1/8. Diastasis with low distal fibula fractures: an anatomic rationale.Tibiofibular diastasis occurs infrequently in displaced ankle fractures that include a low fibula fracture. This is because the interosseous ligament, the major ligament resisting diastasis, lies above the level of the fracture. The anatomic study of the syndesmotic complex of the ankle reported here showed that the interosseous ligament has a variable attachment on the fibula, differing between specimens in its distance above the synovial reflection or joint line. Although most specimens had attachments approximately 1 cm or greater above the joint line, one of 18 specimens attached just above the synovial reflection. In such a case, a low fibula fracture would disrupt the interosseous ligament, which explains the anatomic basis for the infrequent diastasis in these ankle fractures.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
2/8. broad ligament hematoma causing fetal death in a case of fracture pelvis.Although motor ventricular accidents complicates 6-7% of all pregnancies, the experience of pelvic fractures in near term gravid patients is limited. We present a unique case of fetal death caused by bilateral broad ligament hematomas following maternal pelvic fracture which improved our understanding of management of such cases.- - - - - - - - - - ranking = 1.25keywords = ligament (Clic here for more details about this article) |
3/8. 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 = 0.5keywords = ligament (Clic here for more details about this article) |
4/8. 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 = 0.25keywords = ligament (Clic here for more details about this article) |
5/8. 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 = 0.25keywords = ligament (Clic here for more details about this article) |
6/8. Treatment of the knee stiffness caused by partial patellectomy--technical tricks.Partial patellectomy is advised in treating comminuted fractures of patella when accurate reduction and stable fixation cannot be achieved. Usually, after partial patellectomy, the tendon-to-bone junction requires prolonged protection. One of the effects of the prolonged immobilization is lack of knee flexion. Stiffness of the knee was treated with manipulation under anaesthesia. In order to protect patellar ligament insertion to the patella remnant, a Steinmann pin was put through tibial tuberosity, a metal wire was pulled through the patella remnant and tied firmly to the pin. Gentle manipulation was performed and full flexion of the knee was achieved without damaging bone ligament complex.- - - - - - - - - - ranking = 0.5keywords = ligament (Clic here for more details about this article) |
7/8. Bridge plating of distal radius fractures: the Harborview method.High-energy comminuted distal radius fractures treated at Level 1 trauma centers represent unique treatment challenges. In particular, two groups of patients require special consideration: patients with high-energy injuries that have fracture extension into the radius and ulna diaphysis and patients with multiple injuries that require load bearing through the injured wrist to assist with mobilization. We report our experiences treating these injuries with a bridge plating technique. The bridge plate acts as an "internal fixator" and depends on ligamentotaxis for fracture reduction. The technique has been found to be performed easily and achieves the goals of maintenance of fracture reduction, allows weightbearing through the injured extremity, and is associated with few complications. We describe the technique and review our experience with a retrospective chart review of 62 consecutive patients. Level of Evidence: Therapeutic study, level IV (case series).- - - - - - - - - - ranking = 0.25keywords = ligament (Clic here for more details about this article) |
8/8. Controversies on the treatment of irreducible elbow dislocations with an associated nonsalvageable radial head fracture.We report the case of a 26-year-old man who sustained an elbow dislocation with an associated radial head fracture entrapped in the joint, preventing closed reduction. A posterolateral approach to the radial head was performed to reduce the dislocation. A comminuted fracture of the entire radial head was found that required excision. Although radial head replacement has been stressed to restore sufficient stability in similar cases (because most are inherently unstable), it is important to determine whether the ulnar collateral ligament (UCL) is intact. Intraoperative use of valgus stress aids in that determination. The radial head can then be excised if the UCL is intact. In this case, no instability resulted with excision of the radial head because the UCL was intact. Failure to recognize and/or to treat an UCL rupture associated with radial head excision can result in elbow instability, increased elbow valgus deformity, and ulnohumeral arthritis.- - - - - - - - - - ranking = 0.25keywords = ligament (Clic here for more details about this article) |