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Sample records for acromioclavicular joint dislocation

  1. Epidemiology of Isolated Acromioclavicular Joint Dislocation

    Claudio Chillemi

    2013-01-01

    Full Text Available Background. Acromioclavicular (AC joint dislocation is a common shoulder problem. However, information about the basic epidemiological features of this condition is scarce. The aim of this study is to analyze the epidemiology of isolated AC dislocation in an urban population. Materials and Methods. A retrospective database search was performed to identify all patients with an AC dislocation over a 5-year period. Gender, age, affected side and traumatic mechanism were taken into account. X-rays were reviewed by two of the authors and dislocations were classified according to the Rockwood’s criteria. Results. A total of 108 patients, with a mean age of 37.5 years were diagnosed with AC dislocation. 105 (97.2% had an isolated AC dislocation, and 3 (2.8% were associated with a clavicle fracture. The estimated incidence was 1.8 per 10000 inhabitants per year and the male-female ratio was 8.5 : 1. 50.5% of all dislocations occurred in individuals between the ages of 20 and 39 years. The most common traumatic mechanism was sport injury and the most common type of dislocation was Rockwood type III. Conclusions. Age between 20 and 39 years and male sex represent significant demographic risk factors for AC dislocation.

  2. Arthroscopically Assisted Treatment of Acute Dislocations of the Acromioclavicular Joint

    Braun, Sepp; Beitzel, Knut; Buchmann, Stefan; Imhoff, Andreas B.

    2015-01-01

    Arthroscopically assisted treatments for dislocations of the acromioclavicular joint combine the advantages of exact and visually controlled coracoid tunnel placement with the possibility of simultaneous treatment of concomitant injuries. The clinical results of previous arthroscopically assisted techniques have been favorable at midterm and long-term follow-up. The presented surgical technique combines the advantages of arthroscopically positioned coracoclavicular stabilization with an additional suture cord cerclage of the acromioclavicular joint capsule for improved horizontal stability. PMID:26870646

  3. A modified surgical technique for reconstruction of an acute acromioclavicular joint dislocation

    Marchie Anthony

    2009-01-01

    Full Text Available We report a modified surgical technique for reconstruction of coracoclavicular and acromioclavicular ligaments after acute dislocation of acromioclavicular joint using suture anchors. We have repaired 3 consecutive type III acromioclavicular dislocations with good results. This technique is simple and safe and allows anatomical reconstruction of the ligaments in acute dislocations.

  4. The acromioclavicular joint: Normal variation and the diagnosis of dislocation

    Acromioclavicular separation is a common traumatic injury. Diagnosis rests on clinical and radiographic findings. However, normal variation in the alignment of the acromioclavicular joint may make the roentgen diagnosis more difficult. We stress the variations of normal alignment at the acromioclavicular joint and offer suggestions for avoiding pitfalls in this clinical situation. (orig.)

  5. Endobutton technique for the treatment of acute acromioclavicular joint dislocations

    Raif Özden

    2014-06-01

    Full Text Available Objective: Acromioclavicular (AC joint dislocation is a common injury frequently affecting young athletes. The aim of this study is to evaluate postoperative functional results in cases diagnosed with acute AC joint dislocation stabilized with endobutton system. Methods: This fixation procedure has been applied on 10 patients. Indications of the technique included: a grade V AC joint dislocation (7 patients, and grade III AC joint dislocation (3 patient according to Rockwood classification. The coracoclavicular (CC interval and AC joint were reduced using two endobuttons. One endobutton was fitted on the clavicle and the second was placed at the undersurface of the coracoid. Outcomes were assessed with the Constant shoulder score and visual analog pain scale. Results: All the patients had powerful intraoperative fixation. Immediately after surgery, and 6 weeks, and 1 year postoperative radiographs showed adequate reduction of the CC distance and the AC joint. The mean Constant shoulder score was 89 (88–92 in the injured shoulder and 90 (88–93 in the uninjured shoulder. There was no statically significant difference between the injured and normal shoulder in terms of Constant shoulder score and there was no complication during the process. Conclusion: This technique is a safe and effective method for providing fixation for the AC joint.

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

    Trikha, S. P.; Acton, D.; Wilson, A. J.; Curtis, M. J.

    2004-01-01

    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 ...

  7. Operative treatment of acromioclavicular joint dislocation: a new technique with suture anchors

    Zhang Jingwei

    2014-07-01

    Full Text Available 【Abstract】Objective: To evaluate clinical outcome of suture anchors in strengthening both acromioclavicular and coracoclavicular ligaments in the surgical treatment of acromioclavicular joint dislocation. Methods: Twenty-eight patients with acute traumatic Rockwood III, IV and V dislocations of the acromioclavicular joint surgically treated at our institute between October 2010 and January 2012 were recruited. All patients underwent open reduction combined with suture anchors. Function was evaluated using the ConstantMurley shoulder score. Clinical and radiographic shoulder ratings were evaluated using Taft criteria at 3, 6 and 12 months. Results:Two cases with fixation loosening were not included in final statistical analysis. Other patients obtained full joint reposition on immediate postoperative radiographs. Follow-up was performed with an average of 15.6 months (range, 12-19. After early range of motion exercises, 96.2% of the patients (25/26 could abduct and elevate their shoulders more than 90 degrees within postoperative 3 months. There was no infection. Average Constant-Murley score was 96.3 points (range, 94-100 and mean Taft shoulder rating was 10.7 points (range, 8-12 at 12 months. Conclusion: The suture anchor is a relatively simple technique and can avoid screw removal which is helpful in reconstructing both acromioclavicular and coracoclavicular ligaments in acute traumatic acromioclavicular joint dislocation. Key words: Acromioclavicular joint; Dislocations; Surgery; Suture anchors

  8. Operative treatment of acromioclavicular joint dislocation:a new technique with suture anchors

    Zhang Jingwei; Li Min; He Xianfeng; Yu Yihui; Zhu Limei

    2014-01-01

    Objective:To evaluate clinical outcome of suture anchors in strengthening both acromioclavicular and coracoclavicular ligaments in the surgical treatment of acromioclavicular joint dislocation.Methods:Twenty-eight patients with acute traumatic Rockwood Ⅲ,Ⅳ and Ⅴ dislocations of the acromioclavicular joint surgically treated at our institute between October 2010 and January 2012 were recruited.All patients underwent open reduction combined with suture anchors.Function was evaluated using the ConstantMurley shoulder score.Clinical and radiographic shoulder ratings were evaluated using Taft criteria at 3,6 and 12 months.Results:Two cases with fixation loosening were not included in final statistical analysis.Other patients obtained full joint reposition on immediate postoperative radiographs.Follow-up was performed with an average of 15.6 months (range,12-19).After early range of motion exercises,96.2% of the patients (25/26) could abduct and elevate their shoulders more than 90 degrees within postoperative 3 months.There was no infection.Average Constant-Murley score was 96.3 points (range,94-100)and mean Taft shoulder rating was 10.7 points (range,8-12) at 12 months.Conclusion:The suture anchor is a relatively simple technique and can avoid screw removal which is helpful in reconstructing both acromioclavicular and coracoclavicular ligaments in acute traumatic acromioclavicular joint dislocation.

  9. Clinical Effect of Acute Complete Acromioclavicular Joint Dislocation Treated with Micro-Movable and Anatomical Acromioclavicular Plate

    Qingjun Liu, Jianyun Miao, Bin Lin, Zhimin Guo

    2012-01-01

    Full Text Available Objectives: We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated with micro-movable and anatomical acromioclavicular plate.Methods: Open reduction and internal fixation was performed using the MAAP in 16 patients (10 males, 6 females; mean age 36 years; range16 to 63 years with acute complete acromioclavicular joint dislocation. Radiographic evaluations were routinely conducted every 3 weeks until 3 months postoperatively. The MAAP were removed under local anesthesia after 3 months postoperatively. We evaluated the functional results by using the constant scoring system and radiological results in the last follow-up time. The mean follow up was 26 months (range 16 to 38 months.Results: The mean Constant score was 94 (range, 78 to 100. The results were excellent in 12 patients (75.0%, good in 3 patients (18.8% and satisfactory in 1patient (6.2%. Three patients with scores of 80 to 90 had mild pain during activity, but have not affected the shoulder range of motion. One patient has both some pain and limited range of motion of shoulder joint. All patients but one have returned to their preoperative work without any limitations. Compared to the contralateral side, radiography showed anatomical reposition in the vertical plane in 14 cases, slight loss of reduction in 2 older patients.Conclusion: We recommend the MAAP fixation for surgical treatment of acute complete acromioclavicular joint dislocation as it could provide satisfactory shoulder functions and clinical results, with lower complication rate. However, it is necessary to continue to observe the clinical effects of this fixation technique.

  10. Type IV acromioclavicular joint dislocation associated with a mid-shaft clavicle malunion

    Khalid D Mohammed

    2016-01-01

    Full Text Available This reports presents the case of a combined clavicle fracture malunion and chronic Type IV acromioclavicular (AC joint dislocation. The patient was seen acutely in the emergency department following a mountain bike accident at which time the clavicle fracture was identified and managed conservatively however the AC dislocation was not diagnosed. The patient presented 25 months following the injury with persistent pain and disability and was treated with clavicle osteotomy and AC stabilization. We document the clinical details, surgical treatment and outcome.

  11. Type IV acromioclavicular joint dislocation associated with a mid-shaft clavicle malunion.

    Mohammed, Khalid D; Stachiw, Danielle; Malone, Alex A

    2016-01-01

    This reports presents the case of a combined clavicle fracture malunion and chronic Type IV acromioclavicular (AC) joint dislocation. The patient was seen acutely in the emergency department following a mountain bike accident at which time the clavicle fracture was identified and managed conservatively however the AC dislocation was not diagnosed. The patient presented 25 months following the injury with persistent pain and disability and was treated with clavicle osteotomy and AC stabilization. We document the clinical details, surgical treatment and outcome. PMID:26980988

  12. Comparative study on treating complete dislocation of acromioclavicular joint with three different methods

    林斌; 练克俭; 郭林新; 郭志民; 庄泽民; 刘庆军; 周亮

    2004-01-01

    Objective: To comparatively study complete dislocation of acromioclavicular joint treated with three different methods.Methods:A total of 96 patients (81 males and 15 females, aged 16-59 years, mean =45 years) with complete dislocation of acromioclavicular joint were treated with Dewar's operation ( Group A, n = 32), internal fixation with Kirschner tension band wires ( Group B, n = 44), or internal fixation with Wolter plates ( Group C, n = 20 ),respectively, in this study. Eighty-five patients suffered from acute dislocations and eleven from chronic dislocations. Results: The patients were followed up for 50 months on an average. According to Karlsson's standard, in Group A, 26 patients were assessed as good, 5 as fair and 1 as poor. In Group B, 20 patients were assessed as good, 13 as fair and 11 as poor. In Group C, 15 patients were assessed as good, 4 as fair and 1 as poor. The good and fair rates were significantly different between Group A and Group B, and between Group C and Group B, but no statistical difference was found between Group A and Group C. The operating time was ( 52.36 ± 7.24 ) minutes, ( 67.43 ± 8.11) minutes and (69.73 ±8.04) minutes in Groups A, B and C, respectively. And the hospitalizing fees were (2 400 ±270) yuan, (2 100±190) yuan and (8450±360) yuan in Groups A, B and C, respectively. Conclusions: Dewar's operation is a good and safe method with shorter operating time and lower hospitalizing fee for treating complete dislocation of acromioclavicular joint. The method is simple without the need of a second operation to remove the implants and with few complications.

  13. Acroplate--a modern solution for the treatment of acromioclavicular joint dislocation.

    Cîrstoiu, C; Rădulescu, R; Popescu, D; Ene, R; Circotă, G; Bădiceanu, Corina

    2009-01-01

    Two main ways to fix the reduction were imposed in surgical treatment of the acromioclavicular joint dislocations: fixation with trans acromioclavicular pin (Phemister method) and fixation with plate and screws type acroplate. The purpose of the present paper work is to compare immediate and later postoperative results between the two types of surgical interventions. During 2005-2007, 37 surgical reductions and fixation of acromioclavicular joint dislocations were performed in the Orthopedic-Traumatology Clinic of SUUB. In 17 cases a fixation with screws and plates type acroplate has been performed and in 20 cases with pins using the Phemister method. Sex ratio: 31 men and 8 women. Patients were aged between 17 and 56 years old. Follow up at 6 weeks, 3, 6, 12 and 18 post-operatory months. Osteosintesis material removing was done postoperatively, at 4 weeks in case of acroplate's and at 6 weeks in case of the pins. All patients treated of fixation with plate and screws acroplate type had a favorable evolution/development, starting with the shoulder joint mobilization at 24 hours postoperatively, with a complete recovery 4 weeks after the operation, at the same time with the ablation, and without immediate other late complications. As far as the patients treated by using the Phemister method are concerned, they were applied an immobilization, postoperatively. Desault bandage or the scarf for a period between 1 and 3 weeks, beginning with the shoulder joint mobilization later on and a full recovery after a minimum of 6 weeks. However, 3 of the cases showed a migration of one or both pins. Following the study, a more rapid recovery resulted, complete, and without complications of mobility in the shoulder joint, when using plate type acroplate vs pin. PMID:20108536

  14. Complete acromioclavicular joint dislocation treated with reconstructed ligament by trapezius muscle fascia and observation of fascial metaplasia

    Wang Chaoliang

    2015-01-01

    Full Text Available We evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated by reconstruction of the acromioclavicular and coracoclavicular ligament using trapezius muscle fascia. Open reduction and internal fixation was performed using the clavicular hook plate in 12 patients with acute complete acromioclavicular joint dislocation, and the acromioclavicular and coracoclavicular ligaments were reconstructed using trapezius muscle fascia. Radiographic evaluations were conducted postoperatively. We evaluated the functional results with constant scoring system and radiological results at the final follow-up visit. The mean Constant score at the final follow-up visit was 91.67 (range, 81 to 100. The results were excellent in eight patients (66.7% and good in four patients (33.3%. Three patients with scores from 80 to 90 had mild pain during activity, but this did not affect the range of motion of the shoulder. All patients have returned to their preoperative work without any limitations. Compared with the contralateral side, radiography showed anatomical reposition in the vertical plane in all cases. The hook-plate fixation with ligament reconstruction was successful in treating AC dislocations. The acromioclavicular and coracoclavicular ligament were reconstructed by trapezius muscle fascia that keep the distal clavicle stable both vertically and horizontally after type III injuries.

  15. Coracoid Process Avulsion Fracture at the Coracoclavicular Ligament Attachment Site in an Osteoporotic Patient with Acromioclavicular Joint Dislocation

    Umemoto, Takahisa; Fukuda, Kimitaka; Kajino, Tomomichi

    2016-01-01

    Coracoid fractures are uncommon, mostly occur at the base or neck of the coracoid process (CP), and typically present with ipsilateral acromioclavicular joint (ACJ) dislocation. However, CP avulsion fractures at the coracoclavicular ligament (CCL) attachment with ACJ dislocation have not been previously reported. A 59-year-old woman receiving glucocorticoid treatment fell from bed and complained of pain in her shoulder. Radiographs revealed an ACJ dislocation with a distal clavicle fracture. Three-dimensional computed tomography (3D-CT) reconstruction showed a small bone fragment at the medial apex of the CP. She was treated conservatively and achieved a satisfactory outcome. CP avulsion fractures at the CCL attachment can occur in osteoporotic patients with ACJ dislocations. Three-dimensional computed tomography is useful for identifying this fracture type. CP avulsion fractures should be suspected in patients with ACJ dislocations and risk factors for osteoporosis or osteopenia. PMID:27493819

  16. Coracoid Process Avulsion Fracture at the Coracoclavicular Ligament Attachment Site in an Osteoporotic Patient with Acromioclavicular Joint Dislocation

    Yoshihiro Onada

    2016-01-01

    Full Text Available Coracoid fractures are uncommon, mostly occur at the base or neck of the coracoid process (CP, and typically present with ipsilateral acromioclavicular joint (ACJ dislocation. However, CP avulsion fractures at the coracoclavicular ligament (CCL attachment with ACJ dislocation have not been previously reported. A 59-year-old woman receiving glucocorticoid treatment fell from bed and complained of pain in her shoulder. Radiographs revealed an ACJ dislocation with a distal clavicle fracture. Three-dimensional computed tomography (3D-CT reconstruction showed a small bone fragment at the medial apex of the CP. She was treated conservatively and achieved a satisfactory outcome. CP avulsion fractures at the CCL attachment can occur in osteoporotic patients with ACJ dislocations. Three-dimensional computed tomography is useful for identifying this fracture type. CP avulsion fractures should be suspected in patients with ACJ dislocations and risk factors for osteoporosis or osteopenia.

  17. Coracoid Process Avulsion Fracture at the Coracoclavicular Ligament Attachment Site in an Osteoporotic Patient with Acromioclavicular Joint Dislocation.

    Onada, Yoshihiro; Umemoto, Takahisa; Fukuda, Kimitaka; Kajino, Tomomichi

    2016-01-01

    Coracoid fractures are uncommon, mostly occur at the base or neck of the coracoid process (CP), and typically present with ipsilateral acromioclavicular joint (ACJ) dislocation. However, CP avulsion fractures at the coracoclavicular ligament (CCL) attachment with ACJ dislocation have not been previously reported. A 59-year-old woman receiving glucocorticoid treatment fell from bed and complained of pain in her shoulder. Radiographs revealed an ACJ dislocation with a distal clavicle fracture. Three-dimensional computed tomography (3D-CT) reconstruction showed a small bone fragment at the medial apex of the CP. She was treated conservatively and achieved a satisfactory outcome. CP avulsion fractures at the CCL attachment can occur in osteoporotic patients with ACJ dislocations. Three-dimensional computed tomography is useful for identifying this fracture type. CP avulsion fractures should be suspected in patients with ACJ dislocations and risk factors for osteoporosis or osteopenia. PMID:27493819

  18. The relationship between chronic type III acromioclavicular joint dislocation and cervical spine pain

    Vestri Anna R

    2009-12-01

    Full Text Available Abstract Background This study was aimed at evaluating whether or not patients with chronic type III acromioclavicular dislocation develop cervical spine pain and degenerative changes more frequently than normal subjects. Methods The cervical spine of 34 patients with chronic type III AC dislocation was radiographically evaluated. Osteophytosis presence was registered and the narrowing of the intervertebral disc and cervical lordosis were evaluated. Subjective cervical symptoms were investigated using the Northwick Park Neck Pain Questionnaire (NPQ. One-hundred healthy volunteers were recruited as a control group. Results The rate and distribution of osteophytosis and narrowed intervertebral disc were similar in both of the groups. Patients with chronic AC dislocation had a lower value of cervical lordosis. NPQ score was 17.3% in patients with AC separation (100% = the worst result and 2.2% in the control group (p Conclusions Our study shows that chronic type III AC dislocation does not interfere with osteophytes formation or intervertebral disc narrowing, but that it may predispose cervical hypolordosis. The higher average NPQ values were observed in patients with chronic AC dislocation, especially in those that developed cervical hypolordosis.

  19. Management of acromioclavicular joint injuries.

    Li, Xinning; Ma, Richard; Bedi, Asheesh; Dines, David M; Altchek, David W; Dines, Joshua S

    2014-01-01

    Acromioclavicular joint injuries are among the most common shoulder girdle injuries in athletes and most commonly result from a direct force to the acromion with the arm in an adducted position. Acromioclavicular joint injuries often present with associated injuries to the glenohumeral joint, including an increased incidence of superior labrum anterior posterior (SLAP) tears that may warrant further evaluation and treatment. Anteroposterior stability of the acromioclavicular joint is conferred by the capsule and acromioclavicular ligaments, of which the posterior and superior ligaments are the strongest. Superior-inferior stability is maintained by the coracoclavicular (conoid and trapezoid) ligaments. Type-I or type-II acromioclavicular joint injuries have been treated with sling immobilization, early shoulder motion, and physical therapy, with favorable outcomes. Return to activity can occur when normal shoulder motion and strength are obtained and the shoulder is asymptomatic as compared with the contralateral normal extremity. The management of type-III injuries remains controversial and is individualized. While a return to the previous level of functional activity with nonsurgical treatment has been documented in a number of case series, surgical reduction and coracoclavicular ligament reconstruction has been associated with a favorable outcome and can be considered in patients who place high functional demands on their shoulders or in athletes who participate in overhead sports. Surgical management is indicated for high-grade (≥type IV) acromioclavicular joint injuries to achieve anatomic reduction of the acromioclavicular joint, reconstruction of the coracoclavicular ligaments, and repair of the deltotrapezial fascia. Outcomes after surgical reconstruction of the coracoclavicular ligaments have been satisfactory with regard to achieving pain relief and return to functional activities, but further improvements in the biomechanical strength of these

  20. 全关节镜下治疗肩锁关节脱位%Arthroscopic treatment of acromioclavicular joint dislocation

    汪国友; 沈骅睿; 曾胜强; 徐平; 邓凯; 扶世杰

    2014-01-01

    Background The dislocation of acromioclavicular joint is a common injury clinically. This study is to investigate the treatment of acute acromioclavicular joint dislocation (Rockwood typeⅢ)and compare the clinical effect of two different ways of coracoclavicular ligament reconstruction. Methods We select the patients with fresh Rockwood type Ⅲ to V dislocation of acromioclavicular joint from January 2008 to June 2013.After randomization,1 6 cases received the reconstruction of coracoclavicular and acromioclavicular ligament arthroscopically with semitendinosus tendon (autogenous group).Among them,12 were males and 4 were females,aged 1 6-62 years old,the average age is 39.8 years old.They were followed up for 9-39 months,the average follow-up was 25.6 months;13 cases underwent the reconstruction of coracoclavicular ligament with the double Endobutton plate and Ethibond suture (Ethibond suture group),including 9 cases of male,4 cases of female,aging from 1 9 to 57 years old,the average age is 36.5 years old,were followed up for 12-35 months with a mean follow-up of 1 9.6 months.The reason of injury:12 cases of traffic injuries,9 cases of sports injury,4 cases of fall,bruise in 2 cases and 2 cases of other injuries.The time between injury to operation was 3-1 1 d,averagely 6 d.8 patients were accompanied by SLAP injury of shoulder joint (5 cases of autologous ligament group,3 cases of Ethibond suture group),3 patients were accompanied by rotator cuff injury (1 cases of autologous ligament group,2 cases of Ethibond suture group).2 patients were combined with glenohumeral joint cartilage injury (1 case of autologous ligament group 1 case,1 case of love help group),2 patients were combined with Bankart injury (both in autologous ligament group ), 1 patient was combined with glenoid fracture (Ethibond suture group).The age,sex,cause of injury,injury side and time from getting injured to operation of the two groups are without significant differences (P >0

