scholarly journals Irreducible Galeazzi Fracture-Dislocations

Hand ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 249-252 ◽  
Author(s):  
Nicholas J. Yohe ◽  
Jadie De Tolla ◽  
Marc B. Kaye ◽  
David M. Edelstein ◽  
Jack Choueka
Keyword(s):  
High Energy ◽  
Fracture Dislocation ◽  
Rare Injury ◽  
Root Cause ◽  
Energy Mechanism ◽  
Galeazzi Fracture ◽  
Pubmed Database ◽  
Fracture Dislocations ◽  
Tendon Entrapment ◽  
Age Range

Background: Fractures of the radial shaft with disruption of the distal radial ulnar joint (DRUJ) or Galeazzi fractures are treated with reduction of the radius followed by stability assessment of the DRUJ. In rare instances, the reduction of the DRUJ is blocked by interposed structures requiring open reduction of this joint. The purpose of this study is to review all cases of irreducible Galeazzi fracture-dislocations reported in the literature to offer guidelines in the diagnosis and management of this rare injury. Methods: A search of the MEDLINE database, OVID database, and PubMed database was employed using the terms “Galeazzi” and “fracture.” Of the 124 articles the search produced, a total of 12 articles and 17 cases of irreducible Galeazzi fracture-dislocations were found. Results: The age range was 16 to 64 years (mean = 25 years). A high-energy mechanism of injury was the root cause in all cases. More than half of the irreducible DRUJ dislocations were not identified intraoperatively. In a dorsally dislocated DRUJ, a block to reduction in most cases (92.3%) was secondary to entrapment of one or more extensor tendons including the extensor carpi ulnaris, extensor digiti minimi, and extensor digitorum communis, with the remaining cases blocked by fracture fragments. Irreducible volar dislocations due to entrapment of the ulnar head occurred in 17.6% of cases with no tendon entrapment noted. Conclusions: In the presence of a Galeazzi fracture, a reduced/stable DRUJ needs to be critically assessed as more than half of irreducible DRUJs in a Galeazzi fracture-dislocation were missed either pre- or intraoperatively.

scholarly journals Coronal Hamate Fracture Associated With Carpometacarpal Dislocations of All of the Fingers: Review of the Literature and Case Report

Hand ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. NP51-NP54 ◽  
Author(s):  
Joseph A. Gil ◽  
Avi D. Goodman ◽  
Adam Starr
Keyword(s):  
Case Report ◽  
Clinical Presentation ◽  
Relevant Literature ◽  
High Energy ◽  
Fracture Dislocation ◽  
Review Of The Literature ◽  
Rare Injury ◽  
Fracture Dislocations ◽  
Hamate Fracture

Background: Dislocation of all 5 carpometacarpal (CMC) joints of a single hand is a rare injury. Methods: The literature regarding CMC fracture-dislocations was reviewed and a case was presented. Results: The relevant literature was consolidated to clinically relevant categories including ‘Clinical Presentation and Diagnosis,’ ‘Management of CMC Fracture Dislocation and Hamate Fractures,’ and ‘Outcomes.’ Conclusions: The mechanism associated with this injury is often high energy that causes multiple simultaneous life- or limb-threatening injuries that could distract the examiner from identifying this injury. The case we present involves an axial dislocation of the carpus that resulted in dorsal dislocations of all CMC joints, dislocation of the hamate-capitate articulation, as well as fractures of the first metacarpal and the hamate.

scholarly journals Open anterolateral fracture dislocation of ankle joint: a rare case report

2018 ◽  
Vol 5 (1) ◽  
pp. 192
Author(s):  
Prasanna Anaberu ◽  
R. Prathik ◽  
R. Manish
Keyword(s):  
Ankle Joint ◽  
Fracture Fixation ◽  
Road Traffic ◽  
Emergency Operation ◽  
High Energy ◽  
Fracture Dislocation ◽  
Anterior Dislocation ◽  
Malleolar Fracture ◽  
Rare Injury ◽  
Wound Debridement

