1/18. Radial head dislocation with plastic deformation of the ulna in children. A rare and frequently missed condition.Although often reported in the literature, 'isolated' traumatic radial head dislocation in children is a rare condition which has not been studied extensively. There is very often a delay in diagnosis and treatment. Lincoln and Mubarak described the 'ulnar bow sign' in 1994. They accurately described the plastic deformity of the ulna and explained how to make a correct diagnosis from the radiographs. Probably most 'isolated' radial head dislocations in children are associated with plastic deformation of the ulna as stated in 1984 by Dubuc et al. (2). The recognition of these "plastic" Monteggia fractures is mandatory, as action on the ulna plays a central role in the treatment. On the other hand, the 'ulnar bow sign' may be used to detect subtle changes in the position of the radial head. We present 4 cases of chronic radial head dislocation associated with plastic deformation of the ulna. Open reduction of the radial head and reconstruction of the annular ligament was performed. An osteotomy of the ulna was deemed necessary in 3 cases.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
2/18. Irreducible elbow dislocation associated with a radial neck fracture: a case report.A rare case of an irreducible elbow dislocation is described. We discuss the causes of irreducibility and the treatment options. Intraoperative assessment of joint stability, repair of the lateral collateral ligament and appropriate postoperative management led to an excellent 5-year outcome, obviating the need for an external fixator or a radial head replacement.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
3/18. 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 = 2keywords = ligament (Clic here for more details about this article) |
4/18. 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 = 5keywords = ligament (Clic here for more details about this article) |
5/18. Reconstruction of longitudinal stability of the forearm after disruption of interosseous ligament and radial head excision (Essex-Lopresti lesion).We have presented a technique for reconstruction of the central band of the interosseous membrane in conjunction with surgical repair of the distal radial joint and radial head prosthesis. With this technique, we address all three anatomic structures that provide longitudinal stability of the forearm, specifically, (1) radial head replacement, (2) interosseous membrane reconstitution, and (3) TFCC repair.- - - - - - - - - - ranking = 4keywords = ligament (Clic here for more details about this article) |
6/18. Combined fractures in the capitellum and the radial head associated with medial capsular avulsion.We present a case with an unusual fracture. A 28-year-old man presented a painful and swollen left elbow after falling down. Radiographs revealed combined fractures in the capitellum and the radial head associated with a medial capsular avulsion. Two osteochondral fragments from the capitellum were found at the operation. One was the free fragment revealed on radiographic examination. Another was not revealed before the operation and was found piercing the fracture line of the radial head. These two fragments were removed. The radial head fracture was reduced and was fixed using two Herbert screws. It is very difficult to detect a fragment of the capitellum that impaled the radial head on a plain radiogram before operation. Also, a capsular injury and/or ligamentous injury is often overlooked. This fact should be kept in mind whenever a non-operatively treated radial head fracture fails to respond as expected.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
7/18. 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 = 1keywords = ligament (Clic here for more details about this article) |
8/18. "Ratchet-type" marginal fracture of the radial head with locked anterior dislocation. A case report.Locked anterior dislocation of the superior radioulnar joint occurred in a 26-year-old man. The configuration of the associated radial head fracture maintained the locked position and predisposed to recurrence after open reduction. Radial head excision was necessary to resolve the problem. Both medial ligament repair and a radial head prosthesis were necessary to stabilize the elbow.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
9/18. Fractures of the radial head in adults with the complication "cubitus valgus".Cubitus valgus is a well-known complication of fracture of the bones of the elbow in childhood, but it is an uncommon deformity in adults. Three adult patients are presented, in each of whom cubitus valgus developed as a complication of a fracture and resection of the radial head. The importance of reestablishing the integrity of the ligaments of the elbow following severe injuries to the elbow is stressed.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
10/18. Concomitant fractures of the capitellum and radial head.Seven cases of coexisting capitellum and radial head fractures are reported. Our best results were obtained when early open reduction and internal fixation (ORIF) of the larger, more suitable fracture was combined with excision of the smaller fracture fragments and the early initiation of motion. Poor results were obtained when there was (a) incomplete removal of intraarticular fragments, (b) associated medial collateral ligament injuries, or (c) when ORIF was attempted on small capitellum fracture fragments.- - - - - - - - - - ranking = 1keywords = ligament (Clic here for more details about this article) |
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