Simultaneous palmar-divergent dislocation of scaphoid and lunate associated with ipsilateral humeroradial joint dislocation and humerus shaft fracture:a rare case report and proposal of an additional subtype 

2021 ◽  
Author(s):  
Wan-Wen Feng ◽  
Yuan Qian ◽  
Cheng-Xiang Han ◽  
Yu-Ping Liu
Keyword(s):  
Open Reduction ◽  
Rare Case ◽  
Radial Head Fracture ◽  
Full Range ◽  
Humeral Fracture ◽  
Shaft Fracture ◽  
Scapholunate Ligament ◽  
Ligament Repair ◽  
Joint Dislocation ◽  
Volar Approach

Abstract Simultaneous palmar dislocation of scaphoid and lunate is rare and currently classified into palmar dislocation as a unit and palmar-divergent dislocation. Up to now, nine cases of palmar-divergent dislocation of scaphoid and lunate have been reported, with one case associated with ipsilateral radial head fracture and another trapezium fracture. Here we presented a 31-year-old male who fell from a three-storey building and diagnosed as palmar-divergent dislocation of scaphoid and lunate associated with ipsilateral humeroradial joint dislocation and open humeral shaft fracture. To raise our awareness of concomitant dislocations or fractures resulting from the same violence transmission in the ipsilateral upper extremity and avoid missed diagnosis and thoroughly evaluate injuries severity, we proposed this injury should be an additional third subtype of palmar dislocation of scaphoid and lunate. Surgical sequence and options consider the location of concomitant dislocations or fractures. This report first performed debridement and internal fixation for humerus fracture and then close reduction for humeroradial joint dislocation. Finally, palmar-divergent dislocation of scaphoid and lunate was treated with open reduction and fixation by Kirschner's wires and only repaired the stronger palmar scapholunate ligament through a single volar approach. At a 3-year follow-up, the patient gained satisfactory wrist function and the humeral fracture healed without evidence of recurrent dislocations, collapse or avascular necrosis of scapholunate. We discussed the potential benefits of the stronger palmar scapholunate ligament repair through a single volar approach to treat palmar-divergent dislocation of scaphoid and lunate. In conclusion, we report a rare case of palmar-divergent dislocation of scaphoid and lunate associated with other ipsilateral dislocations or fractures originating from the same violence traveling and propose that these complex injuries should be subdivided into a third subtype in the modified classification of palmar dislocation of scaphoid and lunate. Once diagnosed, palmar-divergent dislocation of scaphoid and lunate is fit to receive an open reduction and fixation with Kirschner's wires and the stronger palmar scapholunate ligament repair through a single volar approach. A good outcome with an almost full range of motion and freedom from pain can achieve using this method.

scholarly journals Simultaneous palmar divergent dislocation of scaphoid and lunate concurrent with i psilateral humeroradial joint dislocation and humerus shaft fracture: report a rare case and add a new subtype

2020 ◽  
Author(s):  
Wan-wen Feng ◽  
Ya-yi Xia ◽  
Yue-peng Liu ◽  
yuping liu
Keyword(s):  
Open Reduction ◽  
Rare Condition ◽  
Humeral Fracture ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
High Energy ◽  
Humeral Shaft ◽  
Scapholunate Ligament ◽  
Joint Dislocation ◽  
Volar Approach

Abstract Background: Simultaneous palmar dislocation of scaphoid and lunate is a rare condition generally resulting from high-energy trauma and usually classified into two types. The literature has only reported nine patients with palmar divergent dislocation of scaphoid and lunate. Here we we present a case of accompanied ipsilateral humeroradial joint dislocation and open humeral shaft fracture caused by the same violence travelling from the wrist. Considering the emerging cases with their own characteristics, we suggest this severer injury be expanded into the third type of palmar dislocation of scaphoid and lunate. Case presentation: A 31-year-old male who fell from a three-storey building, with his right wrist directly hitting the ground, was admitted to the orthopaedic department of our hospital. Physical and radiographic examinations defined simultaneous palmar divergent dislocations of scaphoid and lunate concurrent with ipsilateral humeroradial joint dislocation and open humeral shaft fracture. After debridement and internal fixation for humerus and close reduction for humeroradial joint, the scaphoid and lunate were treated with open reduction and fixation by Kirschner’s wires, and the palmar scapholunate ligament and anterior capsule were repaired through volar approach. After a 3-year follow-up, his humeral fracture healed without recurrent dislocations, collapse or avascular necrosis of scapholunate. Favorable hand function regained . Conclusions: Palmar divergent dislocation of scaphoid and lunate caused by considerable violence is rare and appropriate to urgent open reduction and fixation with Kirschner’s wires and repair of the stronger palmar scapholunate ligament through single volar approach. When the residual violence continues to transmit to the upper extremity, ipsilateral dislocation or fracture may occur. We advise that this complex injury be classified into a third subtype of simultaneous palmar dislocation of scaphoid and lunate to avoid misdiagnosis.

