1/88. Inferomedial (subsustentacular) dislocation of the navicular: a case report.A unique case of subsustentacular dislocation of the navicular is presented. The authors propose that such a severe displacement cannot occur until there is complete instability across the whole midfoot. The mechanism of injury and the treatment options are discussed. In the present case, there was late collapse of the foot into abduction because the lateral column was not primarily stabilized. Avascular necrosis is a common complication which leads to navicular collapse. A midfoot arthrodesis gave a good result in our patient.- - - - - - - - - - ranking = 1keywords = dislocation (Clic here for more details about this article) |
2/88. wrist arthroscopy and dislocation of the radiocarpal joint without fracture.The authors report a rare case of dorsal dislocation of the radiocarpal joint without any bony lesion associated. The traumatic cause was a high energy motorbike accident. Fractures of the other limbs were associated. The authors report the clinical, radiological, and arthroscopic features. wrist arthroscopy showed a complete tear of all the extrinsic ligaments, a radial avulsion of the triangular fibrocartilage complex, and the integrity of the intracarpal ligaments, which guided the treatment. The dislocation was treated by closed reduction and radiocarpal pinning. The authors propose wrist arthroscopy in radiocarpal dislocation for diagnosis of soft tissue and cartilaginous lesions to guide the treatment (close or open).- - - - - - - - - - ranking = 1.4keywords = dislocation (Clic here for more details about this article) |
3/88. Total dislocations of the navicular: are they ever isolated injuries?Isolated dislocations of the navicular are rare injuries; we present our experience of six cases in which the navicular was dislocated without fracture. All patients had complex injuries, with considerable disruption of the midfoot. Five patients had open reduction and stabilisation with Kirschner wires. One developed subluxation and deformity of the midfoot because of inadequate stabilisation of the lateral column, and there was one patient with ischaemic necrosis. We believe that the navicular cannot dislocate in isolation because of the rigid bony supports around it; there has to be significant disruption of both longitudinal columns of the foot. Most commonly, an abduction/pronation injury causes a midtarsal dislocation, and on spontaneous reduction the navicular may dislocate medially. This mechanism is similar to a perilunate dislocation. Stabilisation of both medial and lateral columns of the foot may sometimes be essential for isolated dislocations. In spite of our low incidence of ischaemic necrosis, there is always a likelihood of this complication.- - - - - - - - - - ranking = 1.6keywords = dislocation (Clic here for more details about this article) |
4/88. Traumatic unilateral avulsion of the anterior superior and inferior iliac spines with anterior dislocation of the hip: a case report.A sixteen-year-old boy involved in a high-speed motor vehicle accident sustained an anterior hip dislocation and avulsion of the anterior ilium extending from the anterior superior iliac spine to the anterior inferior iliac spine. The hip was emergently reduced, and further imaging was obtained to evaluate the bony injury. Computed tomography confirmed the presence of a large displaced bony fragment representing avulsion of the anterior superior and inferior iliac spines and a smaller fragment from the reflected head of the rectus femoris. The patient underwent open reduction and internal fixation of the ilium two days after the initial injury. Postoperatively, he was allowed to bear weight as tolerated with crutches but to avoid active hip flexion. He went on to an uneventful recovery, and at last report (approximately six months after injury), he had returned to full activity. An extensive review of the literature failed to show a similar injury of ipsilateral avulsion of the anterior superior and inferior iliac spines and reflected head of the rectus femoris.- - - - - - - - - - ranking = 1keywords = dislocation (Clic here for more details about this article) |
5/88. Dislocation of the knee with lateral dislocation of the patella. A report of four cases.In a group of 25 patients with traumatic dislocation of the knee, four, all of whom had similar ligament and medial soft-tissue injuries, also had associated lateral patellar dislocation. In all four reconstruction was delayed because of their other serious injuries. Having encountered the combination of knee dislocation and lateral patellar dislocation in 16% of our patients, we believe that it may be less rare than is commonly believed. We think that it is important to maintain a high index of suspicion of possible patellar dislocation when medial structures have been severely damaged. Early recognition and immobilisation in extension can prevent fixed lateral dislocation of the patella.- - - - - - - - - - ranking = 2keywords = dislocation (Clic here for more details about this article) |
6/88. Operative treatment of a transverse fracture-dislocation at the S1-S2 level.SUMMARY: The authors recently treated a multiply injured patient who sustained a rare fracture-dislocation at the S1-S2 level. The S1 vertebra was displaced forward into the pelvic cavity and was located just in front of the S2 vertebra. Because the patient also had extensive neurologic injury to the lumbar plexus and instability of the pelvic ring, operative treatment was deemed necessary. Surgery to stabilize the pelvis and decompress the lumbar plexus proved successful, and the patient experienced marked improvement in her postoperative neurologic function. Nonoperative treatment has traditionally been recommended for this injury, but advances in spinal surgery have made transverse sacral fractures more amenable to open reduction and fixation. Potential benefits of this operative treatment include relief of pressure from the lumbar plexus, a stable pelvis and facilitation of return of neurologic function.- - - - - - - - - - ranking = 1keywords = dislocation (Clic here for more details about this article) |
7/88. Bilateral anterior and posterior traumatic hip dislocation.SUMMARY: A case report of simultaneous traumatic bilateral anterior and posterior hip dislocations is presented, and the management of this injury is discussed.- - - - - - - - - - ranking = 1keywords = dislocation (Clic here for more details about this article) |
8/88. Concomitant fractures of the femoral head and neck without hip dislocation.This case report describes two patients who sustained ipsilateral fractures of the femoral head and femoral neck without dislocation of the hip. The fractures in the two patients resulted from vehicle accidents. The femoral head was fractured in the sagittal plane, and the femoral neck was fractured at the subcapital portion. However, the hip was not dislocated in either patient. Both patients were treated using cementless total hip arthroplasty. These unusual hip injuries have not been reported previously and are not categorized according to any known classification system of hip injuries.- - - - - - - - - - ranking = 1keywords = dislocation (Clic here for more details about this article) |
9/88. Traumatic posterior atlantooccipital dislocation with Jefferson fracture and fracture-dislocation of C6-C7: a case report with survival.Atlantooccipital dislocation (AOD) is a rare and usually fatal injury. In the current study, the authors reported an extremely rare case of posterior AOD with Jefferson fracture and fracture-dislocation of C6-C7. The patient survived the injury and had only incomplete quadriplegia below the C7 segment with anterior cord syndrome. He was successfully managed with in situ occipitocervical fusion using the Cotrel-Dubousset rod system, corpectomy of C6, and anterior interbody fusion of C5-C7 with plating. To our knowledge, this is the first report of posterior AOD with two other non-contiguous cervical spine injuries. A high index of suspicion and careful examination of the upper cervical spine should be considered as the key to the diagnosis of AOD in cases that involve multiple or lower cervical spine injuries.- - - - - - - - - - ranking = 2keywords = dislocation (Clic here for more details about this article) |
10/88. Simultaneous dislocations of the radiocapitellar and distal radioulnar joints.Posttraumatic instability of the distal radioulnar joint (DRUJ), occurring in isolation or in association with fractures of the radius, is well-documented. Few reports have identified simultaneous ipsilateral DRUJ instability and elbow dislocation. The authors of the present study describe a case of persistent radiocapitellar subluxation after closed reduction of an elbow dislocation, secondary to irreducible volar subluxation of the DRUJ.- - - - - - - - - - ranking = 1.2keywords = dislocation (Clic here for more details about this article) |
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