  1. Tratamento artroscópico da luxação acromioclavicular aguda com âncoras Arthroscopic treatment of acute acromioclavicular joint dislocation using suture anchors

    Leonardo Muntada Cavinatto

    2011-01-01

    Full Text Available OBJETIVO: Apresentar os resultados clínicos e radiográficos de uma série de casos com diagnóstico de Luxação Acromioclavicular (LAC Aguda, tratados através da fixação coracoclavicular com âncoras por via artroscópica. MÉTODO: Vinte pacientes apresentando LAC com menos de 30 dias de evolução foram operados pela técnica da estabilização coracoclavicular com âncoras por via artroscópica. Duas âncoras metálicas com dois fios cada, foram inseridas no coracóide. Os fios foram amarrados sobre a clavícula passando por túneis transósseos claviculares. Para a avaliação radiográfica, foi utilizada a medida comparativa da distância coracoclavicular com o lado contralateral e a avaliação funcional através dos escores de Constant e UCLA o seguimento foi de seis meses. RESULTADO: Dos vinte casos inicialmente selecionados, seis necessitaram de novo procedimento cirúrgico e foram excluídos do estudo. Dos quatorze pacientes restantes, apenas dois mantiveram redução da articulação acromioclavicular, enquanto os demais apresentaram algum grau de desvio no decorrer da evolução. Desconsiderando os pacientes excluídos, os escores de Constant e UCLA tiveram média 94,79 (82-100 e, 32,64 (26-35, respectivamente. CONCLUSÃO: A técnica apresentou um alto índice de perda da redução ao longo da evolução de seis meses. A avaliação funcional apresentou resultado satisfatório com escore médio elevado de Evidência: Nível de Evidência: Nível III, estudo retrospectivo.OBJECTIVE: To present the clinical and radiographic results of a case series of patients with acute acromioclavicular dislocation (AAD treated by arthroscopic coracoclavicular fixation with suture anchors. METHOD: Twenty patients with AAD with less than 30 days since the injury were submitted to a coracoclavicular stabilization procedure using 2 suture anchors placed at the base of the coracoid process. Each suture anchor was connected to 2 strands of No.2

  2. Radiographic changes in the operative treatment of acute acromioclavicular joint dislocation – tight rope technique vs. K-wire fixation

    Operative treatment of higher degree acromioclavicular joint luxation is common. A new option is made available by the tight rope technique. It claims to provide adequate outcome with the use of a minimally invasive technique. First clinical studies justified its medical use, but the equivalence to established surgical methods remains unclear. We therefore analyzed radiographic data from patients that were treated with the tight rope system (TR) and compared them to those treated with K-wires (KW) fixation. Retrospective study with inclusion criteria: surgery for acromioclavicular joint luxation between 2004 and 2011, classified as Rockwood type III, no concomitant injury, first event injury. We compared pre- and post-operative X-rays with those taken at the end of treatment. Clinical data from follow-ups and radiographic data were evaluated. The main outcome variable was the remaining distance between the acromion and clavicle (ACD), as well as the coracoid process and clavicle (CCD). 27 patients (TR: n=16; KW: n=11) with comparable demographics and injury severity were included. Surgery reduced ACD (TR: p=0.002; KW: p<0.001) and CCD (TR: p=0.001; KW: p=0.003). Heterotopic ossification or postoperative osteolysis was not significantly associated with either one of the procedures. Three patients (18.75%) in the TR group showed impaired wound healing, migrating K-wires were recorded in 2 patients (18.2%) and impingement syndrome occurred in 1 patient (9.1%) with K-wires. Posttraumatic arthritis was not seen. There was a loss of reduction in 2 cases within the TR-group (12.51%) and 1 in the KW-group (9.1%). At last follow up, ACD and CCD were wider in both groups compared to the healthy side. This study shows that the Tight rope system is an effective alternative in the treatment of higher degree acromioclavicular luxation and comparable to the established methods

  3. Treatment of Chronic Acromioclavicular Joint Dislocation in a Paraplegic Patient with the Weaver-Dunn Procedure and a Hook-Plate

    Godry, Holger; Citak, Mustafa; Königshausen, Matthias; Schildhauer, Thomas A.; Seybold, Dominik

    2016-01-01

    In case of patients with spinal cord injury and concomitant acromioclavicular (AC) joint-dislocation the treatment is challenging, as in this special patient group the function of the shoulder joint is critical because patients depend on the upper limb for mobilization and wheelchair-locomotion. Therefore the goal of this study was to examine, if the treatment of chronic AC-joint dislocation using the Weaver-Dunn procedure augmented with a hook-plate in patients with a spinal cord injury makes early postoperative wheelchair mobilization and the wheelchair transfer with full weight-bearing possible. In this case the Weaver-Dunn procedure with an additive hook-plate was performed in a 34-year-old male patient with a complete paraplegia and a posttraumatic chronic AC-joint dislocation. The patient was allowed to perform his wheelchair transfers with full weight bearing on the first post-operative day. The removal of the hook-plate was performed four months after implantation. At the time of follow-up the patient could use his operated shoulder with full range of motion without restrictions in his activities of daily living or his wheel-chair transfers. PMID:27433301

  4. Reconstruction of displaced acromio-clavicular joint dislocations using a triple suture-cerclage: description of a safe and efficient surgical technique

    Sandmann Gunther H

    2012-10-01

    Full Text Available Abstract Purpose In this retrospective study we investigated the clinical and radiological outcome after operative treatment of acute Rockwood III-V injuries of the AC-joint using two acromioclavicular (AC cerclages and one coracoclavicular (CC cerclage with resorbable sutures. Methods Between 2007 and 2009 a total of 39 patients fit the inclusion criteria after operative treatment of acute AC joint dislocation. All patients underwent open reduction and anatomic reconstruction of the AC and CC-ligaments using PDS® sutures (Polydioxane, Ethicon, Norderstedt, Germany. Thirty-three patients could be investigated at a mean follow up of 32±9 months (range 24–56 months. Results The mean Constant score was 94.3±7.1 (range 73–100 with an age and gender correlated score of 104.2%±6.9 (88-123%. The DASH score (mean 3.46±6.6 points, the ASES score (94.6±9.7points and the Visual Analogue Scale (mean 0.5±0,6 revealed a good to excellent clinical outcome. The difference in the coracoclavicular distance compared to the contralateral side was Conclusion Open AC joint reconstruction using AC and CC PDS cerclages provides good to excellent clinical results in the majority of cases. However, radiographically, the CC distance increased significantly at final follow up, but neither the amount of re-dislocation nor calcifications of the CC ligaments or osteoarthritis of the AC joint had significant influence on the outcome. Level of evidence Case series, Level IV

  5. Mid-term results after operative treatment of rockwood grade III-V Acromioclavicular joint dislocations with an AC-hook-plate

    Kienast B

    2011-02-01

    Full Text Available Abstract Acromioclavicular joint dislocations often occur in athletic, young patients after blunt force to the shoulder. Several static and dynamic operative procedures with or without primary ligament replacement have been described. Between February 2003 and March 2009 we treated 313 patients suffering from Rockwood III-V lesions of the AC joint with an AC-hook plate. 225 (72% of these patients could be followed up. Mean operation time was 42 minutes in the conventional group and 47 minutes in the minimal invasive group. The postoperative pain on a scale from 1 to 10 (VAS-scale was rated 2.7 in the conventional group and 2.2 in the minimal invasive group. Taft score showed very good and good results in 189 patients (84%. Constant score showed an average of 92.4 of 100 possible points with 89% excellent and good results and 11% satisfying results. All patients had some degree of pain or discomfort with the hookplate in place. These symptoms were relieved after removal of the plate. The overall complication rate was 10.6%. There were 6 superficial soft tissue infections, 1 fracture of the acromion, 7 redislocations after removal of the hook-plate. We observed 4 broken hooks which could be removed at the time of plate removal, 4 seromas and 2 cases of lateral clavicle bone infection, which required early removal of the plate. We can conclude that clavicle hook plate is a convenient device for the surgical treatment of Rockwood Grade III-V dislocations, giving good mid-term results with a low overall complication rate compared to the literature. Early functional therapy is possible and can avoid limitations in postoperative shoulder function.

  6. Clinical results of coracoacromial ligament transfer in acromioclavicular dislocations: A review of published literature

    Sood Aman

    2008-01-01

    Full Text Available Acromioclavicular joint dislocations are common injuries, which typically occur with trauma in young men. Treatment recommendations for these injuries are highly variable and controversial. There are greater than 100 surgical techniques described for operative treatment of this injury. One of the most widely recommended methods of surgical reconstruction for acromioclavicular joint dislocations is to utilize the coracoacromial ligament for stabilization of the distal clavicle. Several modifications of this procedure have been described which have involved adjunct coracoclavicular fixation or fixation across acromioclavicular joint. Although the literature is replete with descriptive papers, there is paucity of studies evaluating the surgical outcome of this procedure. We systematically reviewed the English language published literature in peer reviewed journals (Medline, EMBASE, SCOPUS and assigned a level of evidence for available studies. We critically reviewed each paper for the flaws and biases and then evaluated the comparable clinical outcomes for various procedures and their modifications. The published literature consists entirely of case series (Level IV evidence with variability in surgical technique and outcome measures. On review there is low level evidence to support the use of coracoacromial ligament for acromioclavicular dislocation but it has been associated with high rate of deformity recurrence. Adjunct fixation does not improve clinical results when compared to isolated coracoacromial ligament transfer. This is in part because of the high incidence of fixation related complications. Similar results are reported with coracoacromial ligament reconstruction for acute and chronic cases. The development of secondary acromioclavicular joint symptoms with distal clavicle retention is poorly reported with the incidence rate varying from 12% to 32%. Despite this, the retention or excision of distal clavicle did not affect overall

  7. 关节镜下喙锁韧带增强术治疗肩锁关节脱位%Arthroscopic treatment of acute acromioclavicular joint dislocations by coracoacromial ligament augmentation and suture

    皇甫小桥; 赵金忠; 何耀华; 杨星光; 刘旭东; 刘闻欣; 王海明

    2013-01-01

    目的:研究关节镜下缝线钢板增强喙锁韧带术治疗肩锁关节脱位的近期治疗效果。方法2010年3月至2011年3月,在关节镜下使用膝关节韧带重建技术的缝线钢板(德国 ASCULAP 公司, B′BRAUN)增强重建喙锁韧带(三角韧带与斜方韧带),治疗 Rockwood Ⅲ型9例、Ⅴ型3例新鲜肩锁关节脱位。行 X线片、美国肩肘关节外科医师(America Shoulder Elbow Surgeons,ASES)评分和 Constant 评分,随访12~18个月。结果 ASES 评分:术前28.7分,术后86.9分;Constant 评分:术前24分,术后91分。治疗组 X线片显示,肩锁关节复位良好。术后1年,91.7%(11/12)病例获得满意治疗效果,83.3%(10/12)恢复到术前运动水平,仅有1例出现肩锁关节半脱位。结论关节镜下缝线钢板喙锁韧带增强术治疗肩锁关节脱位,早期可以获得满意的治疗效果,术后复位良好,并发症少。%Objective Acromioclavicular joint dislocation is commonly seen in shoulder joint injuries. Dysfunction as well as pain and discomfort usually occurred when the integrity of shoulder is damaged,for the acromioclavicular (AC)joint is involved in the connection between the scapula and the body as well as the activities of shoulder joint.Therefore,a consensus has been reached to treat severe AC joint dislocation by surgery.Based on different anatomical and functional cognition,methods for AC joint dislocation are various,which are typically performed by incision to reconstruct its stability and restore function.Attempts had been made by many doctors in the reconstruction of AC joint dislocation with the development of arthroscopy.From March 2010 to March 2011,obvious therapeutic effect was obtained in treating Rockwood type Ⅲ and Ⅴ AC joint dislocation arthroscopically with the suture plate used for the reconstruction of ligaments of knee joint to augment the reconstructed CC ligaments (conoid ligament and trapezoid ligament).Methods From March 2010 to March 2011

  8. COMPARATIVE ANALYSIS OF AUTOGRAFT TECHNIQUE AND CLAVICULAR HOOK PLATE IN GRADE 3 ACROMIOCLAVICULAR DISLOCATIONS

    Rahul Narayan; Ojas

    2016-01-01

    OBJECTIVE To evaluate clinical outcome of clavicular hook plate and autograft technique in the surgical treatment of Rockwood Grade-III acromioclavicular joint dislocation. METHODS Fifteen patients were operated using standard clavicular hook plate and another fifteen patients were operated using autograft technique. After a minimum follow-up of one year, clinical assessment was done using Constant-Murley Score. Statistical evaluation was done using SPSS ver. 21.0. RES...

  9. Three Endobutton plates in reconstruction of coracoclavicular ligament for the dislocations of the acromioclavicular joint%三Endobutton钢板解剖重建喙锁韧带治疗肩锁关节脱位

    吕书军; 曹勇; 洪晔; 蒋栋; 周广(钅监)

    2012-01-01

    目的 探讨三Endobutton钢板解剖重建喙锁韧带治疗肩锁关节脱位的初步临床疗效.方法 对25例肩锁关节脱位患者应用三Endobutton钢板解剖重建喙锁韧带治疗的临床疗效进行分析.结果 25例均获随访,时间14~29个月.X线检查证实肩锁关节脱位均完全复位.肩关节外展活动范围术前为40°~80°,术后为140°~150°.肩关节功能按Constant标准,评分术前为(66.5±3.2)分,术后3个月为(90.5±2.3)分,术后6个月为(93.5±3.1)分.结论 三Endobutton钢板解剖重建喙锁韧带治疗肩锁关节脱位固定确实,不损伤关节面,术后患者可以早期功能锻炼,无需二次手术,疗效满意.%Objective To evaluate the clinical results of three Endobutton plates in reconstruction of coracoclavicular ligament for the dislocations of the acromioclavicular joint. Methods 25 patients with the dislocations of the acromi-oclavicular joint were reviewed retrospectively. The Constant evaluation system were used to analyze the clinical effects of triple button plates technique. Results All patients obtained the follow-up and the time was 14 to 29 months. Preoperative shoulder abduction range was 40° to 80°. Postoperative abduction range was 140° to 150°. Pre-operative shoulder function according to the standard of Constant score was 66. 5 ± 3. 2 points. After 3 months, Constant score was ( 90. 5 ± 2. 3 ) points, and 6 months Constant score was ( 93. 5 ± 3. 1 ) points. Conclusions The treatment of dislocations of acromioclavicular joint by using reconstruction of coracoclavicular ligament has satisfactory functional outcome and a few trauma in joint surface, without the secondary operation.

  10. Treatment of Rockwood type Ⅲ acromioclavicular joint dislocation with endobutton technique%应用 Endobutton 带袢钢板技术治疗RockwoodⅢ型肩锁关节脱位

    宋哲; 张堃; 朱养均; 李忠; 庄岩; 魏巍; 杨娜

    2015-01-01

    Background Acromioclavicular joint dislocation is a common injury which often occurs in heavy manual workers and young athletes.It is usually caused by collision of the shoulder on the ground.Acromioclavicular joint dislocation of Rockwood type Ⅲ often needs surgical treatment. There are several kinds of operation methods reported in the literature,but no universally accepted technique exists.From June 2010 to June 2013,21 patients of Rockwood type Ⅲ acromioclavicular joint dislocation were treated with Endobutton technique in our hospital,shoulder functional and radiological evaluations were performed and the outcome is encouraging.Methods (1 )General information:Twenty-one patients were included in this study.Patients were 14 males and 7 females. Nine cases were on the left side and 12 cases were on the right side.The age ranged from 1 9 to 52 with an average of 31.2 years.The causes were traffic injury in 8 cases,fall damage in 9 cases,sports injury in 2 cases and heavy object hit injury in 2 cases.All patients were diagnosed as acromioclavicular joint dislocation of Rockwood type Ⅲ without clavicle fracture,multiple fractures,closed chest injury and cerebral injury.The clinical presentations included pain over the lateral side of clavicle with its distal end protruding upward,tenderness and a feeling of floating;X-ray examinations revealed that the distal clavicle was higher than the acromion.21 cases were all fresh dislocations without neurovascular injuries;The operation time was 1-5 days after injury.(2)Operation method:After successful general anesthesia or cervical plexus block,the patient was in supine or “beach chair”position with head turned to the uninjured side.The straight incision was extended longitudinally from coracoid upward to the posterior edge of clavicle.The skin and subcutaneous tissue was incised layer by layer.The deltoid muscle was bluntly separated and the periosteum was stripped to expose acromioclavicular joint

  11. 关节镜下四骨道双束固定治疗急性肩锁关节Rockwood Ⅴ型脱位%Arthroscopic fixation in the treatment of Rockwood Ⅴ acute acromioclavicular joint dislocation

    陆伟; 王大平; 朱伟民; 欧阳侃; 柳海峰; 彭亮权; 李皓; 冯文哲

    2014-01-01

    Background Treatment methods for acromioclavicular joint dislocation of Rockwood type V are numerous.The commonly used is the open surgery with large trauma (by clavicular hook plate fixation).In recent years,some scholars use clavicle-coracoid screws fixation method under arthroscopy,but the screws need to be removed after 6 weeks; there are also scholars using arthroscopic double Endobutton loops single bundle fixation method with good effect,but they found suture rupture between the Endobutton,redislocation or fracture,bone absorption under the loops in some patients. This article investigates the method of arthroscopic procedure with four-tunnel quadruple double-bundle Endobutton double-bundle fixation via self-designed positioning apparatus in the treatment of acute acromioclavicular joint (ACJ)Rockwood Ⅴ degree dislocations and their short-term therapeutic effect.Methods (1)Patient selection:12 patients (9 male and 3 female)with acute acromioclavicular joint dislocation of Rockwood type V were selected from October 2010 to June 2013. Their average age is 28.2 years.with sports injury in 10 cases and fall injury in 2 cases.All patients received surgical repair within 2 weeks after injury.The operations were performed by the same senior surgeon.(2)Preoperative bone tunnel positioning design:All patients had CT scan in the position of 90°internal rotating of bilateral shoulder joint (palm down).Measure the angle of scapular long axis and coronal section (A)separately,make the line in the coracoid neck parallel to the long axis of scapula (S),and then measure the width of parallel line in the part of coracoid neck (P).The midpoint of the coracoid neck is the center between the two preparatively drilled bone tunnels.Make the cross line vertical to line P,and the bone tunnels are located in the I and II quadrant.The distance between two bone tunnels is 6 mm.(3 )Surgical techniques:According to the data of preoperative measurement of bone tunnel,the self

  12. Acromioclavicular joint reconstruction using the LockDown synthetic implant: a study with cadavers.

    Taranu, R; Rushton, P R P; Serrano-Pedraza, I; Holder, L; Wallace, W A; Candal-Couto, J J

    2015-12-01

    Dislocation of the acromioclavicular joint is a relatively common injury and a number of surgical interventions have been described for its treatment. Recently, a synthetic ligament device has become available and been successfully used, however, like other non-native solutions, a compromise must be reached when choosing non-anatomical locations for their placement. This cadaveric study aimed to assess the effect of different clavicular anchorage points for the Lockdown device on the reduction of acromioclavicular joint dislocations, and suggest an optimal location. We also assessed whether further stability is provided using a coracoacromial ligament transfer (a modified Neviaser technique). The acromioclavicular joint was exposed on seven fresh-frozen cadaveric shoulders. The joint was reconstructed using the Lockdown implant using four different clavicular anchorage points and reduction was measured. The coracoacromial ligament was then transferred to the lateral end of the clavicle, and the joint re-assessed. If the Lockdown ligament was secured at the level of the conoid tubercle, the acromioclavicular joint could be reduced anatomically in all cases. If placed medial or 2 cm lateral, the joint was irreducible. If the Lockdown was placed 1 cm lateral to the conoid tubercle, the joint could be reduced with difficulty in four cases. Correct placement of the Lockdown device is crucial to allow anatomical joint reduction. Even when the Lockdown was placed over the conoid tubercle, anterior clavicle displacement remained but this could be controlled using a coracoacromial ligament transfer. PMID:26637681

  13. Arthroscopic coracoclavicular ligament reconstruction for Rockwood type Ⅲ acromioclavicular joint dislocations%肩关节镜下喙锁韧带重建术治疗 RockwoodⅢ型肩锁关节脱位的疗效研究

    李奉龙; 姜春岩

    2015-01-01

    目的:分析采用肩关节镜下喙锁韧带重建术治疗 Rockwood Ⅲ型肩锁关节脱位的临床疗效。方法回顾性研究2013年2月至2014年1月连续收治并获得随访的21例 Rockwood Ⅲ型肩锁关节脱位患者的资料。其中男性17例,女性4例。平均年龄42.8岁,平均受伤到手术时间11.1 d。所有患者均于肩关节镜下应用同种异体肌腱重建喙锁韧带并高强度缝线捆扎固定喙锁间隙治疗肩锁关节脱位。术后定期随访,记录患侧肩关节活动范围,并采用疼痛视觉模拟评分(visual analogue score,VAS)、ASES(American shoulder and elbow surgeons)评分及 UCLA(university of California Los Angeles)评分评价患者肩关节功能状况;同时拍摄肩关节正位、侧位及腋位 X 线片,评估是否有肩锁关节复位丢失。结果21例患者术后平均随访(14.6±3.9)个月。末次随访时肩关节平均前屈上举为173.9°±10.3°,体侧外旋为59.5°±14.3°,内旋为第12胸椎体水平,平均 UCLA 评分为(34.1±2.5)分,平均 ASES 评分为(95.5±4.7)分,平均 VAS 评分(0.3±0.6)分。末次随访拍摄肩关节 X 线片未发现肩锁关节复位丢失。结论采用肩关节镜下喙锁韧带重建术治疗 Rockwood Ⅲ型肩锁关节脱位的临床疗效满意,患者术后可获得良好的肩关节功能。%Background Dislocation of the acromioclavicular joint is a common injury of shoulder girdle.For the dislocation of acromioclavicular joint of Rockwood type Ⅰ and type Ⅱ,patient can obtain satisfactory result from conservative treatment; For the severe dislocation such as Rockwood type Ⅳ and type Ⅴ,operative treatment should be a good choice.However,for the patients of Rockwood type Ⅲ dislocation,the treatment is still controversial.With the development of minimally invasive technique,arthroscopic ligament reconstruction is gradually widely used in the treatment of acromioclavicular joint dislocation.Shoulder arthroscopic operation has the

  14. Type RockwoodIII in the treatment of small incision of clavicular hook plate for acromioclavicular joint dislocation in 66 cases%小切口锁骨钩钢板治疗RockwoodIII型肩锁关节脱位66例

    李克军; 邹方亮; 邹孝军; 杨志乐

    2013-01-01

      Objective To summarize the operation method and clinical effect of dislocation of small incision of clavicular hook plate in treatment of type RockwoodIII shoulder. Methods From 2004 January ~ 2012 year in January, the treatment of 66 cases of RockwoodIII type acromioclavicular joint dislocation were treated with clavicular hook plate, with only the clavicular hook plate, repair of acromioclavicular joint capsule and the acromioclavicular ligament, not deliberately repair of coracoclavicular ligament. Reset X ray to evaluate the postoperative dislocation of acromioclavicular joint, shoulder joint function exercise. Remove the clavicular hook plate in 9 ~ 18 months after operation, 11 months after operation on the average. Through the bilateral shoulder joints in patients with normal and weight-bearing flms, evaluation of acromioclavicular joint dislocation after operation, after taking out the internal fixation of shoulder joint function and repair and no repair of coracoclavicular ligament of shoulder joint function infuence. Results All cases were followed up, followed up for 15 ~ 32 months, an average of 20 months follow-up, according to the function evaluation standard patients, excellent in 40 cases, good in 26 cases. Conclusion The small incision of clavicular hook plate in treatment of acromioclavicular joint dislocation with RockwoodIII type acromioclavicular joint anatomic and biomechanical characteristics, reliable fxation, coracoclavicular ligament can repair, postoperative early functional exercise, is worthy of promotion.%  目的总结小切口锁骨钩钢板治疗RockwoodIII型肩锁关节脱位的手术方法和临床疗效。方法2004年1月至2012年1月,应用锁骨钩钢板治疗66例RockwoodIII型肩锁关节脱位,术中仅行锁骨钩钢板固定,修复肩锁关节关节囊和肩锁韧带,未刻意修复喙锁韧带。术后X光片评估肩锁关节脱位的复位,行肩关节功能锻炼。锁骨钩钢板在术后9~18

  15. Non-operative treatment of a fracture to the coracoid process with acromioclavicular dislocation in an adolescent

    Vera Pedersen

    2014-08-01

    Full Text Available Coracoid process fractures are rare and often associated with dislocations of the acromioclavicular (AC joint. There is little evidence about the treatment of these injuries in adolescents, but the few case reports published recommend surgery. We report a case of a dislocated epiphyseal fracture to the base of the coracoid process with AC joint dislocation in a 14-year-old ice-hockey player following direct impact to his left shoulder. Since magnetic resonance tomography revealed intact AC and coracoclavicular ligaments, we initiated non-operative treatment with immobilization and unloading of the shoulder by an abduction brace allowing limited rotation for 6 weeks. This treatment resulted in complete recovery after 8 weeks and return to full sports on first league level after 3 month. In conclusion, non-operative treatment of coracoid base fractures with concomitant AC-joint injury in the adolescent can result in excellent functional results and early recovery.

