1/19. Proximal median neuropathy secondary to humeral neck fracture.Median neuropathies proximal to the wrist are uncommon and usually result from penetrating injuries, fracture dislocation of the distal humerus, or compression by fibrous bands. A 66-year-old man suffered a comminuted fracture of the proximal humerus after a fall. Electrodiagnostic studies revealed a severe proximal median neuropathy and a mild distal radial mononeuropathy. Proximal median neuropathy rarely occurs in humeral neck fracture, mostly because the median nerve is not in close contact with the humerus proximally.- - - - - - - - - - ranking = 1keywords = dislocation (Clic here for more details about this article) |
2/19. Comminuted fracture-dislocations of the elbow treated with an AO wrist fusion plate.Comminuted fracture-dislocations of the elbow are complex injuries that can result in significant postoperative loss of motion. Rigid anatomic fixation with early range of motion is the required treatment. Because of the local anatomy of the proximal ulna, it often is difficult to achieve a rigid fixation construct. A fixation technique of a dorsally applied AO limited contact-dynamic compression wrist fusion plate contoured to fit the anatomy of the proximal ulna is presented. Advantages of the AO wrist fusion plate in comminuted olecranon fractures include the ease of contouring, a low profile, and the use of variable screw hole sizing to achieve stable fixation. The hybrid design allows for rigid 3.5-mm plate fixation distally while providing low profile 2.7-mm plate fixation over the subcutaneous olecranon. The technical and biomechanical features of this plate make it an ideal alternative for fixation of these complex injuries.- - - - - - - - - - ranking = 5keywords = dislocation (Clic here for more details about this article) |
3/19. Comminuted Monteggia fracture-dislocation--a technique for restoration of ulnar length: case reports.A technique to aid the reconstruction of the ulna in case of comminuted Monteggia fracture-dislocation is presented. This involves reducing the proximal radioulnar joint and temporarily transfixing the radial head to the ulna by 1 or 2 Kirschner (K) wires to establish the ulnar length. Once ulnar length has been defined, reconstruction of the comminuted ulna fracture is simplified. The radioulnar K-wires are then removed and the radioulnohumeral joint is tested for stability. This technique has been used in 6 cases of type-1 Monteggia fracture-dislocation with no subsequent malunion of the ulnar fracture or redislocation' of the radial head. After an average of 13 months follow-up, all patients had nearly full range of motion of the elbow joint.- - - - - - - - - - ranking = 7keywords = dislocation (Clic here for more details about this article) |
4/19. Traumatic posterior rotatory fracture-dislocation of lumbo-sacral spine.Fracture-dislocation of the lumbo-sacral spine was an unusual injury and was divided into anterior, posterior and lateral types depending on the displacement of the cephalad portion of the spine over the caudal portion. According to the authors' knowledge, only 31 cases of traumatic fracture-dislocation of the lumbo-sacral spine were reported in the English literature. Only 3 previous reports referred to this injury with a posterior displacement, which was an even rarer injury. This was the fourth report of this type of injury.- - - - - - - - - - ranking = 6keywords = dislocation (Clic here for more details about this article) |
5/19. Sigmoid notch reconstruction using osteoarticular graft in a severely comminuted distal radius fracture: a case report.A case of a young patient with a severely comminuted intra-articular distal radius fracture dislocation and severe injury of the distal radioulnar joint is presented. Early reconstruction of the sigmoid notch and radioulnar ligaments was performed using the remaining scaphoid facet of the distal radius articular surface, an autogenous tendon graft for ligament reconstruction, and radioscapholunate arthrodesis. The patient was able to return to his manual work without limitations. We present additional information on the comparative anatomy of the sigmoid notch and scaphoid facet that may guide surgeons in treating this severe injury.- - - - - - - - - - ranking = 1keywords = dislocation (Clic here for more details about this article) |
6/19. Supplementary transverse wire fixation through cuneiforms and cuboid in combination with a screw for the comminuted tarsal navicular fractures.An isolated fracture dislocation of the body of the tarsal navicular is an unusual injury; a displaced one is difficult to treat, and a comminuted one poses a further therapeutic problem. Previously, several authors have described various options with additional fixation across the cuneonavicular joint through a tarsal navicular. However, in the comminuted tarsal navicular fracture, the question arises regarding the efficacy of the wires through the comminuted fracture fragments to maintain satisfactory reduction. The technique that several authors have described is impractical for the treatment of a severe comminuted tarsal navicular fracture. We present two cases of a comminuted fracture treated with open reduction and internal fixation with supplementary wire fixation through cuneiforms and cuboid as an ancillary method. This method proved to be satisfactory for the treatment of a comminuted fracture of the body of the navicular.- - - - - - - - - - ranking = 1keywords = dislocation (Clic here for more details about this article) |
