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At least 55 records · Page 3Linked to original sources
PubMed1981

Acromioclavicular joint dislocation - surgical results in 36 patients.

45 patients were operated on because of acromioclavicular joint dislocation in the period reviewed. 36 patients attended for follow-up examination in 1979, on an average 4.8 years after the operations. In these patients, acromioclavicular joint dislocation was surgically treated as follows: A-O cortical screw in 27 cases, two Kirschner wires in five cases, and wire loop in three cases. Repair of the coracoclavicular ligament by Henry's procedure was performed in two patients in connection with acromioclavicular joint transfixion. Late resection of the distal end of the clavicle was performed in one case. The results were good in 28 patients, fair in five and poor in three cases (Ejeskär in 1974). In cases with a poor result, the findings were: 1) increased displacement of the joint surfaces on stress radiographs, 2) disabling pain at work, 3) restriction of movement of more than 20 degrees in several directions and 4) age over 42 years at operation.

Acromioclavicular Joint↗
PubMed2005

Arthroscopic treatment of acute and chronic acromioclavicular joint dislocation.

This article presents an all-arthroscopic technique for coracoclavicular ligament reconstruction by ligamentoplasty after acute or chronic acromioclavicular joint dislocation. A coracoacromial ligament transfer is done to reconstruct the torn coracoclavicular ligaments, similar to open surgery. The coracoacromial ligament is dissected from the undersurface of the acromion and is reinserted on the inferior clavicle by transosseous suture fixation. Additional wire or screw stabilization may be used. With this method, we achieve a very satisfactory reduction of the dislocated acromioclavicular joint.

Acromioclavicular Joint↗
PubMed2004

Posterior sternoclavicular joint dislocation in a wrestler.

Injury to the sternoclavicular joint is uncommon but may be a life-threatening injury if the diagnosis is not made acutely. Posterior sternoclavicular joint dislocation is associated with a number of complications including tracheal tear or trauma to the great vessels. Diagnosis by conventional radiography is difficult. Even experienced examiners may miss the diagnosis unless a high level of suspicion exists and the appropriate imaging studies are ordered. Computed tomography is the imaging modality of choice, and prompt diagnosis is essential for early, successful reduction of the joint.

Adolescent↗
PubMed2000

Irreducible palmar metacarpophalangeal joint dislocation due to junctura tendinum interposition: a case report and review of the literature.

Three different anatomic structures have been reported to prevent reduction of a palmar dislocation of metacarpophalangeal joint: dorsal capsule, palmar plate, and a ruptured collateral ligament. In our case, extensor digitorum communis of the fifth finger and extensor digiti minimi subluxated on the ulnar side of the fifth metacarpal neck. Extensor digitorum communis of the fourth finger remained in its anatomic location. The junctura tendinum connecting the fourth and fifth extensor digitorum communis tendons slipped distal and then palmar to the metacarpal head, where it was trapped between the metacarpal neck and the base of the proximal phalanx. It was easily pulled out and the joint promptly reduced. Residual subluxation persisted due to rupture of the radial collateral ligament and the dorsal capsule. Repair restored joint reduction and stability. (J Hand Surg 2000; 25A:166-172.

Accidents, Traffic↗
PubMed1983

Systematic approach to identifying fourth and fifth carpometacarpal joint dislocations.

Dislocations of the carpometacarpal (CMC) joints are rare injuries which often have subtle radiographic findings that may be overlooked. A systematic approach for evaluation of the carpometacarpal joints is developed from analyzing the radiographic findings in 17 cases of CMC dislocations at the fourth and fifth CMC joints. Principles of parallelism, symmetry, overlapping articular surfaces, indistinct cortical rim, and parallel M lines are used in this evaluation. Ten patients had combined fourth and fifth CMC joint dislocations and seven had solitary dislocations at the fifth CMC joint. Most of these CMC dislocations are dorsal (71%). In combined fourth and fifth CMC joint dislocations, loss of parallelism and symmetry is observed at the fourth CMC joint with overlap identified primarily at the fifth CMC joint. Fracture of the fourth metacarpal base is often an associated injury. In solitary fifth CMC dislocations, slight ulnar offset of the fifth metacarpal on the hamate is the most consistent finding in association with loss of parallelism, symmetry, and overlap. Fracture of the radial margin of the fifth metacarpal base is often observed with solitary fifth CMC joint dislocations. A systematic approach and establishing the diagnosis from standard radiographic views is emphasized.

