Cases reported "Dislocations"

Filter by keywords:



Filtering documents. Please wait...

1/72. The prevention of irreversible lung changes following reversible phrenic nerve paralysis.

    phrenic nerve paralysis frequently follows operations on the neck such as resection of a cervical or first rib. It all too often passes unrecognised or is incorrectly treated, leading to permanent lung damage which may be severe enough as to result in a functional pneumonectomy. This is particularly unfortunate since the phrenic nerve paralysis is usually temporary. Three case histories are described of reversible paralysis of the phrenic nerve in which, due to prompt diagnosis, the ensuing lung changes were either prevented or immediatley treated. Intermittent assisted respiration with a Monaghan respirator was used to provide nebulised inhalations of mesna several times a day. The method is applicable via a tracheostomy, an endotracheal tube or a simple mouthpiece. The latter is illustrated. The therapy is not hindered by immobilisation of the head and neck and the level of consciousness of the patients is of no importance. Many chest x-rays demonstrate the rapid clearing of the lungs achieved. All three patients were discharged with perfectly normal lungs.
- - - - - - - - - -
ranking = 1
keywords = ray
(Clic here for more details about this article)

2/72. Posterior sternoclavicular dislocations--a diagnosis easily missed.

    Posterior dislocation of the sternoclavicular joint is a relatively rare injury and can be difficult to diagnose acutely. We report 3 cases of posterior dislocation of the sternoclavicular joint who presented to the Accident & Emergency Department within a 3 month period. All 3 patients had sustained a significant injury to the shoulder region and complained of pain around the medial clavicle. Two patients had also complained of dysphagia following the injury. Plain x-rays of the shoulder and chest were reported as normal by junior and senior medical staff. The diagnosis was delayed until CT scans were performed, and once this was established, open reduction and stabilisation was performed.
- - - - - - - - - -
ranking = 1
keywords = ray
(Clic here for more details about this article)

3/72. Second carpometacarpal joint dislocation: an impossible situation?

    We report a case of a seemingly anatomically impossible dislocation of the second carpometacarpal joint treated by closed manipulation, and a review the literature. Isolated second carpometacarpal joint dislocation is rare, whereas dislocations of the first, fourth and fifth joints are more common. A true lateral X-ray is necessary if the injury is suspected clinically. We recommend that closed reduction under local anaesthetic is attempted, although the patient should be warned that subsequent open reduction may be necessary if closed reduction fails. Chronic unreduced dislocations do not produce serious disabilities in the hand.
- - - - - - - - - -
ranking = 1
keywords = ray
(Clic here for more details about this article)

4/72. Use of calcitonin for the treatment of an odontoid fracture. Case report.

    The authors report on the efficacy of nonsurgical treatment of an older patient with a fractured odontoid process. The patient, an 85-year-old woman, had multiple medical problems that put her at an increased surgery-related risk. Therefore, an alternative approach was elected, including immobilization with a philadelphia collar and the provision of calcitonin nasal spray. Bone union and clinical recovery were achieved within 8 weeks of initiating the nasal calcitonin therapy (12 weeks postinjury). Considering the patient's age, comorbidities, and the severity of the fracture, the recovery period was unusually short. The authors believe that calcitonin played a pivotal role in the healing process of the fractured odontoid bone. There is no question that the fusion in this patient could be unrelated to the medical therapy. This description of one patient, as well as the lack of a large randomized study, precludes any scientific conclusions. Nevertheless, the authors believe that the development of a successful fusion in this high-risk patient should be reported as an observation that merits confirmation and study. The authors also discuss the physiological effects of calcitonin and the research and clinical experience with this hormone in different conditions affecting bone.
- - - - - - - - - -
ranking = 1
keywords = ray
(Clic here for more details about this article)

5/72. Isolated palmar dislocation of the fifth carpometacarpal joint diagnosed by stress x-rays.

    Isolated palmar ulnar dislocation of the fifth carpometacarpal (CMC) joint is a rare injury which often yields only subtle radiographic findings that may be easily overlooked, especially when there is no associated fracture. We reported a case of an isolated palmar dislocation of the fifth CMC joint, diagnosed correctly by means of simple stress x-rays (traction and axial compression stress views). This method proved to be useful and needs no special equipment.
- - - - - - - - - -
ranking = 5
keywords = ray
(Clic here for more details about this article)

6/72. Atlanto axial instability due to neurofibromatosis: case report.