HERBERT SCREW FIXATION FOR THE TREATMENT OF SCAPHOLUNATE LIGAMENT RUPTURE

Hand Surgery ◽  
1998 ◽  
Vol 03 (01) ◽  
pp. 47-55 ◽  
Author(s):  
Susan L. Filan ◽  
Timothy J. Herbert
Keyword(s):  
Open Reduction ◽  
Screw Fixation ◽  
Moderate Activity ◽  
Activity Levels ◽  
Scapholunate Ligament ◽  
Ligament Repair ◽  
Wrist Motion ◽  
Bone Screw ◽  
Ligament Rupture ◽  
Full Loading

Complete rupture of the scapholunate ligament was treated by open reduction, ligament repair and internal splintage with a Herbert bone screw. After an average of 12 months, the screw was removed to allow full loading of the repair. In 33 procedures, there were 22 good and 11 poor results. In five cases with a poor outcome, the screw pulled or fractured out of the scaphoid or lunate. Grip and range of wrist motion improved in patients with a good outcome, and repair of the ligament was noted at all revision and open screw removal surgeries. A comparison of the good and poor results leads us to recommend this technique for patients with relatively recent injuries and light to moderate activity levels. Longstanding injuries and heavy occupational wrist loading led to poorer results.

scholarly journals Dislocation of the proximal tibiofibular joint

2013 ◽  
Vol 66 (9-10) ◽  
pp. 387-391 ◽  
Author(s):  
Miroslav Milankov ◽  
Vaso Kecojevic ◽  
Nemanja Gvozdenovic ◽  
Mirko Obradovic
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Full Range ◽  
Open Reduction Internal Fixation ◽  
Outer Side ◽  
Lateral Side ◽  
Proximal Tibiofibular Joint ◽  
Joint Dislocation ◽  
X Ray ◽  
Tibiofibular Joint

Introduction. Dislocation of the proximal tibiofibular joint is a rare injury. It occurs during a sports activity that includes rough twisting movements of the bent knee. The role of the proximal tibiofibular joint is to reduce torsional loads to the ankle, to distribute the bending moment of the outer side of tibia, and transfer the vertical load while standing. In the literature there is no larger series; only several cases of the proximal tibiofibular joint dislocation treated by different methods have been published so far. Case Report. A 23-year-old male soccer player sustained an injury after he had joined the game without previous warming-up. He fell on his right side because of a sudden change of direction while his foot was fixed to the base. He felt a severe pain and had a sensation as if something had snapped in his right knee. Pain and swelling at the head of fibula were found by physical examination, which, however, did not reveal any pain, swelling and instability of the ankle or peroneal nerve palsy. The x-ray showed anterolateral dislocation of the proximal tibiofibular joint, Ogden type II. Since manual reposition in general anesthesia failed, open reduction internal fixation was performed and proximal tibiofibular joint was transfixed with a screw. After the wound closure, the above-the-knee plaster cast was applied. The screw was extracted six weeks later, full weight bearing was allowed and he started with physical therapy. Four months after the injury he returned to sports activities. On the follow- up one year after the injury he had the full range of motion of the knee, no complains, and continued with active soccer playing. X-ray showed no signs of arthrosis of the proximal tibiofibular joint. Conclusion. The proximal tibiofibular joint dislocation may be the cause of the chronic pain of the knee so it has to be taken into account when making differential diagnosis in case of the pain at the lateral side of the knee. The key for making the accurate diagnosis is the technically correct X-ray of the injured knee compared with the opposite one, showing the displacement of fibular head. If manual reposition fails, open reduction internal fixation and screw transfixation of the proximal tibiofibular joint allow good results and fast return to sport activities.

scholarly journals “Twist of the Wrist” A Rare Case of Carpal Dislocation

Hand ◽  
2009 ◽  
Vol 4 (3) ◽  
pp. 308-310
Author(s):  
L. C. Vermeer ◽  
R. Kooijman
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Rare Case ◽  
Kirschner Wire ◽  
Full Recovery ◽  
Ligament Repair

