Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “DISLOCATIONS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 541 records · Page 30Linked to original sources
PubMed1983

Isolated traumatic dorsal dislocation of the distal radio-ulnar joint. Report of seven cases.

The authors report seven cases of isolated dorsal dislocations of the distal radio-ulnar joint. Four were recent dislocations and three were old, chronic dislocations. Acute dislocations were treated surgically. An anatomic study on human cadavers enabled us to define the injuries responsible for radio-ulnar dislocations. An electromyographic study of the extensor carpi ulnaris confirmed its role as a dynamic stabilizer of the ulnar head. Two of the three old dislocations were revised after an attempt at ligamentous reconstruction. These patients benefitted from a resection of the ulnar head. The third patient one underwent a Sauve-Kapandji procedure. Cadaver studies underline the fact that ligamentous reconstruction procedures are actually tenodeses.

Acute Disease↗
PubMed1995

Influence of surgical approach on dislocations after Charnley hip arthroplasty.

Dislocations occurring in 3,199 Charnley total hip arthroplasties in two orthopaedic centers between 1979 and 1991 performed by either the transtrochanteric or posterior approach were studied. The incidence of dislocation within 2 years of surgery (2.8%), as well as the overall frequency (3.4%), did not differ between the two centers. Regardless of approach, there was a higher risk of dislocations for patients with osteoarthrosis. A logistic regression analysis, reflecting the differences in preoperative hip diagnoses and sex, indicated that the dislocation rate was not influenced by the surgical approach. More early dislocations were documented after the posterior approach, but without increases in the rates of recurrence or revision. Arthroplasties performed by less experienced surgeons through the posterior approach resulted in more dislocations.

Aged↗
PubMed1995

Dislocation after bipolar hemiarthroplasty of the hip.

Although bipolar hemiarthroplasty of the hip is a frequently performed procedure, little information is available about the frequency of postoperative dislocation and its treatment. For this study, 1,934 hips treated consecutively with primary bipolar hemiarthroplasty were reviewed. A postoperative dislocation developed in 29 patients (1.5%): during the first month after surgery in 24 patients and between 1 month and 5 years after surgery in five patients. Of the 29 dislocations, 25 were successfully reduced with with routine closed methods. Among these 25 hips, 13 (52%) subsequently redislocated, and 7 of these required operative treatment for the recurrent dislocation. Dislocation after primary bipolar hemiarthroplasty is infrequent, can usually be reduced by routine closed methods, but is associated with a high rate of recurrent dislocation.

Adolescent↗
PubMed1999

Risk factors for dislocation during the first 3 months after primary total hip replacement.

The prevalence of dislocation of a total hip replacement during the first 3 postoperative months was determined for a series of 315 patients who underwent a unilateral primary total hip operation. All operations were performed by 1 surgeon using a standardized posterior approach with a complete capsulectomy. All of the patients had a femoral component made by 1 manufacturer that had the same 28-mm modular head, the same femoral neck diameter, and the same offset for each size implant. One cementless acetabular component was used for all patients. All of the patients followed the same postoperative rehabilitation program. Of 315 patients, 14 sustained a dislocation, resulting in a prevalence of 4%. There were 13 posterior dislocations and 1 anterior dislocation. Because the surgeon, the surgical approach, the femoral component design, and the rehabilitation protocol were identical for all of these patients, the only variables that could affect the risk of dislocation were the size of the acetabular component and the femoral neck length, the type of fixation of the femoral component, the orientation of the acetabular component, and the characteristics of each patient. The patient characteristics that were studied included age; gender; height; weight; preoperative diagnosis; and a category termed cerebral dysfunction, which included a state of confusion during the hospital stay, a prior history of excessive alcohol consumption, or both of these conditions. Statistical analysis demonstrated 1 variable that was associated with a higher dislocation rate, the presence of cerebral dysfunction. There was a trend toward increased age as a risk factor. None of the other patient or component variables were found to be significant risk factors.

Adult↗
PubMedDate not supplied

An operative technique for recurrent shoulder dislocations in older patients.

