scholarly journals Anterior Dislocation of the Radial Head Combined with Plastic Deformity of the Ulnar Shaft in an Adult: A Case Report

2018 ◽  
Vol 21 (1) ◽  
pp. 42-47
Author(s):  
Sang Won Moon ◽  
Youngbok Kim ◽  
Young Chang Kim ◽  
Ji Wan Kim ◽  
Taiyeon Yoon ◽  
...  

A 25-year-old woman presented to the emergency room with a painful and swollen right forearm. She had just sustained an injury from an accident during which her arm was tightly wound by a rope as she was lowering a net from a fishing boat. Before being released, her arm was rigidly trapped in the rope for approximately ten minutes. Radiographs revealed anterior dislocation of the radial head that was accompanied by plastic deformation of the proximal ulna, manifested as a reversal of the proximal dorsal angulation of the ulna (PUDA); suggested a Monteggia equivalent fracture. With the patient under general anesthesia, we reduced the radial head by posterior compression at 90° of elbow flexion and at neutral rotation of the forearm. However, the reduction was easily lost and the elbow re-dislocated with even slight supination or extension of the arm. After the osteotomy of the ulnar deformity to restore the PUDA to normal, the reduction remained stable even with manipulation of the arm. We found that the patient could exercise a full range of motion without pain at the 3-month follow-up, and neither residual instability nor degenerative changes were observed at the final 3-year follow-up.

2021 ◽  
Vol 11 (7) ◽  
Author(s):  
Matevž Topolovec ◽  
Ingrid Milošev ◽  
Andrej Cör

Introduction: Revisions due to the fracture of ceramic-on-ceramic (CoC) bearing are rare, however when they occur, they represent a major challenge to an orthopedic surgeon for ensuring safe and long-term survival of the replaced bearing. Case Report: We present a case of fractured ceramic liner of total hip prosthesis that underwent revision to a metal-on-polyethylene (MoP) bearing couple, with consequent huge periprosthetic metallosis. Shortly after, the second revision operation followed using the third bearing couple of ceramic-on-polyethylene (CoP). At 10 years follow-up after the operation due to ceramic fracture, the patient is now pain free with full range of motion of the revised hip. Conclusion: Establishment of diagnostic routes and recommended protocols for CoC bearing fracture would allow easier recognition of potential fracture and diminish its consequences for the patients. Keywords: Tribology, Revision Hip Arthroplasty, Ceramic Bearing Fracture.


Author(s):  
Ashish Devgan ◽  
Umesh Yadav ◽  
Rajesh Rohilla ◽  
Pankaj Sharma ◽  
Varun Goel ◽  
...  

<p class="abstract">Surgical procedures for recurrent anterior dislocation of the shoulder include using capsuloligamentous or bone blocks to create barriers and active interventions using muscle actions. Fracture of glenoid acts as a barrier for bone block procedures. Boytchev procedure, though outmoded, yet acts as simple and effective procedure in this condition. Here we report a 44 year old male with recurrent anterior dislocation with glenoid fracture treated by Boytchev procedure. The patient is on regular follow up since 3 years with no episode of shoulder dislocation till now with full range of movements. To conclude, Boytchev procedure is technically simple and effective method in patients with recurrent anterior shoulder dislocation with fracture of glenoid.</p>


2019 ◽  
Vol 47 (14) ◽  
pp. 3491-3497 ◽  
Author(s):  
Pascual H. Dutton ◽  
Michael B. Banffy ◽  
Trevor J. Nelson ◽  
Melodie F. Metzger