Adult↗
PubMedDate not supplied

Metacarpophalangeal joint dislocation: indications for open surgical reduction.

In complex dislocations of the metacarpophalangeal joint, the volar plate is separated from the proximal phalanx and the metacarpal head is entrapped within surrounding tissue structures. These complex dislocations must be managed by open surgical reduction to reduce the dislocation and realign the volar plate. A 58-year-old male presented to the emergency department with a complex dislocation of the metacarpophalangeal joint of the left little finger, which was successfully treated by open reduction in the operating room. The indications for open reduction of metacarpophalangeal joint dislocations are reviewed.

Collateral Ligaments↗
PubMed2001

Surgical treatment of chronic acromioclavicular joint dislocation by modified Weaver-Dunn procedure.

We present our technique for surgically treating Tossy III acromioclavicular joint dislocation, discuss the indications for various procedures, and evaluate our postoperative results. We operated on 17 patients suffering from chronic acromioclavicular instability after such dislocation using a modified Weaver-Dunn procedure, in which there is no lateral clavicular end resection, the coracoacromial ligament graft is sutured to the inferior part of the clavicle by transosseal sutures, and a Bosworth coracoclavicular screw is used to protect the graft postoperatively for 8 weeks. After a mean of 37 months we evaluated shoulder function by the Constant score and the subjective and radiological results. Mean Constant score was 91.9% (74-100%); it was 80-90% in 5 patients and above 90% in 11. One patient had screw loosing after the operation and suffered partial loss of reduction and discomfort during shoulder loading. All patients but one returned to work, and all but one have returned to their preoperative activity at the same level. Subjectively, there were 11 excellent and 6 good results. Compared to the contralateral uninjured side, radiography showed anatomical reposition in the vertical plane in 9 cases, slight loss of reduction in 6 (difference in the distance between the inferior border of the acromion and the clavicle is 2-4 mm), and partial loss of reduction in 2 (4-8 mm). We recommend the modified Weaver-Dunn procedure for surgical treatment of chronic, Tossy grade III acromioclavicular joint dislocations as it provides good functional and subjective results. Our modification is indicated mainly for young patients because posttraumatic arthrosis occurs more frequently in elderly patients, making clavicular end resection necessary.

Acromioclavicular Joint↗
PubMed2005

Minimally invasive endoscopic reconstruction technique of acute AC-joint dislocations: a cadaver study.

The treatment of acute Rockwood type III AC-joint dislocations is controversial. Problems related to open surgery are soft tissue healing, residual instability and the necessity of hardware removal. After non-operative therapy the cosmetic result may be problematic and in some cases symptomatic instabilities occur. The goal of the present cadaver study was to develop a new, minimally invasive technique for acute AC-joint reconstructions and to analyse its potential risk for neurovascular injuries. The surgical technique was based on an arthroscopically assisted reconstruction of the coracoclavicular ligaments with a suture anchor (Arthrex, Naples, FL, USA) and a supplemental stabilization of the AC-joint capsule with a suture cerclage (Fibre Wire 2, Arthrex) performed on ten cadaveric shoulder specimens. After surgery all specimens were dissected to analyse the anatomy of the coracoclavicular ligament complex, the position of anchors and sutures and to measure the distance to the neurovascular structures at risk. The supraspinatus muscle was never injured by the Neviaser approach. The insertion of the suture anchors never failed, resulting in a secure and reproducible anchor position. The mean distance between the coracoid and suprascapular nerve was 1.8 cm (1.5-2.2), between the coracoid and the suprascapular artery 1.5 cm (1.3-1.9). These structures were never injured. The resulting force vector of the suture located between the anchor and the drill hole was close to the anatomic force vector of the coracoclavicular ligament complex. The suture cerclage was always correctly positioned. The presented technique is at minimal risk for the surrounding neurovascular structures and allows for a minimally invasive and anatomically correct reconstruction of the AC-joint. Further biomechanical analysis is needed to evaluate the strength of the reconstruction technique. The proposed technique might be a reasonable alternative to existing invasive techniques of open reconstruction of acute type III AC-joint dislocations in high-demand patients.

Arthroscopy↗
PubMed2005

A survey of temporomandibular joint dislocation: aetiology, demographics, risk factors and management in 96 Nigerian cases.