  16. COMPARATIVE ANALYSIS OF AUTOGRAFT TECHNIQUE AND CLAVICULAR HOOK PLATE IN GRADE 3 ACROMIOCLAVICULAR DISLOCATIONS

    Rahul Narayan

    2016-04-01

    Full Text Available OBJECTIVE To evaluate clinical outcome of clavicular hook plate and autograft technique in the surgical treatment of Rockwood Grade-III acromioclavicular joint dislocation. METHODS Fifteen patients were operated using standard clavicular hook plate and another fifteen patients were operated using autograft technique. After a minimum follow-up of one year, clinical assessment was done using Constant-Murley Score. Statistical evaluation was done using SPSS ver. 21.0. RESULTS Mean age group was 31.44±7.8 years. Average constant shoulder score for the hook plate group was 81.3 (Range 74–89 and that for autograft technique group was 91.7 (Range 88–97. CONCLUSION Autograft technique was found to be superior in terms of functional outcome when compared to clavicular hook plate. Such superiority can be attributed to the biologic nature of coracoclavicular ligament reconstruction in the autograft technique.

  17. Acromioclavicular dislocation: postoperative evaluation of the coracoclavicular ligaments using magnetic resonance☆

    Faria, Rafael Salomon Silva; Ribeiro, Fabiano Rebouças; Amin, Bruno de Oliveira; Tenor Junior, Antonio Carlos; da Costa, Miguel Pereira; Filardi Filho, Cantídio Salvador; Batista, Cleber Gonçalves; Brasil Filho, Rômulo

    2015-01-01

    Objective To radiologically evaluate the healing of the coracoclavicular ligaments after surgical treatment for acromioclavicular dislocation. Methods Ten patients who had undergone surgical treatment for acromioclavicular dislocation via a posterosuperior route at least one year earlier were invited to return for radiological assessment using magnetic resonance. This evaluation was done by means of analogy with the scale described in the literature for studying the healing of the anterior cruciate ligament of the knee and for measuring the healed coracoclavicular ligaments. Results A scar structure of fibrous appearance had formed in 100% of the cases. In 50% of the cases, the images of this structure had a good appearance, while the other 50% were deficient. Conclusion Late postoperative evaluation using magnetic resonance, on patients who had been treated for acute acromioclavicular dislocation using a posterosuperior route in the shoulder, showed that the coracoclavicular ligaments had healed in 100% of the cases, but that this healing was deficient in 50%. PMID:26229916

  18. Acromioclavicular Dislocation Associated with Coracoid Process Fracture: Report of Two Cases and Review of the Literature

    Ozkan Kose

    2015-01-01

    Full Text Available Acromioclavicular dislocation associated with coracoid process fracture is a rare injury. Herein we reported two further cases with such combination of injuries and reviewed all previously published cases in current literature. In this review, we discussed the demographic characteristics, mechanism of injury, diagnosis, and treatment options extensively.

  19. Acromioclavicular Dislocation Associated with Coracoid Process Fracture: Report of Two Cases and Review of the Literature

    Kose, Ozkan; Canbora, Kerem; Guler, Ferhat; Kilicaslan, Omer Faruk; May, Hasan

    2015-01-01

    Acromioclavicular dislocation associated with coracoid process fracture is a rare injury. Herein we reported two further cases with such combination of injuries and reviewed all previously published cases in current literature. In this review, we discussed the demographic characteristics, mechanism of injury, diagnosis, and treatment options extensively. PMID:26491588

  20. Acromioclavicular Dislocation Associated with Coracoid Process Fracture: Report of Two Cases and Review of the Literature

    Ozkan Kose; Kerem Canbora; Ferhat Guler; Omer Faruk Kilicaslan; Hasan May

    2015-01-01

    Acromioclavicular dislocation associated with coracoid process fracture is a rare injury. Herein we reported two further cases with such combination of injuries and reviewed all previously published cases in current literature. In this review, we discussed the demographic characteristics, mechanism of injury, diagnosis, and treatment options extensively.

  1. The treatment of the acute acromioclavicular joint dislocation with LARS artificial ligament:a preliminary report%应用LARS人工韧带治疗急性肩锁关节脱位的初步报告

    陈爱民; 鹿楠; 叶添文; 杨鹏; 朱磊; 李菁

    2014-01-01

    Background Currently,the clinical perspectives of surgical treatment for Tossy Ⅲacromioclavicular(AC)joint dislocations are relatively identical.Due to the post-traumatic ruptures of the acromioclavicular ligament and coracoclavicular(CC)ligament which are used to maintain stability of the joint,the clavicle moves backward and upward,and the upper arm and the scapula drops downward for the gravity of the upper arm and the influence of the sternocleidomastoid muscle.Since such complications as reduction difficulties,redislocation after external fixation,pressure ulcers of the skin,and so forth are particularly prone to occur in the conservative therapy,the operative treatment is more inclined to be adopted for the Tossy Ⅲ dislocation of the AC joint.With the single repair and fixation of the CC ligament,redislocation is likely to happen after implant removal because the ruptured ligaments healed as scar tissue.Therefore,this study uses an operative method of reconstructing and augmenting the CC ligament with LARS artificial ligament for the treatment of Tossy Ⅲ AC joint dislocation,and evaluates its clinical effect.Methods From November 2006 to July 2009,8 patients with acute AC joint dislocation of Tossy Ⅲ were admitted into our hospital.Five patients were male and 3 were female,and their ages ranged from 21 to 45.Sides:3 injuries were on the left and 5 were on the right.Seven patients suffered from falling on the ground,and 1 patient was inj ured in a traffic accident.All the patients were treated with LARS artificial ligaments to reconstruct the CC ligament.Constant score and VAS score were adopted in clinical evaluation.Zanca view of the bilateral AC joint and the axillary radiograph of the affected shoulder joint were employed for imaging evaluation.All the patients were simple Tossy Ⅲ dislocation of AC joint with no trauma of other parts and skin breakdown.Regular pre-operative examinations and evaluations were carried out after admission,and LARS

  2. Acromioclavicular Joint Dislocation of Types Rockwood Ⅲ, Ⅳ and Ⅴ Treated with Coracoclavicular Bolt Combined with Beak-shoulder Ligament Shif%喙锁螺钉结合喙肩韧带移位治疗Rockwood Ⅲ型、Ⅳ型、Ⅴ型肩锁关节脱位

    谢伟; 郑建平; 黎高明; 吴向科; 傅格深

    2012-01-01

    [目的]探讨喙锁螺钉结合喙肩韧带移位治疗RockwoodⅢ型、Ⅳ型、Ⅴ型肩锁关节脱位的临床疗效.[方法]对32例RockwoodⅢ型、Ⅳ型、Ⅴ型肩锁关节脱位患者采用喙锁螺钉结合喙肩韧带移位治疗,采用Karlasson标准,分析其临床疗效.[结果]术后随访9~21个月,平均13个月,其中A级28例,B级4例,术后均未出现神经血管损伤、螺钉失败等严重并发症.[结论]喙锁螺钉结合喙肩韧带移位是治疗肩锁关节脱位一种有效的治疗方法.%[Objective] To investigate the effects of acromioclavicular joint dislocation of types Rockwood Ⅲ, IV and V treated with coracoclavicular bolt combined with beak-shoulder ligament shift. [Method] Take Karlasson standard to 32 cases, analyse the clinical effect. [Result]Followed up for 9~ 21m after operation, 28 cases were of level A, 4 level B, without nerve or vessel injury or failure bolt or other severe complication. [Conclusion] Coracoclavicular bolt combined with beak-shoulder ligament shift is an effective method for acromioclavicular joint dislocation.

  3. [Arthroscopically assisted techniques for treatment of acute and chronic acromioclavicular joint injuries].

    Braun, S; Imhoff, A B; Martetschläger, F

    2015-05-01

    Acute and chronic acromioclavicular (AC) joint dislocation is frequently encountered in the routine clinical practice. This injury can lead to significant impairment of shoulder girdle function. Therapy based on the severity of injury is recommended to re-establish correct shoulder function. The static radiographic Rockwood classification is used to define the degree of dislocation but the clinical aspects and functional x-ray imaging of horizontal AC joint instability should also be considered for selection of the appropriate procedure. Rockwood grades I and II injuries are treated non-operatively with early functional exercise. The approach for Rockwood grade III injuries should be individual and patient-specific, with non-surgical procedures for low functional requirement patients with a high risk for surgical interventions. For patients with high demands on shoulder function surgery is recommended. A detailed diagnostic assessment frequently reveals Rockwood grade III injuries to be type IV injuries. Rockwood types IV and V AC joint dislocations require surgery for sustained stability. Treatment of acute injuries is recommended within 1-3 weeks after trauma but there is no clear evidence of a cut-off for the presence of chronic injuries. Various surgical techniques have been described in the literature. This article presents an arthroscopically assisted technique that addresses both vertical and horizontal instability of the AC joint. PMID:25964020

  4. Reconstruction of chronic acromioclavicular joint disruption with artificial ligament prosthesis

    Devendra Kumar Chouhan; Uttam Chand Saini; Mandeep Singh Dhillon

    2013-01-01

    Objective:Management of Rockwood type 3 acromioclavicular disruptions is a matter of debate.Should we adopt conservative or operative measures at first presentation? It is not clear but most of the evidences are in favour of conservative management.We present our experience in managing these patients surgically.Methods:We present a prospective series of eight cases of chronic Rockwood type 3 acromioclavicular joint disruptions treated surgically.Anatomical reconstruction of the coracoclavicular ligament was done by artificial braided polyester ligament prosthesis.Results:All the patients were able to perform daily activities from an average of the 14th postoperative day.All patients felt an improvement in pain,with decrease in average visual analogue scale from preoperative 6.5 points (range 3-9 points) to 2.0 points (range 0-5 points),Constant score from 59% to 91% and American Shoulder and Elbow Surgeons shoulder score from 65 to 93 points postoperatively.These results improved or at least remained stationary on midterm follow-up,and no deterioration was recorded at an average follow-up of 46 months.Conclusion:This midterm outcome analysis of the artificial ligament prosthesis is the first such follow-up study with prosthesis.Our results are encouraging and justify the further use and evaluation of this relatively new and easily reproducible technique.

  5. Relationship between MRI and clinical findings in the acromioclavicular joint

    Objective: To determine the relationship between the magnetic resonance (MR) appearance of the acromioclavicular (AC) joint and the physical findings. Design: A total of 116 consecutive patients underwent routine MR imaging (MRI) of the shoulder over an 18-month period. All MR studies were interpreted by a blinded, experienced musculoskeletal radiologist. Eleven variables were studied: the presence of osteophytes; fluid in the joint; fluid outside the joint; high signal in the clavicle or in the acromion; fluid in the subacromial bursa; irregularity of the joint margins; bulging of the capsule; widening of the joint; the age of the patient; and the presence of a rotator cuff tear. The clinical information was supplied by an experienced shoulder surgeon blinded to the MRI findings. A control group of 23 normal volunteers was also studied. Results: The only statistically significant correlation (P=0.0249) was between high signal in the distal clavicle and degenerative changes found clinically. A weaker relationship existed between fluid in the joint and the clinical examination and between increasing degenerative changes and advancing age. Otherwise, no material relationship was found between any of the other MR abnormalities and the clinical picture. Conclusion: There appears to be no real correlation between the MR appearances and the clinical findings in the AC joint. (orig.)

  6. Fratura extra-articular da extremidade medial da clavícula associada à luxação acromioclavicular tipo IV: relato de caso Extra-articular fracture of the medial end of the clavicle associated with type IV acromioclavicular dislocation: case report

    Mário Chaves Correa

    2011-10-01

    Full Text Available Ocorrendo isoladamente, as fraturas da clavícula e as luxações acromioclaviculares são lesões muito comuns. A combinação de uma luxação acromioclavicular e de uma fratura do terço lateral da clavícula não é rara. Entretanto, existem muito poucos casos descritos de luxações acromioclaviculares associadas a fraturas do terço médio da clavícula; aquelas associadas a fraturas do terço medial são ainda mais raras. Nós reportamos o caso de um indivíduo adulto do sexo masculino que sofreu uma luxação acromioclavicular (tipo IV associada a uma fratura extra-articular desviada da extremidade medial da clavícula (grupo 3 de Almann em um acidente ciclístico. O paciente foi tratado na fase aguda com redução aberta e fixação interna das duas lesões. Na avaliação clínica, 12 meses após a cirurgia, o paciente apresentava-se assintomático, com mobilidade ativa e passiva completa, força e resistência normais e simetria das cinturas escapulares. As radiografias e a tomografia computadorizada tridimensional mostravam subluxação posterossuperior persistente da articulação acromioclavicular e consolidação anatômica da fratura clavicular.Fractures of the clavicle and acromioclavicular dislocations are very common injuries when they occur separately. The combination of an acromioclavicular dislocation and a fracture of the lateral third of the clavicle is not rare. However, there are very few reported cases of acromioclavicular dislocations associated with fractures of the middle third of the clavicle; those associated with fractures of the medial third are even rarer. We report the case of an adult male who suffered an acromioclavicular dislocation (type IV associated with a displaced extra-articular fracture of the medial end of the clavicle (Almann group 3 in a cycling accident. The patient was treated during the acute phase with open reduction and internal fixation of the two lesions. At the clinical evaluation 12

  7. Modified Weaver-Dunn Procedure Versus The Use of Semitendinosus Autogenous Tendon Graft for Acromioclavicular Joint Reconstruction

    Hegazy, Galal; Safwat, Hesham; Seddik, Mahmoud; Al-shal, Ehab A.; Al-Sebai, Ibrahim; Negm, Mohame

    2016-01-01

    Background: The optimal operative method for acromioclavicular joint reconstruction remains controversial. The modified Weaver-Dunn method is one of the most popular methods. Anatomic reconstruction of coracoclavicular ligaments with autogenous tendon grafts, widely used in treating chronic acromioclavicular joint instability, reportedly diminishes pain, eliminates sequelae, and improves function as well as strength. Objective: To compare clinical and radiologic outcomes between a modified Weaver-Dunn procedure and an anatomic coracoclavicular ligaments reconstruction technique using autogenous semitendinosus tendon graft. Methods: Twenty patients (mean age, 39 years) with painful, chronic Rockwood type III acromioclavicular joint dislocations were subjected to surgical reconstruction. In ten patients, a modified Weaver-Dunn procedure was performed, in the other ten patients; autogenous semitendinosus tendon graft was used. The mean time between injury and the index procedure was 18 month (range from 9 – 28). Clinical evaluation was performed using the Oxford Shoulder Score and Nottingham Clavicle Score after a mean follow-up time of 27.8 months. Preoperative and postoperative radiographs were compared. Results: In the Weaver-Dunn group the Oxford Shoulder Score improved from 25±4 to 40±2 points. While the Nottingham Clavicle Score increased from 48±7 to 84±11. In semitendinosus tendon graft group, the Oxford Shoulder Score improved from 25±3 points to 50±2 points and the Nottingham Clavicle Score from 48±8 points to 95±8, respectively. Conclusion: Acromioclavicular joint reconstruction using the semitendinosus tendon graft achieved better Oxford Shoulder Score and Nottingham Clavicle Score compared to the modified Weaver-Dunn procedure. PMID:27347245

  8. Acromioclavicular joint reconstruction with coracoacromial ligament transfer using the docking technique

    Gobezie Reuben

    2009-01-01

    Full Text Available Abstract Background Symptomatic Acromioclavicular (AC dislocations have historically been surgically treated with Coracoclavicular (CC ligament reconstruction with transfer of the Coracoacromial (CA ligament. Tensioning the CA ligament is the key to success. Methods Seventeen patients with chronic, symptomatic Type III AC joint or acute Type IV and V injuries were treated surgically. The distal clavicle was resected and stabilized with CC ligament reconstruction using the CA ligament. The CA ligament was passed into the medullary canal and tensioned, using a modified 'docking' technique. Average follow-up was 29 months (range 12–57. Results Postoperative ASES and pain significantly improved in all patients (p = 0.001. Radiographically, 16 (94% maintained reduction, and only 1 (6% had a recurrent dislocation when he returned to karate 3 months postoperatively. His ultimate clinical outcome was excellent. Conclusion The docking procedure allows for tensioning of the transferred CA ligament and healing of the ligament in an intramedullary bone tunnel. Excellent clinical results were achieved, decreasing the risk of recurrent distal clavicle instability.

  9. Static and functional ultrasonographic picture shoulder and acromioclavicular joints in normal and at hypermobility

    Litvin Yu.P.

    2012-01-01

    Full Text Available Studying of anatomy humeral and acromioclavicular joints according to static and functional ultrasonography in norm and at hypermobility was an objective of this research. For the decision of an object in view we had been surveyed 45 persons at the age from 15 till 59 years (middle age has made 32,4±1,6 year, from them 32 men and 13 women. To clinical signs of hypermobility an investigated contingent have divided on two groups: the basic – 15 patients and control – 30 patients. It is established that humeral and acromioclavicular joints on ultrasonograms the features have display of elements. In research are described not changed soft tissue and bone structures, and also variants of their normal structure. By means of functional ultrasonography the basic signs of instability humeral and acromioclavicular joints have been defined.

  10. Acromioclavicular joint cyst: nine cases of a pseudotumor of the shoulder

    (1) To analyse the imaging appearances of nine patients with acromioclavicular joint cysts presenting as shoulder masses for tumor staging with operative, histopathological and joint aspiration findings. Retrospective review of imaging and correlation with clinical, operative and surgical notes. Images were reviewed by two musculoskeletal radiologists by consensus. Nine patients who presented clinically with a shoulder mass were evaluated by radiographs (n=9), ultrasound (n=1), conventional arthrography (n=3), MRI (n=6; with direct MR arthrography n=2, indirect MR arthrography n=4). All patients had a focal mass superior to the AC joint, with a size ranging from 1.5 cm to 6 cm and a mean of 3.27 cm. Correlation was available with surgery (n=7), histopathology (n=2) and cyst aspiration (n=2). Two patients were managed conservatively. Geyser sign was positive in all three arthrograms. All MRIs revealed extensive rotator cuff tears with a column of fluid extending from the glenohumeral joint through the rotator cuff tear into the acromioclavicular joint and acromioclavicular cyst. Chondrocalcinosis was seen in the acromioclavicular joint cyst (n=2) and in the glenohumeral joint (n=1). Aspirate in two patients contained calcium pyrophosphate dihydrate crystals. (orig.)

  11. 肩锁关节脱位的诊断与治疗%Diagnosis and treatment of acromioclavicular dislocation

    黄高; 王金华; 孔建中

    2012-01-01

    The acromioclavicular dislocation is a type of common shoulder athletic injury in clinic , and its incidence accounted for 12% of the local sites injuries. At present,The acute dislocation of Rockwood type I , II was recommended to be managed non -operatively, while acute dislocation of type IV, V and VI operatively. But there still exist controversial in the treatment of acute dislocation of type III. In this peper, the authors have reviewed the current status of treatment of acromioclavicular dislocation .%肩锁关节脱位是临床常见的肩部运动损伤.目前,临床认为Rockwood Ⅰ、Ⅱ型急性脱位应行非手术治疗,Ⅳ、V及Ⅵ型急性脱位应行手术治疗,但对Ⅲ型急性脱位是采取非手术治疗还是手术治疗仍存在争议.本文对肩锁关节脱位的治疗现状进行综述.

  12. Acromioclavicular joint separations grades I-III: a review of the literature and development of best practice guidelines.

