scholarly journals Coracoid Osteotomy, Greater Tuberosity Take Down and Latarjet Procedure for Missed Bilateral Locked Anterior Shoulder Fracture-Dislocations in a Young Man

2021 ◽  
Vol 11 (10) ◽  
Author(s):  
Neil Jones ◽  
Oliver Clough ◽  
Avadhoot Kantak ◽  
Surendra Patnaik
Keyword(s):  
Soft Tissue ◽  
Shoulder Dislocation ◽  
Open Reduction ◽  
Soft Tissue Release ◽  
X Rays ◽  
Latarjet Procedure ◽  
Greater Tuberosity ◽  
Forward Flexion ◽  
Fracture Dislocations ◽  
The Right

Introduction:It is rare to see chronic bilateral anterior fracture-dislocations as a result of seizure, and we present a case of this type and review of the literature. Despite the signs and symptoms of shoulder dislocation being well documented, and X-ray imaging being good at identifying such pathology, there are a few cases in the literature of missed or chronic shoulder dislocation (a shoulder that has been dislocated for more than 3 weeks) but these are extremely rare. Our case represents the first example of chronic bilateral locked anterior fracture-dislocations requiring open reduction and coracoid osteotomy with GT takedown to gain adequate exposure and allow soft tissue release to facilitate joint reduction. No other case has used anchors to achieve GT fixation, and our patient is the youngest published case with such pathology. Case Report: A 16-year-old boy presented to the emergency department with reduced range of movements in both shoulders. Six weeks prior he had suffered an epileptic seizure. X-rays confirmed bilateral anterior shoulder dislocations with displaced greater tuberosity (GT) fractures. Staged open reduction was performed in the right and then left shoulder. Coracoid osteotomy with takedown of the malunited GT fracture was needed to assist with gradual soft tissue contracture release and a successful relocation. Latarjet procedure was then performed and the GTs were fixed using rotator cuff anchors. At 6 months post-operation, on the right side, he achieved forward flexion to 150o and abduction to 120o. On the left side, forward flexion was 110o and abduction was 90o. X rays showed satisfactory maintenance of the reduction without signs of avascular necrosis of the humeral head. Conclusions: Surgical management of this injury in this way is effective and achieves good results in the first 6 months of follow up. A high index of suspicion should be employed for this injury in post-ictal patients with shoulder pain. Early mobilization and

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.

CHARACTERISTICS OF SOFT TISSUE MASS IN THE HAND BY ULTRASONOGRAPHIC EXAMINATION

2005 ◽  
Vol 09 (01) ◽  
pp. 45-51
Author(s):  
Alexander Blankstein ◽  
Aharon Chechick ◽  
Abraham Adunski ◽  
Uri Givon ◽  
Yigal Mirovski ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Mass ◽  
Wrist Joint ◽  
Imaging Modality ◽  
Routine Practice ◽  
X Rays ◽  
Diagnostic Challenge ◽  
Tissue Mass ◽  
Soft Tissue Masses ◽  
The Right

Soft tissue masses are amongst the commonest complaints encountered in orthopedic practice. Of these, masses found in the hand and the wrist are presented at higher frequency. They are often painful and may cause limitation of movement. This work describes the prevalence and the nature of soft tissue masses in the hand and wrist encountered in routine practice. This work was performed to assess the characteristics of soft tissue mass in the hand and the effectiveness of ultrasonography in the diagnosis of soft tissue masses and their differentiation from other lesions in the hand and wrist. Orthopedic surgical conditions that involve soft tissue in the hand and wrist may remain a diagnostic challenge when clinical diagnosis is uncertain and standard X-rays are non-diagnostic. High resolution ultrasound is widely available, non-invasive, without damage of radiation, imaging modality that can help the diagnosis. We reviewed retrospectively 25 patients with soft tissue masses. We compared the ultrasound findings with the histological findings in seven operated patients. A substantial majority of these lesions occurred in the right hand: 79% of the lesions were in the dorsal aspect of the hand, of which 37% were distal to the wrist joint, among them 42% at wrist either radial or ulnar; and 21% of the lesions were found in the volar aspect, among them 17% at wrist aspect, either radial or ulnar side. No predisposing factors could be found. The findings of this study reaffirm the utility of ultrasonography as primary diagnostic tool in routine orthopedic practice.

scholarly journals Management of Fracture of Posterior Malleolus, Trimalleolar Fracture, Fracture Dislocations, and Syndesmosis Injury of Ankle Joint

2017 ◽  
Vol 4 (2) ◽  
pp. 90-96
Author(s):  
Satish R Gawali ◽  
Raman O Toshniwal ◽  
Shashikant B Kukale, ◽  
Pramod V Nirvane,
Keyword(s):  
Soft Tissue ◽  
Ankle Joint ◽  
Open Reduction ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Malleolar Fractures ◽  
Posterior Malleolus ◽  
Syndesmosis Injury ◽  
Fracture Dislocations ◽  
Trimalleolar Fracture

