scholarly journals Trans-scaphoid Perilunate Fracture Dislocation

2021 ◽  
Author(s):  
Hee-Soo Kim ◽  
Won-Tack Oh ◽  
Il-Hyun Koh ◽  
Yun-Rak Choi ◽  
Ho-Jung Kang
Keyword(s):  
Operative Treatment ◽  
Treatment Options ◽  
Young Patients ◽  
High Energy ◽  
Review Article ◽  
Fracture Dislocation ◽  
Fracture Dislocations ◽  
Wrist Anatomy ◽  
Perilunate Fracture Dislocation ◽  
And Function

Trans-scaphoid perilunate fracture dislocations, which account for more than half of total cases of perilunate injuries, are common in young patients and occur as a result of high-energy injuries, and improper management can impair wrist alignment and function. Understanding the related wrist anatomy and pathomechanics may help surgeons evaluate and diagnose patients. Early operation to reduce and fix the injuries should be considered to achieve optimal clinical and radiological outcomes. In this review article, we present an overview of wrist pathoanatomy, the pathomechanics of trans-scaphoid perilunate fracture dislocations, operative treatment options including an arthroscopic procedure, and reported clinical and radiological outcomes.

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.

scholarly journals Treatment of unusual locked posterior fracture–dislocation of the shoulder: a case series

2020 ◽  
Vol 23 (4) ◽  
pp. 190-196
Author(s):  
Ho Yeon Park ◽  
Seok Jung Kim ◽  
Yoo Joon Sur ◽  
Jae Woong Jung ◽  
Chae-gwan Kong
Keyword(s):  
Total Shoulder Arthroplasty ◽  
Young Patients ◽  
Case Series ◽  
High Energy ◽  
Fracture Dislocation ◽  
Long Term Outcome ◽  
First Choice ◽  
Vas Scores ◽  
The Mean

Background: Locked posterior fracture-dislocation of the shoulder (LPFDS) is a very rare injury that occurs predominantly in young patients following high-energy trauma. The long-term outcome of the treatment of this injury is often poor. This study sought to present the characteristics of injury, discuss the pathological anatomy, and to report the treatment outcomes of our case series. Methods: Between January 2012 and May 2018, a total of 234 patients who underwent surgical treatment for proximal humerus fractures were reviewed. Among them, six patients (mean age, 54.7 years; range, 35–76 years) with LPFDS were included in this study. Four patients were treated with open reduction and internal fixation (ORIF) with locking plates, one with hemiarthroplasty, and one with reverse total shoulder arthroplasty. Clinical results were evaluated by Constant, American Shoulder and Elbow Surgeons (ASES), and visual analog scale (VAS) scores and radiologic evaluation was conducted using follow-up radiographs. Results: The mean length of follow-up was 26.2 months (range, 12–54). The mean Constant, ASES, and VAS scores were 66.7, 65.5, and 2.2, respectively. Four patients who underwent ORIF achieved bony union, but avascular necrosis (AVN) of the humeral head was observed in two patients. No complications were observed in the patients who underwent arthroplasty surgery until final follow-up. Conclusions: In the treatment of LPFDS, replacement arthroplasty can produce predictable results. The approach of ORIF may be considered as a first choice of treatment in young patients but is sometimes correlated with postoperative complications such as AVN and the functional outcomes may be unpredictable. Therefore, patients should undergo careful diagnosis and treatment of this type of injury.

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.

Proximal and Palmar Dislocation of the Lunate and Proximal Scaphoid as a Unit in a Case of Scaphocapitate Syndrome

1998 ◽  
Vol 23 (2) ◽  
pp. 266-268 ◽  
Author(s):  
R. PANDIT
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Functional Result ◽  
Fracture Dislocation ◽  
Long Term Results ◽  
Proximal Pole ◽  
Fracture Dislocations ◽  
Perilunate Fracture Dislocation ◽  
Palmar Aspect

Various patterns of transscaphoid, transcapitate fracture-dislocations have been described in the literature. There is little information on the method of management and the long-term results of such severe and rare injuries. The case described here involved a transscaphoid, transcapitate, palmar perilunate fracture-dislocation with ejection of the proximal pole of the scaphoid and lunate into the palmar aspect of the forearm. The functional result 32 months after delayed open reduction and internal fixation is reported.

