scholarly journals Luxación Facetaria Unilateral Lumbosacra Postraumática

10.15417/474 ◽  
2016 ◽  
Vol 81 (3) ◽  
pp. 232
Author(s):  
Manuel González Murillo ◽  
Lorenzo Zuñiga Gómez ◽  
Patricia Álvarez González ◽  
Felisa Sánchez-Mariscal ◽  
Javier Pizones Arce ◽  
...  
Keyword(s):  
Standard Treatment ◽  
Pedicle Screws ◽  
High Energy ◽  
Lumbosacral Junction ◽  
Interbody Cage ◽  
Rare Injury ◽  
Instrumented Fusion ◽  
Energy Mechanism ◽  
Palabras Clave ◽  
Lumbosacral Dislocation

<p><strong>RESUMEN</strong></p><p>En la bibliografía se han reportado alrededor de medio centenar de casos de luxaciones lumbosacras; la mayor parte se tratan de luxaciones facetarias bilaterales. Presentamos el caso de una paciente mujer de 42 años con luxación facetaria unilateral lumbosacra de un mes de evolución tras accidente de tráfico. Se realiza artrodesis circunferencial L5-S1 instrumentada con caja intersomática y tornillos pediculares L5-S1.</p><p> </p><p>La luxación lumbosacra es una lesión poco habitual que se produce gracias a la combinación de un mecanismo de alta energía con factores anatómicos predisponentes. Recientes publicaciones defienden la reducción quirúrgica y estabilización con instrumentación como tratamiento estándar.</p><p><strong>Palabras clave</strong></p><p>Luxación; unión lumbosacra; artrodesis</p><p> </p><p> </p><p><strong>ABSTRACT</strong></p><p>In the literature have been reported around fifty cases of lumbosacral dislocations; treated most bilateral facet dislocations. We report the case of a female 42 year old with unilateral lumbosacral facet dislocation of one month duration after accident. Circumferential instrumented fusion L5-S1 with interbody cage and pedicle screws L5-S1 was performed.</p><p> </p><p>The lumbosacral dislocation is a rare injury that occurs due to the combination of a high-energy mechanism predisposing anatomical factors. Recent publications advocate the surgical reduction and stabilization with instrumentation as standard treatment.</p><p><strong>Key Words</strong></p><p>Dislocation; Lumbosacral junction; Arthrodesis.</p>

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.

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 Unilateral Lumbosacral Dislocation: Case Report and a Comprehensive Review

2012 ◽  
Vol 6 (1) ◽  
pp. 473-477 ◽  
Author(s):  
Theodoros B Grivas ◽  
Stamatios A Papadakis ◽  
Vassiliki Katsiva ◽  
George Koufopoulos ◽  
Vassilios Mouzakis
Keyword(s):  
Open Reduction ◽  
English Literature ◽  
Posterior Instrumentation ◽  
Fracture Dislocation ◽  
Lumbosacral Junction ◽  
Rare Injury ◽  
Unusual Condition ◽  
Post Traumatic ◽  
Lumbosacral Dislocation

Lumbosacral fracture-dislocation is a rare occurrence. There are more than 73 cases reported in the English literature. We report on the imaging findings and surgical treatment in a patient suffered of unilateral traumatic L5-S1 dislocation associated with severe disruption of the posterior ligamentous complex. The patient underwent open reduction and stabilization of L4-S1 vertebrae with posterior instrumentation system. Open reduction and internal fixation was mandatory as post-traumatic ligamentous insufficiency would lead to abnormal motion. Operative treatment managed to produce a solid arthrodesis and restore stability of the lumbosacral junction. Follow-up revealed excellent results. This study reports a rare injury of the lumbosacral junction, and the literature concerning this unusual condition is extensively reviewed.

scholarly journals Traumatic Lumbosacral Dislocation: Current Concepts in Diagnosis and Management

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Andrew S. Moon ◽  
Kivanc Atesok ◽  
Thomas E. Niemeier ◽  
Sakthivel R. Manoharan ◽  
Jason L. Pittman ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Lumbar Vertebra ◽  
Operative Management ◽  
High Energy ◽  
High Quality ◽  
Diagnosis And Management ◽  
Energy Mechanism ◽  
Fifth Lumbar Vertebra ◽  
Lumbosacral Dislocation

Traumatic lumbosacral dislocation is a rare, high-energy mechanism injury characterized by displacement of the fifth lumbar vertebra in relation to the sacrum. Due to the violent trauma typically associated with this lesion, there are often severe, coexisting injuries. High-quality radiographic studies, in addition to appropriate utilization of CT scan and MRI, are essential for proper evaluation and diagnosis. Although reports in the literature include nonoperative and operative management, most authors advocate for surgical treatment with open reduction and decompression with instrumentation and fusion. Despite advances in early diagnosis and management, this injury type is associated with significant morbidity and mortality, and long-term patient outcomes remain unclear.

