Luxación esternoclavicular posterior

Resumen La luxación esternoclavicular posterior es una patología extremadamente infrecuente, que se presenta, sobre todo, en varones jóvenes como consecuencia de un traumatismo de alta energía. Hasta en un 25% de los casos pueden aparecer complicaciones potencialmente letales por compresión de estructuras mediastínicas, que requieren de la reducción urgente de la luxación. El diagnóstico radiográfico puede ser difícil, siendo de gran utilidad la tomografía computerizada para determinar el tipo y grado de desplazamiento, así como la relación anatómica con las estructuras mediastínicas. Se presenta el caso de una paciente de 14 años de edad que presentó una luxación esternoclavicular posterior traumática aguda tras una caída practicando karate. Abstract Posterior sternoclavicular joint dislocation is an extremely rare condition, usually seen in males after high energy concussion. Potentially lethal complications may appear in 25% of cases, due to compression of mediastinic structures. Radiological diagnose may be difficult, why computed tomography is usually used to determine type and grade of displacement and relation with mediastinic structures. We present a case of a 14 year-old woman who presented a posterior sternoclavicular dislocation due to a fall while playing karate. Resumo A luxação posterior esternoclavicular é a condição extremamente rara, que ocorre principalmente em homens jovens, como resultado de trauma de alta impacto. Em até 25% dos casos, podem acontecer complicações potencialmente fatais por compressão de estruturas do mediastino, que exigem a redução urgente da luxação. O diagnóstico radiográfico pode ser difícil, sendo a tomografia computadorizada considerada útil para determinar o tipo e grau de deslocamento e a relação anatômica com as estruturas do mediastino. Aqui se apresenta o caso de um jovem de 14 anos que apresentou uma luxação esternoclavicular posterior traumática aguda após uma queda durante a prática de karatê.

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Computed Tomography with Stress Maneuver to Demonstrate Sternoclavicular Joint Dislocation

Journal of Computer Assisted Tomography ◽

10.1097/00004728-199001000-00036 ◽

1990 ◽

Vol 14 (1) ◽

pp. 159-160 ◽

Cited By ~ 10

Author(s):

Mark I. Burstein ◽

Myron A. Pozniak

Keyword(s):

Computed Tomography ◽

Sternoclavicular Joint ◽

Joint Dislocation

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Posterior Sternoclavicular Joint Dislocation in Children-Role of Spiral Computed Tomography

Pediatric Emergency Care ◽

10.1097/01.pec.0000159068.17197.8e ◽

2005 ◽

Vol 21 (5) ◽

pp. 325-326 ◽

Cited By ~ 10

Author(s):

Arockia Doss ◽

Isla M. Lang ◽

Iwan Roberts ◽

M.J. Bell ◽

T.W.D. Smith

Keyword(s):

Computed Tomography ◽

Sternoclavicular Joint ◽

Spiral Computed Tomography ◽

Spiral Computed ◽

Joint Dislocation

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Repair of Unstable Posterior Sternoclavicular Dislocation Using Nonabsorbable Tape Suture and Tension Band Technique: A Case Report with Good Results

Case Reports in Orthopedics ◽

10.1155/2015/750898 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

Ekrem Aydın ◽

Turan Cihan Dülgeroğlu ◽

Ali Ateş ◽

Hasan Metineren

Keyword(s):

Closed Reduction ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Rare Condition ◽

Sternoclavicular Joint ◽

Tension Band ◽

Imaging Studies ◽

Vehicle Accident ◽

Sternoclavicular Dislocation ◽

Tension Band Technique

Posterior sternoclavicular joint dislocation (PSCJD) is quite a rare condition. Nearly half of the closed reduction attempts fail due to various reasons. In this paper, we present a 25-year-old male patient who was admitted to the emergency department in our hospital after having a motor-vehicle accident. It was decided to do PSCJD after physical and imaging studies. Following necessary preparations, closed reduction was attempted with abduction-traction maneuver under general anesthesia; however, adequate stabilization could not be achieved and redislocation was detected during control. Therefore, joint was stabilized with tension band technique using 6 mm polyamide nonabsorbable type suture during open reduction. Painless and complete range of motion in shoulder was achieved at the postoperative 10th week.

