Open reduction and posterior instrumentation of Type 3 high transverse sacral fracture-dislocation

2014 ◽  
Vol 21 (2) ◽  
pp. 286-291 ◽  
Author(s):  
Konstantinos A. Starantzis ◽  
Babak Mirzashahi ◽  
Eyal Behrbalk ◽  
Mirmostafa Sadat ◽  
Masood Shafafy
Keyword(s):  
Open Reduction ◽  
Posterior Approach ◽  
Sagittal Alignment ◽  
Posterior Instrumentation ◽  
Sacral Fracture ◽  
Fracture Dislocation ◽  
Sacral Fractures ◽  
Posterior Translation ◽  
Type 3 ◽  
First Time

The authors describe an open reduction and fixation through a posterior approach of Roy-Camille Type 3 transverse sacral fractures. This technique involves posterior staged reduction of the fracture applying distraction forces to restore the height, followed by posterior translation to restore sagittal alignment. Tips and pearls of this procedure, described for the first time in the literature, are also discussed in this report.

scholarly journals Treatment of subacute thoracic spine fracture-dislocation by total vertebrectomy and spine shortening

2013 ◽  
Vol 18 (2) ◽  
pp. 194-200 ◽  
Author(s):  
Alecio C. E. S. Barcelos ◽  
Ricardo V. Botelho
Keyword(s):  
Posterior Approach ◽  
Posterior Instrumentation ◽  
Complete Recovery ◽  
Current Treatment ◽  
Fracture Dislocation ◽  
Fracture Dislocations ◽  
Thoracic Spine Fracture ◽  
Surgical Teams ◽  
Anterior Support ◽  
Vertebral Resection

Vertebral resection with spine shortening has been primarily reported for the treatment of demanding cases of nontraumatic disorders. Recently, this technique has been applied to the treatment of traumatic disorders. The current treatment of vertebral fracture-dislocation when there is partial or total telescoping of the involved vertebrae is a combined anterior-posterior approach with corpectomy, anterior support implant, and further posterior instrumentation. These procedures usually require 2 surgical teams, involve longer operating times and greater risk of surgical complications related to the anterior approach, and commonly entail longer postoperative care before discharge. The authors report on 2 patients with high thoracic fracture-dislocations with telescoping (T-2 and T-4) who were treated in the subacute phase with total spondylectomy (T-3 and T-5, respectively) and spine shortening by using only a posterior approach. Complete recovery of the sagittal balance was achieved with this technique and the postoperative periods were clinically uneventful. One patient presented with asymptomatic hemothorax that did not require drainage. In paraplegic patients with anterior thoracic dislocation fractures in which one vertebral body blocks the reduction of the other, total spondylectomy and spine shortening seem to be a reasonably safe and effective technique.

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.

Maisonneuve fracture

2020 ◽  
Vol 99 (2) ◽  
pp. 77-85
Keyword(s):  
Open Reduction ◽  
Lower Leg ◽  
Fracture Dislocation ◽  
Deltoid Ligament ◽  
Ct Reconstruction ◽  
Distal Fibula ◽  
Ct Examination ◽  
Maisonneuve Fracture ◽  
Fibular Fracture ◽  
Wide Range