Lumboiliac fixation in lumbosacral dislocation and associated injuries of the pelvis and lumbosacral junction: a long‐term radiological and clinical follow‐up

Injury ◽  
2016 ◽  
Vol 47 ◽  
pp. S44-S48 ◽  
Author(s):  
Federico De Iure ◽  
Michele Cappuccio ◽  
Matteo Palmisani ◽  
Raffaele Pascarella ◽  
Matteo Commessatti
Keyword(s):  
Associated Injuries ◽  
Lumbosacral Junction ◽  
Lumbosacral Dislocation

scholarly journals Evaluation of Outcome of Transpedicular Decompression and Instrumented Fusion in Thoracic and Thoracolumbar Tuberculosis

2017 ◽  
Vol 11 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Akshay Jain ◽  
R.K. Jain ◽  
Vivek Kiyawat
Keyword(s):  
Back Pain ◽  
Pedicle Screws ◽  
Direct Access ◽  
Instrumented Fusion ◽  
Loss Of Correction ◽  
Vas Score ◽  
Transpedicular Approach ◽  
Thoracolumbar Region ◽  
Radiological Healing

<sec><title>Study Design</title><p>Retrospective analysis.</p></sec><sec><title>Purpose</title><p>We evaluated the functional, neurological, and radiological outcome in patients with thoracic and thoracolumbar tuberculosis operated through the transpedicular approach.</p></sec><sec><title>Overview of Literature</title><p>For surgical treatment of thoracic and thoracolumbar tuberculosis, the anterior approach has been the most popular because it allows direct access to the infected tissue, thereby providing good decompression. However, anterior fixation is not strong, and graft failure and loss of correction are frequent complications. The transpedicular approach allows circumferential decompression of neural elements along with three-column fixation attained via pedicle screws by the same approach.</p></sec><sec><title>Methods</title><p>A total of 47 patients were diagnosed with tuberculosis of the thoracic or thoracolumbar region from August 2012 to August 2013. Of these, 28 patients had progressive neurological deterioration or increasing back pain despite conservative measures and underwent transpedicular decompression and pedicle screw fixation with posterior fusion. Antituberculosis therapy was given till signs of radiological healing were evident (9–16 months). Functional outcome (visual analog scale [VAS] score for back pain), neurological recovery (Frankel grading), and radiological improvement were evaluated preoperatively, immediate postoperatively, and at 3 months, 6 months, and 1 year.</p></sec><sec><title>Results</title><p>Mean VAS score for back pain improved from 8.7 preoperatively to 1.1 at 1 year follow-up. Frankel grading preoperatively was grade B in 7, grade C in 11, and Grade D in 10 patients, which improved to grade D in 6 and grade E in 22 patients at the last follow-up. Radiological healing was evident in the form of reappearance of trabeculae formation, resolution of pus, fatty marrow replacement, and bony fusion in all patients. Mean correction of segmental kyphosis postoperatively was 10.5°. Mean loss of correction at final follow-up was 4.1°.</p></sec><sec><title>Conclusions</title><p>Transpedicular decompression with instrumented fusion is a safe and effective approach for management of patients with thoracic and thoracolumbar tuberculosis.</p></sec>

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 Leg Impalement – A Rare Injury Pattern Case Report

2021 ◽  
Vol 11 (10) ◽  
Author(s):  
Gabriel Pina ◽  
Maria Rita Vaz ◽  
Ana Vaz ◽  
Nuno Borralho
Keyword(s):  
Foreign Body ◽  
Operating Room ◽  
Hospital Care ◽  
High Energy ◽  
Massive Hemorrhage ◽  
Road Accident ◽  
Body Region ◽  
Rare Injury ◽  
Foreign Body Removal ◽  
Wound Debridement