A rare case of a scaphoid–trapezium dislocation is presented. The treatment was open reduction, ligament repair, and internal fixation with a Kirschner wire. After 4 weeks of immobilization, the Kirschner wire was removed, and full recovery was obtained 12 weeks after the trauma.

scholarly journals Open Reduction and Internal Fixation of a Proximal Femoral Shaft Fracture in a Patient with Bilateral Congenital Hip Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Stefania Kanata ◽  
Antonios Anastasiadis
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Rare Case ◽  
Femoral Shaft Fracture ◽  
Hip Dislocation ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Leg Length ◽  
Congenital Hip Dislocation ◽  
Hip Disease

We present a rare case of a femoral shaft fracture in a 74-year-old woman with a preexisting untreated bilateral congenital hip dislocation and with concomitant leg length discrepancy. Because of the marked deformity of the upper femur, a derivative of the congenital hip disease, an open reduction and internal fixation was performed, with the use of an anatomic femur plate originally designed for the treatment of periprosthetic fractures. The patient was treated successfully and returned to her previous status of activity. The management of a femoral fracture in the presence of ipsilateral hip disease is a challenging issue. The surgical treatment choice in such cases has to be individualized, taking into consideration several anatomic and medical parameters.

scholarly journals Combined Ipsilateral Humeral Shaft and Galeazzi Fractures Creating a Floating Elbow Variant

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Patrick Lee ◽  
Allison Z. Piatek ◽  
Michael J. DeRogatis ◽  
Paul S. Issack
Keyword(s):  
Internal Fixation ◽  
Range Of Motion ◽  
Open Reduction ◽  
Humeral Fracture ◽  
Humeral Shaft ◽  
Proximal Ulna ◽  
Elbow Injury ◽  
Anatomic Reduction ◽  
Elbow Injuries ◽  
Floating Elbow

“Floating elbow” injuries of the arm traditionally represent a combination of humeral shaft and forearm fractures which require anatomic rigid open reduction and internal fixation of all fractures to allow for early range of motion exercises of the elbow. There are published variants of the floating elbow injury which include ipsilateral diaphyseal humeral fracture, proximal ulna fracture with proximal radioulnar joint disruption, and ipsilateral diaphyseal humeral fracture with elbow dislocation and both bones forearm fracture. We present the case of a 21-year-old woman whose left arm became caught between the side of a waterslide and adjacent rocks at a park. She sustained a torsional and axial loading injury to her left upper extremity resulting in ipsilateral humeral shaft and Galeazzi fractures. The combination of ipsilateral humeral shaft and Galeazzi fractures resulted in a rare floating elbow variant. Prompt open reduction and internal fixation of both fractures and early range of motion of the elbow and wrist resulted in an excellent clinical and radiographic result. Floating elbow injuries and their variants should be promptly recognized as early anatomic reduction, and rigid internal fixation can allow for good elbow function with minimization of stiffness.

scholarly journals Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis and Open Reduction Internal Fixation on Proximal Humeral Fracture in Elder Patients: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Zhao ◽  
Yuhui Zhang ◽  
Dongni Johansson ◽  
Xingyu Chen ◽  
Fang Zheng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Humeral Fracture ◽  
Plate Osteosynthesis ◽  
Meta Analysis ◽  
Humeral Fracture ◽  
Open Reduction Internal Fixation ◽  
Elder Patients

Objective. The study aims to compare minimally invasive percutaneous plate osteosynthesis (MIPO) and open reduction internal fixation (ORIF) in the treatment of proximal humeral fracture in elder patients. Method. PubMed, Medline, EMbase, Ovid, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wangfang, and VIP Database for Chinese Technical Periodicals were searched to identify all relevant studies from inception to October 2016. Data were analyzed with Cochrane Collaboration’s Review Manage 5.2. Results. A total of 630 patients from 8 publications were included in the systematic review and meta-analysis. The pooled results showed that MIPO was superior to ORIF in the treatment of proximal humeral fracture in elder patients. It was reflected in reducing blood loss, operation time, postoperative pain, or fracture healing time of the surgery and in improving recovery of muscle strength. Concerning complications, no significant difference was seen between MIPO and ORIF. Conclusion. The MIPO was more suitable than ORIF for treating proximal humeral fracture in elder patients.

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