Interphalangeal Dislocation of the Fourth Toe with Avulsion-Fracture in a Child: Report of a Case

1997 ◽  
Vol 18 (3) ◽  
pp. 175-177 ◽  
Author(s):  
Thomas Neubauer ◽  
Michael Wagner ◽  
Michael Quell
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Pediatric Patients ◽  
Avulsion Fracture ◽  
Joint Stability ◽  
Middle Phalanx ◽  
Avulsion Fractures ◽  
Child Report ◽  
Plantar Plate ◽  
Pathological Mechanism

Phalangeal dislocations of toes are extremely rare in childhood and usually can be treated by closed reduction. We present a proximal interphalangeal dislocation of the fourth toe with an irreducible avulsion fracture of the middle phalanx requiring open reduction. To our knowledge concomitant avulsion fractures in this condition have not been reported thus far in pediatric patients. The pathological mechanism of this injury is discussed, and the significance of the plantar plate for joint stability is emphasized.

scholarly journals Mini-Plate and Screw Fixation Technique for Comminuted Flexor Digitorum Profundus Avulsion Fracture

2020 ◽  
Vol 25 (1) ◽  
pp. 33-38
Author(s):  
Hye Yeon Choi ◽  
Jeong Hwan Kim ◽  
Young Ju Noh
Keyword(s):  
Open Reduction ◽  
Avulsion Fracture ◽  
Screw Fixation ◽  
Flexor Digitorum Profundus ◽  
Fixation Technique ◽  
Avulsion Fractures ◽  
Pin Fixation ◽  
Flexor Digitorum ◽  
Mini Plate ◽  
Pull Out Suture

Avulsion fracture of flexor digitorum profundus (FDP) tendon is relatively rare fracture at the distal phalangeal base than avulsion fracture of terminal extensor tendon. Terminal extensor avulsion fracture, known as bony mallet finger, could be successfully treated by closed reduction and pinning, such as extension block technique. However, most of FDP avulsion fracture, known as Jersey’s finger, needed open reduction, because of the proximal migration of fracture fragment and difficulty of pin fixation. Up to date, most of FDP avulsion fractures were treated by open reduction and fixation by pull-out suture or suture anchor technique. We report a case of comminuted FDP avulsion fracture, successfully treated by open reduction and mini-plate and screw fixation technique.

Management of Nonreducible Lesser Toe Interphalangeal Dislocation

2012 ◽  
Vol 102 (3) ◽  
pp. 252-255 ◽  
Author(s):  
Antonio Córdoba-Fernández
Keyword(s):  
Clinical Practice ◽  
Closed Reduction ◽  
Open Reduction ◽  
Joint Space ◽  
Interphalangeal Joint ◽  
Surgical Correction ◽  
Collateral Ligament ◽  
Plantar Plate ◽  
Joint Dislocations ◽  
The One

Interphalangeal joint dislocations of the lesser toes are relatively rare in clinical practice. Most nonreducible interphalangeal joint dislocations occur as a result of rupture or interposition of the plantar plate or of the collateral ligament in the joint space, thus hindering a closed reduction and, in most cases, compelling an open reduction. A post-reduction radiologic exploration is then essential to identify such an entity and proceed consequently. In some cases, such as the one introduced herein, a misdiagnosis, along with an inadequate surgical correction may lead to recurrence of the deformity and, ultimately, to a salvage arthrodesis. (J Am Podiatr Med Assoc 102(3): 252–255, 2012)

scholarly journals Tibial Tubercle Avulsion Fractures in Adolescents: A Narrative Review & Case Report

2021 ◽  
Vol 2 (3) ◽  
pp. 12-18
Author(s):  
Gregory W. Kunis ◽  
Joshua A. Berko ◽  
Jeffrey C. Shogan ◽  
Joshua B. Sharan ◽  
Derek Jones
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Avulsion Fracture ◽  
Open Reduction Internal Fixation ◽  
Fracture Pattern ◽  
Tibial Tuberosity ◽  
Tibial Tubercle ◽  
Significant Past Medical History ◽  
Anterior Portion ◽  
Avulsion Fractures