Introduction: Maisonneuve fracture (MF) is a generally known entity in ankle trauma. However, details about this type of injury can be found only rarely in the literature. For these reasons we have decided to perform a study on MF epidemiology and pathoanatomy. Methods: The group comprised 70 patients (47 men, 23 women), with the mean age of 48 years, who sustained an ankle fracture-dislocation involving the proximal quarter of the fibula. Ankle radiographs in three views and lower leg radiographs in two views were performed in all patients. A total of 59 patients underwent CT examination in three views, including 3D CT reconstruction in 49 of these patients. MRI was performed in 4 patients. Operative treatment was used in 67 patients; open reduction of the distal fibula into the fibular notch was opted for in 54 of them. Results: The highest MF incidence rate was recorded in the 5th decade in the whole group and in men, while in women the peak incidence was in the 6th decade. After the age of 50, the share of women significantly increased. In 64 cases, the fibular fracture was subcapital, and in 6 cases it involved the fibular head. In 24% of the patients, the fibular fracture was seen only in the lateral radiograph of the lower leg. Widening of the tibiofibular clear space was shown by radiographs in 40 cases. Posterior dislocation of the fibula (Bosworth fracture) and tibiofibular diastasis were recorded in 2 cases each. An injury to the anterior and posterior tibiofibular ligaments was found in all 54 patients with open reduction of the distal fibula. A fracture of the medial malleolus was identified in 27 cases (39%) and a complete lesion of the deltoid ligament in 36 cases (51%); in 7 cases (10%) the medial structures were intact. A fracture of the posterior malleolus occurred in 54 (77%) patients. Osteochondral fracture of the talar dome was diagnosed in 2 patients and compression of the articular surface of the distal tibia in the region of the fibular notch in 1 patient. Conclusion: Maisonneuve fracture includes a wide range of injuries both to bone and ligamentous structures of the ankle. Therefore, CT examination is an indispensable part of assessment of this type of fracture.

scholarly journals Nascent Malunion of an Isolated Intraarticular Fracture of the Ulnar Head

2019 ◽  
Vol 09 (03) ◽  
pp. 240-243
Author(s):  
Frank Nienstedt ◽  
Markus Mariacher ◽  
Günther Stuflesser ◽  
Wilhelm Berger
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Excellent Result ◽  
Corrective Osteotomy ◽  
Fracture Dislocation ◽  
Intraarticular Fracture ◽  
Ulnar Head ◽  
Ulnar Styloid Fracture ◽  
Palmar Approach

Abstract Background Isolated fractures of the ulnar head are rare. Only few cases have been reported in literature. Case Description We report a case of a 16-year-old student who was treated for an ulnar styloid fracture conservatively. An associated displaced intraarticular fracture of the ulnar head has been overlooked. He presented late in our clinic with a symptomatic nascent malunion of the ulnar head fracture. A corrective osteotomy by a palmar approach was performed. Fixation by screws was used with an excellent result at 7-year follow-up. Literature Review The rare cases of isolated ulnar head fractures reported in literature were treated by open reduction and internal fixation only in case of fracture dislocation. Clinical Relevance The authors highlight the fact that even a nascent malunion of an isolated intraarticular fracture of the ulnar head may be treated successfully by open reduction and internal fixation.

Results of Treatment of Chronic Dorsal Fracture-Dislocations of the Proximal Interphalangeal Joints of the Fingers

1998 ◽  
Vol 23 (6) ◽  
pp. 798-801 ◽  
Author(s):  
O. ISHIDA ◽  
Y. IKUTA
Keyword(s):  
Articular Cartilage ◽  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Results Of Treatment ◽  
Palmar Plate ◽  
Fracture Dislocations

We reviewed 20 cases of chronic dorsal fracture-dislocation of the proximal interphalangeal joint, with a mean follow-up period of 74 months. In patients without comminuted palmar fragments, open reduction and internal fixation or osteotomy of the malunited fragment provided good results. In treating patients with damaged articular cartilage or with comminuted palmar fragments by palmar plate arthroplasty, poor results were obtained because of secondary osteoarthritic changes.

scholarly journals Transtrapezial Peritrapezoidal Transcapital Axial Radial Fracture Dislocation of the Carpus

Hand ◽  
2009 ◽  
Vol 4 (3) ◽  
pp. 319-322 ◽  
Author(s):  
Jürg Häcki ◽  
Ladislav Nagy ◽  
Andreas Schweizer
Keyword(s):  
Internal Fixation ◽  
Range Of Motion ◽  
Open Reduction ◽  
Dislocation Line ◽  
Fracture Dislocation ◽  
Radial Fracture ◽  
Unique Pattern