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Posterior sternoclavicular joint dislocation: case report and discussion

CJEM ◽

10.1017/s148180350001407x ◽

2006 ◽

Vol 8 (05) ◽

pp. 355-357 ◽

Cited By ~ 6

Author(s):

Nick Kuzak ◽

Adrian Ishkanian ◽

Riyad B. Abu-Laban

Keyword(s):

Emergency Department ◽

Case Report ◽

Signs And Symptoms ◽

Sternoclavicular Joint ◽

Joint Dislocation ◽

Joint Dislocations ◽

Posterior Neck ◽

Sternoclavicular Dislocation

ABSTRACTThe sternoclavicular joint is the most frequently mobilized non-axial, major joint, but is the least frequently dislocated. Most sternoclavicular dislocations are anterior. When posterior sternoclavicular joint dislocations do occur, they may present with a variety of signs and symptoms, including serious intrathoracic injuries. We discuss the case of a patient with a subacute posterior sternoclavicular dislocation who presented to the emergency department 2 months after being hit in the posterior neck. We also review the signs, symptoms and management of posterior sternoclavicular dislocation and the literature on this topic.

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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

10.21203/rs.2.19896/v1 ◽

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.

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Debut de lupus eritematoso sistémico en paciente masculino

Mediciencias UTA ◽

10.31243/mdc.uta.v4i1.322.2020 ◽

2020 ◽

Vol 4 (1) ◽

pp. 55

Author(s):

Jair Albán Recalde ◽

Andrés Jácome Sánchez ◽

Danny Trujillo Medina ◽

Mateo Sánchez Villaroel

Keyword(s):

Las Mujeres ◽

Para Determinar ◽

Sobre Todo

Introducción: El lupus eritematoso sistémico (LES) es una enfermedad multisistémica inflamatoria crónica y autoinmune que produce anticuerpos antinucleares, misma que es capaz de afectar cualquier órgano, su prevalencia es mayor en las mujeres sobre todo en edad fértil que en hombres con una relación 9:1. Su presentación clínica es insidiosa y variable desde lesiones cutáneas típicas como el eritema malar hasta alteraciones sistémicas cardíacas, pulmonares o renales. Su diagnóstico se enfoca en la clínica más la determinación de Anticuerpos antinucleares y de varios anticuerpos y exámenes de laboratorio, así como de imagen para determinar la presencia de otras complicaciones. Objetivo: Aplicar los conocimientos teóricos del Lupus eritematoso sistémico para analizar el caso clínico del debut de un paciente masculino de 60 años. Material y métodos: Estudio descriptivo retrospectivo, presentación de caso clínico. Resultados: Se presenta un caso clínico de un paciente masculino de 60 años de edad que presentó un síndrome coronario agudo, acompañado de lesiones dérmicas y pérdida de peso que después de varias sospechas diagnósticas se confirmó el diagnóstico de LES. Conclusiones: A pesar de la prevalencia más frecuente del LES en mujeres jóvenes; esta patología puede presentarse en varones mayores de 50 años y su sospecha diagnóstica debe estar presente en pacientes que presenten características clínicas insidiosas de LES ya que su diagnóstico temprano puede evitar las complicaciones sistémicas que esta patología puede desarrollar si no se da el tratamiento adecuado

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Programming Effect of the Parental Obesity on the Skeletal System of Offspring at Weaning Day

Animals ◽

10.3390/ani11020424 ◽

2021 ◽

Vol 11 (2) ◽

pp. 424

Author(s):

Radoslaw Piotr Radzki ◽

Marek Bienko ◽

Dariusz Wolski ◽

Monika Ostapiuk ◽

Pawel Polak ◽

...