Background: Although numerous techniques of reconstruction of the medial ulnar collateral ligament (mUCL) have been described, limited evidence exists on the biomechanical implication of changing the ulnar tunnel position despite the fact that more recent literature has clarified that the ulnar footprint extends more distally than was appreciated in the past. Purpose: To evaluate the size and location of the native ulnar footprint and assess valgus stability of the medial elbow after UCL reconstruction at 3 ulnar tunnel locations. Study Design: Controlled laboratory study. Methods: Eighteen fresh-frozen cadaveric elbows were dissected to expose the mUCL. The anatomic footprint of the ulnar attachment of the mUCL was measured with a digitizing probe. The area of the ulnar footprint and midpoint relative to the joint line were determined. Medial elbow stability was tested with the mUCL in an intact, deficient, and reconstructed state after the docking technique, with ulnar tunnels placed at 5, 10, or 15 mm from the ulnotrochlear joint line. A 3-N·m valgus torque was applied to the elbow, and valgus rotation of the ulna was recorded via motion-tracking cameras as the elbow was cycled through a full range of motion. After kinematic testing, specimens were loaded to failure at 70° of elbow flexion. Results: The mean ± SD length of the mUCL ulnar footprint was 27.4 ± 3.3 mm. The midpoint of the anatomic footprint was located between the 10- and 15-mm tunnels across all specimens at a mean 13.6 mm from the joint line. Sectioning of the mUCL increased elbow valgus rotation throughout all flexion angles and was statistically significant from 30° to 100° of flexion as compared with the intact elbow ( P < .05). mUCL reconstruction at all 3 tunnel locations restored stability to near intact levels with no significant differences among the 3 ulnar tunnel locations at any flexion angle. Conclusion: Positioning the ulnar graft fixation site up to 15 mm from the ulnotrochlear joint line does not significantly increase valgus rotation in the elbow. Clinical Relevance: A more distal ulnar tunnel may be a viable option to accommodate individual variation in morphology of the proximal ulna or in a revision setting.


Hand ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. NP166-NP169 ◽  
Author(s):  
Michael T. Edgerton ◽  
Robert C. Kollmorgen

Background: Triangular fibrocartilage complex (TFCC) injuries are a known cause of ulnar-sided wrist pain. Wrist arthroscopy is the gold standard for diagnosis of these lesions and is becoming a more frequent method of treatment. Isolated radial-sided tears are uncommon and treatment of these lesions is controversial. There are few reports on repair techniques. Here we report on a novel arthroscopic, all-inside technique for traumatic radial-sided TFCC tears that resulted in full range of motion, significant improvement in pain, and ultimately return to sport. Methods: This is a single case report describing an all-inside, arthroscopic repair of a radial-sided TFCC tear. The techniques and postoperative protocol are discussed. Clinical outcomes were reported at final follow-up of 3.5 months. Results: At final follow-up, our patient had full wrist range of motion, 95% strength, occasional 1/10 pain, and returned to sport at her previous level of play. There were no complications. Conclusion: Although just a single case report, our patient had an excellent result based on modified Mayo wrist score. When comparing our result and the previous literature, this technique seems to be a valid method for addressing radial-sided TFCC tears.


2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Taku Hatta ◽  
Kiyotsugu Shinagawa ◽  
Kou Hayashi ◽  
Kazushige Hasegawa ◽  
Yoshinori Miyasaka ◽  
...  

Isolated recurrent dislocation of the radial head (RH) is very rare, and there have been few reports describing the surgical treatment of this injury. We herein report the case of a 13-year-old girl who underwent ligament reconstruction surgery for isolated recurrent RH dislocation. Her symptoms included pain and apprehension at the elbow with the forearm in supination. A radiologic examination revealed anterior dislocation of the RH with the forearm in supination but complete reduction with the forearm in neutral to pronated positions. Surgical treatment to reconstruct the annular ligament and facilitate the radial collateral ligament was performed using an autograft with internal brace augmentation. At a 12-month follow-up examination, the patient had asymptomatic stability with recovery to sports activities. This case report describes a novel technique for the treatment of a rare pathological condition of the elbow.


2005 ◽  
Vol 14 (5) ◽  
pp. 554-556 ◽  
Author(s):  
Kota Watanabe ◽  
Shohei Iwabu ◽  
Toshihiko Hosoya

2021 ◽  
Vol 27 (3) ◽  
pp. 319-321
Author(s):  
K. Li ◽  
◽  
S. Rong ◽  
C. Zheng ◽  
Y. Teng ◽  
...  

Objective To evaluate the use of Ilizarov external mini-fixation in the treatment of Monteggia fractures (dislocation of the radial head with an associated fracture of the proximal ulna) in children. Methods Children with proximal ulnar fracture were included and underwent fracture reduction surgery with Ilizarov external mini-fixators, followed by immobilization of the supinated forearm with plaster. The reduction was evaluated intra-operatively using arthrography. Mackay criteria were used to evaluate clinical outcomes at follow-up. Results A total of 15 children were included in the study. Mackay efficacy was 100 %, indicating excellent outcomes using the Ilizarov external mini-fixator. Conclusion Use of the Ilizarov external mini–fixator is particularly suitable in the treatment of children with comminuted and compression fractures of proximal ulna. It is easy to operate, low invasive and is worthy of promotion.


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