A Complex Variant of Lisfranc Joint Complex Injury

2009 ◽  
Vol 99 (4) ◽  
pp. 359-363 ◽  
Author(s):  
Güven Bulut ◽  
Davud Yasmin ◽  
Nurettin Heybeli ◽  
Hüseyin Yener Erken ◽  
Muzaffer Yildiz
Keyword(s):  
Unusual Case ◽  
Pain Syndrome ◽  
Recovery Process ◽  
Fracture Dislocation ◽  
Kirschner Wires ◽  
Lisfranc Injury ◽  
Medial Cuneiform ◽  
Pin Tract Infection ◽  
Plantar Dislocation

We report an unusual case of a variant of Lisfranc injury, plantar dislocation of the medial cuneiform with plantar fracture-dislocation of the intermediate cuneiform and dorsal fracture-dislocation of the lateral cuneiform, which has never been reported, to our knowledge. The entire pathologic abnormality was treated by open reduction and fixation with Kirschner wires, which were removed 8 weeks postoperatively because of pin-tract infection. Complex regional pain syndrome, which was a problem early in the recovery process, is now in remission, and at the 25-month follow-up examination, the patient was almost symptom free. (J Am Podiatr Med Assoc 99(4): 359–363, 2009)

scholarly journals Bilateral symmetrical anterior fracture dislocation of shoulder

2020 ◽  
Vol 6 (3) ◽  
pp. 635
Author(s):  
Yogendra Kumar ◽  
Shashi Kul Bhaskar ◽  
Bharti Lal ◽  
Vijendra Gahnolia
Keyword(s):  
Unusual Case ◽  
Open Reduction Internal Fixation ◽  
Fracture Dislocation ◽  
Seizure Disorders ◽  
Shoulder Joints ◽  
Fracture Dislocations ◽  
Bilateral Fracture ◽  
Seizure Episode ◽  
Anterior Direction

<p>The incidence of simultaneous bilateral shoulder joint dislocation is rare and is almost always posterior usually caused by violent muscle contraction as in patients with seizure disorders or who experience electric shock or undergo electroconvulsive therapy. simultaneous bilateral fracture-dislocation is even rarer, with a few cases reported in the literature. We report an unusual case with dislocation of the both shoulder joints in anterior direction after a seizure episode, With symmetrical unifocal 2-part extraarticular vertical fracture of proximal end segment of humerus (11A3) both sides. Although there have been a few reports of bilateral symmetrical fracture dislocations of the shoulder in the past, an injury pattern resembling our case has, to the best of our knowledge, not been described in the literature so far. Our report describes regarding the mechanism of injury in a case of a bilateral symmetrical anterior fracture dislocation following a seizure episode that treated with open reduction internal fixation using proximal humerus internal locking system (PHILOS). At final follow-up, the patient had healed fractures, painless near normal range of motion.</p>

A Unique Case of Isolated Lateral Epicondyle Fracture in an Adolescent Boy

2020 ◽  
Author(s):  
Monir Najafi Pirasteh ◽  
Ehsan Seif ◽  
Arvin Najaf ◽  
Salman Azarsina
Keyword(s):  
Closed Reduction ◽  
Treatment Approach ◽  
Rare Condition ◽  
Fracture Dislocation ◽  
Kirschner Wires ◽  
Unique Case ◽  
Lateral Epicondyle ◽  
K Wires ◽  
The Stability

Background: The lateral epicondyle fracture in children is a rare condition and only few cases have been reported in the literature. The isolated fracture without concomitant fracture/dislocation is even more uncommon, with unclear outcome and treatment approach. Case Report: We present a case of an 11-year-old boy with restricted right elbow range of motion (ROM) after falling. The radiograph and computed tomography (CT) scan showed a displaced lateral epicondyle fracture without accompanying fracture or dislocation. Due to the stability of the joint and patient’s compliance, a closed reduction with Kirschner wires (K-wires) was selected for treatment. Follow-up results were satisfactory and showed no complications. Conclusion: Closed reduction of dislocated lateral epicondyle fracture in children can result in acceptable outcomes.

scholarly journals Outcome assessment of two stage reduction and fixation in neglected trans scaphoid peri lunate fracture dislocation

2018 ◽  
Vol 4 (6) ◽  
pp. 904
Author(s):  
Ratan Lal Dayma ◽  
Rahul Temani ◽  
Prashant Modi ◽  
Vijay Prakash Yadav ◽  
Jitesh Jain
Keyword(s):  
High Energy ◽  
Routine Activity ◽  
Fracture Dislocation ◽  
Medical College ◽  
Post Surgery ◽  
Radiocarpal Joint ◽  
Pin Tract Infection ◽  
Midcarpal Joint ◽  
Joint Arthritis