Keyword(s):

Computed Tomography ◽

Bone Mineral ◽

High Energy ◽

Diet Group ◽

Male Rats ◽

Bending Test ◽

Male Rat ◽

Skeletal System ◽

Mineral Density ◽

Trabecular Thickness

Our study aimed to verify the hypothesis of the existence of a programming effect of parental obesity on the growth, development and mineralization of the skeletal system in female and male rat offspring on the day of weaning. The study began with the induction of obesity in female and male rats of the parental generation, using a high-energy diet (group F). Females and males of the control group received the standard diet (group S). After 90 days of dietary-induced obesity, the diet in group F was changed into the standard. Rats from groups F and S were mated to obtain offspring which stayed with their mothers until 21 days of age. Tibia was tested using dual-energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT), micro-computed tomography (µCT) and mechanical strength using the three-point bending test. Biochemical analysis of blood serum bone metabolism markers was performed. DXA analysis showed higher tibia bone mineral content (BMC) and area. pQCT measurements of cortical and trabecular tissue documented the increase of the volumetric bone mineral density and BMC of both bone compartments in offspring from the F group, while µCT of the trabecular tissue showed an increase in trabecular thickness and a decrease of its separation. Parental obesity, hence, exerts a programming influence on the development of the skeletal system of the offspring on the day of the weaning, which was reflected in the intensification of mineralization and increased bone strength.

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Computed tomography angiography and microsurgical flaps for traumatic wounds: What is the added value?

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-200986 ◽

2021 ◽

pp. 1-9

Author(s):

Lucas Sousa Macedo ◽

Renato Polese Rusig ◽

Gustavo Bersani Silva ◽

Alvaro Baik Cho ◽

Teng Hsiang Wei ◽

...

Keyword(s):

Computed Tomography ◽

Upper Limb ◽

Computed Tomography Angiography ◽

Lower Limb ◽

High Energy ◽

Lower Limbs ◽

Added Value ◽

Vascular Lesions ◽

Limb Injuries ◽

Significant Difference

BACKGROUND: Microsurgical flaps are widely used to treat complex traumatic wounds of upper and lower limbs. Few studies have evaluated whether the vascular changes in preoperative computed tomography angiography (CTA) influence the selection of recipient vessel and type of anastomosis and the microsurgical flaps outcomes including complications. OBJECTIVE: The aim of this study was to evaluate if preoperative CTA reduces the occurrence of major complications (revision of the anastomosis, partial or total flap failure, and amputation) of the flaps in upper and lower limb trauma, and to describe and analyze the vascular lesions of the group with CTA and its relationship with complications. METHODS: A retrospective cohort study was undertaken with all 121 consecutive patients submitted to microsurgical flaps for traumatic lower and upper limb, from 2014 to 2020. Patients were divided into two groups: patients with preoperative CTA (CTA+) and patients not submitted to CTA (CTA–). The presence of postoperative complications was assessed and, within CTA+, we also analyzed the number of patent arteries on CTA and described the arterial lesions. RESULTS: Of the 121 flaps evaluated (84 in the lower limb and 37 in the upper limb), 64 patients underwent preoperative CTA. In the CTA+ group, 56% of patients with free flaps for lower limb had complete occlusion of one artery. CTA+ patients had a higher rate of complications (p = 0.031), which may represent a selection bias as the most complex limb injuries and may have CTA indicated more frequently. The highest rate of complications was observed in chronic cases (p = 0.034). There was no statistically significant difference in complications in patients with preoperative vascular injury or the number of patent arteries. CONCLUSIONS: CTA should not be performed routinely, however, CTA may help in surgical planning, especially in complex cases of high-energy and chronic cases, since it provides information on the best recipient artery and the adequate level to perform the microanastomosis, outside the lesion area.

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