is the most appropriate imaging modality if this injury is suspected. Posterior dislocation of the first rib costal cartilage with an associated fracture of the posterior sternal aspect of the synchondrosis has not been previously reported.- - - - - - - - - - ranking = 0.2keywords = fracture (Clic here for more details about this article) |
10/878. Simultaneous bilateral elbow dislocation in an international gymnast.elbow dislocation is a rare injury in elite athletes. We report an unusual case of simultaneous bilateral elbow dislocations with a unilateral radial head fracture in an international female athlete competing on the asymmetrical bars. These injuries require prompt reduction and immediate mobilisation if an abrupt end to a promising career is to be prevented.- - - - - - - - - - ranking = 0.2keywords = fracture (Clic here for more details about this article) |
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