<p class="abstract">Anterior ankle dislocation with associated compound bi-malleolar fracture is a rare injury. Ankle fracture dislocations most frequently occurs in young males caused by high energy trauma. The direction of the joint dislocation is determined by the position of the foot and the direction of the force being applied. A middle aged male presented to us with history of road traffic accident and was diagnosed to have anterior dislocation of right ankle joint with compound bi-malleolar fracture. Patient was taken to emergency operation theatre for wound debridement and immediate ankle reduction done under sedation. Due to wound contamination fracture fixation was delayed, once the wound healed bi-malleolar fracture fixation was done.</p>

scholarly journals Evaluation of results of three and four-part fracture dislocations of proximal humerus in young adults using philos (proximal humerus internal locking system)

2018 ◽  
Vol 6 (2) ◽  
pp. 585
Author(s):  
Amit Thakur ◽  
Khalid Muzzafar ◽  
Sumeet Singh Charak ◽  
Bias Dev ◽  
Abdul Ghani
Keyword(s):  
Proximal Humerus ◽  
Young Patients ◽  
Soft Tissue Injuries ◽  
Functional Results ◽  
High Energy ◽  
High Rate ◽  
Fracture Dislocation ◽  
Rotator Cuff Insufficiency ◽  
Fracture Dislocations ◽  
Adequate Management

Background: The fractures of proximal humerus constitute about 5% of fractures in adults third in number to fracture colles and hip usually in elderly patients due to a low energy trauma. In young patients the fractures are mostly due to high energy trauma and as such are associate with other soft tissue injuries. A sub group of young patients have a three or four fracture dislocation of shoulder joint. The aim of this study was to find the results of fixation by PHILOS in these young patients.Methods: This study was done in a teritiary referral centre over a period of about 1 year. All patients were operated within three weeks. Open fractures, patients with age more than 50 years were excluded from the study. All patients underwent open reduction and fixation using commercially available PHILOS. A minimum of 6 months follows up was essential for inclusion into the study. Final functional results were evaluated by Constant Murley scoring.Results: 14 patients were included in the study. The average age of patients was 38.42years. All fractures united. We had 71.4% excellent or good results. The complications noted were shoulder stiffness in 3, inadequate post op reduction, rotator cuff insufficiency, head necrosis, secondary osteo arthritis 1 each.Conclusions: Despite the relatively high rate of complications encountered in the management of these complicated high-energy fractures, the PHILOS plating system could be considered an adequate management of these patients.

Hawkins type III talar neck fracture dislocation with neurovascular and tendon entrapment in a toddler

2021 ◽  
Vol 14 (5) ◽  
pp. e241830
Author(s):  
Naresh Kumar Saini ◽  
Vijay Kumar Jain ◽  
Karthikeyan P Iyengar
Keyword(s):  
Current Literature ◽  
Functional Outcomes ◽  
Fracture Dislocation ◽  
Radiological Findings ◽  
Rare Injury ◽  
Type Iii ◽  
Emergency Presentation ◽  
Neck Fracture ◽  
Tendon Entrapment ◽  
Displaced Fracture

Paediatric displaced fracture of the neck of talus is extremely rare injury with variable outcomes. We report our experience in managing a Hawkins type III talar neck fracture dislocation with neurovascular and tendon entrapment in a 3-year-old boy. We describe the emergency presentation, radiological findings, orthopaedic management and clinical and functional outcomes in this toddler following the injury with review of the current literature.

scholarly journals The Unique Bipolar Clavicle Dislocation: A Novel Reconstruction Technique and Case Report

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Ameesh Dev ◽  
Gautham Prabhakar ◽  
Anil Dutta ◽  
Khang Dang
Keyword(s):  
Motor Vehicle ◽  
Treatment Options ◽  
High Energy ◽  
Reconstruction Technique ◽  
Unique Case ◽  
Rare Injury ◽  
Energy Mechanism ◽  
Vehicle Collision ◽  
Fall From Height ◽  
Single Standard