A retrospective study of 96 cases of temporomandibular joint dislocation was undertaken. Patients' ages ranged from 9 to 85 years (mean+/-SD, 35.3+/-17.4 years) and peak incidence was at 20-29 years. Mean duration was 7.9 weeks (range, 1h to 3 years). Acute, chronic and recurrent dislocations were seen in 46 (47.9%), 29 (30.2%) and 21 (21.9%) patients, respectively. Males dominated in all three categories but this was not statistically significant (P = 0.8). Excessive mouth opening while yawning (44 cases) was the commonest cause of dislocation, followed by road traffic accidents (13 cases). Ten patients (10.4%) had an underlying systemic disease, the commonest being epilepsy (four cases); those with acute dislocation recorded the highest incidence of underlying illness. Bilateral anterior (86 cases) dislocations were the most frequent. Of the 96 patients, 89 (92.7%) were available for treatment. Manual reduction with or without anaesthesia proved effective for 38/45 acute, 5/24 chronic and 14/20 recurrent cases. Chronic dislocations were treated mainly by surgical osteotomy (13/24). Vertical subsigmoid and oblique ramus osteotomies were the commonest surgical techniques recorded. Treatment was satisfactory for all patients surgically handled except for one case of anterior open bite postoperatively. This study has shown that excessive mouth opening while yawning is the commonest cause of temporomandibular joint dislocation in Nigerians, and conservative approaches to management remain quite effective irrespective of the duration and clinical subtype. The best choice of surgical technique should be determined by proper clinical evaluation and the need to avoid or minimize postoperative morbidity.

Accidents, Traffic↗
PubMed2003

Concomitant plantar tarsometatarsal (Lisfranc) and metatarsophalangeal joint dislocations.

We report an unusual case of concomitant plantar tarsometatarsal (Lisfranc) and 1st and 2nd metatarsophalangeal (MTP) joint dislocations and fracture of the neck of the third metatarsal bone which has never been reported before. The plantar dislocation of the Lisfranc joint was treated by open reduction and fixation with K-wires; the dislocations of the MTP joints and neck fracture of the third metatarsal bone were treated by closed reduction and percutaneous fixation with K-wires and immobilized with a plaster cast. At the 5 year follow-up examination, our patient had no complaints, but the radiograph showed degenerative changes of the Lisfranc and the 1st MTP joint.

Adult↗
PubMed2003

Treatment of recurrent temporomandibular joint dislocation with intramuscular botulinum toxin injection.

Recurrent dislocation of the mandibular condyle poses a difficult problem for affected patients. In the course of time, dislocations often become more frequent and more difficult to avoid. Even with good patient compliance, conservative treatment is often not sufficient. Operative procedures have also been described for the treatment of temporomandibular joint dislocation. However, these interventions are invasive, involving open arthrotomy with possible complications, and cannot safely guarantee a successful outcome. On the other hand, botulinum toxin injections into the lateral pterygoid muscles offer the option of a predictable and prolonged period without renewed dislocation. We present the results of this treatment carried out in 21 patients with recurrent temporomandibular joint dislocation. Four patients were treated following unsuccessful physical therapy and the use of occlusal splints. The remaining 17 patients were treated for a number of conditions resulting in dislocation, including some with senile dementia and mental impairment in whom compliance with conservative measures was poor or completely absent. Injections were given on a 3-month basis in order to have a sustained effect. Within the study period of 6 months to 3 years, only two of the 21 patients suffered further dislocation. There were no side effects recorded as a result of treatment.

Adult↗
PubMed1998

Progressive subtalar joint dislocation and limb-length inequality. An unusual case.

Subtalar joint dislocation is a rare entity, accounting for only 1% of all traumatic dislocations. The authors report a case of an adolescent with gradual lateral subluxation of an anatomically abnormal subtalar joint with no history of trauma, an extremely rare presentation. The patient also had a congenitally short limb. The patient underwent llizarov leg lengthening along with multiple surgeries of the subtalar joint. The choice of the Ilizarov technique to lengthen the leg and realign the subtalar joint in this case is discussed.

Abnormalities, Multiple↗
PubMed1976

Clinical features and treatment of joint dislocations in Larsen's syndrome. Report of three cases in one family.

Of 3 cases of Larsen's syndrome in one family, one had bilateral dislocation of the hip and the knee joints. The knee joint was not reduced by manipulation and corrective cast, while both hip and knee joints were simultaneously reduced by skeletal traction of the tibia at the age of 4 months, and the course was satisfactory. Reduction of joint dislocations should be attempted by a conservative method such as skeletal traction as early as possible. Various radiographic skeletal abnormalities occurred in all 3 cases. Larsen's syndrome very likely has a genetic origin.

Abnormalities, Multiple↗