1/320. 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 = 1keywords = ligament (Clic here for more details about this article) |
2/320. Subtalar subluxation in ballet dancers.ankle injuries frequently occur in dancers. Among these injuries, only a few cases of talar subluxation have been reported in the literature. In our series, we diagnosed and treated 25 subtalar subluxations over a 1-year period in the Ballet Bejart Lausanne company. The subluxations occurred after a grand plie on pointes or at the landing of a jump on demi-pointes, without any mechanism of ankle sprain. The dancer usually noted a sudden and sharp pain in the talonavicular joint and hindfoot with a feeling of "forward displacement" of the foot. At palpation, the talonavicular ligament, the anterior talofibular ligament, and the posteromedial part of the subtalar joint were painful. A limitation of the ankle extension and a clear hypomobility of the subtalar joint were noted. Under the effect of shearing forces on the midtarsal joint, a posteromedial subtalar subluxation occurred. Treatment consisted of a manipulation that reduced the subluxation. Continuous taping, which locks the talonavicular joint in the anterior direction, was recommended for 6 weeks. dancing could be resumed in a swimming pool after 2 weeks, and on the ground after 3 to 4 weeks. We found that subluxation could recur, and that it could eventually become chronic.- - - - - - - - - - ranking = 0.5keywords = ligament (Clic here for more details about this article) |
3/320. 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 = 1keywords = ligament (Clic here for more details about this article) |
4/320. Atlanto-occipital subluxation/dislocation: a "survivable" injury in children.Atlanto-occipital dislocation occurs more often in children due to the laxity of the ligamentous structures anchoring the occiput to the axial skeleton. The mechanism of action usually involves a sudden acceleration-deceleration force on the head of the child. The dislocation usually severs the spinal cord at the foramen magnum, resulting in acute respiratory arrest. We have managed four patients who sustained this injury and arrived at our trauma center with signs of life. Two patients were hemodynamically unstable, had positive diagnostic peritoneal lavage, and underwent splenectomy. Both patients had obvious separation of the occiput and C1 on lateral cervical spine films. Both remained very unstable and died soon after celiotomy. The other two patients were stabilized, and both met criteria for brain death; one family agreed to organ donation. A 5-year analysis revealed 57 pediatric deaths, with 10 patients sustaining atlanto-occipital dislocations (17.5%). Nine of 10 patients sustained other injuries, but in only 2 patients were the injuries immediately life-threatening. With continued improvement in emergency medical systems and pediatric trauma care, we can expect to see more pediatric patients with this injury arriving in trauma centers with signs of life. In our experience, 50 per cent of patients may meet organ donor criteria, and our incidence of this injury (17.5%) reveals atlanto-occipital dislocation as a major contributor to pediatric trauma mortality.- - - - - - - - - - ranking = 0.25keywords = ligament (Clic here for more details about this article) |
5/320. Volar dislocation of the proximal interphalangeal joint of the finger: an indication for urgent operative treatment.Two patients are described with persistent acute volar dislocation of the middle phalanx of a finger. Closed reduction was impossible due to intra-articular interposition of the lateral slip of the extensor mechanism, combined with a tear of a collateral ligament. It is important to recognize these injuries at an early stage and an operative treatment is required.- - - - - - - - - - ranking = 0.25keywords = ligament (Clic here for more details about this article) |
6/320. Management of chronic posttraumatic radial head dislocation in children.We describe a new procedure for the management of chronic posttraumatic radial head dislocation, which uses two drill holes in the proximal ulna. The holes are placed at the original attachments of the annular ligament and thereby allow repair of the annular ligament (frequently avulsed from one attachment and impinged within the joint) or reconstruction of the annular ligament with whatever tissue or material desired (triceps tendon is convenient). It secures the radial head in its normal position from any dislocated position. It also allows for osteotomy of any accompanying deformity of the ulna or radius. This operation developed gradually between 1967 and 1995 while we treated seven female patients. The average age at time of injury was 5 years 10 months (range, 3 years 4 months to 8 years 11 months). The interval between injury and operation averaged 30 months (range, 3 months to 7 years). The age at time of surgery averaged 8 years 4 months (range, 5 years 4 months to 13 years 5 months). The only criterion for surgery was a normal concave proximal radial articular surface. Follow-up averaged 48 months. At final follow-up, all patients were fully active and had no elbow pain or instability. Analysis of these cases suggests that the criteria for surgical repair should be based on two features: (a) normal concave radial head articular surface, and (b) normal shape and contour of the ulna and radius (deformity of either should be corrected by osteotomy). The age of the patient and duration of the dislocation are unimportant.- - - - - - - - - - ranking = 0.75keywords = ligament (Clic here for more details about this article) |
7/320. Palmar oblique ligament reconstruction for carpometacarpal joint dislocation in an 11-year-old: a case report.Traumatic dislocation of the thumb carpometacarpal joint has been rarely reported in children. An 11-year-old boy presented with a traumatic dislocation of the trapeziometacarpal joint. He was successfully treated surgically with ligament reconstruction as previously described.- - - - - - - - - - ranking = 1.25keywords = ligament (Clic here for more details about this article) |
8/320. Recurrent dislocation of the elbow in children: description of a case.The authors report a case of recurrent dislocation of the elbow in a boy aged 11 years, surgically treated by reconstruction of the lateral capsuloligamentous structures. After a review of the literature, the need for a diagnostic protocol to establish the main cause of recurrent dislocation is emphasized.- - - - - - - - - - ranking = 0.25keywords = ligament (Clic here for more details about this article) |
9/320. knee dislocation following anterior cruciate ligament disruption without any other ligament tears.We report a rare case of complete knee dislocation following anterior cruciate ligament (ACL) disruption without any other ligament tears. The pathology of the knee joint was torn ACL, intact other ligaments, osteochondral fractures and bone bruise of the lateral femoral condyle, and torn lateral meniscus. In this case, osteochondral fracture resulting from the anteriorly sublaxiation of the tibia following ACL disruption was considered to prevent from spontaneous reduction. This case suggests that anterolateral knee dislocation and spontaneous reduction may occur in ACL injuries.- - - - - - - - - - ranking = 2.75keywords = ligament (Clic here for more details about this article) |
10/320. Craniocervical junction synovial cyst associated with atlanto-axial dislocation--case report.A 51-year-old female presented with a rare case of synovial cyst at the cruciate ligament of the odontoid process associated with atlanto-axial dislocation, manifesting as a history of headache and numbness in her left extremities for 5 months, and progressive motor weakness of her left leg. neuroimaging studies revealed a small cystic lesion behind the dens, which severely compressed the upper cervical cord, and atlanto-axial dislocation. The cyst was successfully removed via the transcondylar approach. C-1 laminectomy and foramen magnum decompression were also performed. Posterior craniocervical fusion was carried out to stabilize the atlanto-axial dislocation. The cyst contained mucinous material. Histological examination detected synovial cells lining the fibrocartilaginous capsule. Synovial cysts of this region do not have typical symptoms or characteristic radiographic features. Careful preoperative evaluation of the symptoms and a less invasive strategy for removal of the cyst are recommended.- - - - - - - - - - ranking = 0.25keywords = ligament (Clic here for more details about this article) |
| | Next -> |