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PubMedDate not supplied

[Dislocation of the knee joint].

Dislocations are the rarest but the most severe injuries of the knee joint. Six patients with traumatic knee joint dislocation were treated at the Clinic for Traumatology and Orthopedics of the Military Medical Academy in the period January 1989-November 1998. Popliteal artery was injured in 3 patients. The injuries required reconstruction and the treatment in 1 patient ended with upper leg amputation. In one case the diagnosis was irreducible lateral dislocation. Surgical reparation--reconstruction of ligamentary apparatus was performed in 4 patients. Concerning the knee joint stability satisfactory results were achieved. Knee joint dislocations are very severe injuries requiring thorough diagnosis of the possible injury of neurovascular bundle and surgical treatment.

Adult↗
PubMed1993

Dislocations of the sternoclavicular joint.

Dislocations of the sternoclavicular joint are uncommon, with the posterior variety having a potential for considerable morbidity. Radiologic management and diagnosis can be difficult. In this review article, the joint anatomy and mechanisms of dislocation are discussed and the incidence and clinical manifestations described. Six case reports are presented to illustrate causative mechanisms, diagnoses, and radiologic appearances. Computed tomography is the best method of demonstrating the sternoclavicular joint, but a number of specialized plain film projections are also described and illustrated; these should be more widely known. Treatment of the joint dislocations is briefly discussed.

Adolescent↗
PubMed1994

Dislocation and fracture-dislocation of the carpometacarpal joints.

Dislocations and fracture-dislocations of the carpometacarpal joints are rare. Diagnosis requires a high index of suspicion, careful examination, and appropriate radiography. Treatment is controversial and is based upon the injury pattern and the surgeon's experience and preference. This article reviews the pertinent anatomy, mechanism of injury, evaluation, and treatment of patients with carpometacarpal joint injuries.

Algorithms↗
PubMed1987

Dislocations and fracture dislocations of the tarsometatarsal joints.

Dislocations and fracture-dislocations of the tarsometatarsal joints are potentially disabling injuries that present challenging therapeutic problems. Early recognition is imperative and is based on a familiarity with the important anatomic features of this joint, mechanism of injury, and subtle radiographic changes that often accompany these lesions. Following injury, a precise anatomic reduction of the tarsometatarsal joint is critical if long-term disability is to be avoided. There appears to be a direct correlation between achieving an accurate reduction and a satisfactory clinical result. In our experience, surgical reduction offers the most effective and reliable means of achieving this goal. We have presented an approach for the management of these lesions, which we believe offers advantages over previously described techniques. Our experience has shown that accurate anatomic operative reduction and rigid internal fixation provide an increased assurance of a pain-free, durable, and functional foot in the great majority of cases.

Bone Screws↗
PubMed1979

Computed tomography in the diagnosis of dislocations of the sternoclavicular joint.

Dislocations of the sternoclavicular joint can be easily characterized with computed tomography. Two typical cases, one demonstrating superior dislocation and the other showing posterior dislocation of the clavicle, illustrate the value of the method. Correlated anatomical observations demonstrate the proximity of the great vessels to the sternoclavicular joint.

Adolescent↗
PubMed1990

Simultaneous dorsal dislocation of interphalangeal joints in a finger.

Simultaneous proximal and distal interphalangeal joint dislocations in a single finger are rare. Even though the joints above and below are routinely evaluated, one of the joint dislocations can be missed. When phalangeal dislocations are suspected, special attention should be given to obtaining sufficient roentgenographic views both before and after reduction. The joints should be thoroughly examined in an attempt to distinguish capsular contraction from soft-tissue interposition. Failure to recognize initial simultaneous dislocations may result in capsular contraction and require surgical intervention.

Adult↗
PubMed1998

Transoral joint release of the dislocated atlantoaxial joints combined with posterior reduction and fusion for a late infantile atlantoaxial rotatory fixation. A case report.

STUDY DESIGN: A case of a late infantile atlantoaxial rotatory fixation is reported for which transoral anterior release was performed. OBJECTIVES: To report a patient who underwent transoral anterior release of the dislocated atlantoaxial joint for a case of late infantile atlantoaxial rotatory fixation and quadriparesis. SUMMARY OF BACKGROUND DATA: Infantile atlantoaxial rotatory fixation is diagnosed easily by using recently developed imaging techniques such as computed tomography, magnetic resonance imaging, and three-dimensional computed tomography. Nevertheless, patients in whom the condition has been overlooked still are encountered, and the reduction in these patients becomes impossible by traction or by simple posterior open reduction. Few reports on the management of type II-IV chronic atlantoaxial rotatory fixation in which an anterior surgery was performed exist in the literature, and no report exists in which atlantoaxial joint release on the both sides was attained. METHODS: A 9-year-old girl had a type III atlantoaxial rotatory fixation and quadriparesis. She received direct skull traction and repeated manual reduction while she was awake or under general anesthesia. Neither reduction nor movement was obtained, according to the radiographs. Therefore, it was necessary to perform open reduction posteriorly and transorally to release the fixed and contracted joints between C1 and C2. RESULTS: After the anterior release of the joints, there was an inherent force preventing a complete rotational reduction. However, after a successful posterior reduction and fusion, and for more than 4 years after surgery, neither rotatory displacement nor neurologic deterioration was noted. CONCLUSIONS: The authors suggest that careful transoral anterior release of the atlantoaxial joint permits successful reduction in a case of chronic fixed atlantoaxial rotatory fixation combined with cord compression.