A bipolar clavicle separation is defined as a simultaneous dislocation of the ipsilateral sternoclavicular joint (SCJ) and acromioclavicular joint (ACJ). This rare injury pattern is usually the result of a high-energy mechanism, such as a motor vehicle collision or fall from height. While there are several treatment options such as screw fixation, sutures, or plate fixations, there is no single standard approach for this infrequent injury. We describe a unique case of bipolar clavicle dislocation, specifically an anteriorly displaced SCJ and posteriorly displaced ACJ, treated with a novel surgical technique—a TightRope technique (Arthex®) and semitendinosus allograft.

Dorsal Fracture-Dislocation of the Tarsal Navicular

2017 ◽  
Vol 107 (3) ◽  
pp. 226-230 ◽  
Author(s):  
Isidro Jimenez ◽  
Juan Pedro Rodriguez-Alvarez ◽  
Ricardo Navarro-Navarro
Keyword(s):  
Clinical Case ◽  
Case Reports ◽  
High Energy ◽  
Fracture Dislocation ◽  
Published Data ◽  
Excellent Outcome ◽  
Appropriate Treatment ◽  
Chopart Joint ◽  
Fracture Dislocations ◽  
Tarsal Navicular Bone

Fracture-dislocations of the tarsal navicular are rare and highly complex injuries to the midfoot. The only published data on this type of fracture are clinical case reports. These injuries are normally caused by high-energy trauma, and their pathophysiology and most appropriate treatment remain unclear. We report a clinical case of a dorsal fracture-dislocation of the tarsal navicular bone associated with a medial swivel dislocation of the Chopart joint caused by a bicycle fall in a 20-year-old healthy man. Open reduction and percutaneous pinning in a novel arrangement was performed, with an excellent outcome 18 months after the injury.

scholarly journals The “floating ulna” injury in adults: a case report, literature review and proposed injury classification

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tian He ◽  
Xin Wang ◽  
Shui Sun ◽  
Lugang Zhou
Keyword(s):  
Dynamic Compression ◽  
Elbow Dislocation ◽  
Shaft Fracture ◽  
Distal Radioulnar Joint ◽  
High Energy ◽  
Injury Pattern ◽  
Rare Injury ◽  
Galeazzi Fracture ◽  
Instability Range ◽  
Type Of Injury

Abstract Background Ipsilateral Galeazzi fracture with elbow dislocation, namely the “floating ulna” injury, is a rare injury pattern. A few reports have described this type of injury and its treatment. Case presentation A 33-year-old female at 38+ weeks gestational age presented with Galeazzi fracture and posterolateral elbow dislocation of the left upper extremity. The patient was treated with closed reduction of the elbow, open reduction, and internal fixation of the radial shaft fracture with a dynamic compression plate and K-wire stabilization of the unstable distal radioulnar joint. At the 12-month follow-up, the patient had no pain or signs of instability. Range of motion was 0–135° at the elbow, 70° extension and 80° flexion at the wrist, and 80° supination and 80° pronation at the forearm. Conclusion The “floating ulna” injury is a rare and special injury pattern with ipsilateral Galeazzi fracture and elbow dislocation. This type of injury was likely caused by significant amount of deforming force and the unique position of upper limb when the patient fell from a height of 1–2 m in high-energy trauma.