Recurrent anterior shoulder dislocation in the elderly is not as exceptional as it was once thought to be. That anterior shoulder dislocation in older patients is caused by a rotator cuff tear through the posterior mechanism is well accepted. However, in the subset of patients who have multiple recurrent or intractable dislocations develop, there may be combined pathologic conditions at work: large or massive rotator cuff tears together with anterior capsulolabral injuries such as a Bankart lesion or fracture of the glenoid rim. These patients have multiple recurrences because of disruption of both the anterior and the posterior stability mechanisms. We suggest a procedure that provides anterior stabilization with the capsular shift technique and that is supplemented by Bankart repair as necessary. The capsule transfer is performed superiorly and posteriorly to close the defect in the cuff. In this way a capsulodesis effect can be achieved that displaces the humeral head downward and produces active centering of the head in the course of abduction. Use of only the anterior capsule for the shift, and not the subscapularis tendon, does not compromise subscapularis function. Between 1990 and 1996, we used this technique to treat 16 patients older than 55 years of age with multiple recurrent anterior shoulder dislocation and massive rotator cuff tear. We report the results for the first 10 patients with a minimum follow-up of 2 years (range 2 to 7 years) and an average follow-up of 52 months. There were 7 excellent results, 2 good results, and 1 fair result according to the Rowe criteria. None of the patients had a recurrence of the dislocation. All the patients regained full or functional range of motion with stable shoulders, and most of them could perform activities of daily living without limitation. The average Constant score was 83%. This procedure appears to be successful in treating older patients with recurrent shoulder dislocation.

Aged↗
PubMedDate not supplied

Asymptomatic chronic anterior posttraumatic dislocation in a young male patient.

We report an unusual case of chronic anterior glenohumeral dislocation in a young active patient. The diagnosis was not made until 4 years after the initial injury occurred. X-ray evaluation and magnetic resonance imaging showed an anterior dislocated humeral head that was locked anteroinferior of the glenoid as a result of a large Hill-Sachs lesion. Passive and active range of motion was surprisingly normal, and the patient had no pain and no limitation in his activities of daily living. A chronic dislocation of the glenohumeral articulation has been defined as a joint that has been dislocated for at least several days. It is generally accepted that the longer the dislocation persists, the more the difficulties and complications of reduction increase. In most of the patients the persistence of an unreduced chronic dislocation is a very difficult problem. This condition is mostly seen in elderly patients and in those with limited general mental status. We report a case of a young male patient with only minor clinical symptoms.

Adult↗
PubMedDate not supplied

Shoulder dislocation after infraclavicular coracoid block.

OBJECTIVE: We report a case of shoulder dislocation after a brachial plexus block with a double-injection technique using the infraclavicular coracoid approach. CASE REPORT: An obese woman with no previous episodes of joint dislocation developed an anterior dislocation of the head of the humerus after an infraclavicular coracoid block performed for hand surgery. Dislocation was probably because of a combination of unrecognized glenohumeral instability, paralysis of some muscles of the shoulder, and positioning of her arm on a board below her torso. Shoulder dislocation was recognized after surgical positioning of her arm, and painless reduction was achieved. There were no sequelae after 10-day follow-up. CONCLUSIONS: When motor block of the muscles of the shoulder occurs after brachial plexus anesthesia, special care must be taken in patient positioning to avoid shoulder dislocation.

Carpal Tunnel Syndrome↗
PubMedDate not supplied

Medial and lateral rotatory dislocations of the ankle after trivial trauma--pathomechanics and management of two cases.

Pure frontal plane rotatory dislocation of the ankle joint without an associated fracture is an extremely rare injury. We report one such case of an eversion rotatory dislocation and one case of an inversion rotatory dislocation. To our knowledge, this is the first report of an eversion injury resulting in dislocation of the ankle without fracture. Both patients had low energy trauma, predisposing ligamentous injuries, and recurrent sprains. In the patient with lateral rotatory dislocation, medial malleolar hypoplasia was also a contributing factor. Both patients healed the presenting index injury with nonoperative treatment, whereas the lateral rotatory dislocation had a lateral ankle stabilization to prevent subsequent injury.

Adult↗
PubMedDate not supplied

Anteromedial subtalar dislocation.