<p class="abstract"><strong>Background:</strong> Perilunate instability is a type of carpal instability complex. Perilunate injuries occur after high-energy traumas to the wrist or falls on the outstretched hand.</p><p class="abstract"><strong>Methods:</strong> The hospital based prospective study was held in the department of Orthopaedics, SMS medical college and Hospital, Jaipur from April 2016 to November 2017. It included 25 cases of neglected trans scaphoid peri lunate fracture dislocation treated in 2 stages surgical procedures.<strong></strong></p><p class="abstract"><strong>Results:</strong> Median nerve was involved in 6 (24%) patients. Pain was also graded as subjective pain. Most of patients had pain free wrist at 1 year follow up post surgery while 2 patients had pain on routine activity, 5 patients had pain on sternous activity and pain was permanent in 1 patient. Mean scapholunate and radiolunate angles were 54 degrees (range 40 to 60 degrees) and 9.8 degrees (range 5 to 15 degrees) on the immediate postoperative radiographs and 54.8 degrees (range 40 to 65 degrees) and 10.6 degrees (5 to 20 degrees) at 1 years follow up. Mild degenerative changes were seen in the radiocarpal joint in 3 patients and in midcarpal joint in 4 patients one patient had both radiocarpal joint arthritis and midcarpal joint arthritis two patients developed superficial pin tract infection.</p><p class="abstract"><strong>Conclusions:</strong> On the basis of our study we finally conclude staged reduction should be considered for neglected trans scaphoid peri lunate dislocations.</p>

scholarly journals Volar Buttress Plating for Unstable Dorsal Fracture-Dislocations of the Proximal Interphalangeal Joint

2019 ◽  
Vol 11 (02) ◽  
pp. 106-110 ◽  
Author(s):  
Talvinder Singh ◽  
Roshenka Jayawardhana ◽  
Michael Craigen ◽  
Vaikunthan Rajaratnam
Keyword(s):  
Articular Surface ◽  
Pain Syndrome ◽  
Hand Surgery ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Bony Union ◽  
Superficial Infection ◽  
Early Return

AbstractThe authors present a series of 11 patients. All of them sustained an unstable dorsal fracture-dislocation of the proximal interphalangeal joint (PIPJ). These were managed with open reduction and internal fixation (ORIF) by use of an eight-hole, 1.3-mm oblique-angled strut plate, cut to shape to produce a four-hole plate, acting as a buttress plate. The operations were performed by orthopaedic surgeons with a special interest in hand surgery. Range of motion (ROM) and fixed flexion deformity (FFD) were measured postoperatively. Outcomes were assessed using the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) scoring system. Bony union, articular step-off, degenerative changes, persistent subluxation, or dislocation were confirmed by review of radiographs at latest follow-up. One patient developed a superficial infection and another developed complex regional pain syndrome. However, all patients were pain free at final follow-up. Radiographs at final follow-up confirmed bony union with no step-off, except for one patient who had a 1-mm step-off of the articular surface. Our attractive and novel technique of ORIF allows articular congruity to be restored anatomically with early active mobilization of the affected digit and early return to function.

Impact of the Subtle Lisfranc Injury on Foot Structure and Function

2021 ◽  
pp. 107110072110129
Author(s):  
Daniel Garríguez-Pérez ◽  
María Puerto-Vázquez ◽  
José Luis Tomé Delgado ◽  
Enrique Galeote ◽  
Fernando Marco
Keyword(s):  
Chronic Pain ◽  
Case Series ◽  
Pain Syndrome ◽  
Level Of Evidence ◽  
Lisfranc Injury ◽  
Foot Arch ◽  
Foot Function ◽  
K Wires ◽  
American Orthopaedic

Background: The subtle Lisfranc injury is the disruption of the osteoligamentary complex between the first cuneiform and the second metatarsal, resulting in minor widening of this space that is often difficult to detect with plain radiographs. In this study, we assessed the results after treatment of the different stages of subtle Lisfranc injuries, focusing on their impact on foot arch anatomy and functionality at short- to midterm follow-up. Methods: A retrospective study including patients treated in our center for a subtle Lisfranc injury between 2012 and 2019 was conducted. Demographic, epidemiologic, radiographic, and clinical data were obtained and assessed, focusing on foot arch structure and foot function, which was evaluated with the American Orthopaedic Foot & Ankle Society (AOFAS) midfoot score and the Foot Function Index (FFI). Results: A total of 42 patients with a mean age of 49 ± 17.5 years were included, with an average of 4.3 years’ follow-up (range, 1-8). Stage I injuries according to Nunley classification represented 19% and were treated conservatively. Stage II (66.7%) and stage III (14.3%) injuries were treated operatively, via osteosynthesis with screws (74%), K-wires (19%), or plates (7%). Flattening of foot arch after treatment was observed in 42.9% of patients, with significant increases in Costa-Bertani (12 ± 7 degrees), Hibbs (7 ± 6 degrees), and Meary (3 ± 1 degrees) angles. Other complications included complex regional pain syndrome (28.6%) and painful hardware (23.8%). Secondary joint arthrodesis was needed in 16.6% of patients. Chronic pain was present in 71.4% of patients with a mean visual analog scale (VAS) pain score at final follow-up of 4 of 10 points. Results in AOFAS midfoot score and FFI were 87.4 ± 8.3 and 15 ± 6.4, respectively. Conclusion: The subtle Lisfranc injury shows dissociation between the initial relatively mild radiographic changes and important future complications. Chronic pain and foot arch flattening were not uncommon. Overall foot function in the short- or midterm was found to be modestly diminished in this somewhat heterogenous cohort. Level of Evidence: Level IV, therapeutic case series.