    Reid, Duncan; Polson, Kate; Johnson, Louise

    2012-08-01

    Acromioclavicular joint (ACJ) separation injuries are common injuries among sporting populations. ACJ separations are graded according to severity from grade I being a mild sprain to grade VI, which is severe dislocation with displacement. There is consensus in the literature that grade I-III ACJ separations are managed conservatively and grades IV-VI are managed surgically. Despite conservative care being recommended for lesser grades of injury, there is very little evidence in the literature as to what constitutes conservative care. Therefore, the purpose of this paper was, first, to review the relevant anatomy and kinematics of the ACJ and, second, to review the literature relating to current evidence of conservative management of ACJ injury. Using this data, a best practice guideline for conservative rehabilitation in grade I-III ACJ separations was developed. For the conservative management, a literature search was undertaken using the following databases in the Auckland University of Technology's electronic library resources; MEDLINE, CINAHL, SPORTDiscus™ and the Cochrane Library. The following keywords or phrases were used: 'acromioclavicular joint separations', 'injury', 'dislocations', 'rehabilitation', 'conservative care', 'physiotherapy' and 'exercise'. A total of 24 articles was identified. There were no randomized controlled trials (RCTs) that investigated conservative treatment for grade I-III ACJ sprains. Therefore, a narrative review was formulated covering the anatomy and biomechanics of the ACJ, injury mechanisms and relevant literature reviewed covering rehabilitation principles. Conservative management of grade I-III ACJ separations is still the main recommendation following this review. A best practice guideline for managing grade I-III ACJ separations is presented to help guide clinicians until well constructed RCTs are carried out to improve the conservative management of ACJ injuries. PMID:22784232

  13. Nonoperative management of a sagittal coracoid fracture with a concomitant acromioclavicular joint separation

    Thomas Kristen

    2010-01-01

    Full Text Available Separation of the acromioclavicular joint in conjunction with a coracoid fracture is a rare injury. Treatment decisions are traditionally based on the level of the fracture, the status of the coracoclavicular ligament and the activity level of the patient. We present a novel coracoid fracture pattern treated nonoperatively in a young, active patient and a thorough review of the literature regarding this topic.

  14. Shoulder tendinitis and osteoarthrosis of the acromioclavicular joint and their relation to sports.

    Stenlund, B

    1993-01-01

    A sample of 207 men from the construction industry was studied using an epidemiological technique of cross-sectional design to investigate if sport activities involving the arms increase the risk of developing shoulder tendinitis or osteoarthrosis of the acromioclavicular joint. The relative risk for shoulder tendinitis was estimated to be 9.5 on the right side, and 4.9 on the left side for a lifetime of sport activity exceeding 8399 h. Subjects who reported both extremely high physical load ...

  15. Axial and tangential views of the acromioclavicular joint: the introduction of new projections

    CHEN Wei; ZHAGN Qi; SU Yan-ling; ZHANG Ze-kun; HOU Zhi-yong; PAN Jin-she; ZHANG Xiao-lin; ZHANG Ying-ze

    2012-01-01

    Background Routine anteroposterior radiographs of the acromioclavicular (AC) joint with or without weight bearing have limitations in demonstrating the AC joint.Transarticular fixation with Kirschner wire is a treatment choice for AC dislocations.However,percutaneous fixation of the AC joint is technically demanding.The C-arm fluoroscopy can be used as routine intraoperative guidance to facilitate this procedure.The current study aims to introduce new projections,the axial and tangential views of AC joint,to help evaluate the severity of the injury and facilitate the percutaneous procedure.Methods Three shoulder specimens were used to find the projection directions of the axial and tangential views of the AC joint by using the digital radiography (DR) unit.The axial and tangential views were taken of 20 adult volunteers by referencing the projection directions determined in the shoulder specimens.The angles showed on the DR system and the angles between the coronal plane of the body and the vertical plane of the flat panel detector (FPD) during taking these radiographs were recorded.The C-arm fluoroscopy unit was used to take the axial and tangential views referencing the angles measured on the DR system.Routine anteroposterior radiographs of the AC joint were taken on the volunteers.The minimal distances from the distal clavicle to the acromion were measured on both tangential and anteroposterior radiographs.The data was statistically analyzed.Results The clear axial and tangential radiographs of AC joints of the volunteers were obtained using both DR and C-arm fluoroscopy units.The angles demonstrated on the DR window are (20.8±2.4)° for male and (18.3±2.3)° for female.During taking the axial views,the angles between the coronal plane of the body and vertical plane of FPD are (23.3±3.2)° for male and (20.1±2.4)° for female.During taking tangential views,the corresponding angles are (117.5±3.7)° for male and (113.1±3.3)° for female.On the tangential

  16. Acute septic arthritis of the acromioclavicular joint caused by Haemophilus parainfluenzae: a rare causative origin.

    Hong, Myong-Joo; Kim, Yeon-Dong; Ham, Hyang-Do

    2015-04-01

    Septic arthritis of the acromioclavicular (AC) joint is a rare entity with symptoms that include erythema, swelling, and tenderness over the AC joint, fever, and limitation of shoulder motion with pain. In previous reports, Staphylococcus and Streptococcus species have been mentioned as common causative organisms. Haemophilus parainfluenzae is a normal inhabitant of the oral cavity, respiratory tract, gastrointestinal tract, and urogenital tract. However, it sometimes causes opportunistic infections leading to septic arthritis and osteomyelitis. AC joint infection associated with H.parainfluenzae is very rare, and only one case has been reported in the literature. Moreover, septic arthritis in immunocompetent patients is also very rare. Here, we report the case of a healthy patient with H. parainfluenzae-related septic arthritis of the AC joint. PMID:24584486

  17. Bioabsorbable Suture Anchor Migration to the Acromioclavicular Joint: How Far Can These Implants Go?

    Giovanna Medina

    2014-01-01

    Full Text Available Few complications regarding the use of bioabsorbable suture anchors in the shoulder have been reported. What motivated this case report was the unusual location of the anchor, found in the acromioclavicular joint which, to our knowledge, has never been reported so far. A 53-year old male with previous rotator cuff (RC repair using bioabsorbable suture anchors presented with pain and weakness after 2 years of surgery. A suspicion of retear of the RC led to request of a magnetic resonance image, in which the implant was found located in the acromioclavicular joint. The complications reported with the use of metallic implants around the shoulder led to the development of bioabsorbable anchors. Advantages are their absorption over time, minimizing the risk of migration or interference with revision surgery, less artifacts with magnetic resonance imaging, and tendon-to-bone repair strength similar to metallic anchors. Since the use of bioabsorbable suture anchors is increasing, it is important to know the possible complications associated with these devices.

  18. ISAKOS upper extremity committee consensus statement on the need for diversification of the Rockwood classification for acromioclavicular joint injuries

    Beitzel, Knut; Mazzocca, Augustus D; Bak, Klaus;

    2014-01-01

    Optimal treatment for the unstable acromioclavicular (AC) joint remains a highly debated topic in the field of orthopaedic medicine. In particular, no consensus exists regarding treatment of grade III injuries, which are classified according to the Rockwood classification by disruption of both th...

  19. Via de acesso cirúrgico posterossuperior para o tratamento das luxações acromioclaviculares: resultados de 84 casos operados Posterosuperior surgical access route for treatment of acromioclavicular dislocations: results from 84 surgical cases

    Danilo Canesin Dal Molin

    2012-10-01

    Full Text Available OBJETIVO: Avaliar os resultados do tratamento cirúrgico de 84 luxações acromioclaviculares agudas com a utilização da via de acesso posterossuperior do ombro. MÉTODOS: Foram avaliados 84 casos de luxações acromioclaviculares agudas grau III da classificação de Allman-Tossy operados de novembro de 2002 a maio de 2010. A média de idade dos pacientes foi de 34 anos. O diagnóstico foi realizado por avaliação clínica e radiográfica. Os pacientes foram operados pela mesma equipe cirúrgica em até três semanas da data do trauma realizando-se a via de acesso posterossuperior do ombro com acesso ao topo da base do processo coracoide para colocação de duas âncoras utilizadas na redução da luxação. O seguimento mínimo foi de 12 meses. A avaliação clínica-radiográfica pós-operatória foi realizada pelos critérios de Karlsson modificados e do escore da Universidade da Califórnia em Los Angeles (UCLA. RESULTADOS: Dos 84 pacientes operados, 92,8% apresentavam resultados bons ou excelentes e 7,2% de resultados regulares ou fracos pelo escore de avaliação da UCLA. Pelos critérios de Karlsson modificados 76,2% foram avaliados como grau A, 17,9% como grau B e 5,9% como grau C. CONCLUSÃO: A VIA de acesso posterossuperior do ombro é uma nova opção para acesso ao processo coracoide e tratamento das luxações acromioclaviculares, com resultados clínicos e radiográficos equivalentes aos da literatura.OBJECTIVE: To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. METHODS: Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification operated between November 2002 and May 2010 were evaluated. The patients' mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a

  20. Bipolar dislocation of the clavicle

    Wei Jiang

    2012-01-01

    Full Text Available Bipolar dislocation of the clavicle at acromioclavicular and sternoclavicular joint is an uncommon traumatic injury. The conservative treatments adopted in the past is associated with redislocation dysfunction and deformity. A 41 years old lady with bipolar dislocation of right shoulder is treated surgically by open reduction and internal fixation by oblique T-plate at sternoclavicular joint and Kirschner wire stabilization at acromioclavicular joint. The patient showed satisfactory recovery with full range of motion of the right shoulder and normal muscular strength. The case reported in view of rarity and at 2 years followup.

  1. Bipolar dislocation of the clavicle.

    Jiang, Wei; Gao, Shu-Guang; Li, Yu-Sheng; Lei, Guang-Hua

    2012-11-01

    Bipolar dislocation of the clavicle at acromioclavicular and sternoclavicular joint is an uncommon traumatic injury. The conservative treatments adopted in the past is associated with redislocation dysfunction and deformity. A 41 years old lady with bipolar dislocation of right shoulder is treated surgically by open reduction and internal fixation by oblique T-plate at sternoclavicular joint and Kirschner wire stabilization at acromioclavicular joint. The patient showed satisfactory recovery with full range of motion of the right shoulder and normal muscular strength. The case reported in view of rarity and at 2 years followup. PMID:23325981

  2. Acromioclavicular joint acceleration-deceleration injury as a cause of persistent shoulder pain: Outcome after arthroscopic resection

    Ehud Atoun; Artan-Athanasios Bano; Alexander Van Tongel; Ali Narvani; Giuseppe Sforza; Ofer Levy

    2014-01-01

    Background: Shoulder pain in general and acromioclavicular joint (ACJ) pain specifically is common after acceleration-deceleration injury following road traffic accident (RTA). The outcome of surgical treatment in this condition is not described in the literature. The aim of the present study was to report the outcome of arthroscopic resection of the ACJ in these cases. Materials and Methods: Nine patients with localized ACJ pain, resistant to nonoperative treatment were referred on an a...

  3. Clinics in diagnostic imaging (151). Acromioclavicular joint geyser sign with chronic full-thickness supraspinatus tendon (SST) tear.

    Khor, Andrew Yu Keat; Wong, Steven Bak Siew

    2014-01-01

    An 82-year-old man presented with neck pain, right upper limb radiculopathy and right shoulder pain. Physical examination revealed a soft lump over the right shoulder joint, as well as reduced range of shoulder movements. On magnetic resonance imaging, the soft lump was shown to be a cystic mass over the acromioclavicular joint and was related to a full-thickness supraspinatus tendon tear. This is the classic geyser sign. The pathophysiology and clinical features of the geyser sign, and its i...

  4. Arthroscopic resection of the distal clavicle in osteoarthritis of the acromioclavicular joint

    Park, Tae-Soo; Lee, Kwang-Won

    2016-01-01

    Background: Symptomatic acromioclavicular joint (ACJ) lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle. Materials and Methods: 20 shoulders of 20 consecutive patients with painful and isolated osteoarthritis of the ACJ who were treated by arthroscopic en bloc resection of the distal clavicle were included in the study. There were 10 males and 10 females with an average age of 56 years (range 42–70 years). The mean duration of followup was 6 years and 2 months (range 4–8 years 10 months). The results were evaluated using the University of California Los Angeles (UCLA) shoulder rating score. Results: The overall UCLA score was 13.7 preoperatively, which improved to 33.4 postoperatively. All subscores were improved significantly (P painful osteoarthritis of the ACJ lesions in active patients engaged in overhead throwing sports and heavy labor. PMID:27512219

  5. Surgical Treatment Experience of Patients With Acromioclavicular Dislocation%肩锁关节脱位患者的手术治疗体会

    王凤彦

    2015-01-01

    目的:对肩锁关节脱位患者的手术治疗方法以及效果进行分析,并对手术治疗体会进行总结。方法选取于2013年11月~2014年8月期间在我院接受治疗的35例肩锁关节脱位患者,并对所有患者进行手术治疗,对手术方法和效果进行总结。结果按照Karlsson评价标准来评定术后疗效,优27例,占比77.1%,良5例,占比14.3%,差3例,占比8.6%,则本次研究的优良率为91.4%。结论对肩锁关节脱位患者采用手术治疗具有十分显著的临床效果,并且具有固定可靠、减少疼痛、防止肩部畸形以及获得较好的肩关节功能等诸多优点。%Objective To analyze surgical treatment method and its effect of patients with acromioclavicular dislocation and then summarize its surgical treatment experience.Methods Choose 35 patients with acromioclavicular dislocation who are received and treated in hospital from November 2013 to August 2014 and have them cured with surgical treatment and then make a summary of treatment experience.ResultsMake an evaluation on surgery treatment effect according to Karlsson standard, the result shows that 27 cases of performance are excellent, accounting 77.1%; 5 cases of performance are good, accounting 14.3%; and 3 cases of performance are bad, accounting 8.6%, the treatment excellence rate is up to 91.4%. Conclusion Surgical treatment is of efifcacy in treatment of patients with acromioclavicular dislocation; and such a treatment method has advantages of reliable fixation and pain alleviation, prevention form shoulder deformation and improvement of shoulder function; thus, surgical treatment is quite worthwhile to be promoted and applied clinically in treatment of acromioclavicular dislocation.

  6. Surgical treatment of acromioclavicular dislocation with coracoclavicular screw and double Endobutton plate%喙锁螺钉与双Endobutton钢板治疗肩锁关节脱位的临床研究

    杨杰; 赵友明; 孙辽军; 洪建军; 孔建中; 杨雷; 窦海成; 邵荣学

    2011-01-01

    Objective To evaluate and compare the clinical outcome of coracoclavicular screw and double Endobutton plate in treatment of acromioclavicular dislocation ( Rockwood Ⅲ-Ⅴ ). Methods Twenty-eight patients with Rockwood Ⅲ-Ⅴ acromioclavicular dislocation were subjected to surgical reconstruction from January 2008 to October 2009. The coracoclavicular screw was performed in 14 patients and the double Endobutton plate in the other 14 patients. Clinical evaluation was performed by using Constant score and subject should value (SSV) in both groups, and the preoperative and postoperative radiographs, curative effects and complications were compared. Results The patients in two groups were followed up for a range of 6-25 months (average 12.6 months) , which showed higher postoperative Constant score and SSV score than preoperation in both groups (P<0.05). But the postoperative Constant sore and postoperative SSV score in the double Endobutton group were (89.8 ±8.3) points and (85.7 ±7. 3) points respectively, significantly better than (78. 0 ± 10. 3) points and (71. 8 ±9. 7) points respectively in the coracoclavicular screw group ( P < 0.05). The radiologic measurement showed no significant difference in regard of the coracoclavicular distance three months after operation in two groups (P>0.05). Conclusions The double Endobutton plate can attain significantly superior clinical outcomes for Rockwood Ⅲ-Ⅴ acromioclavicular dislocation compared with the coracoclavicular screw. The surgical technique of reconstructing the coracoclavicular ligament through anatomical approach will be the future trend in treatment of the acromioclavicular joint dislocation.%目的 探讨喙锁螺钉与双Endobutton钢板治疗Rockwocd Ⅲ~Ⅴ型肩锁关节脱位的临床疗效,并对两者进行对比研究.方法自2008年1月至2009年10月收治Rockwood Ⅲ~Ⅴ型肩锁关节脱位患者28例,电脑随机抽样分为两组,14例采用喙锁螺钉治疗,另14例采用

  7. Dislocations

    Dislocations are joint injuries that force the ends of your bones out of position. The cause is often a fall or a blow, sometimes from playing a contact sport. You can dislocate your ankles, knees, shoulders, hips, elbows and jaw. You can also dislocate your finger and toe joints. Dislocated joints often ...

  8. Locked volar distal radioulnar joint dislocation

    Bouri, Fadi; Fuad, Mazhar; Elsayed Abdolenour, Ayman

    2016-01-01

    Introduction Volar dislocation of the distal radioulnar joint is a rare injury which is commonly missed in the emergency departments. A thorough review of literature showed very few reported cases and the cause for irreducibility varied in different cases, Lack of suspicion and improper X-ray can delay the diagnosis. Case presentation Our article discusses a case 40 year old construction worker, who presented to the Emergency with work-related injury, complaining of left wrist pain, deformity and inability to rotate his forearm. X-rays revealed a volar dislocation of distal ulna which was reducible after manipulation under General Anesthesia (GA). The joint was stable after the reduction. Discussion Isolated dislocation of the distal radioulnar joint can be either volar or dorsal, although dorsal dislocation is more common. The distal radioulnar articulation plays an important role in the rotational movement of the forearm. It allows pronation and supination which are essential for the function of the upper limb. Pronator Quadratus muscle spasm is an important blockade to reduction and was preventing reduction in this case. Methods The work has been reported in line with the CARE criteria [9]. Conclusion Volar locked dislocation of Distal Radio ulnar joint is a rare injury. High degree of clinical suspicion and proper X-ray is required for prompt detection. The importance of this case is to raise the awareness among physicians in treating these kind of injuries by careful assessment of the patient and radiographs, and to consider pronator quadratus as an important cause for the blockade to reduction. PMID:27016647

  9. 应用不同手术方法治疗陈旧性肩锁关节脱位的疗效分析%Review of the results of different operative procedures for old acromioclavicular dislocation

    吴其常; 卞传华; 苗旭漫

    2001-01-01

    目的比较分析应用不同手术方法治疗陈旧性肩锁关节脱位的疗效。方法对43例陈旧性肩锁关节脱位患者分别应用单纯切开复位克氏针内固定(9例);切开复位内固定并肩锁关节韧带重建(14例);切开复位内固定并喙突上移(20例)三种手术方法进行治疗,术后平均随访4.8年,对其自觉症状、上肢肌力、肩关节功能和肩锁关节间隙等改善程度进行比较。结果三种术式的优良率分别为33%(3/9)、50%(7/14)和74%(15/20)。单纯切开复位克氏针内固定法的疗效与切开复位内固定并肩锁韧带重建法相比,差异无显著性意义(P>0.05),两者与切开复位内固定并喙突上移法比较,差异有显著性意义(均P 0.05). Modified Dewar's operation was better compared with Kirschner wire fixation and reconstruction of acromioclavicular ligament (P< 0.05). Conclusion A satisfactory surgical procedure for treatment of old acromioclavicular dislocation should accomplish the following points: removal of scar tissue and intra articular cartilaginous fragments, reconstruction of joint stability and effective internal fixation until complete healing of the ligament structures.

  10. Dislocation of the proximal tibiofibular joint

    Milankov Miroslav

    2013-01-01

    Full Text Available Introduction. Dislocation of the proximal tibiofibular joint is a rare injury. It occurs during a sports activity that includes rough twisting movements of the bent knee. The role of the proximal tibiofibular joint is to reduce torsional loads to the ankle, to distribute the bending moment of the outer side of tibia, and transfer the vertical load while standing. In the literature there is no larger series; only several cases of the proximal tibiofibular joint dislocation treated by different methods have been published so far. Case Report. A 23-year-old male soccer player sustained an injury after he had joined the game without previous warming-up. He fell on his right side because of a sudden change of direction while his foot was fixed to the base. He felt a severe pain and had a sensation as if something had snapped in his right knee. Pain and swelling at the head of fibula were found by physical examination, which, however, did not reveal any pain, swelling and instability of the ankle or peroneal nerve palsy. The x-ray showed anterolateral dislocation of the proximal tibiofibular joint, Ogden type II. Since manual reposition in general anesthesia failed, open reduction internal fixation was performed and proximal tibiofibular joint was transfixed with a screw. After the wound closure, the above-the-knee plaster cast was applied. The screw was extracted six weeks later, full weight bearing was allowed and he started with physical therapy. Four months after the injury he returned to sports activities. On the follow- up one year after the injury he had the full range of motion of the knee, no complains, and continued with active soccer playing. X-ray showed no signs of arthrosis of the proximal tibiofibular joint. Conclusion. The proximal tibiofibular joint dislocation may be the cause of the chronic pain of the knee so it has to be taken into account when making differential diagnosis in case of the pain at the lateral side of the knee. The

  11. Help Desk Answers: Surgery vs conservative management for AC joint repair: How do the 2 compare?

    Matchin, Bruce; Yee, Bruce; Mott, Timothy

    2016-04-01

    When not considering the grade of acromioclavicular (AC) joint dislocation, both conservative and surgical management lead to positive outcomes, although surgically managed patients require more time out of work. PMID:27262254

  12. Parasymphyseal fracture with an associated temporomandibular joint dislocation: case report.

    Pynn, B R; Clarke, H M

    1992-02-01

    A case of traumatic mandibular fracture with associated unilateral anterior dislocation of the temporomandibular joint in a child is described. Although anterior dislocation is common, this combination of fracture and separate dislocation to our knowledge has not been reported in a young child. The unusual management required in this case is discussed. PMID:1740810

  13. Dislocation

    ... Alternative Names Joint dislocation Images Radial head injury Dislocation of the hip Shoulder joint References Boss SE, Mehta A, Maddow C, ... Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also ... Browse the Encyclopedia A.D.A.M., Inc. ...

  14. In-game Management of Common Joint Dislocations

    Skelley, Nathan W.; McCormick, Jeremy J; Smith, Matthew V.

    2014-01-01

    Context: Sideline management of sports-related joint dislocations often places the treating medical professional in a challenging position. These injuries frequently require prompt evaluation, diagnosis, reduction, and postreduction management before they can be evaluated at a medical facility. Our objective is to review the mechanism, evaluation, reduction, and postreduction management of sports-related dislocations to the shoulder, elbow, finger, knee, patella, and ankle joints. Evidence Ac...

  15. The morphologic and radiologic evaluation of the acromioclavicular joint in healthy individuals

    Yucel, Mustafa

    2004-01-01

    The topographic and functional anatomy and the age depended osteoarthrosis of the right acromioclaviculer joint has been examined on 39 dead bodies by means of anatomopathologic and radiologic tools. The AC joints have been extirpated in to, fixed in formalin and pinned in the horizontal plane; they have been arthrotomizedn and the macroscopic view of the joint surface photographed. Subsequently, the joint surfaces have been lamellized in the frontal plane, and decalcified; three different h...