We report a unique pattern of an axial radial fracture dislocation of the carpus. The fracture dislocation line runs transtrapezial peritrapezoidal transcapital transmetacarpal III/IV. Open reduction and internal fixation was performed 11 days after the accident. The result at 9 months is moderate, with a range of motion of 63% and strength of 46% compared to the opposite side.

scholarly journals Natural course of spontaneously reduced lumbo-sacral fracture-dislocation--a case report

1993 ◽  
Vol 8 (5) ◽  
pp. 390 ◽  
Author(s):  
Kyeong Seok Lee ◽  
Wong Kyong Bae ◽  
Hack Gun Bae ◽  
Il Gyu Yun
Keyword(s):  
Case Report ◽  
Sacral Fracture ◽  
Natural Course ◽  
Fracture Dislocation

scholarly journals Delayed Peroneal Neuropathy After Bosworth Fracture Dislocation of the Ankle

2021 ◽  
Vol 111 (4) ◽  
Author(s):  
Sung Hoon Choi ◽  
Jeong Min Hur ◽  
Kyu-Tae Hwang
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Fracture Dislocation ◽  
Tibial Tubercle ◽  
Proximal Fragment ◽  
Rare Injury ◽  
Soft Tissue Swelling ◽  
Severe Soft Tissue

The Bosworth ankle fracture-dislocation is a rare injury and is often irreducible because of an entrapped proximal fragment of the fibula behind the posterior tibial tubercle. Repeated closed reduction or delayed open reduction may result in several complications. Thus, early open reduction and internal fixation enable a better outcome by minimizing soft-tissue damage. We report on a 27-year-old man who underwent open reduction and internal fixation after multiple attempts at failed closed reduction, complicated by severe soft-tissue swelling, rhabdomyolysis, and delayed peroneal nerve palsy around the ankle.

Fractures and Fracture Dislocations of the Midfoot: Occurrence, Causes and Long-term Results

2001 ◽  
Vol 22 (5) ◽  
pp. 392-398 ◽  
Author(s):  
Martinus Richter ◽  
Burkhard Wippermann ◽  
Christian Krettek ◽  
Hanns Eberhard Schratt ◽  
Tobias Hufner ◽  
...  
Keyword(s):  
Open Reduction ◽  
Traffic Accidents ◽  
Fracture Dislocation ◽  
Long Term Results ◽  
Treatment Optimization ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Fracture Dislocations

Etiology and outcome of 155 patients with midfoot fractures between 1972 and 1997 were analyzed to create a basis for treatment optimization. Cause of injuries were traffic accidents (72.2%), falls (11.6%), blunt injuries (7.7%) and others (5.8%). Isolated midfoot fractures (I) were found in 55 (35.5%) cases, Lisfranc fracture dislocations (L) in 49 (31.2%), Chopart-Lisfranc fracture dislocations (CL) in 26 (16.8%) and Chopart fracture dislocations (C) in 25 (16%). One hundred and forty eight (95%) of the midfoot fractures were treated operatively; 30 with closed reduction, 115 with open reduction, 3 patients had a primary amputation. Seven (5%) patients were treated non-operatively. Ninety seven (63%) patients had follow-up at an average of 9 (1.3–25, median 8.5) years. The average scores of the entire follow-up group were as follows: AOFAS – sum of all four sections (AOFAS-ET): 296, AOFAS-Midfoot (AOFAS-M): 71, Hannover Scoring System (HSS): 65, and Hannover Questionnaire (Q): 63. Regarding age, gender, cause, time from injury to treatment and method of treatment no score differences were noted (t-test: p > 0.05). L, C or I showed similar scores and CL significantly lower scores (AOFAS-ET, AOFAS-M, HSS, Q). The highest scores in all groups were achieved in those fractures treated with early open reduction and operative fixation. Midfoot fractures, particularly fracture dislocation injuries, effect the function of the entire foot in the long-term outcome. But even in these complex injuries, an early anatomic (open) reduction and stable (internal) fixation can minimize the percentage of long-term impairment.

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