Fracture-Dislocation of the Articular Surface of the Third Metatarsal Head

Foot & Ankle ◽  
1989 ◽  
Vol 10 (1) ◽  
pp. 43-44 ◽  
Author(s):  
Joseph Dutkowsky ◽  
Barney L. Freeman
Keyword(s):  
Closed Reduction ◽  
Articular Surface ◽  
Metatarsal Head ◽  
Fracture Dislocation ◽  
Cast Immobilization ◽  
Osteochondral Fracture ◽  
The Third

Fracture of the metatarsal head is uncommon, and reports are rare of isolated osteochondral fracture of the articular surface of the metatarsal head, as occurred in the 18-year-old man reported here. Good results were obtained with closed reduction by manipulation and traction, followed by cast immobilization for 6 weeks.

An Isolated Chronic Osteochondral Fracture of the Third Metatarsal Head Treated With Bioabsorbable Pins

2016 ◽  
Vol 9 (6) ◽  
pp. 555-559 ◽  
Author(s):  
Toshinori Kurashige ◽  
Seiichi Suzuki
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Case Reports ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Osteochondral Fracture ◽  
The Third ◽  
Freiberg’S Disease ◽  
Type Of Fracture

An osteochondral fracture of the metatarsal head is generally the result of direct trauma and is associated with additional proximal fractures of the medially adjacent metatarsals. An isolated osteochondral fracture of the metatarsal head is extremely rare, with only 10 published case reports. Open reduction and internal fixation was performed in 6 of 10 cases and in 2 of 4 chronic cases, each with different implants previously. The mechanism of injury was considered to be shear force in 5 of the reported cases. It is difficult to achieve and maintain reduction in these cases, and the best method for treatment of this type of fracture is unclear. We report a case of an isolated chronic osteochondral fracture of the third metatarsal head in a 14-year-old boy. The boy reported pain in his third metatarsophalangeal joint on dismounting from a bicycle 2 months prior to presentation. He could play soccer at first; however, the pain worsened after running long distances. Therefore, he was referred to our department. Magnetic resonance imaging revealed an osteochondral fracture of the metatarsal head without Freiberg’s disease. We achieved a good result 12 months postoperatively by using open reduction and internal fixation with 2 bioabsorbable thread pins. Levels of Evidence: Therapeutic, Level IV: Case study

The Treatment of Dorsal Fracture-Dislocation of the Proximal Interphalangeal Joint by Closed Reduction and Kirschner Wire Fixation: A 16-Year Follow Up

2001 ◽  
Vol 26 (6) ◽  
pp. 537-540 ◽  
Author(s):  
D. P. NEWINGTON ◽  
T. R. C. DAVIS ◽  
N. J. BARTON
Keyword(s):  
Closed Reduction ◽  
Articular Surface ◽  
Kirschner Wire ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Long Term Results ◽  
Kirschner Wire Fixation ◽  
Wire Fixation

Ten patients who had sustained 11 unstable dorsal fracture-dislocations of finger proximal interphalangeal joints were reviewed at a mean follow-up of 16 years. All had been treated acutely by closed reduction and transarticular Kirschner wire fixation of the proximal interphalangeal joint, without any attempt at reduction of the fracture of the base of the middle phalanx, which probably involved 30–60% of the articular surface. Seven of the ten patients complained of no finger pain or stiffness, and none complained of severe pain. There was a mean fixed flexion deformity of 81 at the proximal interphalangeal joint, which had a mean arc of movement of 851. Although subchondral sclerosis and mild joint space narrowing were observed in some instances, there were no severe degenerative changes. These results confirm that this technique is a reliable treatment method for these injuries, and produces satisfactory long-term results.

Plaster immobilization versus anterior plating for dorsally displaced distal radial fractures in elderly patients in Pakistan

2021 ◽  
pp. 175319342097778
Author(s):  
Muhammad Tahir ◽  
Faridullah Khan Zimri ◽  
Nadeem Ahmed ◽  
Allah Rakhio Jamali ◽  
Ghulam Mehboob ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Randomized Trial ◽  
Closed Reduction ◽  
Primary Outcome ◽  
Locking Plate ◽  
Cast Immobilization ◽  
Distal Radial Fractures ◽  
Level Of Evidence ◽  
Anterior Plating ◽  
Plaster Immobilization

This prospective, multi-centred, randomized trial examined outcomes of 3- and 12-month follow-ups of 159 elderly participants aged more than 75 years with isolated distal radial fractures, treated by anterior locking plate or closed reduction and cast immobilization. The primary outcome was the patient-rated wrist evaluation (PRWE) score. The PRWE score at 12 months was not significantly different between the two groups; however, the radiological outcomes and complications rates were worse in the casting group. Level of evidence: III

scholarly journals A case report of femoral head fracture with osteochondral lesion treated by osteosynthesis and biomimetic scaffold: 2-year clinical and radiological follow-up