  16. 锁骨钩钢板治疗Rockwood Ⅲ型肩锁关节脱位的治疗分析%Study of treatment of Rockwood type Ⅲ acromioclavicular dislocation with Hook plate

    郭丹; 周海斌

    2012-01-01

    [Objective] To analyze shoulder pain and restricted movement after treatment with Hook plate about Rockwood type HI acromioclavicular dislocation patients. [Method] From February ,2008 to February,2011,35 Rockwood type Ⅲ acromioclavicular dislocation patients (23 male and 12 female,average age 42.4) were treated in our hospital. They were treated with Hook plate. Adjusted Constant-Murley score was used to evaluate shoulder function. The Average follow-up time were 13.5 months. [Result]In Rockwood type Ⅲ acromioclavicular dislocation,there were 11 cases with different grade shoulder pain and restricted movement in the 19 patients. The score difference was significant ( P < 0.05 ). [ Conclusion ] Rockwood type Ⅲ acromioclavicular dislocation,treated with Hook plate leads to high rate of shoulder pain and restricted movement,which is not beneficial to functional rehabilitation.%[目的]探讨Rockwood Ⅲ型肩锁关节脱位行锁骨钩钢板手术治疗后肩关节疼痛、活动受限的原因.[方法]苏北人民医院和苏州大学附属第二医院自2008年2月~2011年2月共35例Rockwood Ⅲ型肩锁关节脱位病人,无骨折、神经损伤及血管损伤等其他合并伤,其中,男23例,女12例,平均42.4岁,行锁骨钩钢板手术治疗,术后按调整的Constant-Murley随访观察各病例肩关节恢复情况,平均随访13.5个月.[结果]35例Rockwood Ⅲ型肩锁关节脱位行锁骨钩钢板手术治疗中,有11例出现不同程度的肩关节肩痛、活动受限的症状,统计检验无肩痛、活动受限症状病例与有肩痛、活动受限症状病例之间评分差异有统计学意义(P<0.05).[结论]Rockwood Ⅲ型肩锁关节脱位行锁骨钩钢板手术治疗术后易出现肩痛、活动受限的症状,会明显影响肩关节功能恢复.

  17. Posterior dislocation of the shoulder joint

    Thakker Tejas

    2006-01-01

    Full Text Available Background: Posterior dislocation of shoulder is a rather uncommon injury that is often not diagnosed at the initial examination. However certain constant clinical signs may lead the examiner to suspect the presence of this condition. Even the routine antero-posterior roentgenogram may provide a few clues to diagnosis but the axillary view is mandatory to verify diagnosis. Material and methods : We report a series of 15 shoulders (14 patients with a locked posterior dislocation. Electric shock (7 patients, vehicular accident (4 patients and epileptic seizure (3 patients was causes of dislocation in these patients. The diagnosis was missed initially in 10 cases. An axillary radiograph confirmed the diagnosis in all. Treatment consisted of closed reduction, which was successful in 5, Neer′s modification of McLaughlin procedure (transfer of subscapularis in 6, hemireplacement arthroplasty in one shoulder and tuberosity fixation in one patient. Results : Follow-up ranged from 1 year to 4 years. Five patients had excellent, five good, two poor and one had fair result. Conclusion : Key to diagnosis is a high index of suspicion. The prognosis became less favorable and the therapeutic difficulties were found to be increased in direct proportion to the length of time, these lesions remain undiagnosed. With early recognisition of dislocation, prompt reduction is relatively easy. Surgical intervention is necessary for old unreduced posterior dislocations.

  18. Cervical facet joint kinematics during bilateral facet dislocation

    Panjabi, Manohar M.; Simpson, Andrew K.; Ivancic, Paul C.; Pearson, Adam M.; Tominaga, Yasuhiro; Yue, James J.

    2007-01-01

    Previous biomechanical models of cervical bilateral facet dislocation (BFD) are limited to quasi-static loading or manual ligament transection. The goal of the present study was to determine the facet joint kinematics during high-speed BFD. Dislocation was simulated using ten cervical functional spinal units with muscle force replication by frontal impact of the lower vertebra, tilted posteriorly by 42.5°. Average peak rotations and anterior sliding (displacement of upper articulating facet s...

  19. CONGENITAL DISLOCATION OF RIGHT HIP JOINT: IMPORTANCE OF DYNAMIC ASSESSMENT

    Pranita viveki; R. G. Viveki

    2014-01-01

    Congenital Dislocation of Hip (CDH), is one of the most common congenital diseases in the orthopedic field. It is also known as Developmental Dysplasia of Hip. The condition can be diagnosed by clinical, ultrasonographic and radiological examination. Here we are reporting two days old male baby with congenital dislocation of right hip joint. The goal of treatment is to obtain a reduction to provide an optimal environment for femoral head and acetabular development. Early diagnosis is the mo...

  20. Inferior glenohumeral joint dislocation with greater tuberosity avulsion

    Mohd Faizan; Latif Zafar Jilani; Mazhar Abbas; Yasir Salam Siddiqui; Aamir Bin Sabir; M.K.A.Sherwani; Saifullah Khalid

    2015-01-01

    Inferior glenohumeral dislocation is the least common type of glenohumeral dislocations.It may be associated with fractures of the adjacent bones and neurovascular compromise.It should be treated immediately by close reduction.The associated neuropraxia usually recovers with time.Traction-counter traction method is commonly used for reduction followed by immobilization of the shoulder for three weeks.Here,we report a case of inferior glenohumeral joint dislocation with greater tuberosity fracture with transient neurovascular compromise and present a brief review of the literature.

  1. Titanium Cable Bundling in Treatment of Acromioclavicular Dislocation%钛缆捆扎治疗肩锁关节脱位

    吴冬灵; 刘中国; 余跃伟

    2015-01-01

    Objective To investigate the effect of titanium cable in the treatment of the dislocation of the shoulder joint.Methods 28 cases of patients with dislocation of the shoulder joint were treated,and the clinical data were retrospectively analyzed.Results Al patients were folowed up for 3 to 12 months,and al the patients were folowed up for anatomic reduction. The average constant score was 91.4 points at the end of folow-up.Conclusion The use of titanium cable in the treatment of shoulder joint dislocation is significant.%目的:探讨钛缆捆扎治疗肩锁关节脱位的疗效。方法收集28例肩锁关节脱位患者进行治疗,并回顾性分析其临床资料。结果重建后随访3~12个月,所有患者术中、术后锁骨远端高度均达到解剖复位。终末随访时,平均Constant 评分为91.4分。结论采用钛缆捆扎治疗肩锁关节脱位疗效理想。

  2. Spontaneous atraumatic dislocation of sternoclavicular joint in Reiter's syndrome

    Vijay Kumar Digge; Sanjay Meena; Sheh Alam Khan; Ravi Mittal

    2012-01-01

    Reactive arthritis or Reiter's syndrome characteristically affects the joint of the lower limb in an asymmetrical pattern.Usually it does not affect the axial skeleton or upper limbs.Although cases of atraumatic atlantoaxial subluxations have been reported,no case of spontaneous sternoclavicular dislocation in Reiter's syndrome has been reported.This paper describes a case of a 26 year old male patient who developed a spontaneous posterior sternoclavicular joint dislocation.No attempt of reduction was made and the patient was managed conservatively with good results.

  3. CONGENITAL DISLOCATION OF RIGHT HIP JOINT: IMPORTANCE OF DYNAMIC ASSESSMENT

    Pranita viveki

    2014-11-01

    Full Text Available Congenital Dislocation of Hip (CDH, is one of the most common congenital diseases in the orthopedic field. It is also known as Developmental Dysplasia of Hip. The condition can be diagnosed by clinical, ultrasonographic and radiological examination. Here we are reporting two days old male baby with congenital dislocation of right hip joint. The goal of treatment is to obtain a reduction to provide an optimal environment for femoral head and acetabular development. Early diagnosis is the most crucial aspect of the treatment of children with congenital dislocation of hip. If dislocation remains undiagnosed or neglected, the secondary pathological changes take place. Education of primary care colleagues, in making the diagnosis and prompt referral for management is recommended.

  4. Systematics of glenohumoral and acromioclavicular arthritis

    A common risk factor for osteoarthritis (OA) of the glenohumeral joint is instability and is often observed as a sequel to dislocation. Altered biomechanics will ultimately result in joint degeneration including osteophyte development at the lower margin of the humerus, glenoidal cartilage loss and surface deformity. An OA of the glenohumeral joint is often coexistent with soft tissue derangement of the shoulder. In advanced stages defects of the rotator cuff and OA of the glenohumeral joint may accelerate disease progression. Degenerative changes of the acromioclavicular joint (AC joint) are commonly seen in older persons with only modest correlation with clinical symptoms. Symptomatic OA of the AC joint is often concomitantly observed with degenerative changes of the glenohumeral joint. Standard radiographs are the basis of a structural assessment of shoulder OA but lack correlation with clinical symptoms and are insensitive for the detection of early degenerative changes. Magnetic resonance imaging (MRI) provides increased sensitivity for the detection of cartilage defects and reveals relevant soft tissue changes, such as lesions of the glenoid labrum and capsuloligamentous structures, which are seen in conjunction with instability. It is also the method of choice to detect clinically relevant bone marrow edema-like lesions or synovial changes that are associated with symptomatic OA. Standard radiographs are not applicable for detection of early degenerative changes. Once OA is suspected clinically, MRI is the method of choice for further structural assessment. The administration of an intravenous contrast agent is useful for assessing synovitis, which commonly correlates with clinical disease manifestations. For preoperative and surgical planning of joint replacement, MRI or CT should be used. (orig.)

  5. Dorsal dislocation of the trapezoid at the scaphotrapeziotrapezoidal joint.

    Ricciardi, Benjamin F; Malliaris, Stephanie; Weiland, Andrew J

    2015-05-01

    Background Axial dislocations of the trapezoid are rare, high-energy injuries. We present an unusual case of isolated dorsal dislocation of the trapezoid and index metacarpal at the scaphotrapeziotrapezoidal (STT) joint due to steering wheel injury. Case Description A 56-year-old man presented to our office with right hand pain for 10 days after a head-on motor vehicle accident (MVA) in which he suffered an axial load injury to his hand on the steering wheel. X-ray images were reported as unremarkable. Further workup with computed tomography (CT) scan revealed an isolated dorsal dislocation of the trapezoid with its associated index metacarpal at the STT joint. The patient was treated with open reduction, pinning, and dorsal capsulodesis. Literature Review Dorsal dislocation of the trapezoid has been associated with high-energy trauma such as industrial accidents or motorcycle accidents; however, recent case reports have also revealed an axial loading mechanism from a steering wheel injury as an increasingly common mechanism. These cases typically occur concomitantly with other fractures or dislocations of the carpal bones or carpometacarpal (CMC) joints. Multiple reports of delayed diagnoses due to distracting injuries and difficulty of recognition on plain radiographs have been reported. Clinical Relevance Dorsal dislocation of the trapezoid with its associated second metacarpal is a rare, high-energy injury that can often be missed on plain radiography. We report a rare variant with no concomitant injury to the metacarpals or carpal bones. A low index of suspicion for further imaging should exist in the setting of an axial loading injury to the hand. PMID:25945300

  6. Recurrent Dislocation of the Shoulder Joint

    Brand, Richard A.

    2008-01-01

    Dr. Anthony F. DePalma is shown. Photograph provided with kind permission of the Art Committee of Thomas Jefferson University, Philadelphia, PA. Dr. DePalma was the first editor of Clinical Orthopaedics and Related Research, established by the recently formed Association of Bone and Joint Surgeons. The idea of forming the Association of Bone and Joint surgeons had been conceived by Dr. Earl McBride of Oklahoma City in 1947, and organized by a group of twelve individuals (Drs. Earl McBride, Ga...

  7. A comparison of two treatments of Rockwood type Ⅲ acromioclavicular dislocation%Rockwood Ⅲ型肩锁关节脱位两种治疗方法分析

    郭丹; 周海斌

    2013-01-01

    目的 探讨Rockwood Ⅲ型肩锁关节脱位手术及保守两种方法治疗后效果及对肩关节功能恢复的影响.方法 苏北人民医院和苏州大学附属第二医院骨科自2008年2月-2010年2月66例Rockwood Ⅲ型肩锁关节脱位病人,其中女性29例,男性37例,平均41.6岁,分锁骨钩钢板手术治疗和背带式锁骨固定带保守治疗,按调整的Constant-Murley评分系统随访观察各病例肩关节恢复情况.结果 Rockwood Ⅲ型肩锁关节脱位中,35例锁骨钩钢板手术治疗病例中3例出现肩关节活动受限、肩痛症状,背带式锁骨固定带保守治疗组31例病人中3例出现肩关节活动受限、肩痛症状,统计检验手术治疗组与保守治疗组之间评分差异无统计学意义(P>0.05).结论 Rockwood Ⅲ型肩锁关节脱位手术治疗与保守治疗对功能恢复影响差异不明显.%Objective To evaluate two treatment methods in Rockwood type Ⅲ acromioclavicular dislocation patients,and to evaluate the influence of trement methods on shoulder function. Methods From February,2008 to February,2010,66 Rockwood type Ⅲ acromioclavicular dislocation patients( 37 male and 29 female,average age 41. 6 )were treated in the Northern Jiangsu People' s Hospital and the Second Affiliated Hospital of Soochow University, with operation used hook plate and conservative treatment by clavicle sling immobilization respectively. Adjusted Constant-Murley Scale was used to evaluate shoulder function. Results In Rockwood type Ⅲ acromioclavicular dislocation. There were 3 cases with shoulder painful and restricted symptoms in the 35 patients treated with operation. There were 3 cases with shoulder painful and restricted symptoms in the 31 patients treated with conservative treatment patients. The difference between operation and conservative treatment was not significant P >0.05 ). Conclusion In Rockwood type Ⅲ acromioclavicular dislocation,for operation and conservative treatment,we could not

  8. Isolated Dislocation of Proximal Tibiofibular Joint

    Oktay, Alper; Baysal, Ozgur; Ecevız, Engin; Elmalı, Nurzat

    2014-01-01

    Objectives: Proximal tibiofibular joint luxation is very rare condition and usually missed in the ED. The aim of the study is if a patient is brought to ED with knee injury, we should keep in mind this pathology. Methods: A 23 year old man was admitted to emergency department with knee pain and restricted movement of the knee during the football match. Physical examination revealed mild swelling and limited ROM on his knee. We took AP and lateral X-rays immediately. We diagnosed the proximal ...

  9. Imaging features of traumatic dislocation of the lumbosacral joint associated with disc herniation

    Tohme-Noun, C.; Krainik, A.; Menu, Y. [Department of Radiology, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de Medecine Bichat-Beaujon, Paris (France); Rillardon, L.; Guigui, P. [Department of Orthopedic Surgery, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de Medecine Bichat-Beaujon, Paris (France); Feydy, A. [Department of Radiology, Hopital Beaujon, AP HP, Universite Paris 7, Faculte de Medecine Bichat-Beaujon, Paris (France); Department of Radiology, Hopital Beaujon, 100 avenue du General Leclerc, 92118, Clichy (France)

    2003-06-01

    Bilateral facet dislocation of the lumbosacral joint is an uncommon injury. We report on the imaging findings in a patient who had an acute disc herniation associated with a bilateral traumatic lumbosacral dislocation. (orig.)

  10. Imaging features of traumatic dislocation of the lumbosacral joint associated with disc herniation

    Bilateral facet dislocation of the lumbosacral joint is an uncommon injury. We report on the imaging findings in a patient who had an acute disc herniation associated with a bilateral traumatic lumbosacral dislocation. (orig.)

  11. Bilateral temporomandibular joint dislocation in a 29-year-old man: a case report

    Thangarajah Tanujan

    2010-08-01

    Full Text Available Abstract Introduction A dislocation of the temporomandibular joint represents three percent of all reported dislocated joints. The treatment entails reduction of the deformity and this can often be achieved in a ward setting. Case presentation We present the case of a 29-year-old Caucasian man with a non-traumatic bilateral anterior temporomandibular joint dislocation. Following several unsuccessful attempts, due to both inadequate patient analgesia and sedation, joint reduction had to be performed in theatre with the patient under general anesthesia. Conclusion This case highlights the importance of providing the patient with adequate analgesia and sedation when attempting the reduction of temporomandibular joint dislocations.

  12. Divergent dislocation of the ring and little finger carpometacarpal joints--a rare injury pattern.

    Dillon, John

    2012-02-03

    Hand injuries due to longitudinal forces in the line of the metacarpals demonstrate unusual dislocation patterns. We describe a case of volar intra-articular fracture dislocation of the ring finger carpometacarpal joint in association with a pure dorsal dislocation of the little finger carpometacarpal joint. Open reduction supplemented with Kirschner wire fixation restored normal carpometacarpal joint anatomical relations and achieved an excellent clinical result.

  13. POSTERIOR STERNOCLAVICULAR JOINT DISLOCATION IN A DIVISION I FOOTBALL PLAYER: A CASE REPORT

    Cruz, Mario F.; Erdeljac, Joe; Williams, Richard(Institut für Theoretische Physik, Justus-Liebig–Universität Giessen, 35392 Giessen, Germany); Brown, Mike; Bolgla, Lori

    2015-01-01

    Posterior dislocation of the sterno‐clavicular (SC) joint is a rare injury in athletes. It normally occurs in high collision sports such as American football or rugby. Acute posterior dislocations of the SC joint can be life‐threatening as the posteriorly displaced clavicle can cause damage to vital vascular and respiratory structures such as the aortic arch, the carotid and subclavian arteries, and the trachea. The potential severity of a posterior SC joint dislocation provides multiple chal...

  14. Posterior dislocation of the sternoclavicular joint leading to mediastinal compression.

    Jougon, J B; Lepront, D J; Dromer, C E

    1996-02-01

    Dislocations of the sternoclavicular joint are uncommon, and the posterior variety have a potential for considerable morbidity. We report a case with compression of the vital structures within the superior mediastinum. It was a rugby player getting run over by the scrum. The mechanism was an indirect force exerted forward and laterally against the shoulder. The patient complained of pain and dysphagia. A systolic right cervical murmur was heard. Angiography was normal and esophagography showed extrinsic esophageal compression. Surgical reduction was performed because there was a slight pneumomediastinum on the computed tomography. This case report demonstrates the mechanism, complications, and treatment of such a lesion. PMID:8572795

  15. Simultaneous Dislocation of Radiocapitellar and Distal Radioulnar Joint

    Tomio Nishi; Noriyuki Suzuki; Takayuki Tani; Hiroshi Aonuma

    2013-01-01

    A 45-year-old male presented to the emergency room of our institution complaining of severe pain around the left elbow. While playing volleyball, he slipped down with his left arm hit between the floor and his body. He complaind of strong pain from left elbow to hand, and active motion of elbow and wrist joint was impossible. His forearm was held in supinated position. On X-ray examination, radius head was deviated to anterior lateral side, and distal end of radius was dislocated to dorsal si...

  16. Acromioclavicular joint reconstruction using a tendon graft: a biomechanical study comparing a novel “sutured throughout” tendon graft to a standard tendon graft

    Naziri Qais

    2016-01-01

    Full Text Available Background: With a recurrence rate of over 30%, techniques that offer stronger acromioclavicular (AC joint reconstruction through increased graft strength may provide longevity. The purpose of our study was to determine the biomechanical strength of a novel tendon graft sutured throughout compared to a native tendon graft in Grade 3 anatomical AC joint reconstruction. Methods: For this in vitro experiment, nine paired (n = 18 embalmed cadaveric AC joints of three males and six females (age 86 years, range 51–94 years were harvested. Anatomic repair with fresh bovine Achilles tendon grafts without bone block was simulated. Specimens were divided into two groups; with group 1 using grafts with ultra-high molecular-weight polyethylene (UHMWPE suture ran throughout the entire length. In group 2, reconstruction with only native allografts was performed. The distal scapula and humerus were casted in epoxy compound and mounted on the mechanical testing machine. Tensile tests were performed using a mechanical testing machine at the rate of 50 mm/min. Maximum load and displacement to failure were collected. Results: The average load to failure was significantly higher for group 1 compared to group 2, with mean values of 437.5 N ± 160.7 N and 94.4 N ± 43.6 N, (p = 0.001. The average displacement to failure was not significantly different, with 29.7 mm ± 10.6 mm in group 1 and 25 mm ± 9.1 mm in group 2 (p = 0.25. Conclusion: We conclude that a UHMWPE suture reinforced graft can provide a 3.6 times stronger AC joint reconstruction compared to a native graft.

  17. Dorsal Buttress Plate Fixation of Ulnar Carpometacarpal Joint Fracture Dislocations.

    Tan, En Si; Chao, Tay Shian

    2016-06-01

    We propose a method for open reduction and internal fixation of early and unstable ulnar (fourth and/or fifth) carpometacarpal joint (CMCJ) fracture subluxations or dislocations using a dorsal buttress plate. In ulnar CMCJ fracture dislocations, the metacarpal has a tendency to displace dorsally and proximally when there is an axial load. Using the dorsal buttress plate method of fixation, a plate is fixed proximally to the hamate, aligned parallel and dorsal to the metacarpal to act as a buttress, to resist this movement. To preserve the fourth and the fifth CMCJ mobility, the distal end of the plate is not fixed to the metacarpal base. We illustrate the use of this technique on 4 patients who had different patterns of injury at the ulnar CMCJ. All patients regained excellent range of motion and function. None of the patients had redisplacement or nonunion of fracture. The dorsal buttress plate is a viable option for fixation of early and unstable ulnar CMCJ fracture subluxations or dislocations. PMID:27077465

  18. Simultaneous dislocation of radiocapitellar and distal radioulnar joint.

    Nishi, Tomio; Suzuki, Noriyuki; Tani, Takayuki; Aonuma, Hiroshi

    2013-01-01

    A 45-year-old male presented to the emergency room of our institution complaining of severe pain around the left elbow. While playing volleyball, he slipped down with his left arm hit between the floor and his body. He complaind of strong pain from left elbow to hand, and active motion of elbow and wrist joint was impossible. His forearm was held in supinated position. On X-ray examination, radius head was deviated to anterior lateral side, and distal end of radius was dislocated to dorsal side. Tenderness was prominent at the site of radial head and distal radioulnar joint. Surgical treatment was performed using triceps tendon strip. Good functional recovery was gained. PMID:24194995

  19. Simultaneous Dislocation of Radiocapitellar and Distal Radioulnar Joint

    Tomio Nishi

    2013-01-01

    Full Text Available A 45-year-old male presented to the emergency room of our institution complaining of severe pain around the left elbow. While playing volleyball, he slipped down with his left arm hit between the floor and his body. He complaind of strong pain from left elbow to hand, and active motion of elbow and wrist joint was impossible. His forearm was held in supinated position. On X-ray examination, radius head was deviated to anterior lateral side, and distal end of radius was dislocated to dorsal side. Tenderness was prominent at the site of radial head and distal radioulnar joint. Surgical treatment was performed using triceps tendon strip. Good functional recovery was gained.