Unstable Ankle Fractures in Older Patients: A Consecutive Series with Modern Internal Fixation Techniques

2013 ◽  
Vol 3 (1) ◽  
pp. 25-31
Author(s):  
Samuel B Adams ◽  
Nicholas A Viens ◽  
E Grant Sutter ◽  
Daniel S Mangiapani
Keyword(s):  
Internal Fixation ◽  
Clinical Outcomes ◽  
Older Patients ◽  
External Rotation ◽  
High Energy ◽  
Ankle Fractures ◽  
Consecutive Series ◽  
Energy Mechanism ◽  
Fracture Dislocations ◽  
Fixation Techniques

ABSTRACT Background Ankle fractures are among the most common injuries sustained by older patients. Management of these fractures remains both controversial and challenging. Clinical outcomes from a series of older patients treated surgically for unstable ankle fractures were reviewed to determine the effects of patient, injury and fixation factors on postoperative outcomes. Materials and methods A retrospective series of 58 consecutive patients age 60 years and older with 63 unstable ankle fractures treated surgically by a single surgeon over a 5- year period was reviewed. Forty-seven females (81.0%) and 11 males (19.0%) with a mean age of 72.6 (range, 60 to 88.4) years made up the sample. Results The most common injuries were OTA type 44-B2 (66.7%) or Lauge-Hansen supination-external rotation type-4 (76.2%) fractures. Forty-seven (74.6%) fractures were due to a low energy mechanism. Nineteen (30.6%) injuries were fracturedislocations and seven (11.1%) fractures were open. Augmented techniques were used in 31 (49.2%) cases overall. Ten (17.2%) patients experienced postoperative complications. Males, patients with fracture dislocations, high energy fractures, and open fractures experienced significantly worse outcomes (p < 0.05). Age, fracture type and the use of augmented technique were not predictive of clinical outcomes. Conclusion Overall in this series, older patients treated surgically for ankle fractures experienced good clinical outcomes. Further investigations are required in order to find patient and injury factors that can assist preoperative planning and predict outcomes. Viens NA, Sutter EG, Mangiapani DS, Adams SB, Zura RD. Unstable Ankle Fractures in Older Patients: A Consecutive Series with Modern Internal Fixation Techniques. The Duke Orthop J 2013;3(1):25-31.

scholarly journals Traumatic Lumbar Spondylolisthesis: A Systematic Review and Case Series

2018 ◽  
Vol 9 (7) ◽  
pp. 767-782 ◽  
Author(s):  
Mikhail Lew P. Ver ◽  
John R. Dimar ◽  
Leah Y. Carreon
Keyword(s):  
Systematic Review ◽  
Interbody Fusion ◽  
Case Reports ◽  
Case Series ◽  
High Energy ◽  
Acute Injury ◽  
Fracture Dislocation ◽  
Rare Injury ◽  
Neurologic Deficits ◽  
Traumatic Spondylolisthesis

Study Design: Systematic review and case series. Objectives: Any acute injury to the posterior elements of the lumbar spine resulting in listhesis is considered a traumatic spondylolisthesis. This rare injury caused by high-energy trauma is variably described in the literature as fracture-dislocation, where only case reports and series have been published. Our objectives were to propose evidence-based treatment recommendations and a new classification system for this injury. Methods: A systematic review of literature from PubMed, EMBASE, and Cochrane without time frame limitations was performed, which included 77 level IV and V articles and 9 patients as case series in the analysis. Results: A total of 125 cases were reviewed with mean age of 30.5 years. Half of the cases resulted from a vehicular accident. Back pain presented in 82%, while 50% had neurologic deficits. Operative treatment was performed in 93.6% (posterior decompression [PD] = 4%; posterior spinal fusion [PSF] = 43.2%; interbody fusion [IB] = 46.4%) with overall fusion rates of 74%. Binomial regression analysis for achieving solid fusion showed a 28.6× higher odds for IB compared to PSF ( P = .008, r2 = 0.633). Subanalysis of cases with disc injuries revealed higher fusion outcomes for IB (87%) compared to PSF (46%; P = .006), while there were no significant differences for patients without disc injury. Pain and neurological symptoms improved significantly on final follow-up ( P < .001). Overall complication rate was 22%. Conclusion: Operative management with reduction, decompression for neurologic deficits, instrumentation, and fusion is recommended for traumatic spondylolisthesis. Interbody fusion is recommended to achieve better fusion outcomes especially with preoperatively identified disc lesions.

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