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 Kawasaki like illness due to COVID-19: a review of the literature

2021 ◽  
Vol 15 (05) ◽  
pp. 630-638
Author(s):  
Yulin Fang ◽  
Veeraraghavan Meyyur Aravamudan ◽  
Gurusaravanan Kutti Sridharan ◽  
Keyur Kamlesh Mehta ◽  
Ramkumar Sekhar ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Viral Infections ◽  
Treatment Options ◽  
Young Patients ◽  
Intravenous Immunoglobulins ◽  
Review Article ◽  
H1n1 Pandemic ◽  
Review Of The Literature ◽  
Search Terms ◽  
Parenchymal Damage

Introduction: Viral infections have been described as triggers for Kawasaki Disease (KD), a medium vessel vasculitis that affects young children. Akin to the H1N1 pandemic in 2009, there is a similar rise in the incidence of KD in children affected with Coronavirus disease 2019 (COVID-19). Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) has been reported to induce an exaggerated systemic inflammatory response resulting in multi-organ involvement, particularly initiated with pulmonary parenchymal damage. This review article will discuss KD-like manifestations in COVID-19 patients in the pediatric cohort. Methodology: Search terms “Kawasaki” “COVID-19” “SARS-COV-2” “PIM-TS” and “MIS-C” were used to look for relevant articles in PubMed and Google Scholar published in the last 5 years. Results: There is some evidence to suggest that SARS-CoV-2 stimulates dysfunctional and hyperactive immune reactions mimicking KD in young patients. Conclusions: Therapeutic options, both investigational and repurposed, include intravenous immunoglobulins, steroids and anticoagulation. More studies are required to evaluate the effectiveness of these treatment options.

scholarly journals Perilunate instability: A rare variant

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110169
Author(s):  
Amanda Partap ◽  
Ian James Persad
Keyword(s):  
High Energy ◽  
Fracture Dislocation ◽  
Proximal Pole ◽  
Lunotriquetral Ligament ◽  
Fracture Dislocations ◽  
Ligament Disruption ◽  
Serious Injuries ◽  
High Degree ◽  
Lunate Fossa

Perilunate dislocations and perilunate fracture dislocations are rare injuries that occur as a result of high energy trauma. We describe a case of a volar fracture dislocation of the proximal pole of the scaphoid with an associated scapholunate and lunotriquetral ligament disruption as well as a lunate fossa fracture of the distal radius. These injuries are serious injuries that require a high degree of clinical acumen and radiographic scrutiny to allow for prompt treatment in order to avoid the sequelae of long-term complications that can arise. This case serves as a reminder of the complexity of these injuries and their associated mechanics.

scholarly journals An Unusual Localization of Lunate in a Transcaphoid Volar Lunate Dislocation: Current Concepts

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Grigorios Kastanis ◽  
George Velivasakis ◽  
Anna Pantouvaki ◽  
Manolis Spyrantis
Keyword(s):  
Early Recognition ◽  
Scaphoid Fracture ◽  
Styloid Process ◽  
High Energy ◽  
Fracture Dislocation ◽  
Loss Of Function ◽  
Perilunate Dislocation ◽  
Fracture Dislocations ◽  
Polytrauma Patients ◽  
Car Accident

Perilunate dislocation and fracture dislocations are rare injuries corresponding to 10% of all carpal injuries. They usually come with high-energy trauma, with associated injuries representing 61%. Volar lunate dislocation or fracture-dislocation accounts for 3% of perilunate injuries. We present a case of a 42-year-old polytrauma male, transmitted to our department 48 hours after a car accident with a trans-scaphoid volar lunate dislocation. During operation, the lunate was displaced volarly to the ulnar side of the wrist, forward to the styloid process of the distal ulna, while the scaphoid fracture appeared at the waist with comminution, and the proximal pole of the scaphoid protruded under the dorsal capsule. Carpal injuries are often missed out in polytrauma patients, and these injuries are underestimated because of the severity of the other visceral or extremity lesions. Untreated or improperly treated, those injuries lead to serious morbidity and loss of function. Therefore, good functional prognosis with decreased percentage of complications can be achieved following early recognition and early open surgical ligamentous complex repair.

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 Case Report of an Acute Complex Perilunate Fracture Dislocation Treated with a Three-Corner Fusion

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Graeme Matthewson ◽  
Samuel Larrivee ◽  
Tod Clark
Keyword(s):  
Pain Syndrome ◽  
High Energy ◽  
Open Reduction Internal Fixation ◽  
Fracture Dislocation ◽  
Salvage Procedure ◽  
First Case ◽  
Satisfactory Outcome ◽  
Dominant Female ◽  
Increased Risk ◽  
Perilunate Fracture Dislocation

Perilunate fracture dislocations are a rare but devastating injury, which is often missed on initial presentation leading to significant delays in treatment. With the delay in treatment and a high energy mechanism of injury, patients are at increased risk of developing complex regional pain syndrome following trauma. In this report, we review the case of a 57-year-old left-hand dominant female who presented to a clinic with a five-and-a-half-week-old transtriquetral, perilunate fracture dislocation with comminution of the scaphoid facet. Due to the increased likelihood of a secondary procedure and low probability of a satisfactory outcome with open reduction internal fixation secondary to the loss of the scaphoid articulation, a salvage procedure was deemed her best option. To our knowledge, this is the first case reported in the literature in which a scaphoidectomy, triquetromy, and midcarpal fusion (three-corner fusion) was performed in the acute setting for a perilunate fracture dislocation.

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