Subtalar dislocation is the simultaneous dislocation of the distal articulations of the talus at both the talocalcaneal and talonavicular joints. It can occur in any direction and can always produce significant deformity. The medial dislocation is most common. Less common presentations are lateral, anterior, and posterior dislocations. These dislocations are associated with osteochondral fractures. Closed reduction and immobilization remain the mainstays of treatment. Proper radiographs and computed tomography scan confirm the postreduction alignment stability of subtalar joints and intraarticular fracture fragments. We report a case of anteromedial subtalar dislocation with no osteochondral fracture fragments in a 25-year-old man.

Accidental Falls↗
PubMedDate not supplied

The microscopic pathoanatomy of acute anterior shoulder dislocations in a simian model.

PURPOSE: The purpose of this study was to determine the extent of capsular injury that occurs at a microscopic level in association with acute anterior shoulder dislocations. TYPE OF STUDY: The study was an anatomic, cadaveric study using a simian model. The microscopic slide review was blinded regarding the presence or absence of dislocation. METHODS: Three cadaveric monkey shoulder specimens were dissected free of muscle tissue but left undislocated as controls. Eleven cadaveric monkey shoulder specimens were dislocated with an abduction and external rotation force and subsequently evaluated grossly and histologically for the presence and direction of gross and microscopic injury. RESULTS: All dislocated specimens had an associated Bankart lesion. In addition, all dislocated specimens had histologic evidence of capsular microtearing. The tears were in no specific location or direction and were at times located perpendicular to, obliquely to, or between the longitudinal orientation of the fibers. CONCLUSIONS: Based on this model, a Bankart lesion is a common and usual occurrence with acute anterior shoulder dislocations. In these specimens, the Bankart lesion was never an isolated pathology. Microscopic capsular injury was always associated. Additionally, the direction of the capsular injury is highly variable.

Animals↗
PubMed2002

Heterotopic ossification associated with knee dislocation.

PURPOSE: The purpose of this study was to determine the prevalence of heterotopic ossification following knee dislocation. TYPE OF STUDY: Prospective clinical evaluation and a retrospective chart review. METHODS: This study evaluated 57 knees in 55 patients who sustained high-energy blunt trauma with resultant knee dislocations. Radiographs were reviewed by 2 of the authors (J.P.S., T.C.W.), and the incidence of heterotopic ossification (HO) was documented. Additionally, patients were classified regarding the degree of HO on a scale from 0 to 4. One is punctate calcification, 2 is HO involving less than 50% of the joint space; 3 is HO involving more than 50%; and 4 is ankylosis of the joint. RESULTS: Thirteen patients with 15 knee dislocations developed HO. The incidence of HO was 26%. Seven knees demonstrated severe HO (grade 3 or 4) which represented an incidence of 12% of all knee dislocations. Injury severity score for both groups was 18, documenting that the patients in this study represent multiple trauma patients. There was no significant difference in the incidence of HO based on mechanism of injury with the current number enrolled in the study. However, 60% (3 of 5) of patients involved in a motor vehicle versus pedestrian accident developed HO. There was a significant increase in the incidence of arthrofibrosis in patients with severe HO (P <.05). Patients with significant HO had a mean flexion of 97 degrees, compared with flexion of 117 degrees in patients with no or mild HO. This difference was borderline significant (P =.058). There was no difference between the groups in mean extension. There was a significant increase in knee HO in patients with HO at another anatomic site (P =.01). CONCLUSIONS: HO is a common problem following knee dislocation. Of the 7 knees with severe HO, 5 developed HO medially, 4 developed HO posteriorly, 3 developed HO laterally, and only 1 had involvement anteriorly. A similar distribution was present in the patients with mild HO, with posterior and medial ossification being the most common. Five of the 7 severe HO cases involved at least 3 of the 4 sides (anterior, posterior, medial, or lateral) of the knee. Patients were evaluated for the presence of head injury and any relationship to the development of HO around the knee. There was no increased incidence of HO around the knee in our 10 patients with severe head injuries when compared with those with no head injury. There was also no increased incidence of HO in knee dislocations associated with periarticular fractures.

Adolescent↗
PubMed2001

[Carpo-metacarpal dislocation injuries].