ABSTRACT Background Malleolar fractures of ankle are usually complex injuries, as they are associated with significant ligament and soft tissue injury—injury to syndesmosis and injury to medial and lateral collateral ligaments. The open reduction and internal fixation is not feasible until recovery of significant soft tissue injury and subsidence of edema. Malleolar fractures are articular fractures and have associated subluxation and dislocation of talus. The aims of treatment are to restore normal anatomy and provide sufficient stability for early movements. Malleolar fractures more often require open reduction. Our study aimed to know efficacy and outcome of operative management of them. Materials and methods From January 2013 to March 2015, 35 patients with syndesmotic ankle injury and trimalleolar ankle fractures admitted to the Government Medical College, Latur, India, were operated and followed up prospectively. Results Mean age of patients is 35 years (25–60 years). Fracture union was seen radiologically in 3 to 4 months depending on fracture geometry. We achieved good to excellent results of 90%. Conclusion We conclude that malleolar fractures encountered in clinical practice need thorough assessment and meticulous surgical intervention, as they are associated with injury to ligament complex, i.e., ligament is a key structure in the stability of ankle mortise. Abduction and external rotation types of injuries are the most common types to be seen. We achieved stable fixation and performed early mobilization of the ankle joint, which limits the complications of mainly ankle stiffness. Each malleolus has got its inherent associated complications and calls for special attention for identifying associated conditions, such as syndesmotic injury, talus dislocation in posterior malleolar fractures, irreducible ankle dislocation with trimalleolar fracture, and entrapped fibula behind tibia with irreducible dislocation. How to cite this article Gawali SR, Kukale SB, Nirvane PV, Toshniwal RO. Management of Fracture of Posterior Malleolus, Trimalleolar Fracture, Fracture Dislocations, and Syndesmosis Injury of Ankle Joint. J Foot Ankle Surg (Asia-Pacific) 2017;4(2):90-96.

scholarly journals Management of Shoulder Dislocation by Prakash Method

2021 ◽  
Vol 8 (1) ◽  
pp. 21-24
Author(s):  
Ihsan Ullah ◽  
Samir Khan Kabir ◽  
Khalid . ◽  
Mohammad Inaam ◽  
Gul Hassan ◽  
...  
Keyword(s):  
Success Rate ◽  
Shoulder Dislocation ◽  
Recurrent Dislocation ◽  
Study Data ◽  
Posterior Shoulder ◽  
Fracture Dislocations ◽  
History Of ◽  
The Right ◽  
First Time ◽  
Anterior Posterior

OBJECTIVES: The objective of the study is to evaluate the effectiveness and safety of shoulder reduction developed by Prakash. METHODOLOGY: This descriptive study was carried out at Rehman Medical and Surgical Center District Buner and Naseer Teaching Hospital Peshawar from June 2017 to December 2019. All patients with a history of trauma to either shoulder were subjected to anterior-posterior shoulder radiograph. Those having shoulder dislocation were enrolled in the study. Data including age, gender, previous dislocation history, duration of dislocation and associated fracture, and fracture type were recorded in patient case sheet. Patients having recurrent dislocation, polytrauma, low GCS, fracture-dislocations, and more than a week history of dislocation were excluded from the study. RESULTS: This study was performed on 30 patients. The mean age of the patients was 36.46±11.58 years. Among them, 83.3% (n=25) were male and 16.7% (n=5) were female. While dislocation occurred on the right shoulder in 63.3% (n=19) and in 36.7% (n=11) on the left side. All the patients have dislocation for the first time. The reduction was performed using Prakash’s method. The success rate was 90% (n=27) and 10% (n=3) the reduction failed, which was then reduced under anesthesia using the Hippocratic method. CONCLUSION: The Prakash's method for reducing anterior shoulder dislocation requires minimum assistance with no anesthesia, it is safe, less time consuming, has a high success rate, less pain, and has minimal complications.  

scholarly journals Irreducible Anterior Shoulder Dislocation with Interposition of the Long Head of the Biceps and Greater Tuberosity Fracture: A Case Report and Review of the Literature

2017 ◽  
Vol 11 (1) ◽  
pp. 327-334 ◽  
Author(s):  
Konstantinos Pantazis ◽  
Andreas Panagopoulos ◽  
Irini Tatani ◽  
Basilis Daskalopoulos ◽  
Ilias Iliopoulos ◽  
...  
Keyword(s):  
Case Report ◽  
Shoulder Dislocation ◽  
Open Reduction ◽  
Biceps Tendon ◽  
Full Range ◽  
Successful Outcome ◽  
Anterior Shoulder Dislocation ◽  
Greater Tuberosity ◽  
Greater Tuberosity Fracture ◽  
Long Head