Atlanto-Axial Joint↗
PubMed2001

Irreducible open dorsal dislocation of the proximal interphalangeal joint.

Dislocations of the proximal interphalangeal joint rarely present a problem in reduction. We report a case of dorsal dislocation in which attempts at reduction by manipulation were not successful. A probable mechanism is discussed. In most cases of such injury, the flexor tendons should be elevated by a probe to allow replacement of the head of the proximal phalanx.

Adult↗
PubMed2004

The prevalence of joint hypermobility among high school students.

OBJECTIVE: The aim of this study was to determine the prevalence of joint hypermobility among high school students and to define the characteristics of patients with joint hypermobility. METHODS: The students underwent complete history and physical examination. In order to designate marfanoid habitus, body weight, height, and span/height and upper/lower segment ratios were recorded. The degree of joint hypermobility was scored by the Beighton scoring system. The following features were also examined: arthralgia, myalgia, low back pain, sciatica, spinal deformities, temporomandibular joint pain and crepitus, effusion, swan neck deformity, arachnodactyly, joint dislocation, joint sprain, Raynaud's phenomenon, stria, varicose veins, abdominal and inguinal hernia, heart disease history, myopia, dropping eyelids, and antimongoloid slant. RESULTS: Eight hundred sixty-one students (433 females and 428 males) with a mean age of 15.4+/-1.1 years (range 13-19) were examined. Joint hypermobility was observed in 101 (11.7%) of the students. According to the Beighton scoring system, the majority of these (61.4%) were observed to score 4. Our results show that phenotype has no relation with joint mobility. Of the total number of students, there were 31 male (7.2%) and 70 female (16.2%) hypermobile subjects. The difference between sexes was highly significant (P=0.00005). Joint sprain was detected in 14 of hypermobile students (13.9%) and 50 of nonhypermobile students (6.6%). Its presence was the only significant parameter between hypermobile and nonhypermobile students (P=0.0094). CONCLUSIONS: Joint hypermobility was found in 11.7% of the students in our study, and the results are in harmony with the previous studies on Western populations. Although hypermobility does not seem to be very problematic in young people, as in our focus group, we believe that it is important for physicians to recognize this problem to ensure correct diagnosis and treatment, since it may lead to mimic rheumatic diseases in the future.

Adolescent↗
PubMed2005

Isolated dislocation of the four ulnar carpometacarpal joints.

Dislocation of the multiple carpometacarpal joints without associated fractures of the metacarpal and/or carpal bones is an exceedingly rare injury. An earlier belief that carpometacarpal dislocations are high-energy injuries is questioned due to an unusual case of isolated dislocation of the four ulnar metacarpals that occurred after a relatively minor hand trauma. Early recognition and anatomical reduction are essential to achieving good long-term outcomes. Massive edema, interposed volar ligaments and overlapping metacarpal bases are the usual obstacles to a successful closed reduction.

Adult↗
PubMed2004

A new method of arthroscopic reconstruction of the dislocated acromio-clavicular joint.

BACKGROUND: Symptomatic total acromio-clavicular joint dislocation (Rockwood et al. types III-VI) may be treated by surgical reconstruction. AIM: To describe an arthroscopically assisted technique to reconstruct anatomically the coraco-clavicular ligaments in acute or chronic (> 6 weeks) acromio-clavicular joint dislocation. METHODS: This new technique involves arthroscopic exposure of the coracoid process. Prior to introducing this technique, cadaveric studies were undertaken. RESULTS: Five patients underwent this procedure. All engaged in regular sports or manual-type work. All patients were discharged the same day with the shoulder immobilised for 4 weeks, with no heavy lifting for 3 months. All patients were pain-free at 6 weeks with full function and maximum Constant scores at 3 months. There have been no complications. CONCLUSIONS: A new, safe technique is described which provides a cosmetically acceptable, anatomically solid reconstruction of the coraco-clavicular ligaments.

Acromioclavicular Joint↗
PubMed2000

Proximal interphalangeal joint fracture dislocations.

Proximal interphalangeal joint fracture dislocations are complex, potentially disabling injuries for any patient, especially the competitive athlete. Dorsal fracture dislocations are fairly common and volar fracture dislocations are rare. Stable injuries often heal with minimal functional deficit, whereas unstable injuries can result in limitation in range of motion, joint incongruity, and degenerative joint disease. A number of surgical procedures have been described to treat the unstable dorsal fracture dislocation, including ORIF, extension block pinning, external fixation, dynamic traction, and volar plate arthroplasty. Volar fracture dislocations are usually amenable to closed or open reduction and internal fixation. The results of treatment of both volar and dorsal fracture dislocations can be unpredictable.

Athletic Injuries↗