  20. Compare of 3 different types of closed reduction and internal fixation for the fresh complete acromioclavicular dislocation%3种闭合复位内固定法治疗新鲜肩锁关节全脱位的疗效比较

    聂伟志; 谭远超; 杨茂清; 朱惠芳

    2011-01-01

    目的:比较3种闭合复位内固定法治疗新鲜肩锁关节全脱住的疗效.方法:136例新鲜肩锁关节全脱位患者,闭合复位后采用经皮"肩峰-锁骨"双枚钢针固定治疗31例(A组),采用经皮"肩峰-锁骨"双枚钢针固定+经皮缝合肩锁关节囊治疗45例(B组),采用经皮"肩峰一锁骨"双枚钢针固定+经皮"锁骨一喙突"空心螺钉固定+经皮缝合肩锁关节囊治疗60例(c组,"三联固定"组),参照Karlsson评价标准比较3组疗效.结果:3组疗效之间的差异有统计学意义(x2=21.623,P=0.002),C组疗效优于B组(u=2.014,P=0.002),B组疗效优于A组(u=2.781,P=0.006).结论:经皮"肩峰-锁骨"双枚钢针固定+经皮"锁骨-喙突"空心螺钉固定+经皮缝合肩锁关节囊治疗新鲜肩锁关节全脱位,疗效优于经皮"肩峰-锁骨"钢针固定+经皮缝合肩锁关节囊,更优于单纯"肩峰-锁骨"钢针固定.%Objective: To compare the curative effect of 3 different types of closed reduction and internal fixation on fresh complete acromioclavicular dislocation. Methods: 136 patients sustained complete acromioclavicular dislocation were divided into 3 groups. 31 cases in Group A were treated with acromioclavicular closed reduction and acromioclavicular internal fixation by 2 steel - wire per cutem. 45 cases in Group B were treated with acromioclavicular closed reduction and acromioclavicular internal fixation by 2 steel - wire per cutem and suturation of the capsula articularis acromioclavicularis per cutem. 60 cases in Group C were treated with acromioclavicular closed reduction and acromioclavicular internal fixation by 2 steel - wire per cutem and suturation of the capsula articularis acromioclavicularis per cutem and fixation with a hollowed screw between the clavicle and the coracoid (three point fixation). The curative effects were evaluated according to Karlsson' s standard. Results: There was statistical difference in the curative effects between the 3 groups(x2 = 21. 623

  1. Bilateral Anterior Fracture-Dislocation of Shoulder Joint- A rare case with Delayed Presentation

    Sunku, Nithin; Kalaiah, Kiran; Marulasidappa, G.; Gopinath, P

    2012-01-01

    Introduction: The shoulder is the most frequently dislocated joint. Bilateral glenohumeral dislocations are rare and almost always posterior. Bilateral anterior fracture dislocations of humeral neck in a patient with seizure are extremely rare. We report one such case of delayed presentation of bilateral anterior fracture dislocation of shoulder after an epileptic attack. Case Report: We describe a rare case of 30 year old gentleman who presented with first episode of seizure following alcoho...

  2. Dorsal traumatic dislocation of first and second metatarsophalangeal joint (A case study

    Baghery Fard A

    2001-11-01

    Full Text Available Dorsal traumatic dislocation of metatarsophalangeal joint of great toe is a rare injury. Ability to reduce the dislocation by nonoperative measures depends largely on the type of dislocation and involvement of the sesamoid complex. There are three basic types of dislocations. Type I cases are usually irreducible on closed reduction, the metatarsal head being incarcerated by the conjoined tendons with their intact sesamoids. In type II, the sesamoid complex disruption usually pemits closed reduction. We present an irreducible dislocation of the first metatarsophalangeal joint with fibular sesamoid fracture in an 80-year-old man. In addition, he had a concomitant dorsal dislocation of the second MTP of the same foot, to our knowledge only one case with this injury was reported in the literature.

  3. [Post-traumatic bipolar dislocation of the clavicle: is operative treatment reasonable?].

    Dudda, M; Kruppa, C; Schildhauer, T A

    2013-02-01

    Bipolar dislocation of the clavicle ("floating clavicle") is extremely rare. It exists no standardised treatment for this trauma and the treatment is often conservative. This is mainly an anterior displacement of the sternoclavicular joint (type III according to Allman) and a posterior dislocation of the acromioclavicular joint (type IV according to Rockwood).We report on a 60 year old male who fell onto the right shoulder. He sustained a 'floating clavicle' and had a massive dislocation, impairment of range of motion and pain. Venous congestion was observable. We stabilised the dislocated acromioclavicular joint with a Balser's plate, the sternoclavicular joint was fixed with PDS cord tension band technique around the first rip and the sternum. In addition we resected the anterior part of the distal clavicle to get a better cosmetic result. Post-operatively the patient had an excellent range of motion without any further symptoms after six weeks and one year. Venous congestion was not more observable.In most of the cases dislocations of both ends of the clavicle are treated conservatively. We recommend an operative treatment especially in young and active patients to avoid re-dislocation and to archive better cosmetic results. PMID:22367519

  4. Biepicondylar fracture dislocation of the elbow joint concomitant with ulnar nerve injury

    Konya, M Nuri; Aslan, Ahmet; Sofu, Hakan; Yıldırım, Timur

    2013-01-01

    In this article, we present a case of humeral biepicondylar fracture dislocation concomitant with ulnar nerve injury in a seventeen year-old male patient. Physical examination of our patient in the emergency room revealed a painful, edematous and deformed-looking left elbow joint. Hypoesthesia of the little finger was also diagnosed on the left hand. Radiological assessment ended up with a posterior fracture dislocation of the elbow joint accompanied by intra-articular loose bodies. Open redu...

  5. The Classic: A Dissertation Upon Dislocations and Fractures of the Clavicle and Shoulder-Joint

    Callaway, Thomas

    2011-01-01

    This Classic Article is a reprint of a section on scapula fractures in the original work by T. Callaway, Jr., A Dissertation Upon Dislocations and Fractures of the Clavicle and Shoulder-Joint. An accompanying biographical sketch of Thomas Callaway, Jr. is available at DOI 10.1007/s11999-011-2097-2. The Classic Article is ©1849 and is reprinted from Callaway T. A Dissertation Upon Dislocations and Fractures of the Clavicle and Shoulder-Joint. London: Samuel Highly; 1849.

  6. Dislocations

    Representations of main geometrical properties of dislocations, their interaction between each other and with a free surface are given. Mechanisms of dislocation formation and movements in different crystal lattices and their role in material strain hardening are considered. Grain boundaries and twin ones are described as dislocation rows imposed on each other

  7. Dislocation of the temporomandibular joint meniscus: contrast arthrography vs. computed tomography

    Thompson, J.R.; Christiansen, E.; Sauser, D.; Hasso, A.N.; Hinshaw, D.B. Jr.

    1985-01-01

    A prospective study to determine the accuracy of computed tomography (CT) for the diagnosis of dislocation of the temporomandibular joint (TMJ) meniscus was made by performing both CT and contrast arthrography on 18 joints suspected of meniscus dislocation. Arthography rather than surgery was chosen as the quality standard for comparing CT findings, as not all patients undergoing the studies underwent surgery. The results of each test were reported independently by the radiologist who obtained either all of the arthograms or all of the CT scans. For dislocation of the meniscus, there were excellent agreement between the two methods. CT seems to be nearly as accurate as arthrography for showing meniscus dislocation, is performed with lower x-ray exposure, and is noninvasive. Arthrograpy discloses more detailed information about the joint meniscus, such as perforation and maceration, and should continue to be used when this kind of information is clinically important.

  8. The surgical treatment of the recurrent dislocation on the shoulder joint with minimum invasion anterior approach

    Ninković Srđan; Stanković Milan; Savić Dragan; Matijević Radmila; Milankov Miroslav

    2008-01-01

    Shoulder joint is one of the spherical joints and one of the most movable but also the most unstable joint of locomotive apparatus. The aims of this work are to review and analyze the results of medical treatment of frontal recurrent dislocations on the shoulder with open surgery technique on the Clinic for Orthopaedic Surgery and Traumatology in Novi Sad in the period from 2002 to 2005. Twenty one patients with anterior recurrent dislocations of the shoulder were operated on, 19 men and 2 wo...

  9. Ipsilateral dislocation of the shoulder and elbow joints with contralateral comminuted humeral fracture

    Ipsilateral dislocation of the shoulder and elbow joints is a rare and complex injury. During the last 25 years, only 3 cases have been reported in the literature. We report a 50-year-old woman who suffered ipsilateral elbow and shoulder dislocation with contralateral comminuted humeral fracture. Both shoulder and elbow joints were reduced, but the elbow was dislocated subsequently at follow-up. The reduction in the elbow was stabilized by a Kirschner wire that was removed at 3 weeks, and the elbow was then stable. A U-shaped coaptation splint was applied for the contralateral comminuted humeral fracture. At 6 months, she had acquired a nearly full range of motion of both shoulder and elbow with complete healing in the contralateral humerus. Although rare and complex, ipsilateral shoulder and elbow dislocation, which is the result of a high-energy trauma, can be treated conservatively. (author)

  10. Non-traumatic posterior atlanto-occipital joint dislocation

    Takechi, Yasuhiko; Iizuka, Haku; Sorimachi, Yasunori; Ara, Tsuyoshi; Nishinome, Masahiro; Takagishi, Kenji

    2010-01-01

    This report presents a case of non-traumatic posterior atlanto-occipital dislocation. A 36-year-old female was referred with a history of numbness of the extremities, vertigo and neck pain for 1 year. The patient had no history of trauma. The axial rotation of range of motion of the cervical spine was severely restricted. A lateral cervical radiograph in the neutral position demonstrated a posterior atlanto-occipital dislocation. A coronal view on a computed tomography (CT) reconstruction ima...

  11. Management of acute dislocation of the temporomandibular joint in dental practice.

    McGoldrick, David M

    2010-12-01

    Acute dislocation of the temporomandibular joint is a situation that, although rare, may present to the dentist in practice at any time. A number of activities, such as removal of a tooth, may cause dislocation. The event is painful and distressing for the patient, their family and the dental team. Prompt management minimises discomfort, distress and long-term morbidity to the patient. We describe the aetiology of acute dislocation and outline a number of techniques that will aid the clinican in dealing with this event.

  12. Dislocation of temporo-mandibular joint - an uncommon circumstance of occurrence: vaginal delivery

    Abderrahim El Bouazzaoui

    2010-06-01

    Full Text Available Dislocation of temporo-mandibular joint (TMJ is an infrequent disease but still almost spectacular. This disease consists of a permanent, to some extent complete disruption of the temporo-mandibular joint. These dislocations often occurs in a context of yawning, and less frequently after a burst of laughing or relatively mild facial trauma (slap, punch on the chin.We report a case of TMJ occurring in an uncommon circumstance : vaginal delivery. A young woman aged 24-years with no special past medical history; primipara was admitted in the Department of Maternity of the University Hospital Hassan II of Fez for an imminent delivery of a twin pregnancy. Obstetrical analgesia was not possible so the parturient cried in a strong manner during labour. Ten minutes after admission, the patient delivered vaginally with episiotomy. She gave birth to twins weighing 2800g and 2400g. During labour, and effort of crying, the patient presented a sudden and immediate loss of function of the temporo-mandibular joint, with difficulty of speaking, the mouth permanently opened, with the chin lowered and thrown forward. The examination found an emptiness of the glenoid fossa of the temporo-mandibular joint in both sides. The diagnosis of dislocation of the TMJ has established. Performance of special radiologic screening to study the TM was technically not possible. A CT scan of facial bones has been achieved so objectifying a bilateral dislocation of TMJ. The reduction of this dislocation was performed in the operating room under sedation

  13. Arteriovenous Fistula Secondary to Recurrent Metacarpophalangeal Joint Dislocation: A Case Report

    Ha, Jennifer F.; Sieunarine, Kishore

    2009-01-01

    Acquired traumatic arteriovenous fistula in the hand is rare, and only a few cases have been reported in the literature. It should be considered as a possible complication when there is a persistent palpable lesion after the traumatic swelling in the hand has resolved. We report a case of a rare arteriovenous fistula secondary to recurrent metacarpophalangeal joint dislocation.

  14. Posterior treatment of delayed traumatic atlantoaxial joint dislocation with apofix internal fixation

    Objective: To assess the effect of posterior fixation and fusion with Apofix device for the treatment of delayed traumatic atlantoaxial joint dislocation. Methods: Eighteen patients with delayed traumatic atlantoaxial joint dislocation were included. Posterior fixation and fusion with Apofix device were performed. First step was one or two week skull traction. After the atlantoaxial joint dislocation had been reduced, the posterior fixation and fusion with Apofix was performed. Using local anaesthesia, atlantoaxial interval and posterior structure of atlas and dentata were exposed by midline operative approach. Apofix interlaminar clamps were placed at posterior arch of atlas and odontoid vertebral laminae, autologous iliac bone graft was placed for fusion. Then the device to proper position was pressurized and items locked. Results: All of the patients were followed up, the mean follow-up period was 38 months (13 ∼ 84 months). Fifteen patients obtained complete reduction, the others were partial reduction. Seventeen patients had successful fusion after 3 or 4 months, only 1 patient who had partial reduction had internal fixation loose and nonfusion, leading to recurrence of atlantoaxial joint dislocation. An occipitocervical fusion surgery was performed on this patient. As to neurological assessment, 16 patients had neurological deficit before operation, while 6 of them recovered completely after operation, another 10 patients' neurological status improved significantly. JOA score was improved from 9.5 pre-operative to 15.8 post-operative. Conclusion: Apofix internal fixation and fusion seems to be feasible in treatment of delayed traumatic atlantoaxial joint dislocation. Successful reduction before operation and proper treatment after operation is also important. (authors)

  15. Volar dislocation of the radiocarpal joint with volar radiocarpal ligament rupture: a case report

    Gokhan Meric

    2012-12-01

    Full Text Available Radiocarpal joint dislocation, with or without fracture of the radius, is an uncommon injury. Volar radiocarpal dislocation is often associated with injury to the dorsal capsular and ligamentous structures. It does not have clear information about the injury and functional outcomes of treatment. It has been reported successful results treatment of the radiocarpal dislocation with closed reduction cast immobilisation, Kirshner wire fixation and open reduction. We report a case of 19 years old man admitted to our emergency department who had radiocarpal dislocation, distal volar chip fracture and volar radiocarpal ligament rupture due to a motorbike accident. We treated open reduction of radiocarpal joint, internal fixation of fracture with Kirshner wire and velar radiocarpal ligament repair with anchor suture. 6 months after operation we observed the union of the fracture and that the joint was stable during controls and radiological examinations. We did not find any pain or discomfort during daily activity and found that the full range of motion. [Hand Microsurg 2012; 1(3.000: 107-110

  16. A comparison of ketamine versus etomidate for procedural sedation for the reduction of large joint dislocations

    Salen, Philip; Grossman, Michelle; Grossman, Michael; Milazzo, Anthony; Stoltzfus, Jill

    2016-01-01

    Study Objectives: Ketamine and etomidate are used for procedural sedation (PS) to facilitate the performance of painful procedures. We hypothesized that ketamine produces adequate and comparable sedation conditions for dislocated large joint reduction when compared to etomidate and results in fewer adverse events. Methods: This Institutional Review Board approved prospective trial compared a convenience sample of subjects, who were randomized to receive either ketamine or etomidate for PS to facilitate reduction of large joint dislocations. Following informed consent, subjects were assigned via a computer-generated algorithm to receive either etomidate (0.1 mg/kg) or ketamine (0.5 mg/kg) intravenously; if PS was not sufficient, subjects received repeat doses of etomidate or ketamine until adequate PS was achieved. The protocol's primary endpoint was a successful reduction of dislocated, large joints. Secondary endpoints included alteration in blood pressure, vomiting, recovery agitation, hypersalivation, laryngospasm, myoclonus, hypoxia, airway assistance with chin lift or jaw thrust, bag-valve-mask ventilation, endotracheal intubation, utilization of additional doses of ketamine or etomidate, and recovery time from sedation. Results: Total enrollment was eighty subjects, 46 in the ketamine cohort and 34 in the etomidate cohort. The two PS groups were comparable in terms of gender, age, and weight. There was no significant difference in the primary endpoint of large joint dislocation reduction between the ketamine and etomidate cohorts (46/46, 100%; 32/34, 94.1%; P – 0.1). Shoulder, hip, and ankle joints account for the majority of joint reductions in this trial. Titration of PS was necessary for almost half of each cohort as evidenced by the utilization of additional dosages of the sedative agents: ketamine (22/46, 47.8%) and etomidate (14/34, 41.2%; P – 0.56). Among secondary outcome variables, significant differences between ketamine and etomidate cohorts

  17. Reduction of temporomandibular joint dislocation: an ancient technique that has stood the test of time.

    Forshaw, R J

    2015-07-01

    The first known recorded evidence for the reduction of a mandibular joint dislocation is documented in a papyrus dated to c. 1500 BC that originated from ancient Egypt. This same technique was later discussed by Hippocrates in Greece and the Hippocratic corpus is referred to in early Islamic writings. It is detailed in medieval European texts and eventually was incorporated into modern dental and medical practice. Today, mandibular joint dislocation is probably not that common but to be included in an important ancient Egyptian treatise, predominately concerned with trauma to the head and neck, could suggest it was a more frequent occurrence in antiquity. This could relate to the heavy tooth wear, frequent antemortem tooth loss and the related sequelae of severe malocclusion and overclosure evident in many surviving ancient Egyptian skulls. PMID:26114704

  18. Lateral dislocation of the knee joint after total knee arthroplasty: a case report

    Ugutmen, Ender; Ozkan, Korhan; Unay, Koray; Mahirogullari, Mahir; Eceviz, Engin; Taser, Omer

    2008-01-01

    Background Total knee arthroplasty (TKA) is a successful therapy for functional improvement and pain relief in advanced symptomatic degeneration of the knee joint. But it can be associated with many complications, one of which is instability. Case presentation A 70-year-old woman was referred to our hospital because of right knee dislocation after TKA was performed on her right knee due to severe varus deformity and flexion contracture. This instability was caused by persistent MCL tightness ...

  19. Complete medial column dislocation at the cuneonavicular joint: an unusual Lisfranc-like injury.

    Schepers, T; de Jong, V M; Luitse, J S K

    2014-09-01

    Lisfranc injuries represent a wide spectrum of different injuries at the tarsometatarsal joint. Not all types fit the currently available classifications. This case illustrates a rare subtype of a Lisfranc injury, with a dislocation of the entire first ray. It is presented to create more awareness for midfoot injuries. This article reviews the literature and provides recommendations for the treatment of similar cases in the future. PMID:25063016

  20. A closed dorsolateral dislocation of PIP joint of the fourth toe-a case report and review of literature

    Prof. Giris Kumar Singh

    2009-01-01

    Full Text Available Interphalangeal (IP joint dislocations of the toes are uncommon lesions. We present here a case of closed dorsolateral dislocation of proximal interphalangeal (PIP joint of the fourth toe. Closed reduction and buddy strapping have been done with middle toe for two weeks under digital block. There was painless full range of movement after 2 weeks. We propose that attempt of closed reduction must be given adequately under anesthesia before proceeding for open reduction.

  1. Invited Hand Article: Current Concepts in Treatment of Fracture-Dislocations of the Proximal Interphalangeal Joint

    Haase, Steven C.; Chung, Kevin C.

    2014-01-01

    Background Proximal interphalangeal joint fracture-dislocations are common injuries that require expedient and attentive treatment for the best outcomes. Management can range from protective splinting and early mobilization to complex operations. In this review, the current concepts surrounding the managment of these injuries are reviewed. Methods A literature review was performed of all recent articles pertaining to proximal interphalangeal joint fracture-dislocation, with specific focus on middle phalangeal base fractures. Where appropriate, older articles, or articles on closely related injury types were included for completeness. The methodology and outcomes of each study were analyzed. Results When small avulsion fractures are present, good results are routinely obtained with reduction and early mobilization of stable injuries. Strategies for management of the unstable dorsal fracture-dislocation have evolved over time. To provide early stability, a variety of techniques have evolved, including closed, percutaneous, external, and internal fixation methods. Although each of these techniques can be successful in skilled hands, none have been subjected to rigorous, prospective, comparative trials. Volar dislocations fare less well, with significant loss of motion in many studies. Pilon fractures represent the most complicated injuries, and return of normal motion is not expected. Conclusion The best outcomes can be achieved by (1) establishing enough stability to allow early motion, (2) restoring gliding joint motion rather than non-congruent motion, and (3) restoring the articular surface congruity when possible. Although the majority of literature on this topic consists of expert opinion and retrospective case series, the consensus appears to favor less invasive techniques whenever possible. PMID:25415092

  2. Diagnostic challenges in acromioclavicular septic arthritis.

    Williams, Mark

    2016-01-01

    A 69-year-old man with Klinefelter's syndrome presented with a painful shoulder and staphylococcal sepsis. He received intravenous antibiotics while investigations were performed to locate the source of infection. MRI demonstrated infection in the acromioclavicular joint (ACJ). The patient clinically improved and a further 5 weeks of oral antibiotics were given. He remained asymptomatic at 2-year follow-up. Although ACJ septic arthritis is rare, independent of immune-competent status, a high index of suspicion is essential for prompt diagnosis. The condition presents additional diagnostic challenges due to unfamiliarity, the challenges of interpreting imaging, desire for radiological guided arthrocentesis and low volume aspirates. Overcoming these pitfalls is essential to avoid significant morbidity and mortality. PMID:27257000

  3. The surgical treatment of the recurrent dislocation on the shoulder joint with minimum invasion anterior approach

    Ninković Srđan

    2008-01-01

    Full Text Available Shoulder joint is one of the spherical joints and one of the most movable but also the most unstable joint of locomotive apparatus. The aims of this work are to review and analyze the results of medical treatment of frontal recurrent dislocations on the shoulder with open surgery technique on the Clinic for Orthopaedic Surgery and Traumatology in Novi Sad in the period from 2002 to 2005. Twenty one patients with anterior recurrent dislocations of the shoulder were operated on, 19 men and 2 women. The average age of those patients was 24.8 (15-40 year-olds. Ten patients had an injury of the left and 11 patients the injury of the right shoulder. There were eight handball players, four fighting skills players; two of them played volleyball and one was a basketball player. Six of them were not sportsmen. The preoperational and post operational mean value of the modified Rowe scale showed a statistically significant difference (P<0.001. Observing the patients after the operation in the period of 2 years, according to Neer scale, 3 patients (14.28% had great results (grade over 90, 16 patients (76.19% had a good result, (75-89, and only two patients (9.52% had results less than 75. The measuring of the volume of movements after physical treatment in 12 patients (57.14% has shown the decrease of the outside rotation. Open surgery treatment of the front unstable shoulder joint is reliable and time tested and it gives good clinical results in young sportsmen with undirected unstable, bigger number of dislocations and associated osseous defects. .