Introduction: Impalement injuries are defined as rare, high-energy lesions caused by foreign bodies, usually steel bars or wooden objects, which pierce body cavities or extremities and remain interposed in the perforated body region. They usually occur with road accident or civil construction falls. Case Report:A 24-year-old male patient was admitted at the emergency department after a motorcycle accident, resulting a left leg impalement with a wooden object. A partial deep peroneal nerve palsy and a proximal third fibula fracture were observed. The foreign body removal and wound debridement were performed. The patient evolved favorably without complications, with complete neurological recovery and returning to his normal life activities. Discussion: Impalement injuries represent a challenge in pre-hospital care, emergency room, and operating room hospital care, due to its rarity and specificity: Type of object, anomalous foreign body location, and trajectory. There is a consensus that whenever possible, it should be removed in the operating room, due to the foreign body may be tamponing a major arterial laceration, thus preventing massive hemorrhage. Conclusion: Neurovascular injury exclusion, foreign body removal in the operating room, debridement, and antibiotic prophylaxis represent the treatment basis of these injuries. Keywords: Impalement, Trauma, Leg

Predictors of Time to Union After Operative Fixation of Closed Ankle Fractures

2016 ◽  
Vol 10 (4) ◽  
pp. 308-314 ◽  
Author(s):  
Andrew P. Matson ◽  
Kamran S. Hamid ◽  
Samuel B. Adams
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Case Series ◽  
Patient Characteristics ◽  
High Energy ◽  
Delayed Union ◽  
Ankle Fractures ◽  
Patient Counseling ◽  
Chi Square ◽  
Energy Mechanism

Background. Ankle fractures are common and represent a significant burden to society. We aim to report the rate of union as determined by clinical and radiographic data, and to identify factors that predict time to union. Methods. A cohort of 112 consecutive patients with isolated, closed, operative malleolar ankle fractures treated with open reduction and internal fixation was retrospectively reviewed for time to clinical union. Clinical union was defined based on radiographic and clinical parameters, and delayed union was defined by time to union >12 weeks. Injury characteristics, patient factors and treatment variables were recorded, and statistical techniques employed included the Chi-square test, the Student’s T-test, and multivariate linear regression modeling. Results. Forty-two (37.5%) of patients who achieved union did so in less than 12 weeks, and 69 (61.6%) of these patients demonstrated delayed union at a mean of 16.7 weeks (range, 12.1-26.7 weeks), and the remaining patient required revision surgery. Factors associated with higher rates of delayed union or increased time to union included tobacco use, bimalleolar fixation, and high energy mechanism (all p<0.05). In regression analysis, statistically significant negative predictors of time to union were BMI, dislocation of the tibiotalar joint, external fixation for initial stabilization and delay of definitive management (all p<0.05). Conclusion. Patient characteristics, injury factors and treatment variables are predictive of time to union following open reduction and internal fixation of closed ankle fractures. These findings should assist with patient counseling, and help guide the provider when considering adjunctive therapies that promote bone healing. Levels of Evidence: Prognostic, Level IV: Case series

Compression fracture in the middle of a chronic instrumented fusion that developed into pseudarthrosis after balloon kyphoplasty

2014 ◽  
Vol 20 (6) ◽  
pp. 705-708 ◽  
Author(s):  
Stephen M. Pirris ◽  
Sherri M. Kimes
Keyword(s):  
Lumbar Fusion ◽  
Compression Fracture ◽  
Pedicle Screws ◽  
Balloon Kyphoplasty ◽  
Vertebral Compression Fractures ◽  
Adjacent Segment ◽  
Rare Occurrence ◽  
Instrumented Fusion ◽  
Compression Fractures ◽  
Surgical Options

There are only 2 documented cases of vertebral compression fractures occurring within a solid lumbar fusion mass: one within the fusion mass after hardware removal and the other within the levels of the existing instrumentation 1 year postoperatively. The authors report a case of fracture occurring in a chronic (> 30 years) solid instrumented fusion mass in a patient who underwent kyphoplasty. The pain did not improve after the kyphoplasty procedure, and the patient developed a posterior cleft in the fusion mass postoperatively. The patient, a 46-year-old woman, had undergone a T4–L4 instrumented fusion with placement of a Harrington rod when she was 12 years old. Adjacent-segment breakdown developed, and her fusion was extended to the pelvis, with pedicle screws placed up to L-3 to capture the existing fusion mass. Almost 2 years after fusion extension, she fell down the stairs and suffered an L-2 compression fracture, which is when kyphoplasty was performed without pain relief, and she then developed a cleft in the posterior fusion mass that was previously intact. She refused further surgical options. This case report is meant to alert surgeons of this possibility and allow them to consider the rare occurrence of fracture within the fusion mass when planning extension of chronic spinal fusions.

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