Carpometacarpal dislocations are rare. In most cases, the dislocation is caused by a violent injury, e.g. the crash of a motorcyclist or a fall from great height. A considerable swelling of the back of the hand may mask the characteristic lump at the root of the hand. The diagnosis can be easily missed due to serious associated injuries. The lesion is also often overlooked in the routine X-ray diagnostic. Lateral and oblique views are important for the recognition of the true extent of the lesion. Anatomical reposition is difficult if the dislocation is not fresh and open reposition is necessary. Between 1990 and 1999, altogether 16 patients who had suffered a carpometacarpal dislocation were treated. One patient had a rare dislocation of the III. to V. joints. Simultaneous dislocation of all five carpometacarpal joints was seen in three cases. The treatment mostly consists of closed reduction and temporary Kirschner wire transfixation. Fourteen patients were controlled (clinical examination and X-ray control) after an average follow-up time of three years. In addition, the DASH questionnaire was used. After an average time of 3 years the patients showed in 64% of the cases excellent and good results (eight excellent, one good). The subjective function of the hand was moderate in 29% (four patients), in one patient the subjective function was poor (7%). Five patients had a diminished range of motion of the hand. The average points in the DASH questionnaire were 24. We recommend as therapy of choice after primary closed repositioning, primary surgery by means of short Kirschner wires introduced from distal-dorsal to proximal-palmar. In cases of impossible closed reduction or in cases with local additional injuries, open treatment for fixation, is indicated.

Adult↗
PubMed2002

[Dislocation of the pisiform bone. A review of the literature].

Dislocation of the pisiform bone is extremely rare. So far, only 25 cases proved by radiographs have been reported. The sturdiness and stability of its ligamentous attachments may explain why dislocations of the pisiform are so rare. Often the dislocation is the result of direct trauma to the palmar and ulnar aspect of the wrist and less frequently due to indirect force or forceful muscular contraction. Dislocation of the pisiform bone occurs predominantly in young and active males. Usually, the pisiform is dislocated proximally or distally. The diagnosis is made by plain radiography. Operative treatment with pisiform excision and meticulous reapproximation of the attached soft-tissue structures yielded the most reliable results with preservation of wrist-flexion strength. Thus, although being very heterogenous with regard to mechanism of injury and displacement, pisiform dislocations should receive uniform treatment to obtain predictable results.

Carpal Bones↗
PubMed2006

[Initial results of shoulder MRI in external rotation after primary shoulder dislocation and after immobilization in external rotation].

PURPOSE: A change in the strategy for treating primary anterior traumatic dislocation of the shoulder has occurred. To date, brief fixation of internal rotation via a Gilchrist bandage has been used. Depending on the patient's age, a redislocation is seen in up to 90 % of cases. This is due to healing of the internally rotated labrum-ligament tear in an incorrect position. In the case of external rotation of the humerus, better repositioning of the labrum ligament complex is achieved. Using MRI of the shoulder in external rotation, the extent of the improved labrum-ligament adjustment can be documented, and the indication of immobilization of the shoulder in external rotation can be derived. The aim of this investigation is to describe the degree of position changing of the labrum-ligament tear in internal und external rotation. MATERIALS AND METHODS: 10 patients (9 male, 1 female, mean age 30.4 years, range 15 - 43 years) with a primary anterior dislocation of the shoulder without hyper laxity of the contra lateral side and labrum-ligament lesion substantiated by MRI were investigated using a standard shoulder MRI protocol (PD-TSE axial fs, PD-TSE coronar fs, T2-TSE sagittal, T1-TSE coronar) by an axial PD-TSE sequence in internal and external rotation. The dislocation and separation of the anterior labrum-ligament complex were measured. The shoulders were immobilized in 10 degrees external rotation for 3 weeks. After 6 weeks a shoulder MRI in internal rotation was performed. RESULTS: In all patients there was a significantly better position of the labrum-ligament complex of the inferior rim in external rotation, because of the tension of the ventral capsule and the subscapular muscle. In the initial investigation, the separation of the labrum-ligament complex in internal rotation was 0.44 +/- 0.27 mm and the dislocation was 0.45 +/- 0.33 mm. In external rotation the separation was 0.01 +/- 0.19 mm and the dislocation was - 0.08 +/- 0.28 mm. After 6 weeks of immobilization in 10 degrees external rotation, the separation of the labrum was - 0.10 +/- 0.14 mm and the dislocation was - 0.23 +/- 0.21 mm. CONCLUSION: In anterior labrum-ligament tears, the axial MRI of the shoulder in external rotation demonstrates a more physiologic position of the glenoid. This may indicate an immobilization of the shoulder in external rotation, which results in a more anatomical healing of the glenoidal tear. Thus, in the case of labrum-ligament tears, MRI in external rotation is becoming indispensable.