scholarly journals A case report of femoral head fracture with osteochondral lesion treated by osteosynthesis and biomimetic scaffold: 2-year clinical and radiological follow-up

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Alessandro Casiraghi ◽  
Claudio Galante ◽  
Marco Domenicucci ◽  
Stefano Cattaneo ◽  
Andrea Achille Spreafico ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Articular Surface ◽  
Osteochondral Lesion ◽  
Hip Dislocation ◽  
Fracture Dislocation ◽  
Osteochondral Lesions ◽  
Femoral Head Fracture ◽  
Osteochondral Scaffold

AbstractThe aim of the present study was to present clinical and radiological outcome of a hip fracture-dislocation of the femoral head treated with biomimetic osteochondral scaffold.An 18-year-old male was admitted to the hospital after a motorcycle-accident. He presented with an obturator hip dislocation with a type IVA femoral head fracture according to Brumback classification system. The patient underwent surgery 5 days after accident. The largest osteochondral fragment was reduced and stabilized with 2 screws, and the small fragments were removed. The residual osteochondral area was replaced by a biomimetic nanostructured osteochondral scaffold. At 1-year follow-up the patient did not complain of hip pain and could walk without limp. At 2-year follow-up he was able to run with no pain and he returned to practice sports. Repeated radiographs and magnetic resonance imaging studies of the hip showed no signs of osteoarthritis or evidence of avascular necrosis. A hyaline-like signal on the surface of the scaffold was observed with restoration of the articular surface and progressive decrease of the subchondral edema.The results of the present study showed that the biomimetic nanostructured osteochondral scaffold could be a promising and safe option for the treatment of traumatic osteochondral lesions of the femoral head.Study Design: Case report.

scholarly journals Narratives of Change: Identity and Recognition Dynamics in the Process of Moving Away From a Life Dominated by Drug Use

2021 ◽  
pp. 009145092110270
Author(s):  
Inger Eide Robertson ◽  
Hildegunn Sagvaag ◽  
Lillian Bruland Selseng ◽  
Sverre Nesvaag
Keyword(s):  
Drug Use ◽  
Identity Formation ◽  
Recovery Process ◽  
Way Of Life ◽  
Positive Identity ◽  
The Social ◽  
Changing Practices ◽  
Struggle For Recognition ◽  
Depth Interviews

The concepts of identity and recovery capital are recognized as being an embedded part of moving away from a life dominated by drug use. However, the link between these two concepts and the effect of broader social structures, and the normative assumptions underpinning the condition of recovery, is less explored. This article focuses on the social practices of everyday life in the foreground of identity formation, meaning that “who I am” is an inseparable part of “what I do.” A narrative approach was employed to analyze qualitative follow-up data extracted from 48 in-depth interviews with 17 males and females with drug-using experience that were conducted posttreatment on three separate occasions over a period of 2.5 years. Theories of identity formation were employed to analyze the interdependent dynamic between social structure, persona and social resources, and way of life and identity. The analyses identified four narratives related to how people present themselves through the process of changing practices. Following the work of Honneth, we argue that the positive identity formation revealed in these narratives is best understood as a struggle for recognition via the principle of achievement. However, the participants’ self-narratives reflected cultural stories—specified as formula stories—of “normality,” “addiction,” and the “addict,” which work into the concepts of self and confine options of storying experiences during the recovery process. This study demonstrate that the process of recovery is culturally embedded and constitutes a process of adaption to conventional social positions and roles. We suggest challenging dominant discourses related to “addiction as a disease” and “normality” in order to prevent stigma related to drug use and recovery. In so doing, it may contribute to broaden conditions for identity (trans)formation for people in recovery.

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.

An unusual ischaemic presentation of thrombosed intracranial mycotic aneurysm with subsequent subarachnoid haemorrhage

2020 ◽  
Vol 13 (10) ◽  
pp. e237044
Author(s):  
Patrick Brown ◽  
Daniel Fulks
Keyword(s):  
Clinical Outcome ◽  
Subarachnoid Haemorrhage ◽  
Mycotic Aneurysm ◽  
Unusual Case ◽  
Endovascular Management ◽  
Coil Embolisation ◽  
Vessel Occlusion ◽  
Aneurysmal Rupture ◽  
Excellent Clinical Outcome

We present an unusual case of acute ischaemic stroke secondary to thrombosed mycotic aneurysm with subsequent early aneurysmal rupture and subarachnoid haemorrhage, successfully treated with endovascular coil embolisation of the thrombosed segment. Imaging correlates are presented demonstrating successful endovascular management despite vessel occlusion precluding angiographic visualisation of the aneurysmal segment. Imaging and clinical follow-up is provided demonstrating durable occlusion and excellent clinical outcome with full functional recovery.

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.

Sign in / Sign up

Export Citation Format

Share Document