Intro: Tibial tuberosity avulsion fractures are rare fracture patterns accounting for less than 1% of all pediatric fractures. These fractures occur when there is a sudden unbalancing of forces through the patellar tendon that separates the tibial tubercle from the anterior portion of the proximal tibia. These forces are commonly introduced in sporting activities and show a predominance for adolescent males. Treatment with open reduction internal fixation commonly results in favorable outcomes with minimal complications. In this presentation, we explore a case of a tibial tuberosity avulsion fracture and give an in-depth review of all aspects concerning this fracture pattern. Case Description: A 14-year-old male with no significant past medical history presented via emergency medical services after a ground level fall while playing basketball. Radiographs of the left knee and tibia revealed an Ogden Type III, distracted avulsion fracture of the tibial tuberosity with suprapatellar effusion. Surgical intervention was achieved through open reduction internal fixation of the left tibial tubercle. Discussion: Although a relatively rare fracture pattern, this case demonstrates a classic presentation and treatment of a tibial tuberosity avulsion fracture. This case serves as a reminder that despite the rarity of the injury, a clinician with an appropriate index of suspicion can accurately diagnose and treat this fracture and achieve positive outcomes in returning the patient to pre-injury activities. For those reasons, we provide a comprehensive overview of all aspects regarding this fracture pattern including the anatomy, embryology, mechanism of action, predisposing conditions, treatment considerations, complications and associated injuries.

Open Reduction for Dorsal Dislocation of Second to Fifth Carpometacarpal Joints: A Case Report

2020 ◽  
Author(s):  
Hiroo Kimura ◽  
Akira Toga ◽  
Taku Suzuki ◽  
Takuji Iwamoto
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Delayed Diagnosis ◽  
Preoperative Assessment ◽  
Radiographic Examination ◽  
Clinical Images ◽  
Left Hand ◽  
Carpometacarpal Joints ◽  
Joint Deformity ◽  
Poor Outcomes

Abstract Background Fracture-dislocations of all four ulnar (second to fifth) carpometacarpal (CMC) joints are rare hand injuries and frequently overlooked or missed. These injuries can be treated conservatively when closed reduction is successfully achieved, though they are sometimes irreducible and unstable. Case Description We report the case of a 17-year-old boy involved in a vehicular accident. Clinical images showed dorsal dislocation of all four ulnar CMC joints of the left hand associated with a fracture of the base of the fourth metacarpal. Although closed reduction was attempted immediately, the affected joints remained unstable and easily redislocated. Therefore, we performed open reduction and percutaneous fixation of all ulnar CMCs. He showed excellent recovery after 1 year postoperatively, reported no pain, and demonstrated complete grip strength and range of motion of the affected wrist and fingers. Literature Review Accurate clinical diagnosis of this lesion is difficult because of polytrauma, severe swelling masking the dislocated CMC joint deformity, and overlapping of adjacent metacarpals and carpal bones on radiographic examination. As for the treatment strategy, it has yet to obtain a consensus. Some reports value open reduction to guarantee anatomical reduction, and it is definitely needed in the patients with interposed tissues to be removed or with subacute and chronic injuries. Clinical Relevance Delayed diagnosis or treatment could lead to poor outcomes. Therefore, surgeons must be aware that precise preoperative assessment is critical, and anatomical open reduction of interposed bony fragments, like our case, may be required even in an acute phase.

scholarly journals Clinical outcomes after mini-hook plate fixation for small avulsion fractures around the interphalangeal or metacarpophalangeal joints of the hand

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jung Il Lee ◽  
Ki-Chul Park ◽  
Hyun Soo So ◽  
Duk Hee Lee
Keyword(s):  
Clinical Outcomes ◽  
Plate Fixation ◽  
Hook Plate ◽  
Joint Stability ◽  
Avulsion Fractures ◽  
Metacarpophalangeal Joints ◽  
Early Results ◽  
Mallet Fracture ◽  
Osseous Union ◽  
Central Slip

Abstract Background Mini-hook plate has been described for the treatment of various small avulsion fragments in the hand. This retrospective study aimed to evaluate clinical outcomes after mini-hook plate fixation in patients with an avulsion fracture around the interphalangeal or metacarpophalangeal joints of the hand. Methods Nineteen patients with avulsion fractures around the interphalangeal or metacarpophalangeal joints of the hand were included in this study. Seven patients had a mallet fracture, and 12 patients had other phalangeal avulsion fractures including central slip, collateral ligament, volar plate, and flexor avulsion fractures. The osseous union and functional outcomes, including finger joint motion, joint stability, pinching strength, and the disabilities of the arm, shoulder, and hand score, were evaluated. Results The mean duration of follow-up was 33.8 months. All patients in mallet and other phalangeal avulsion fractures achieved osseous union between the avulsion fragment and phalangeal bone, and there was no joint subluxation. There were no significant differences in the disabilities of the arm, shoulder, and hand scores. However, the patients with mallet fracture have lower mean percentage values of the total active range of motion and pinching strength than other phalangeal avulsion fractures. We abandoned this procedure in mallet fractures because the early results after mini-hook plate fixation in mallet fractures appeared unfavorable. Conclusion These results suggest that the mini-hook plate fixation can provide sufficient stability and good clinical outcomes in those with phalangeal avulsion fractures. However, the outcomes for mallet fractures were not as good as those for other phalangeal avulsion fractures.

