1/23. 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 = 1keywords = ligament (Clic here for more details about this article) |
2/23. The clearance of procalcitonin (PCT) during continuous veno-venous hemodiafiltration (CVVHD)OBJECTIVE: To evaluate the Procalcitonin (PCT) clearance during continuous veno-venous hemodiafiltration (CVVHD). DESIGN: Case report SETTING: Surgical intensive care unit.PATIENT: 51-year-old man, who had undergone total thyroidectomy about ten years before owing to multiple endocrine neoplasia 2 (MEN 2), suffering from multiple organ dysfunction syndrome (MODS) with acute renal failure after severe trauma caused by a traffic accident. MEASUREMENTS AND MAIN RESULT: The samplings of prefilter (afferent) and post-filter (efferent) blood and of ultradiafiltrate were 6 times performed during 24 h of CVVHD to calculate the PCT clearance of hemdiafiltration. During the first half period of CVVHD the serum PCT concentration did not decrease, though PCT had been eliminated from serum. On the other hand during the latter half period of it the serum PCT value decreased (from 46.8 ng/ml to 29.4 ng/ml) and the amount of the eliminated PCT from serum was about 100 ng per minute and its clearance was 2.3 approximately 3.4 ml/min. CONCLUSION: The CVVHD could eliminate PCT from serum. First it was brought about by the adsorption by the filter membrane and then by ultradiafiltration.- - - - - - - - - - ranking = 0.00050666604158063keywords = membrane (Clic here for more details about this article) |
3/23. Bilateral external iliac and common femoral artery disruptions after blunt trauma.Blunt trauma to the external iliac or common femoral artery is relatively rare. Since its original description as the "motor-scooter handlebar syndrome," this type of injury has been hypothesized as resulting from compression of the artery by the inguinal ligament. We report a case of mirror-image arterial injuries from blunt trauma. At operation, each distal external iliac and proximal common femoral artery was found to have large intimal flaps. Resection of the injured segments with bilateral saphenous vein interposition grafts led to a successful outcome.- - - - - - - - - - ranking = 0.5keywords = ligament (Clic here for more details about this article) |
4/23. Occult ligamentous injury of the cervical spine.Evaluating the cervical spine for injury is an essential part of the assessment of a traumatized patient. Clinical examination and radiographs are the traditional techniques used for this evaluation. Often, however, a reliable clinical examination is not possible because of head injury, altered mental status, or "distracting" injuries. In such cases, cervical spine injury that is not apparent on radiographs may be missed. This case report illustrates a purely ligamentous cervical spine injury resulting in cervical instability. We describe our method of screening for and evaluating these types of injuries using physician-controlled stretch, flexion, and extension examination under fluoroscopy.- - - - - - - - - - ranking = 2.5keywords = ligament (Clic here for more details about this article) |
5/23. Type III tibial avulsion fracture with associated anterior cruciate ligament injury: Report of two cases in adults.Tibial spine avulsion fractures are more common in children than adults. Many reports have provided classification and treatment options, including fixation for displaced type III fractures. However, long-term follow-up on injury to the anterior cruciate ligament and knee joint stability in adults is not well documented. We present 2 cases of type III tibial avulsion fractures in adults with associated interstitial injury to the anterior cruciate ligament. Primary anterior cruciate ligament reconstruction was performed in both patients.- - - - - - - - - - ranking = 3.5keywords = ligament (Clic here for more details about this article) |
6/23. 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 = 0.5keywords = ligament (Clic here for more details about this article) |
7/23. Injuries to the posterolateral aspect of the knee accompanied by compression fracture of the anterior part of the medial tibial plateau.We present 12 cases of patients with injury to the posterolateral aspect of the knee accompanied by a compression fracture of the anterior part of the medial tibial plateau. There were 11 male patients and 1 female patient with an average age of 26 years (range, 17 to 44 years). There were 4 cases of posterolateral rotatory instability and 8 cases of straight lateral instability of the knee. The size of the compression fracture was classified into 2 types, small (8 cases) and large (4 cases). Although the mechanism of injury was considered to be hyperextension and varus force, the pattern of cruciate ligament injuries varied from case to case. The following 3 questions should be considered to determine which cruciate ligament is damaged: (1) Was the ipsilateral foot fixed to the ground? (2) Was forward inertia involved? (3) Was there a direct blow to the anteromedial aspect of the tibia or to the femur? Accompanied fractures of the medial tibial plateau were considered to have been compressed by the medial femoral condyle. The size of the accompanying compression fracture varied; 7 of 8 cases with a small-type fracture had posterior cruciate ligament injuries and 3 of 4 cases with a large-type fracture had anterior cruciate ligament injuries. The size of the fracture is determined by which point of the medial tibial plateau touched the medial femoral condyle. We propose that a compression fracture of the anterior part of the medial tibial plateau indicates a coexistent posterolateral aspect injury, and that especially a small compression fracture strongly suggests an accompanying posterior cruciate ligament injury, as well.- - - - - - - - - - ranking = 2.5keywords = ligament (Clic here for more details about this article) |
8/23. Coincidental rupture of the scapholunate and lunotriquetral ligaments with volar intercalated segment instability complicating a closed distal forearm fracture in an adolescent.A 15-year-old boy is described with concomitant scapholunate and lunotriquetral ligament injuries of the wrist, complicating a closed forearm fracture. The rotatory dislocation could be reduced and stabilized with a soft-tissue procedure.- - - - - - - - - - ranking = 2.5keywords = ligament (Clic here for more details about this article) |
9/23. Postoperative extracorporeal membrane oxygenation for severe intraoperative SIRS 10 h after multiple trauma.A 34-yr-old male suffered multiple trauma in a road traffic accident. He required right thoracotomy and laparotomy to control exanguinating haemorrhage, and received 93 u blood and blood products. Intraoperatively, he developed severe systemic inflammatory response syndrome (SIRS) with coagulopathy and respiratory failure. At the end of the procedure, the mean arterial pressure (MAP) was 40 mm Hg, arterial blood gas analysis showed a pH of 6.9, Pa(CO(2)) 12 kPa, and Pa(O(2)) 4.5 kPa, and his core temperature was 29 degrees C. There was established disseminated intravascular coagulation. The decision was made to stabilize the patient on veno-venous extracorporeal membrane oxygenation (ECMO) only 10 h after the accident, in spite of the high risk of haemorrhage. The patient was stabilized within 60 min and transferred to the intensive care unit. He was weaned off ECMO after 51 h. He had no haemorrhagic complications, spent 3 weeks in the intensive care unit, and has made a good recovery.- - - - - - - - - - ranking = 0.0025333302079032keywords = membrane (Clic here for more details about this article) |
10/23. High-energy knee dislocation without anterior cruciate ligament disruption in a skeletally immature adolescent.Knee dislocations are rare injuries in any age group, but even more unusual in skeletally immature individuals. Such injuries often occur from high-energy mechanisms and are commonly associated with disruption of both anterior and posterior cruciate ligaments. Although there are several previous reports of knee dislocation without disruption of the posterior cruciate ligament, there is only one report citing 3 cases of knee dislocation with the anterior cruciate ligament remaining intact, each occurring in skeletally mature individuals. We present a high-energy knee dislocation in a skeletally immature girl without anterior cruciate ligament disruption. We also discuss the evaluation, management, and outcome. Treatment of this condition with arthroscopically assisted posterior cruciate ligament reconstruction using tibialis anterior allograft 2 weeks after the acute injury resulted in complete functional recovery.- - - - - - - - - - ranking = 4.5keywords = ligament (Clic here for more details about this article) |
| | Next -> |