Adolescent↗
PubMedDate not supplied

[Dislocation of total hip endoprosthesis with special reference to various techniques].

1238 primary total hip replacements for arthritis were performed in our hospital from 1980 until 1988. 26 dislocations (2.1%) were registered during this period. No differences became obvious regarding age, sex, type of prosthesis and different concepts of postoperative treatment. After the posterior approach dislocations occurred in 18 (3.1%) of the cases, 8 dislocations (1.2%) were found after the transgluteal approach. The dislocation rate was significantly higher for the posterior approach. Derotation braces were not able to decrease the risk of redislocation. Most of the dislocations happened during the first postoperative week. The most frequent occasions were rotation of the operated leg while lying in bed and deep sitting positions. Performing the posterior approach for primary total hip arthroplasty the surgeon has to realize the higher dislocation rate.

Aged↗
PubMedDate not supplied

Incidence of dislocation following hip arthroplasty for patients in the rehabilitation setting.

Dislocation of a hip arthroplasty prosthesis is the most common serious complication after hip replacement. It is especially important in the rehabilitation setting because it is potentially preventable. The purpose of this study was to investigate differences in dislocation rates between rehabilitation and acute hospital settings. A retrospective chart review of total hip and bipolar hemiarthroplasty patients admitted to three rehabilitation hospitals was performed. Dislocation rates among 825 rehabilitation patients who met study eligibility criteria were compared with rates found among 5352 acute care patients reported in the published literature. The rate of hip dislocation among total hip replacement patients in rehabilitation hospitals was not significantly higher than that in acute settings (2.17% v 1.27%). Among bipolar hemiarthroplasty patients, however, the dislocation rate was markedly and significantly lower in rehabilitation than in acute settings (0% v 1.95%, P < 0.01). Possible reasons for these results are discussed. Further research is needed to identify risk factors more precisely for prosthesis dislocation.

Aged↗
PubMed1997

Traction in developmental dislocation of the hip. Is its use justified?

Traction has been used for decades in the treatment of developmental dislocation of the hip. Traction is advocated to facilitate closed reduction and to decrease the need for open reduction. The use of prereduction traction also is advocated to decrease the incidence of proximal femoral growth disturbance (aseptic necrosis). Recently, several studies have called into question this widely accepted adjunct in the treatment of developmental dislocation of the hip. A critical look was taken at the use of traction in the treatment of developmental dislocation of the hip and whether its use can be justified by the existing medical literature was ascertained. Although there are several impressive reports of the positive effects of traction in developmental dislocation of the hip, there are no clinical or experimental studies on the direct effect of traction. There are also no well controlled studies to analyze the effect of traction as a single variable. Thus, it cannot be proven that traction alters the outcome of developmental dislocation of the hip treatment, and hence, there is only anecdotal basis for its use in the treatment of developmental dislocation of the hip.

Femur Head Necrosis↗
PubMed2000

Initial treatment of traumatic hip dislocations in the adult.

The initial treatment of traumatic hip dislocations is critical to successful treatment of this injury. It generally is agreed that prompt reduction with the patient under anesthesia or sedation is required. Delay in reduction of posterior hip dislocations is associated with avascular necrosis of the hip. Occasionally the hip dislocation will be irreducible. Various methods to reduce hip dislocations have been described in the literature. The superiority of one particular technique has not been shown and the choice of reduction maneuver must be tailored to the condition of the patient. Traumatic hip dislocations often are associated with multiple injuries that may limit the options available for initial treatment of the hip dislocation. Adherence to general principles of skeletal reduction will increase the ease of reduction and decrease the risk of iatrogenic injury during reduction. Additional clinical and radiographic evaluation of the hip that was reduced often is necessary to determine whether subsequent open treatment is required.

Adult↗