Complications of the Transmasseteric Anteroparotid Approach for Subcondylar Fractures: A Retrospective Study

2021 ◽  
pp. 194338752110169
Author(s):  
Jared Gilliland ◽  
Fabio Ritto ◽  
Paul Tiwana
Keyword(s):  
Retrospective Study ◽  
Facial Nerve ◽  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Mouth Opening ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
University Of Oklahoma ◽  
The University

Study Design: A retrospective analysis of patients with subcondylar fractures treated via a transmasseteric anteroparotid approach by the Oral and Maxillofacial Department at the University of Oklahoma. Objective: The goal of this study was to evaluate complications, morbidity, and safety with the transmasseteric anteroparotid approach for treatment of subcondylar fractures, and compare it to other findings previously reported in the literature. Methods: A retrospective study was conducted that consisted of 23 surgically treated patients in the past 2 years for subcondylar fractures. Only patients with pre-operative malocclusion and who underwent open reduction with internal fixation with the transmasseteric anteroparotid (TMAP) approach were included. Exclusion criteria included 1) patients treated with closed reduction 2) patients who failed the minimum of 1, 3, and 6-week post-operative visits. The examined parameters were the degree of mouth opening, occlusal relationship, facial nerve function, incidence of salivary fistula and results of imaging studies. Results: 20 of the surgically treated patients met the inclusion criteria. Two patients were excluded due to poor post-operative follow up and 1 was a revision of an attempted closed reduction by an outside surgeon that presented with pre-existing complications. There were no cases of temporary or permanent facial nerve paralysis reported. There were 3 salivary fistulas and 2 sialoceles, which were managed conservatively and resolved within 2 weeks, and 2 cases of inadequate post-surgical maximal incisal opening (<40 mm) were observed. Conclusion: The transmasseteric anteroparotid approach is a safe approach for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications.

Translunate, Transmetacarpal, Scapho-Radial Fracture with Perilunate Dislocation A Case Report

1985 ◽  
Vol 10 (3) ◽  
pp. 382-384
Author(s):  
P. TOFT ◽  
K. BERTHEUSSEN ◽  
S. OTKJAER
Keyword(s):  
Case Report ◽  
Avascular Necrosis ◽  
Closed Reduction ◽  
Open Reduction ◽  
X Rays ◽  
Radial Fracture ◽  
Perilunate Dislocation ◽  
Carpal Fracture ◽  
Fracture Dislocations

A case translunate, transmetacarpal, scapho-radial fracture with perilunate dislocation occurred as a young man drove his motorcycle into the side of a car. Closed reduction was performed initially. Open reduction was performed with a screw in the lunate. Eighteen months later the screw was removed and after two and a half years x-rays revealed no signs of avascular necrosis or arthrosis. The patient fully recovered. This case stresses the necessity of open reduction in cases of complicated carpal fracture dislocations.

scholarly journals Intramedullary Nailing for Paediatric Diaphyseal Forearm Bone Fracture

2012 ◽  
Vol 9 (3) ◽  
pp. 198-202 ◽  
Author(s):  
N P Parajuli ◽  
D Shrestha ◽  
D Dhoju ◽  
G R Dhakal ◽  
R Shrestha ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Bone Fracture ◽  
Closed Reduction ◽  
Open Reduction ◽  
Forearm Fracture ◽  
Skin Irritation ◽  
Pediatric Age Group ◽  
Superficial Skin ◽  
Reduction Methods ◽  
Forearm Bone

Background Though most of the pediatric diaphyseal forearm bone fracture can be treated with closed reduction and cast application, indications for operative intervention in pediatric both-bone forearm fractures include open fractures, irreducible fractures, and unstable fractures. Controversy exists as to what amount of angulation, displacement, and rotation constitutes an acceptable reduction. Objective To review union time and functional outcome of pediatric diaphyseal forearm bone fracture managed with intramedullary rush pin by closed or open reduction. Methods Fifty patients with both bone fracture of forearm were treated with intramedullary rush pin by closed or open reduction were included in the study and followed up for minimum six months for radilological and functional outcome. Results Out of 50 patients, 31 underwent closed reduction and 19 underwent open reduction. All fractures maintained good alignment post operatively. Forty seven patients had excellent results with normal elbow range of motion and normal forearm rotation and three patients had good results. In all patients good radiological union was seen in three months time. Eight patients had minor complications including skin irritation over prominent hardware, backing out of ulnar pin, superficial skin break down with exposed hardware. Twenty-three (46%) patients had undergone implant removal at an average of 6 months (range 4-8 months) under regional or general anesthesia Conclusion Fixation with intramedullary rush pin for forearm fracture is an effective, simple, cheap, and convenient way for treatment in pediatric age group. DOI: http://dx.doi.org/10.3126/kumj.v9i3.6305 Kathmandu Univ Med J 2011;9(3):198-202 

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