Cases reported "Sprains and Strains"

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1/28. Pure dislocation of the ankle: three case reports and literature review.

    ankle dislocation without fracture is an extremely rare injury. The results of treatment are reported for three patients who had a posteromedial open dislocation, a lateral open dislocation, and a posterior closed dislocation of the ankle. Management consisted of immediate reduction, debridement and capsular suture in the open dislocations, and immobilization with a short leg cast in all patients. At followup no patient had tibiotalar joint instability; a 10 degrees to 15 degrees loss in the range of dorsiflexion was observed in two patients. One patient reported paresthesia in the area of the superficial peroneal nerve. The three patients achieved good long-term functional and radiographic results. Predisposing factors that contribute to the pathogenesis of this lesion are internal malleolus hypoplasia, ligamentous laxity, weakness of the peroneal muscles, and previous ankle sprains. Among the three patients, medial malleolus hypoplasia was present in one patient and previous sprains were seen in the clinical history of another patient.
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ranking = 1
keywords = fracture
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2/28. Fracture of the hook of the hamate, often misdiagnosed as "wrist sprain".

    A patient with fracture of the hook of the hamate is described, in whom the diagnosis was delayed for 1 year after the initial trauma. This delay in correct diagnosis is often seen, as routine anteroposterior and lateral roentgenograms of the wrist are unlikely to show the fracture. The trauma is often misinterpreted as a "wrist sprain." Nevertheless, with a careful trauma history and a detailed clinical examination and with minimal additional roentgenographic views, it should be possible to correctly diagnose the fracture. Relief of the disabling pain can then be offered by removal of the un-united fracture fragment.
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ranking = 4
keywords = fracture
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3/28. A new consideration in athletic injuries. The classical ballet dancer.

    The professional ballet dancer presents all of the problems of any vigorous athlete. The problems include osteochondral fractures, fatigue fractures, sprains, chronic ligamentous instability of the knee, meniscal tears, impingement syndrome, degenerative arthritis of multiple joints and low back pain. attention to minor problems with sound conservative therapy can avoid many major developments and lost hours. Observations included the extraordinary external rotation of at the hip without demonstrable alteration in the hip version angle and hypertrophy of the femur, tibia and particularly the second metatarsal (in female dancers). Careful evaluation of the range of motion of the extremities, serial roentgenographic examination, and systematic review of previous injuries, training programs and rehearsal techniques have been evaluated in a series of cases to provide the basis for advice to directors and teachers of the ballet.
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ranking = 2
keywords = fracture
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4/28. Recurrent ankle sprains secondary to nonunion of a lateral malleolus fracture.

    A case of an adult man with symptoms of chronic recurrent ankle sprains secondary to nonunion of a fracture of the tip of the lateral malleolus is presented. The nonunion was debrided, bone grafted, and internally fixed by using the tension band wire technique. The fracture healed and the patient experienced no further episodes of ankle sprain.
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ranking = 6
keywords = fracture
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5/28. Occult fractures of the talus.

    A case presentation of a severe ankle sprain in which the patient was nonresponsive to routine therapies is presented. Repeat radiographs and computerized axial tomographic scans (CAT Scans) lead to the final diagnosis of a sagittal plane fracture of the talus. The clinical and radiographic evaluation leading to the diagnosis will be presented, and the surgical and postoperative managements will be discussed.
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ranking = 5
keywords = fracture
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6/28. Clinics in diagnostic imaging (95). Os trigonum.

    A 19-year-old boy presented to the Accident and Emergency Department after sustaining trauma to his left ankle and foot while playing soccer. The radiograph of his left ankle showed a well-corticated triangular fragment of bone posterior to the left talus, typical of an os trigonum. This accessory bone was initially mistaken for a fracture fragment and a plaster cast was applied. The term, do not touch lesion, has been coined to describe this group of benign bony entities which may be classified into three broad categories, namely: normal variants, lesions that are real but obviously benign, and lesions that are related to degenerative disease. The importance of recognising the characteristic radiographical appearances of these entities is emphasised, as the need for further imaging or diagnostic tests can usually be avoided.
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ranking = 1
keywords = fracture
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7/28. chiropractic care of a patient with low back pain associated with subluxations and a Malgaigne-type pelvic fracture.

    OBJECTIVE: To describe the chiropractic care of a patient with a pelvic ring fracture and concomitant subluxations of multiple segments of the spinal column. CLINICAL FEATURES: A 23-year-old male, after falling down a flight of stairs, was initially hospitalized for fractures of the pelvis. Five weeks posthospitalization, the patient initiated chiropractic care with complaints of severe low back pain with lower extremity involvement. He also complained of neck pain and occipital headache. The patient had several positive low back orthopedic tests with bilaterally absent Achilles deep tendon reflexes. The anteroposterior radiographic view revealed ununited fractures at the left superior and inferior pubic ramus, noted as a type I Malgaigne fracture. Subluxations were detected at the left innominate (ie, fracture-subluxation) and at the patient's lumbar, thoracic, and cervical spine. INTERVENTION AND OUTCOME: The patient was cared for with contact-specific, high-velocity, low-amplitude adjustments to sites of vertebral and sacroiliac subluxations. The patient's response to care was positive, receiving great pain relief. Less than 3 months after initiating care, the patient returned to work on regular duty. CONCLUSION: There are indications that patients suffering from the injuries described above may derive benefits from chiropractic care. The practitioner must pay careful attention to issues of biomechanical and vascular stability and adjustment modifications in these types of patients.
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ranking = 9
keywords = fracture
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8/28. Scapholunate failure: a long term clinical follow-up.

    Rotary subluxation of the carpal scaphoid is a rare condition that may lead to collapse of the wrist. The subluxation is the result of disruption of the scapholunate interosseous ligament, often secondary to scaphoid fracture or significant trauma. The characteristic clinical and radiographic findings are discussed. Controversy exists regarding treatment, but lack of treatment predisposes the wrist to degenerative changes. A case report is discussed which illustrates the salient features of this condition.
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ranking = 1
keywords = fracture
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9/28. sports-related two-plane fractures of the distal tibia. Report of two cases.

    Two cases of sports-related two-plane fractures of the distal tibia, their operative treatment and the result of therapy after hardware removal are reported. The incidence and mechanism of this type of fracture in adolescents are shown as well as the indication for surgical reconstruction depending on the gap in the joint surface of the distal tibia.
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ranking = 6
keywords = fracture
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10/28. Pediatric update # 13. Injuries to the inferior pole of the patella in children.

    Sinding-Larsen-Johansson disease and sleeve fractures are two injuries that occur at the inferior pole of the patella in children. The first is a chronic tendinitis accompanied by calcification of the avulsed patellar tendon. The latter are acute injuries that involve a complete avulsion of the proximal insertion of the patellar tendon with a small fleck of bone and portion of patellar articular cartilage. Illustrative case histories and a literature review are presented.
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ranking = 1
keywords = fracture
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