  4. Bilateral Dislocation of Temporomandibular Joint Induced by Haloperidol Following Suicide Attempt: A Case Report

    Mosa Arghand Dargahi

    2012-03-01

    Full Text Available Drug induced dystonic reactions are among common presentations of patients in emergency departments, and typically occur with antidopaminergic agents as their extra-pyramidal side effects. Dystonic reactions usually occur within the first few hours or days after commencing a drug or dose increase. Unlike other extra-pyramidal side effects, a patient may experience acute dystonic reactions (ADRs with the administration of just a single dose. Oromandibular dystonia is a subtype of dystonia which can present with perioral manifestations. In extreme cases, it can lead to temporomandibular dislocation. Haloperidol, as a high potent typical antipsychotic drug, can induce dystonia with blocking D2 dopamine receptors. The present paper reports a case of bilateral dislocation of temporomandibular joint following ingestion of haloperidol in a suicidal attempt in a 17 years old girl.

  5. Simultaneous Volar Dislocation of Distal Interphalangeal Joint and Volar Fracture-Subluxation of Proximal Interphalangeal Joint of Little Finger: A New Mechanism of Injury.

    Mozaffarian, Kamran; Bayatpour, Abdollah; Vosoughi, Amir Reza

    2016-10-01

    Simultaneous volar dislocation of distal interphalangeal (DIP) joint and volar fracture-subluxation of proximal interphalangeal (PIP) joint of the same finger has not been reported yet. A 19-year-old man was referred due to pain on the deformed left little finger after a ball injury. Radiographs showed volar dislocation of the DIP joint and dorsal lip fracture of the middle phalanx with volar subluxation of PIP joint of the little finger. This case was unique in terms of the mechanism of injury which was hyperflexion type in two adjacent joints of the same finger. The patient was treated by closed reduction of DIP joint dislocation and open reduction and internal fixation of the PIP joint fracture-subluxation and application of dorsal external fixator due to instability. Finally, full flexion of the PIP joint and full extension of the DIP joint were obtained but with 10 degree extension lag at the PIP joint and DIP joint flexion ranging from 0 degree to 30 degrees. Some loss of motion in small joints of the fingers after hyperflexion injuries should be expected. PMID:27595966

  6. Posterolateral dislocation of the knee joints:analysis of 9 cases

    顾敏琪; 邓磊; 刘沂

    2004-01-01

    Objective: To analyze the traumatic pathological characteristics of posterolateral dislocation of knee joints and its treatment.Methods: Nine cases of posterolateral dislocation of knee joint, 5 cases of fresh injuries (the fresh injury group) and 4 cases of old injuries ( the old injury group) were reviewed and analyzed. In the fresh injury group 4 cases failed in close reduction due to "buttonholing" through the medial joint, among them 3 cases underwent repair of the damaged ligaments. In the old injury group 2 cases underwent ACL and MCL repair only in acute stage, but re-dislocated. Of the rest 2 cases 1 was associated with peroneal nerve injury and the other was not treated in acute stage. One case was associated with comminuted fracture of the tibial condyle and popliteal artery injury. Open reduction was performed in 3 cases. One case was fixed with 2-crossed pin and another was fixed with one pin through the tibial and femoral condyle and second pin with olecranization fixation. Plaster immobilization for 6-8 weeks respectively was required. In the old injury group in 1 case ACL and PCL repair ( Augustine method ) and posterolateral structure were performed and olecranization fixation and plaster immobilization for 6 weeks was needed.Arthrodesis of the knee was done for the patient with comminuted fracture of the tibial condyle and popliteal artery injury.Results: All the cases were followed up for 1-23 years ( average 6 years). Knee stability in 4 cases with repair of the ligaments was improved, although PDT showed ( + ) with different degrees. The results of the patients treated with ligamentous reconstruction were much better than those of the patients without any repair. Conclusions: Well understanding of the traumatic pathological characteristics, repair of the damaged ligaments, augmentation of olecranization fixation and postoperative immobilization for 6 weeks are the key points of successful treatment.

  7. Irreducible open dorsal dislocation of the proximal interphalangeal joint: a case report.

    Muraoka, Shizuka; Furue, Yukihiro; Kawashima, Mahito

    2010-01-01

    We report a rare case of open dorsal dislocation of the proximal interphalangeal joint which needed operative reduction. A 39-year-old man injured his right middle finger while playing baseball. There was a laceration on the proximal interphalangeal crease, and the condyles of the proximal phalanx protruded through the wound. The flexor tendons had slipped behind the radial condyle, and made reduction impossible. After the flexor tendons and volar plate were replaced back into their normal position, the reduction was successful. Finally, the patient had full and painless motion of the digit. We review the reported cases of this injury in the relevant literature. PMID:20422730

  8. Histomorphologic Characteristics of Newly Formed Cavity of a Hip Joint in Dislocation in Experiment

    Ezhov I.Y.

    2013-06-01

    Full Text Available The aim of the investigation was to study in experiment the head of femur dislocation, which is a variety of transchondral damages, and the process of chondro- and osteogenesis in articular surface formation to create optimal conditions for their reparation and new formation. Materials and Methods. The experiment was carried out on 20 reproductive chinchilla rabbits. The head of femur was dislocated in experiment after joint capsule transaction, and exposed to dosing impact and force effect in the area of its upper pole. A blow was stricken by the device looking like an impact machine. The blow energy was regulated by changing load weight and the pendulum height. The animals were removed from the experiment 3, 7, 14, 30 days and 3 months after the injury. Results. For the initial few days in the dislocation area there were found fibrin effusions, hemorrhage, periosteal edema, and granulation tissue. In 2 weeks in fibrous tissue there were determined focal clusters of chondroblasts. By the end of the first month, near the head of femur, connective tissue was underlaid by newly formed fibrous cartilage with the areas of young hyaline cartilage forming a free margin. In 3 months a submarginal zone was formed of hyaline cartilage with ordered cytoarchitectonics of chondrocytes. Different-sized margins of the newly formed hyaline cartilage with the foci of complete osteogenesis in the wall of forming cavity (in the form of osseous tissue of sponge structure with the blood-forming bone marrow in interjoist were observed in close connection with periosteum of acetabular roof. Conclusion. A joint cavity forms on the basis of the mechanisms of pluripotent development of cambial cell elements towards chondro- and osteogenesis. Its successful formation can be accompanied by the mass of well blood-supplied muscles surrounding the dislocated head, periosteum of acetabular roof, as well as the capability of active movements the head of femur dislocated into

  9. Relação anatômica do nervo supraescapular com o processo coracoide, articulação acromioclavicular e acrômio Anatomical relationship of the suprascapular nerve to the coracoid process, acromio clavicular joint and acromion

    Bernardo Barcellos Terra

    2010-06-01

    Full Text Available OBJETIVO: Estabelecer a relação anatômica do nervo supraescapular (NSE localizado na fossa supraescapular com a borda medial da base do coracoide, face articular acromial da articulação acromioclavicular e a borda anterolateral do acrômio. MÉTODOS: Foram dissecados 16 ombros de 16 cadáveres, sendo nove masculinos e sete femininos, mensurando com auxílio do paquímetro a distância do nervo supraescapular (na sua passagem sob o ligamento transverso com pontos fixos determinados na borda medial da base do processo coracoide, na face articular do acrômio da articulação acromioclavicular e na borda anterolateral do acrômio, correlacionando com a idade e o sexo. Foram excluídos cadáveres com intervenção cirúrgica prévia. RESULTADOS: Com relação à medida do nervo supraescapular, na sua fossa à borda medial da base do processo coracoide, obtivemos uma média de 3,9cm (variando de 3,1cm a 5,2cm; com relação à articulação acromioclavicular, a média foi de 4,7 (3,9cm a 5,2cm; e, com relação à borda anterolateral do acrômio, a média foi de 6,1cm (5,7cm a 6,8cm. CONCLUSÃO: É fundamental o conhecimento exato da anatomia dos nervos da região anterior do ombro para evitar lesões iatrogênicas e para conseguir resultados satisfatórios no tratamento cirúrgico das doenças do ombro, seja ele realizado de forma aberta ou artroscópica.OBJECTIVE: To establish the anatomic relationship of the suprascapular nerve (SSN located in the suprascapular notch to the medial border of the base of the coracoid process, the medial acromial surface of the acromioclavicular joint and the anterolateral edge of the acromion. METHODS: We dissected 16 shoulders of 16 cadavers, 9 males and 7 females. The distance from the suprascapular nerve (in its course beneath the transverse ligament to certain fixed points in the medial base of the coracoid process was measured with the aid of a caliper, as well as to the articular surface of the acromion

  10. Delayed surgical treatment for a traumatic bilateral cervical facet joint dislocation using a posterior-anterior approach: a case report

    Shimada Takashi

    2013-01-01

    Full Text Available Abstract Introduction There have been few reports of patients with bilateral cervical facet dislocations that remain untreated for eight weeks or more. We report the case of a 76-year-old man with an old bilateral cervical facet joint dislocation fracture that was treated by posterior-anterior reduction and fixation. Case presentation A 76-year-old Asian man was involved in a road traffic accident. He presented with neck pain and arm pain on his right side, but motor weakness and paralysis were not observed. He was treated conservatively; however, instability and spondylolisthesis at the C5 to C6 joint increased eight weeks after the injury. We performed a posterior-anterior reduction and fixation. After surgery, bony union was achieved, and his neck pain and arm pain disappeared. Conclusion We recommend reduction and fixation surgery if a patient has an old bilateral facet joint dislocation fracture in the cervical spine.

  11. Volar dislocation of the index carpometacarpal joint in association with a Bennett's fracture of the thumb: a rare injury pattern.

    Dillon, J P

    2012-02-03

    We describe a case of volar dislocation of the index carpometacarpal (CMC) joint in association with a Bennett\\'s fracture of the thumb following a motorcycle accident. Volar dislocation of the index carpometacarpal joint is an exceedingly rare but easily missed injury, with only a few reported cases in the literature. This report highlights the importance of a true lateral radiograph and close scrutiny of the film to detect this injury. Closed reduction supplemented with Kirschner wire fixation restored normal anatomical relations and achieved an excellent clinical result.

  12. Neglected irreducible dislocation of the interphalangeal joint of the great toe: a case report.

    Hatori, Masahito; Goto, Masako; Tanaka, Kentaro; Smith, Richard A; Kokubun, Shoichi

    2006-01-01

    Irreducible dorsal dislocation of the interphalangeal joint of the great toe is rare. We report a case of a 58-year-old man with an irreducible interphalangeal joint of the great toe that had been untreated for 4 years. The mechanism of this injury was thought to be a combination of axial loading with a hyperextension force when the patient hit his great toe against a pipe. Invagination of the sesamoid became a barrier for manual reduction attempted after the initial injury. The patient did not seek treatment because of the minor deformity of the affected great toe and lack of severe symptoms. One year later, symptoms eventually developed on the plantar aspect of the great toe, particularly when the patient was walking upstairs. He decided to seek treatment as pain worsened and he became more active when he changed occupations 4 years later. Manual reduction was impossible. The patient was treated with operative exploration of the joint and arthrodesis of the great toe. The operative course was uneventful. At 4 years after surgery, the patient could walk, run, and walk up and down stairs without discomfort. PMID:16818156

  13. Comparison of different approaches to the reduction of anterior temporomandibular joint dislocation: a randomized clinical trial.

    Ardehali, M M; Tari, N; Bastaninejad, Sh; Amirizad, E

    2016-08-01

    This randomized clinical trial was designed to compare three different reduction methods for anterior temporomandibular joint (TMJ) dislocation. The three methods evaluated were the conventional method, wrist pivot method, and extraoral method. The study sample comprised 90 consecutive patients suffering from anterior dislocation of the TMJ, who were allocated randomly to one of the three groups. This study found success rates of 86.7% for the conventional method, 96.7% for the wrist pivot method, and 66.7% for the extraoral method. The extraoral method was more difficult for the physician and the patient than the other two methods. For the patients, the wrist pivot method was easier than the other methods. For the doctors, the extraoral method was significantly more difficult than the other methods. In conclusion, due to the absence of a biting risk with the extraoral method and the lack of a significant difference in success between this method and the conventional method, the extraoral method could be considered the appropriate first-line treatment where there is a risk of the patient biting the surgeon's hand. Given the overall benefits of the wrist pivot method, this method could be considered the first-line and gold standard treatment modality in other cases. PMID:27160610

  14. Traumatic dislocation of the incudostapedial joint repaired with fibrin tissue adhesive.

    Nikolaidis, Vasilios

    2011-03-01

    We present a case of traumatic dislocation of the incudostapedial joint (ISJ) and a simple method for controlled application of the glue using commercial fibrin tissue adhesive. A 26-year-old female presented to our ENT clinic for hearing impairment to her left ear 2 months after a head trauma due to a motorcycle accident. The audiogram revealed a 40- to 50-dB HL conductive hearing loss with a notch configuration in bone conduction curve on the left ear. Computed tomography of the left temporal bone revealed a longitudinal fracture line. An exploratory tympanotomy was performed under general anesthesia. The ISJ was found dislocated while the incus was trapped by the edges of the bony lateral attic wall fracture. A small bony edge that impeded incus movement was removed and a small amount of the glue was precisely applied to the lenticular process of the incus with an angled incision knife. The long process of the incus was firmly pressed over the stapes for 30 seconds with a 90° hook and 60 seconds after the application of the glue the ISJ was repaired. One year after our patient achieved full airbone gap (ABG) closure (ABG, ≤10 dB HL), while she demonstrated overclosure in frequencies 2 and 4 kHz. Fibrin tissue glue allowed safe, rapid, and accurate repair of the ISJ and resulted in an anatomically normal articulation as the mass and shape of the ossicles was preserved. Moreover, our patient achieved full ABG closure. PMID:21344438

  15. Lateral dislocation of the knee joint after total knee arthroplasty: a case report

    Ugutmen, Ender; Ozkan, Korhan; Unay, Koray; Mahirogullari, Mahir; Eceviz, Engin; Taser, Omer

    2008-01-01

    Background Total knee arthroplasty (TKA) is a successful therapy for functional improvement and pain relief in advanced symptomatic degeneration of the knee joint. But it can be associated with many complications, one of which is instability. Case presentation A 70-year-old woman was referred to our hospital because of right knee dislocation after TKA was performed on her right knee due to severe varus deformity and flexion contracture. This instability was caused by persistent MCL tightness and iatrogenic lateral collateral, arcuate ligament, and popliteus tendon injury. The torn lateral collateral ligament and arcuate ligament were sutured with no. 2 non-absorbable (Ethibond) sutures with plication of the posterolateral knee capsule. A deep-dish liner was inserted to optimize soft tissue tension. Conclusion This is a very severe complication, and surgeons must be cautious about ligament balancing and soft tissue resection during TKA for severe varus and valgus deformities. PMID:18687153

  16. Complex Dorsal Dislocation of the Metacarpophalangeal Joint: The Deep Transverse Metacarpal Ligament as a Barrier to Reduction

    DeCoster, Thomas A; McGrew, Deborah; Omer, George E.

    1988-01-01

    Dorsal dislocation of the second metacarpophalangeal (MCP) joint may involve dorsal displacement of the deep transverse metacarpal ligament (DTMCL). In addition to retraction of the volar plate, reduction of the deep transverse metacarpal ligament to its normal volar position is necessary to achieve stable, complete reduction of the MCP joint. The factors associated with this pathologic condition are reviewed as well as an anatomic study of the mechanism of injury.

  17. Bilateral anterior shoulder dislocation

    Meena, Sanjay; Saini, Pramod; Singh, Vivek; Kumar, Ramakant; Trikha, Vivek

    2013-01-01

    Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side...

  18. Palliative surgery for acetabular metastasis with pathological central dislocation of the hip joint after radiation therapy. A case report

    Orthopedic surgery for bone metastases is mainly a palliative treatment. Pathological central dislocation of the hip joint secondary to osteonecrosis of acetabular metastasis after radiation therapy brings severe suffering to cancer patients. We performed minimally invasive palliative surgery for an elderly woman, and excellent pain relief was achieved. An 80-year-old female suffering from right hip pain was referred to our hospital. She had undergone surgery for lung cancer 5 years previously and her right acetabulum was subsequently affected by metastasis. With the aim of controlling the metastasis, radiation therapy was performed. Two years later, pathological central dislocation of the hip joint occurred with sudden onset of severe pain, and she was unable to maintain a sitting position and became bedridden. After she was referred to our hospital, we created an intentional pseudarthrosis in the femoral neck for palliation. After the surgery, excellent pain relief and remarkably improved mobility were achieved during her limited remaining lifetime. In this report, we introduce a novel method of producing a pseudarthrosis in the femoral neck for pathological dislocation. This procedure is a minimally invasive treatment and an alternative option for palliative surgery for pathological dislocation of the hip joint due to osteonecrosis after radiation therapy. (author)

  19. Percutaneous Screw Fixation of Crescent Fracture-Dislocation of the Sacroiliac Joint.

    Shui, Xiaolong; Ying, Xiaozhou; Mao, Chuanwan; Feng, Yongzeng; Chen, Linwei; Kong, Jianzhong; Guo, Xiaoshan; Wang, Gang

    2015-11-01

    Crescent fracture-dislocation of the sacroiliac joint (CFDSIJ) is a type of lateral compression pelvic injury associated with instability. Open reduction and internal fixation is a traditional treatment of CFDSIJ. However, a minimally invasive method has never been reported. The purpose of this study was to assess the outcome of closed reduction and percutaneous fixation for different types of CFDSIJ and present their clinical outcome. The authors reviewed 117 patients diagnosed with CFDSIJ between July 2003 and July 2013. Closed reduction and percutaneous fixation was performed in 73 patients. Treatment selection was based on Day's fracture classification. For type I fractures, fixation perpendicular to the fracture line were performed. For type II fractures, crossed fixation was performed. For type III fractures, fixation was performed with iliosacral screws. Forty-four patients were treated by open reduction and plate fixation. Demographics, fracture pattern distribution, blood loss, incision lengths, revision surgeries, radiological results, and functional scores were compared. All 117 patients were followed for more than 6 months (mean, 14 months [range, 6-24 months]). Blood loss, extensive exposure, duration of posterior ring surgery, duration of hospital stay, and infection rates were lower in the closed group (P<.01). Patients in the closed group achieved better functional performance (P<.01). There were no significant differences in reduction quality (P=.32), revision surgery rates (P=.27), and iatrogenic neurologic injuries (P=.2) between the 2 groups. The authors' results indicate that closed reduction and percutaneous fixation is a safe and effective surgical method for CFDSIJ. PMID:26558677

  20. Comparative study on double Endobutton plate and clavicular hook plate for repair of Tossy grade Ⅲ acromioclavicular dislocation%双带袢纽扣钢板与锁骨钩钢板治疗TossyⅢ型肩锁关节脱位的疗效评价

    胡晓波; 蒋电明; 阳明明; 何镇江

    2014-01-01

    目的 探讨双带袢纽扣(Endobutton)钢板与锁骨钩钢板(clavicular hook plate,CHP)治疗TossyⅢ型肩锁关节脱位的效果. 方法 回顾性分析2010年1月-2012年8月收治的TossyⅢ型肩锁关节脱位患者82例,按治疗方式分为双Endobutton组(36例)和CHP组(46例),比较两组手术情况及住院指标,治疗后患肩视觉模拟评分(visual analogue scale,VAS)、外展上举及前屈上举活动度、肩关节Constant-Murley评分以及并发症情况. 结果 两组手术时间、出血量、住院时间差异均无统计学意义.双Endobutton组恢复工作时间(13.1±1.4)周,明显短于CHP组(15.5±2.6)周(P<0.01).术后并发症方面,两组差异无统计学意义.术后12个月双Endobutton组VAS (2.1±0.7)分,显著低于CHP组(2.9±0.8)分(P<0.05);患肩外展上举和前屈上举活动度[(138.6±15.7)°、(140.3±17.6)°]显著大于CHP组[(91.7±8.4)°、(96.7±l0.5)°](P<0.05). 结论 治疗TossyⅢ型肩锁关节脱位,双Endobutton钢板较CHP能更明显改善患者早期肩关节疼痛,恢复快,肩关节功能恢复更佳,且可避免二次手术取出.%Objective To compare the outcome of double Endobutton plate versus clavicular hook plate (CHP) in treatment of Tossy grade Ⅲ acromioclavicular dislocation.Methods A cohort of 82 patients with Tossy grade Ⅲ acromiocavicular dislocation treated between January 2010 and August 2012 were reviewed retrospectively.Based on the treatment choices,the patients were divided into double Endobutton group (36 cases) and CHP group (46 cases).Operative situation,in-hospital parameters,and postoperative visual analogue scale (VAS) of the shoulder,shoulder abduction-rise or anteflexionrise,Constant-Murley shoulder score as well as complications were evaluated.Results There were no statistical differences between the two groups in aspects of operation time,intraoperative blood loss,and length of stay.Mean time to return to work was (13.1 ± 1.4) weeks in double Endobutton

  1. Epidemiological survey of orthopedic joint dislocations based on nationwide insurance data in Taiwan, 2000-2005

    Yang Nan-Ping

    2011-11-01

    Full Text Available Abstract Background The epidemiology of acute orthopedic dislocations is poorly understood. A nationwide database provides a valuable resource for examining this issue in the Taiwanese population. Methods A 6-year retrospective cohort study of 1,000,000 randomly-sampled beneficiaries from the year 2005 was used as the original population. Based on the hospitalized and ambulatory data, the concomitant ICD9-CM diagnosis codes and treatment codes were evaluated and classified into 8 and 3 major categories, respectively. The cases matching both inclusive criteria of dislocation-related diagnosis codes and treatment codes were defined as incident cases. Results During 2000-2005, the estimated annual incidence (per 100,000 population of total orthopedic dislocations in Taiwan was 42.1 (95%CI: 38.1-46.1. The major cause of these orthopedic dislocations was traffic accidents (57.4%, followed by accident falls (27.5%. The annual incidence dislocation by location was shoulder, 15.3; elbow, 7.7; wrist, 3.5; finger, 4.6; hip, 5.2; knee, 1.4; ankle, 2.0; and foot, 2.4. Approximately 16% of shoulder dislocations occurred with other concomitant fractures, compared with 17%, 53%, 16%, 76% and 52%, respectively, of dislocated elbow, wrist, hip, knee, and ankle cases. Including both simple and complex dislocated cases, the mean medical cost was US$612 for treatment of a shoulder dislocation, $504 for the elbow, $1,232 for the wrist, $1,103 for the hip, $1,888 for the knee, and $1,248 for the ankle. Conclusions In Taiwan, three-quarters of all orthopedic dislocations were of the upper limbs. The most common complex fracture-dislocation was of the knee, followed by the wrist and the ankle. Those usually needed a treatment combined with open reduction of fractures and resulted in a higher direct medical expenditure.

