Dislocation, Social Isolation, and the Politics of Recovery in Post-Disaster Japan

What happens when temporary shelters become permanent homes? What are the psychosocial impacts of prolonged dislocation, and how might these effects be mitigated through grassroots community activities? Based on fieldwork and interviews with residents in temporary housing and volunteer support groups in northeastern Japan conducted from 2014–2018, this article analyzes the ongoing challenges of delayed recovery, chronic dislocation, and social isolation among survivors of the March 11, 2011 disaster in Japan, with a particular focus on the residents of temporary facilities in Natori City, Miyagi Prefecture. I examine how the complexity of the disaster-recovery process within the local politics of the region has produced new tensions, creating a particular “zoned liminality” for displaced residents while undermining the social nexus of community relations. Then I reflect on certain challenges in treating the psychosocial trauma among survivors, and how their particular needs are addressed through new citizen-based volunteer movements offering holistic activities. These grassroots activities do not necessarily solve the breakdown of social bonds nor improve residents’ prospects of returning home. However, by alleviating survivors’ sense of social isolation and loneliness, this “humanistic” approach highlights the possibilities of participatory-style psychosocial support that goes beyond conventional biomedical services and top-down, state-driven policies.

Chronic Dislocation of the 5th Metatarsophalangeal Joint with Physeal Injury of Metatarsal: A Case Report

Metatarsophalangeal joint dislocations are uncommon injuries. This article describes the surgical management of such injury with six months follow up report. A 13 years old boy presented with the complaints of deformity and shortening of the 5th toe of the right foot with callosity on plantar aspect since last five years. He sustained this injury by hitting a stone.He was diagnosed to have a compound dislocation of a metatarsophalangeal joint with severely angulated Salter and Harris type II epiphyseal injury of 5th toe of the left foot.Joint dislocation caused deformed shortened 5th toe, and epiphyseal malunion resulted in the plantar bony projection, callosity, ulceration, difficulty in walking and wearing the footwear. This case was managed surgically that culminated in an optimum functional and structural outcome. Malunited epiphysis was excised, the metatarsal bone was aligned and fixed with proximal phalanx by Kirschner wire to establish a pseudarthrosis. This method can be useful in such cases; however, needs to be evaluated with future studies.

Treatment of Capitellum Fracture with Chronic Radial Head Dislocation

We encountered a case of capitellum fracture with radial head dislocation in which it was challenging to diagnose whether the dislocation was coincident with the fracture or this was chronic dislocation that presented before the fracture. Chronic radial head dislocation may be congenital or could occur in patients with untreated post-traumatic dislocation, although diagnosis is particularly challenging if the radial head dislocation is unilateral. Classical capitellum fracture involves anterosuperior bone fragment dislocation. However, in the present case, the bone fragment was present beneath the radial head, which suggests chronic radial head dislocation. When the bone fragment appears in a different position than usual, every effort should be made to understand the pathophysiology by reviewing the mechanism of onset, disease history, and imaging.

Clinical and Anatomical Aspects of Anterior Dislocation of the Pisiform Bone

Introduction The pisiform bone is the fourth bone of the proximal row of the carpal bones, and it is located in the tendon of the flexor carpi ulnaris muscle, being considered a sesamoid bone. Traumatic dislocation of the pisiform bone is a rare condition, which usually results from a trauma in dorsal flexion of the wrist. Its treatment can be conservative or surgical, ending or not with the removal of the pisiform bone. Objective To report a case of a child who fell from his own height and presented wrist pain, diagnosed with dislocation of the pisiform bone. We emphasize the importance of anatomy knowledge in the evaluation of wrist trauma. Case Report The anamnesis confirmed that the fall occurred with the wrist in hyperextension. The physical examination showed a slight limitation of movement due to pain. Radiographic exams and a computed tomography (CT) scan of the wrist were performed, in which an anterior deviation/luxation of the pisiform bone was evidenced. A conservative treatment with plaster immobilization for analgesia was performed for 1 week. As there were no symptoms and no signs of trauma consistent with the images, such as edema and local ecchymosis, in addition to the early complete disappearance of pain, the responsible team proposed the hypothesis of asymptomatic chronic dislocation of the pisiform bone. Conclusion Imaging exams in orthopedic traumatology are fundamental for an accurate diagnosis. Nevertheless, they must be associated with knowledge of the anatomy to correlate the image findings with the anamnesis, leading to a better understanding of silent, asymptomatic, and preexisting conditions in the clinical practice.