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Alessandro Casiraghi ◽  
Claudio Galante ◽  
Marco Domenicucci ◽  
Stefano Cattaneo ◽  
Andrea Achille Spreafico ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Articular Surface ◽  
Osteochondral Lesion ◽  
Hip Dislocation ◽  
Fracture Dislocation ◽  
Osteochondral Lesions ◽  
Femoral Head Fracture ◽  
Osteochondral Scaffold

AbstractThe aim of the present study was to present clinical and radiological outcome of a hip fracture-dislocation of the femoral head treated with biomimetic osteochondral scaffold.An 18-year-old male was admitted to the hospital after a motorcycle-accident. He presented with an obturator hip dislocation with a type IVA femoral head fracture according to Brumback classification system. The patient underwent surgery 5 days after accident. The largest osteochondral fragment was reduced and stabilized with 2 screws, and the small fragments were removed. The residual osteochondral area was replaced by a biomimetic nanostructured osteochondral scaffold. At 1-year follow-up the patient did not complain of hip pain and could walk without limp. At 2-year follow-up he was able to run with no pain and he returned to practice sports. Repeated radiographs and magnetic resonance imaging studies of the hip showed no signs of osteoarthritis or evidence of avascular necrosis. A hyaline-like signal on the surface of the scaffold was observed with restoration of the articular surface and progressive decrease of the subchondral edema.The results of the present study showed that the biomimetic nanostructured osteochondral scaffold could be a promising and safe option for the treatment of traumatic osteochondral lesions of the femoral head.Study Design: Case report.

Unusual osteochondral fracture of the second metatarsal head in a paediatric patient treated with bioabsorbable pin

2021 ◽  
Vol 14 (2) ◽  
pp. e238376
Author(s):  
Hafiz Muhammad Umer ◽  
Hafiz Javaid Iqbal ◽  
Raghuram Thonse
Keyword(s):  
Paediatric Patient ◽  
Metatarsal Head ◽  
Management Options ◽  
Osteochondral Fracture ◽  
Second Metatarsal ◽  
Paediatric Case

Osteochondral second metatarsal head fractures are rare. Various management options have been described in the published literature. We used bioabsorbable pin (Activa Pin) system for our case of second metatarsal head fracture. This method not only achieves good compressive fixation, it also eliminates the risk of implant-related issues such as implant irritation. To our knowledge, no such paediatric case managed with this technique has been published in the literature.

Predisposing Factors for Posttraumatic Osteoarthritis After Malleolus Fracture Fixation in Patients Younger Than 50 Years

2021 ◽  
pp. 107110072110500
Author(s):  
Jong Seok Beak ◽  
Yeong Tae Kim ◽  
Sung Hyun Lee
Keyword(s):  
Risk Factors ◽  
Articular Surface ◽  
Binary Logistic Regression ◽  
Ankle Fractures ◽  
Fracture Dislocation ◽  
Posttraumatic Arthritis ◽  
Level Of Evidence ◽  
Posttraumatic Osteoarthritis ◽  
Posterior Malleolus

Background: The purpose of this study was to identify the risk factors for posttraumatic osteoarthritis (OA) after surgery for ankle fractures in patients aged ≤50 years. Methods: We performed a retrospective review of consecutive patients who underwent surgery for ankle fractures and were followed up for a minimum period of 5 years. The patients were assigned to 2 groups according to the presence of advanced OA at the last follow-up. Binary logistic regression was used to model the correlation between risk factors and OA. Functional outcomes were assessed using the Foot and Ankle Outcome Score. Results: The data of 332 patients who met the inclusion criteria were included in the analysis. The overall rate of posttraumatic arthritis was 27.7% (nonarthritis group: 240 patients, arthritis group: 92 patients). The arthritic change was significantly affected by BMI (95% confidence interval [CI] 1.29-19.76; adjusted odds ratio [OR] ≥ 30, 6.56), fracture-dislocation injury (CI 1.66-11.57; adjusted OR, 4.06), posterior malleolus (PM) fracture (CI 1.92-12.73, adjusted OR > 25% of the articular surface, 5.72), and postoperative articular incongruence (CI 1.52-18.10; adjusted OR, 7.21). The mean scores of the arthritis group were lower than those in the nonarthritis group ( P < .05). Conclusion: Obesity, fracture-dislocation injury, concomitant large PM fracture, and articular incongruence were risk factors of posttraumatic OA after surgery for ankle fractures. Surgeons should be aware that accurate reduction is critical in patients with ankle fractures with associated large PM fractures, especially those with obesity or severe initial injuries such as fracture-dislocation. Level of Evidence: Level III, case control study.