Background: Failure of closed manipulative reduction of an acute anterior shoulder dislocation is seldom reported in the literature and is usually due to structural blocks such as soft tissue entrapment (biceps, subscapularis, labrum), bony fragments (glenoid, greater tuberosity) and severe head impaction (Hill-Sachs lesion). Case report: We present a case of an irreducible anterior shoulder dislocation in a 57-year-old male patient after a road-traffic accident. He had severe impaction of the head underneath glenoid rim and associated fracture of the greater tuberosity. Closed reduction performed in the emergency room under sedation and later at the theatre under general anaesthesia was unsuccessful. Open reduction using the dectopectoral approach revealed that the reason for obstruction was the posterolateral entrapment of the biceps tendon between the humeral head and the tuberosity fragment. Reduction was achieved after subscapularis tenotomy and opening of the joint; the tuberosity fragment was fixed with transosseous sutures and the long head of the biceps tendon was tenodesized. The patient had an uneventful postoperative recovery and at his last follow up, 12 months postoperatively, he had a stable joint, full range of motion and a Constant score of 90. Conclusion: A comprehensive literature review revealed 22 similar reports affecting a total of 30 patients. Interposition of the LHBT alone or in combination with greater tuberosity fracture was the most common obstacle to reduction, followed by subscapularis tendon interposition and other less common reasons. Early surgical intervention with open reduction and confrontation of associated injuries is mandatory for a successful outcome.

scholarly journals Foot Width Changes Following Hallux Valgus Surgery

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0048
Author(s):  
Shay Tenenbaum ◽  
Jason Bariteau ◽  
Amir Herman ◽  
Oded Coifman
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Metatarsal Head ◽  
Soft Tissue Release ◽  
X Rays ◽  
Maximal Distance ◽  
Bone Width ◽  
Radiographic Measurements ◽  
Valgus Angle ◽  
The Impact

Category: Midfoot/Forefoot Introduction/Purpose: Hallux valgus is one of the most common deformities of the adult foot, and can adversely affect quality of life, with common complaints including pain, footwear restrictions and cosmesis. Every clinician is familiar with the patients’ concerns regarding the postoperative foot appearance and footwear anticipations. Surprisingly, although patients are concerned with postoperative foot width, there are only scarce reports on this issue. This study was undertaken to evaluate the impact of hallux valgus surgical treatment on foot width. Methods: Study included 71 consecutive cases with moderate to severe hallux valgus treated with Scarf osteotomy, distal soft tissue release and Akin osteotomy as needed. Patients were included only if pre- and postoperative weightbearing X-rays at minimum 6 months followup were available. The average age was 55.7 years (range, 20 to 76), with average follow-up of 20.7 months (range, 6 to 96). Patients’ medical records were reviewed for clinical data, surgical technique and radiographic measurements. The radiographic measurements included hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), and foot width. Foot width was assessed by measuring both the bony width (BW: maximal distance between the medial cortex of 1st metatarsal head and lateral cortex of the 5th metatarsal head) and the soft tissue width (STW: maximal distance between most medial soft tissue outline and the most lateral soft tissue outline at the level of metatarsal heads). Results: Preoperative HV deformity (mean HVA 35.8, IMA 14.1 and DMAA 15.2) was successfully corrected (postoperative mean HVA 13.7, IMA 6.9 and DMAA 7.7). Overall bony foot width was reduced by 5% and soft tissue foot width by 2% postoperatively. Further analysis showed there were 13 feet (18.3%) with increased (>5%) bone width, 26 feet (36.6%) with no change (±5%) and 32 feet (45.1%) for which width decreased in more than 5% postoperatively. Patients with the widest foot before surgery, had a decrease in foot width following surgery whereas, patients with the narrowest foot width, had an increase in foot width. Magnitude of preoperative deformity (as assessed by HVA, IMA and DMMA measurements) or amount of correction had low correlation (<0.2) with postoperative foot width. Conclusion: While the ability of surgery to correct HV deformity is well established and reported in the literature, its effect on foot width is less understood or predictable. Overall, the postoperative reduction of foot with was modest. Furthermore, while postoperative foot width (both bony and soft tissue) decreases or does not change in 4 out of 5 patients, there are cases in which foot width actually increases.

Dynamic External Fixator as Treatment for Congenital Little Finger Contracture

2020 ◽  
Author(s):  
Kenji Ohira ◽  
Yoshitaka Hamada ◽  
Takeyasu Toyama ◽  
Yoshitaka Minamikawa
Keyword(s):  
Clinical Practice ◽  
Soft Tissue ◽  
External Fixator ◽  
Limited Range ◽  
Joint Contracture ◽  
Soft Tissue Release ◽  
Hand Therapy ◽  
Limited Range Of Motion ◽  
The Right ◽  
Little Finger

Abstract The surgical soft tissue release of extension contracture at metacarpophalangeal (MP) joint is technically easy; however, the preventive hand therapy after surgery is really difficult in clinical practice. Congenital MP joint contracture, especially little finger, is also difficult to spread its limited range of motion (ROM). Here, we present a patient with a congenital MP joint contracture of the little finger managed with dynamic external fixator (DEF). A 21-year-old male irritated from limited ROM associated with pain of the right little finger of more than 1 year. The symptom started after trauma on his hand while playing lacrosse. Further examination revealed that his MP joint was congenitally contracted. To address this pathology, DEF followed by orthotic therapy was done. Two years after the procedure and therapy, the MP joint ROM of the finger surpassed that of the contralateral unaffected digit without pain and recurrence. The patient was able to return to his sports of lacrosse.

Sign in / Sign up

Export Citation Format

Share Document