Case report of a new surgical technique for the treatment of chronic dislocation of the plantar fat pad

This is a surgical report of chronic traumatic dislocation of the plantar fat pad, with few descriptions in the PubMed, Web of Science and Scopus databases. In this study, we seek to describe a surgical technique that may be effective in the treatment of this rare affection. We report a patient who underwent surgery by a foot and ankle specialist who performed a technique in which the plantar fat pad was positioned at its place of origin and fixed with two anchors. After 1 year of follow-up, the surgical outcome was effective. Level of Evidence V; Therapeutic Studies; Expert Opinion.

Clinical and Microbiologic Variables Predictive of Orthopedic Complications Following Staphylococcus aureus Acute Hematogenous Osteoarticular Infections in Children

Background Staphylococcus aureus is the most common cause of acute hematogenous osteoarticular infections (AHOAIs) in children. The risk factors for the development of orthopedic complications (OC) after AHOAI are poorly understood. We sought to describe clinical and microbiologic variables present on the index admission that may predict OC in S. aureus AHOAI. Methods Staphylococcus aureus AHOAI cases were identified from 2011–2017 at Texas Children’s Hospital and reviewed for the development of OC. OC included chronic osteomyelitis, growth arrest, avascular necrosis, chronic dislocation, and pathologic fracture. All S. aureus isolates were characterized by pulsed-field gel electrophoresis and agr group. Results A total of 286 cases were examined of which 27 patients (9.4%) developed OC. Patients who developed OC more often had infection with an agr group III organism (P = .04), bacteremia (P = .04), delayed source control (P < .001), ≥2 surgical procedures (P < .001), intensive care unit admission (P = .09), and fever >4 days after admission (P = .008). There was no association with OC and patient age, methicillin resistance, or choice/route of antibiotics. In multivariable analyses of OC, infection with agr group III S. aureus, prolonged fever, and delayed source control remained statistically significant. Conclusions OC develop following S. aureus AHOAI in 9.4% of cases. Although the development of OC is likely multifactorial, agr group III organisms, prolonged fever, and delayed source control are independently associated with OC. Moreover, early aggressive surgical source control may be beneficial in children with S. aureus AHOAI.

MORPHOMETRIC PARAMETERS OF THE TEMPOROMANDIBULAR JOINT ELEMENTS AT ITS CHRONIC LUXATION’S AND SUBLUXATION

The paper notes the relevance of the temporomandibular joint, in particular, chronic dislocation and subluxation. The aim of the study was to study morphometric parameters of the temporomandibular joint using computed tomography and to identify anatomical and topographical features of those with chronic dislocation and subluxation of the joint. The article describes the method of measurement of bone structures, which we studied 27 patients with chronic dislocation and subluxation of the temporomandibular joint. This study allows to conclude that in patients with dislocation and subluxation of the temporomandibular joint have structural violations of the elements of the joint, their proportions that have a significant asymmetry.

MODERN TECHNIQUES OF CERVICAL INSTRUMENTATION IN IMMATURE SKELETON: VIABILITY ASSESSMENT

ABSTRACT Objective: This study describes the use of materials for modern cervical instrumentation, evaluating its viability in children and adolescents, and the techniques used in different cases. The efficacy of the techniques was analyzed through improvement of pain, maintenance of cervical range of motion, recovery of craniocervical stability, bone consolidation, and spinal stenosis in the postoperative follow-up. Method: Retrospective study of the clinical and radiological parameters of 27 patients aged two to 16 years with cervical spine diseases. Results: Two patients had chronic dislocation in C1-C2, one had congenital axis spondylolisthesis, two had congenital dislocation in C1-C2, three had tumors, one had kyphosis after laminectomy, one had post-infection kyphosis, one had fracture, 11 were syndromic with instabilities, and five had congenital cervical scoliosis. As to surgical approaches, two patients were transorally operated, three by anterior approach, 15 by posterior approach, two by anterior and posterior approaches, and five were treated in three stages (anterior, posterior and anterior approaches). Regarding the technique of cervical stabilization, seven patients were treated by Goel-Harms technique, two received Goel’s facet distraction, and three, Wright translaminar screws. There were complications in four cases. Two patients in the instrumentation of C1 lateral mass due to poor positioning, one with cerebrospinal fluid fistula and one with surgical wound infection. Conclusion: Modern cervical instrumentation in pediatric patients is a safe and effective technique for the treatment of cervical instability.