scholarly journals Arthroscopically-assisted fixation of anteromedial coronoid facet fracture and lateral ulnar collateral ligament repair for acute posteromedial rotatory fracture dislocation of the elbow

2017 ◽  
Vol 11 (5) ◽  
pp. 378-383 ◽  
Author(s):  
Abbas Rashid ◽  
David Copas ◽  
Jeremy Granville-Chapman ◽  
Adam Watts
Keyword(s):  
Articular Surface ◽  
Ulnar Collateral Ligament ◽  
Fracture Dislocation ◽  
Ligament Repair ◽  
Collateral Ligament ◽  
Coronoid Fracture ◽  
Elbow Arthroscopy ◽  
Lateral Ulnar Collateral Ligament ◽  
Arthroscopically Assisted ◽  
Facet Fracture

If left untreated, varus posteromedial rotatory injuries of the elbow result in poor functional outcomes. Surgical treatment allows restoration of elbow kinematics, minimizing the chances of chronic varus instability and early onset osteoarthritis. However, large exposures are associated with extensive soft tissue stripping, a high risk of infection, nerve injury, poor visualization of the articular surface and longer recovery. Consequently, there has been renewed interest in the use of elbow arthroscopy to circumvent these problems. Arthroscopic treatment offers the potential advantage of a swift recovery, with instant rehabilitation, less stiffness and swelling than might be expected after open repair. We present the first combined arthroscopic-assisted anteromedial facet coronoid fracture fixation and lateral ulna collateral ligament repair in a varus posteromedial rotatory injury of the elbow.

scholarly journals Closed Reduction and Percutaneous Kirschner Wire Fixation Combined with Plaster Cast versus Conventional Plaster Cast immobilization in the Treatment of Colles' Fracture – A Prospective Randomized Comparative Study

1970 ◽  
Vol 17 (2) ◽  
pp. 98-105 ◽  
Author(s):  
KS Uzzaman ◽  
KA Awal ◽  
MK Alam
Keyword(s):  
Comparative Study ◽  
Closed Reduction ◽  
Kirschner Wire ◽  
Plaster Cast ◽  
Cast Immobilization ◽  
Fixation Group ◽  
Wire Fixation ◽  
Colles Fracture ◽  
End Results

Purpo'e: To evaluate functional & anatomical results of the Colles’ fracture treated by two methods- i) Closed reduction & precutaneous kirschner wire (K- wire) fixation combined with plaster cast & ii) Conventional plaster cast immobilization after closed reduction.Methods: A randomized prospective comparative study was done from July 2003 to June 2005 on 52 patient with Colles' fracture in NITOR, Dhaka. 12 patients lost from follow up. Twenty patient (20) in each group were finally available for evaluation. The group treated by closed reduction & percutaneous K-wire fixation combined with plaster cast- designated as "Arm A" & another group treated conventionally by plaster cast only designated by "Arm-B". Male Female ratio was 1:3, Age range was 35 to 70 years (Mean age 52.5 years) Distribution of limbs side involvement almost equal. Mode of injuries were domestic fall & RTA (4:1) According to AO classification fracture were in both groups- A2 = 13, A3 = 10, C1 = 6, C2 = 8 & C3 = 3 (Total- 40). Follow up period was 6-14 months (mean = 6 month)Results: Union time for most of the fractures was 6-8 weeks. At final follow up Satisfactory Anatomical end results of percutuneous fixation group (Arm-A) were 80% and in conventional plaster cast group (Arm-B) were 35%. (P<0.01). Satisfactory functional end results in Arm-A group were 70% and in Arm-B group were 30% (P<0.01) Complications seen much more in conventional group (Arm-B) than percutaneous K-wire fixation group (Arm-B). Sarmiento & Latta’s criteria was used to evaluate the progress.Conclusion: The coventional plaster cast method for treatment of colles’ fracture usually can't maintain radial length & angulation in many instances and results significant anatomical difficultly and functional disability. On the other hand after close reduction additional fixation in the form of percutaneous crossed K-wire can maintain the reduction till bony union & prevent late collapse at fracture site & provides better result. Key Words: Colles' fracture; closed reduction; Plaster cast & Kirschner wire (K-wire) fixationDOI: 10.3329/jdmc.v17i2.6591J Dhaka Med Coll. 2008; 17(2) : 98-105

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