7/19. Dislocation of the mandibular condyle into the middle cranial fossa: report of a case with 5 year CT follow-up.A 17-year-old patient suffered a dislocation of the right mandibular condyle into the middle cranial fossa following a motorcycle accident. Reduction was delayed because of serious orthopaedic injuries. The condyle was relocated into the glenoid fossa through a combined neurosurgical and preauricular approach. Five years later the patient presented for removal of wisdom teeth and a CT-scan was done to determine the effects of the trauma and management to the condyle. A fibro-osseous ankylosis had occurred in the right temporomandibular joint. The radiological changes confirm that early management appears to improve the prognosis for these injuries.- - - - - - - - - - ranking = 1keywords = dislocation (Clic here for more details about this article) |
8/19. Intrathoracic humeral head fracture-dislocation.There are few cases in the medical literature documenting intrathoracic glenohumeral fracture-dislocations. A total of eight cases have been reported-two intrathoracic humerus dislocations with greater tuberosity fractures 1, 2 and six cases with intrathoracic fracture-dislocations in which the fracture involved the humeral neck. 3-8 With so few cases, treatment modalities vary, and no guidelines exist. patients in five of the reported cases underwent surgery, 1, 3-6 while the other three were treated nonoperatively. 2, 7, 8 We present a case of a middle-aged woman involved in a high-speed motor vehicle accident who sustained an intrathoracic humeral head fracture-dislocation and underwent operative treatment.- - - - - - - - - - ranking = 8keywords = dislocation (Clic here for more details about this article) |
9/19. Early proximal row carpectomy after severe carpal trauma.Complex fracture dislocations of the wrist often result in post-traumatic arthrosis. In these cases, patients can experience severe pain and loss of function of the wrist and as a result many of them end up having a total arthrodesis. In trying to avoid the disadvantages of a total arthrodesis, alternative treatment strategies have been investigated, amongst which proximal row carpectomy (PRC). Basic conditions for a good outcome of PRC are an intact cartilage of the lunate fossa of the distal radius and an intact surface of the head of the capitate for the new radiocapitate joint (, schematic drawing post-PRC). Also, an intact (volar) radioscaphocapitate (RSC) ligament is necessary because it plays an essential role in stabilizing the new joint and preventing volar dislocation and ulnar translocation of the distal carpal row. Acute post-traumatic PRC can be indicated, but is rarely reported in literature. In this article, we present four patients whom we have treated with early PRC after severe trauma of the wrist. Three patients had a good outcome. In the patient with the bad outcome, the before-mentioned prerequisites were not met, which is discussed.- - - - - - - - - - ranking = 2keywords = dislocation (Clic here for more details about this article) |
10/19. Functional outcome after operative treatment of eight type III coronoid process fractures.BACKGROUND: There have been few reports about surgical outcomes of coronoid process fractures. Eight cases of clinical results of type III coronoid process fractures were reviewed. methods: Eight patients with coronoid type III fracture were retrospectively reviewed. All were men with an average age of 33 years. There were three isolated fractures, two elbow dislocations, two radial head and neck fractures, and one medial collateral ligament rupture. An open reduction and internal fixation through an anterior approach with cannulated screws was used. The patients were followed up for a mean of 31 months (range, 24-60 months). RESULTS: Average active elbow joint motion at the most recent follow-up was 105 degrees. The average Mayo Elbow Performance Score was 76.9 (range, 50-95). Of the results, there was one excellent, four good, two fair, and one poor. CONCLUSION: Early open reduction and stable internal fixation provided a reliable method for the treatment of type III coronoid process fractures. Any associated injuries to the elbow and fracture comminution were considered as important prognostic factors.- - - - - - - - - - ranking = 1keywords = dislocation (Clic here for more details about this article) |
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