    Neurofibromatosis is an autosomal dominant genetic disease, characterized by cafe au lait spots, neurofibromas and several bony anomalies. Deformities of the spine are the most frequent alterations. Involvement of the cervical spine has been studied less frequently. The case of a 16-year-old male patient affected by neurofibromatosis, with cervical pain without neurological symptoms is presented. x-rays, CT-scan and MRI demonstrated the presence of cervical kyphosis, occipitoaxial instability and atlantoaxial instability with subluxation. Posterior occipito-C2 fusion was performed with prior placement of a halo-vest. The outcome at four years was good with solid occipito axial fusion, moderate loss of cervical spine flexion and moderate-to-severe limitation of cervical spine rotation. The incidence and variety of alterations of the cervical spine in patients affected with neurofibromatosis is discussed, as well as the results obtained by the treatment.
- - - - - - - - - -
ranking = 1
keywords = ray
(Clic here for more details about this article)

7/72. Acetabular fracture.

    A twenty-eight-year-old female bicyclist was struck by a car. Associated injuries after trauma work-up included a splenic laceration that is to be treated with observation and a history of loss of consciousness with a negative head CT. x-rays and representative CT scan cuts are enclosed.
- - - - - - - - - -
ranking = 1
keywords = ray
(Clic here for more details about this article)

8/72. Simultaneous noncontiguous cervical spine injuries in a pediatric patient: case report.

    OBJECTIVE AND IMPORTANCE: Noncontiguous traumatic injuries of the cervical spine in children are rare. We present the case of a child who simultaneously sustained a separation of the odontoid synchondrosis and a C6-C7 dislocation with a complete spinal cord injury. The management of simultaneous cervical spine injuries is discussed. CLINICAL PRESENTATION: A boy aged 4 years and 2 months was a restrained back-seat passenger involved in a head-on motor vehicle accident. The patient lacked neurological function below C7. Imaging studies revealed a separation of the odontoid synchondrosis as well as a traumatic dislocation of the spine at C6-C7. INTERVENTION: The patient was placed in a halo vest shortly after admission. Four days after his injury, he underwent a posterior wiring and fusion of C6 to C7. As the C6-C7 dislocation was reduced by posterior element wiring, intraoperative x-rays showed a gradual increase in the subluxation of C1 on C2. This increase in C1-C2 subluxation required intraoperative repositioning of the halo crown on the ventral halo vest posts to maintain acceptable C1-C2 alignment. Postoperatively, ideal alignment of the odontoid peg on the body of C2 could not be achieved by halo adjustments alone. The patient required a custom-made posterior neck cushion attached to the halo vest to maintain cervical lordosis and good alignment of the odontoid peg on the body of C2. CONCLUSION: Simultaneous traumatic cervical spine injuries in pediatric patients are rare. The intraoperative reduction of one spine injury can affect the alignment at the location of the second injury. In this case, a custom adjustment of the halo vest improved the alignment of the odontoid peg on the body of C2.
- - - - - - - - - -
ranking = 1.0564830494801
keywords = ray, x-ray
(Clic here for more details about this article)

9/72. Selective paralysis of the upper extremities after odontoid fracture: acute central cord syndrome or cruciate paralysis?

    A patient presented with selective paralysis of the arms after having sustained a fall. X-ray of the cervical spine showed a type II odontoid fracture with posterior atlantoaxial dislocation. The diagnosis in the emergency room was cruciate paralysis, which is frequently associated with fractures of axis and/or atlas. However, magnetic resonance imaging (MRI) of the cervical spine revealed a lesion consistent with the acute central cord syndrome (CCS) at the C2-C6 level. The patient underwent posterior atlantoaxial arthrodesis to correct instability and was discharged, without much neurological improvement. Cruciate paralysis has been reported to be associated with fractures of axis and/or atlas, and acute CCS has rarely been associated with the fractures. However, this case illustrates that the lesion responsible for selective paralysis of the upper extremities is not as specific as it had been thought to be, and that it is difficult to accurately identify the level of the cervical cord injury by neurological diagnosis and x-rays alone. Supplementary diagnostic modalities, particularly MRI, are required to make a correct diagnosis and develop a therapeutic strategy.
- - - - - - - - - -
ranking = 2
keywords = ray
(Clic here for more details about this article)

10/72. Traumatic divergent dislocation of the extensor tendons over the metacarpophalangeal joint.

    Dislocation of the extensor tendon over the metacarpophalangeal joint (MCP) is rare. Involvement of the fifth ray is even more exceptional. The authors of the present study describe such a case that occurred in a professional musician. We report a divergent dislocation of both extensor tendons over the metacarpophalangeal joint of the fifth finger.
- - - - - - - - - -
ranking = 1
keywords = ray
(Clic here for more details about this article)
| Next ->


Leave a message about 'Dislocations'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.