  2. AO锁骨钩钢板中长期留置对肩锁关节脱位术后肩关节功能的影响%Effects of long-and mid-term indwelling of AO clavicular hook plate on the shoulder function following acromioclavicular dislocation surgery

    翟艳斌; 张永红; 王东

    2013-01-01

    目的 探讨AO锁骨钩钢板(CHP)中、长期留置对肩锁关节脱位(RockwoodⅢ~Ⅴ型)术后肩关节功能的影响. 方法 回顾性分析2002年 12月至2011年5月行切开复位AO CHP内固定治疗的95例肩锁关节脱位患者资料,男80例,女15例;年龄20 ~ 63岁,平均45.0岁;Rockwood分型:Ⅲ型40例,Ⅳ型35例,Ⅴ型20例;受伤至手术时间为2 ~7 d,平均4.6d.其中70例患者术后留置CHP,25例患者于术后12 ~ 23个月 (平均16.5个月)取出CHP.采用美国加州大学(UCLA)肩关节评分系统评定疗效,并比较CHP留置患者的患侧与健侧、CHP留置与取出患者患侧的肩关节功能. 结果 95例患者术后获7.5个月至9年(平均38个月)随访.70例CHP留置患者中,发生肩峰下骨侵蚀45例,内固定物断裂3例,肩峰撞击13例,螺钉松动2例,肩周炎5例,并发症发生率为97.1% (68/70).25例取出CHP患者中,发生肩峰下骨侵蚀3例,无肩锁关节再次脱位发生,并发症发生率为12.0%(3/25).70例CHP留置患者患侧的UCLA评分[(27.0±11.0)分]低于其健侧[(34.0±1.0)分]和CHP取出患者患侧评分[(32.0±6.5)分]. 结论 AO CHP中、长期留置对肩锁关节脱位(Rockwood Ⅲ~Ⅴ型)术后的肩关节功能存在不良影响,且术后并发症发生率非常高.%Objective To investigate the effects of long-and mid-term indwelling AO clavicular hook plate (CHP) on the shoulder function following surgery for acromioclavicular dislocation(from grade Ⅲ to grade Ⅴ by Rockwood's classification).Methods A retrospective study was done of 95 patients with acromioclavicular dislocation who had been fixed with AO CHP from December 2002 to May 2011.They were 80 men and 15 women,aged from 20 to 63 years (average,45.0 years).By the Rockwood's classification,there were 40 cases of type Ⅲ,35 ones of type Ⅳ and 20 ones of type Ⅴ.Time from injury to surgery ranged from 2 to 7 days (average,4.6 days).The CHP was indwelling in 70 patients but removed in 25

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

    Patel, M R; Bassini, L

    2000-01-01

    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. PMID:10642488

  4. Ipsilateral fracture dislocations of the hip and knee joints with contralateral open fracture of the leg: a rare case and its management principles

    Sen Ramesh Kumar

    2011-06-01

    Full Text Available 【Abstract】This paper discussed the injury mecha- nism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture. A 32-year-old man presented with ipsilateral fracture- dislocations of the left hip (Pipkin’s type IV and knee (Moore II joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin’s fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabi- lized with lateral buttress plate and a transarticular span- ning fixator. The open fracture on the other leg was de- brided and fixed with an external fixator. There was no insta- bility in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints. Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appro- priate intervention can provide good functional outcome to the patient in this situation. Key words: Hip dislocation; Knee dislocation; Fractures, bone

  5. Treatment of total dislocations of the ankle joint%踝关节完全脱位的治疗

    洪建军; 余可和; 赖红燕; 周一飞; 余洋; 左海强

    2010-01-01

    Objective To explore mechanism and treatment of total dislocations of the ankle joint.Methods Thirty-nine patients with total dislocations of the ankle joint were treated in our department from January 2003 to December 2008. There were 25 males and 14 females. Their ages ranged from 14 to 69 years old, averaging 31.6 years old. There were 10 cases of closed injury and 29 open injury; 23 cases of fracture-dislocation and 16 dislocation. According to the direction of talus dislocation, there were 15 cases of medial dislocation, 10 posterior dislocation, 10 lateral dislocation and 4 upward dislocation. Seven cases received conservative treatment and 32 surgery. Seven cases underwent flap transfer at the second stage and 2 amputation of the total ankle joint. Results Thirty-five patients were followed up for 1 to 4 years (average, 26 months). According to the AOFAS functional evaluation system, their pain score averaged 40,their functional score 50, and their objective sign score 10. The mean postoperative score was 86. 5(ranging from 48 to 96). Conclusions To prevent instability and traumatic arthritis of the ankle joint, it is essential to secure fine reduction and fixation of the fracture-dislocations, as well as repair of the ligaments of the ankle joint at an early stage. As skin necrosis often occurs in open dislocations, it is also important to prevent infection of the ankle joint by early flap transfer.%目的 探讨踝关节完全脱位的损伤机制与疗效.方法 2003年1月至2008年12月共收治39例踝关节完全脱位患者,男25例,女14例;年龄14~69岁,平均31.6岁.闭合性脱位10例,开放性脱位29例;伴踝关节骨折23例.按距骨移位方向分类:内侧脱位15例,外侧脱位10例,踝关节后脱位10例,旋转分离向上脱位4例.保守治疗7例,闭合复位短腿石膏固定6周;手术治疗32例,包括骨折脱位复位内固定22例,其中行外侧副韧带修复6例,三角韧带修复3例;单纯行三角韧带修复2

  6. Rehabilitation of a Completely Edentulous Patient with Nonreducible Bilateral Anterior Dislocation of the Temporomandibular Joint: A Prosthodontic Challenge-Clinical Report.

    Momani, Moath; Abdallah, Mohamed-Nur; Al-Sebaie, Derar; Tamimi, Faleh

    2016-07-01

    Nonreduced bilateral anterior dislocation of the temporomandibular joint (TMJ) is an extremely rare condition, and its prosthodontic rehabilitation is a clinical challenge, especially in patients who refuse to or cannot undergo surgery. There are no previous clinical reports of successful or standardized prosthetic rehabilitation approaches for patients with this condition. This clinical report describes the successful prosthodontic management of an edentulous patient with nonreduced bilateral anterior dislocation of the TMJ. PMID:26216338

  7. Acute spontaneous atraumatic bilateral anterior dislocation of the shoulder joint with Hill-Sachs lesions: first reported case and review of literature

    Manoharan, Gopikanthan; Singh, Rohit; Ahmed, Bessam; Kathuria, Vinod

    2014-01-01

    The anatomy of the shoulder joint comprises a relatively large humeral head with a shallow glenoid cavity allowing a remarkable range of motion at the expense of inherent instability. Despite anterior shoulder dislocations being the most common type encountered, bilateral dislocations are rare and almost always posterior. The aetiology is usually direct or indirect trauma related to sports, seizures, electric shock or electroconvulsive therapy. We present the first reported case of atraumatic...

  8. Successful closed manipulation of a pure lateral traumatic dislocation of the elbow joint using a modified Stimson's technique: a case report

    Khan Sameer K

    2008-05-01

    Full Text Available Abstract Introduction Pure lateral elbow dislocation is rare, and a successful closed reduction is even rarer. Reduction can be hindered by swelling, soft tissue interposition or associated fractures. Case presentation We present a pure lateral traumatic dislocation of the elbow joint in a 40-year-old man. This was successfully manipulated and reduced in casualty using a modification of the gravity-aided 'hanging arm' technique originally described for shoulder dislocations by Stimson. Conclusion We strongly recommend the use of this simple technique in these rare yet difficult injuries, in order to avoid potential complications with general anaesthesia and surgery.

  9. 肩关节后脱位3例报告%Posterior dislocation of shoulder joint in three cases

    寸新华; 李伟强; 鲁宁; 杨阳

    2011-01-01

    Objective By analyzing the diagnosis and treatment of the posterior shoulder dislocation, so as to improve its understanding and reduce the missed diagnosis and misdiagnosis. Methods Retrospective analysis was conducted in three patients with posterior shoulder dislocation, and clinical presentation, imaging characteristics and treatment were analyzed. Results The follow-up time ranged from 6 to 24 months. Shoulder joint movement was good in 2 cases, with 30 points and 33 points respectively scored by UCLA score system. And shoulder joint movement was limited in 1 case, with 25 points by UCLA score system. Conclusion Insufficient understanding is the main reason of the missed diagnosis, so careful physical examinations combined with appropriate imaging studies may prevent the missed diagnosis of posterior dislocation of the shoulder.%目的 通过分析肩关节后脱位的诊治情况,探讨其诊断及治疗方法,从而提高对这一损伤的认识,减少误漏诊.方法 回顾分析3例肩关节后脱位患者的临床资料,分析其临床表现,影像学特点及治疗方法.结果 随访6~24个月,2例肩关节活动良好,美国加州大学肩关节评分系统(UCLA)评分为30分、33分;1例肩关节活动受限,UCLA评分25分.结论 临床对该症认识不足是造成漏诊的主要原因,仔细的体检结合合适的影像学检查可以预防肩关节后脱位早期漏诊.

  10. Epidemiological survey of orthopedic joint dislocations based on nationwide insurance data in Taiwan, 2000-2005

    Yang Nan-Ping; Chen Hou-Chaung; Phan Dinh-Van; Yu I-Liang; Lee Yi-Hui; Chan Chien-Lung; Chou Pesus; Renn Jenn-Huei

    2011-01-01

    Abstract Background The epidemiology of acute orthopedic dislocations is poorly understood. A nationwide database provides a valuable resource for examining this issue in the Taiwanese population. Methods A 6-year retrospective cohort study of 1,000,000 randomly-sampled beneficiaries from the year 2005 was used as the original population. Based on the hospitalized and ambulatory data, the concomitant ICD9-CM diagnosis codes and treatment codes were evaluated and classified into 8 and 3 major ...

  11. Atlantoaxial dislocation

    Vijendra K Jain

    2012-01-01

    Full Text Available Atlanto-axial dislocations (AADs may be classified into four varieties depending upon the direction and plane of the dislocation i.e. anteroposterior, rotatory, central, and mixed dislocations. However, from the surgical point of view these are divided into two categories i.e. reducible (RAADs and irreducible (IAADs. Posterior fusion is the treatment of choice for RAAD. Transarticular screw fixation with sub-laminar wiring is the most stable& method of posterior fusion. Often, IAAD is due to inadequate extension in dynamic X-ray study which may also be due to spasm of muscles. If the anatomy at the occipito-atlanto-axial region {O-C1-C2; O: occiput, C1: atlas, C2: axis} is normal on X-ray, the dislocation should be reducible. In case congenital anomalies at O-C1-C2 and IAAD are seen on flexion/extension studies of the cervical spine, the C1-C2 joints should be seen in computerized tomography scan (CT. If the C1-C2 joint facet surfaces are normal, the AAD should be reducible by cervical traction or during surgery by mobilizing the joints. The entity termed "dolichoodontoid" does not exist. It is invariably C2-C3 (C3- third cervical vertebra fusion which gives an appearance of dolichoodontoid on plain X-ray or on mid-saggital section of magnetic resonance imaging (MRI or CT scan. The central dislocation and axial invagination should not be confused with basilar invagination. Transoral odontoidectomy alone is never sufficient in cases of congenital IAAD, adequate generous three-dimensional decompression while protecting the underlying neural structures should be achieved. Chronic post-traumatic IAAD are usually Type II odontoid fractures which get malunited or nonunited with pseudoarthrosis in dislocated position. All these dislocations can be reduced by transoral removal of the offending bone, callous and fibrous tissue.

  12. Systematics of glenohumoral and acromioclavicular arthritis; Systematik der glenohumeralen und akromioklavikulaeren Arthrose

    Seifarth, A. [Klinikum Augsburg, Klinik fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie, Augsburg (Germany); Roemer, F. [Klinikum Augsburg, Klinik fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie, Augsburg (Germany); Universitaetsklinikum Erlangen, Radiologisches Institut, Erlangen (Germany)

    2015-03-01

    A common risk factor for osteoarthritis (OA) of the glenohumeral joint is instability and is often observed as a sequel to dislocation. Altered biomechanics will ultimately result in joint degeneration including osteophyte development at the lower margin of the humerus, glenoidal cartilage loss and surface deformity. An OA of the glenohumeral joint is often coexistent with soft tissue derangement of the shoulder. In advanced stages defects of the rotator cuff and OA of the glenohumeral joint may accelerate disease progression. Degenerative changes of the acromioclavicular joint (AC joint) are commonly seen in older persons with only modest correlation with clinical symptoms. Symptomatic OA of the AC joint is often concomitantly observed with degenerative changes of the glenohumeral joint. Standard radiographs are the basis of a structural assessment of shoulder OA but lack correlation with clinical symptoms and are insensitive for the detection of early degenerative changes. Magnetic resonance imaging (MRI) provides increased sensitivity for the detection of cartilage defects and reveals relevant soft tissue changes, such as lesions of the glenoid labrum and capsuloligamentous structures, which are seen in conjunction with instability. It is also the method of choice to detect clinically relevant bone marrow edema-like lesions or synovial changes that are associated with symptomatic OA. Standard radiographs are not applicable for detection of early degenerative changes. Once OA is suspected clinically, MRI is the method of choice for further structural assessment. The administration of an intravenous contrast agent is useful for assessing synovitis, which commonly correlates with clinical disease manifestations. For preoperative and surgical planning of joint replacement, MRI or CT should be used. (orig.) [German] Eine haeufige Ursache der Omarthrose ist die Mikro- und Makroinstabilitaet, oft infolge von Luxationen. Bei veraenderter Biomechanik kommt es im Verlauf

  13. Traumatic Elbow Dislocations

    Iordens, Gijs

    2014-01-01

    markdownabstractThe elbow is the second most common major joint to dislocate after the shoulder in the adult population. Its stability is highly dependent on a complex interaction between bony articulations, capsuloligamentous structures and dynamic muscle restraints. Dislocations are traditionally classified by the presence (complex dislocations) or absence (simple dislocations) of associated fractures and by the direction of the displacement of the forearm relative to the humerus. The gener...

  14. A rare combined injury of dorsal fracture-dislocation of four carpometacarpal joints and trapezium, trapezoid and distal radius bone fractures.

    Touloupakis, Georgios; Stuflesser, Wilfried; Antonini, Guido; Ferrara, Fabrizio; Crippa, Cornelio; Lettera, Maria Gabriella

    2016-01-01

    Incorrect or delayed diagnosis and treatment of the carpometacarpal fracture-dislocations is often associated with poor prognosis. We present a rare case of unusual pattern of injury, involving dorsal dislocation of four ulnar carpometacarpal joints, associated with fracture of the trapezium, a burst fracture of the trapezoid  bone and an extra-articular fracture of the third distal  of the radius. The first surgical intervention was followed by unsatisfactory results, confirmed by the CT scans. A second surgery followed and an open reduction and pinning with K wires performed. Post-operative follow up lasting for nine months revealed a very good surgical outcome. PMID:27163903

  15. Dynamic posterior stabilization of shoulder hemiarthroplasty in long-standing neglected posterior dislocation of the glenohumeral joint

    Shyam Kumar A; Oakley Jeremy; Wootton Jamie

    2008-01-01

    Posterior dislocations of the shoulder are rare. They account for less than 3% of all shoulder dislocations. The treatment of neglected bilateral posterior dislocation of the shoulder is controversial. We present a novel operative technique to stabilize a shoulder hemiarthroplasty that we used in the treatment of a chronic posterior dislocation of a shoulder with an acute four-part fracture of the proximal humerus.

  16. Dynamic posterior stabilization of shoulder hemiarthroplasty in long-standing neglected posterior dislocation of the glenohumeral joint

    Shyam Kumar A

    2008-01-01

    Full Text Available Posterior dislocations of the shoulder are rare. They account for less than 3% of all shoulder dislocations. The treatment of neglected bilateral posterior dislocation of the shoulder is controversial. We present a novel operative technique to stabilize a shoulder hemiarthroplasty that we used in the treatment of a chronic posterior dislocation of a shoulder with an acute four-part fracture of the proximal humerus.

  17. A case study of an axillary artery pseudoaneurysm following anterior dislocation of the glenohumeral joint: A rare presentation on plain film radiographs

    Axillary pseudoaneurysm is a rare but important complication of anterior glenohumeral joint dislocation. Diagnosis of axillary pseudoaneurysm is predominantly undertaken following clinical examination but where diagnosis is uncertain, Doppler ultrasound is the imaging examination of choice to confirm diagnosis. In this case study, the initial clinical signs of axillary pseudoaneurysm were masked by the presenting trauma and, although findings indicative of pseudoaneurysm were present on late plain film images, they were not immediately recognised. Misdiagnosis or delayed diagnosis of axillary pseudoaneurysm may result in upper limb morbidity or patient mortality. Consequently, the prompt and accurate identification of an axillary pseudoaneurysm on plain film radiographs, although rare, is essential. Yet for inexperienced film readers, correctly identifying an axillary pseudoaneurysm can be difficult due to its apparent similarity to other pathologies. This article will highlight the differences in radiological appearances between a pseudoaneurysm and a gleno-humeral joint effusion to raise radiographer awareness of the risks and clinical signs of an axillary pseudoaneurysm post gleno-humeral joint dislocation and discuss the difficulties encountered in its diagnosis. Finally, this review will evaluate current diagnostic practices in comparison with best practice, as identified in the literature [Fitzgerald JF, Keates J. False aneurysm as a late complication of anterior shoulder dislocation. Ann Surg 1975;6:785-6; Drury JK, Scullion JE. Vascular complications of anterior dislocation of the shoulder. Br J Surg 1980;67(8):579-81. Waxman DL, France MP, Douglas T, Harryman I. Late lateral displacement of the humeral head after closed reduction of dislocation: a sign of vascular injury. J Bone Joint Surg 1996;78(6):907-10

  18. Ipsilateral fracture dislocations of the hip and knee joints with contralateral open fracture of the leg: a rare case and its management principles

    Ramesh Kumar Sen; Sujit Kumar Tripathy; Vibhu Krishnan; Tarun Goyal; Vanyambadi Jagadeesh

    2011-01-01

    This paper discussed the injury mechanism and management of a patient who had concomitant ipsilateral hip and knee dislocations and contralateral open leg fracture.A 32-year-old man presented with ipsilateral fracturedislocations of the left hip (Pipkin's type Ⅳ) and knee (Moore Ⅱ)joints and contralateral open fracture of the leg bones after a car accident. After emergency resuscitative measures, the hip joint was reduced and Pipkin's fracture was fixed using Ganz approach with lag screws; knee joint was reduced closely and tibial plateau fracture was stabilized with lateral buttress plate and a transarticular spanning fixator. The open fracture on the other leg was debrided and fixed with an external fixator. There was no instability in both joints after fixation when he was examined under anesthesia. The fractures united after 3 months and the patient had no residual instability of hip and knee. There was no clinical or radiological evidence of osteonecrosis in the hip joint after 6 months. At one-year follow-up, he had satisfactory functional outcome with almost normal range of motion at both joints.Ipsilateral hip and knee dislocations are rare injuries and more caution is needed for early diagnosis. A timely appropriate intervention can provide good functional outcome to the patient in this situation.

  19. Traumatic Elbow Dislocations

    G.I.T. Iordens (Gijs)

    2014-01-01

    markdownabstractThe elbow is the second most common major joint to dislocate after the shoulder in the adult population. Its stability is highly dependent on a complex interaction between bony articulations, capsuloligamentous structures and dynamic muscle restraints. Dislocations are traditionally

  20. Posterior talar fracture with dislocation of both talo-navicular and subtalar joints: a variant type II of the Sneppens classification

    Galanopoulos, Ilias; Fogg, Quentin; Ashwood, Neil

    2012-01-01

    A 63-year-old man fell from a ladder, thus causing an axial compression injury to the right ankle. Severe deformity was evident and the ankle could not be reduced by simple manipulation. The skin was tented and appearing critically contused. Radiographs revealed an oblique fracture of the posterior aspect of the talar body with dislocation of both the talo-navicular and subtalar joints, an injury previously not described in the literature. The fracture–dislocation was anatomically reduced within 3 h of presentation and stability achieved with two headless buried compression screws. CT scan confirmed anatomical reduction and the patient remained non-weight bearing in a cast for 6 weeks. One year postoperatively, the patient remains pain-free with no radiological signs of avascular necrosis of the talus. This injury is unique and despite its severity and soft tissue compromise good quality reduction and internal fixation resulted in an excellent clinical outcome. PMID:22847568

  1. Multiligamentous injuries and knee dislocations.

    Gimber, Lana H; Scalcione, Luke R; Rowan, Andrew; Hardy, Jolene C; Melville, David M; Taljanovic, Mihra S

    2015-11-01

    Complex capsular ligamentous structures contribute to stability of the knee joint. Simultaneous injury of two or more knee ligaments, aside from concurrent tears involving the anterior cruciate and medial collateral ligaments, is considered to be associated with femorotibial knee dislocations. Proximal tibiofibular joint dislocations are not always easily recognized and may be overlooked or missed. Patellofemoral dislocations can be transient with MR imaging sometimes required to reach the diagnosis. In this article, the authors describe the mechanism of injury, ligamentous disruptions, imaging, and treatment options of various types of knee dislocations including injuries of the femorotibial, proximal tibiofibular, and patellofemoral joints. PMID:26002747

  2. Complications following arthroscopic fixation of acromioclavicular separations: a systematic review of the literature

    Woodmass JM

    2015-04-01

    Full Text Available Jarret M Woodmass,1 John G Esposito,1 Yohei Ono,1,2 Atiba A Nelson,1 Richard S Boorman,1 Gail M Thornton,1,3 Ian KY Lo1 1Department of Surgery, Section of Orthopaedic Surgery, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada; 2Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan; 3Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada Purpose: Over the past decade, a number of arthroscopic or arthroscopically assisted reconstruction techniques have emerged for the management of acromioclavicular (AC separations. These techniques provide the advantage of superior visualization of the base of the coracoid, less soft tissue dissection, and smaller incisions. While these techniques have been reported to provide excellent functional results with minimal complications, discrepancies exist within the literature. This systematic review aims to assess the rate of complications following these procedures. Methods: Two independent reviewers completed a search of Medline, Embase, PubMed, and the Cochrane Library entries up to December 2013. The terms “Acromioclavicular Joint (MeSH” OR “acromioclavicular* (text” OR “coracoclavicular* (text” AND “Arthroscopy (MeSH” OR “Arthroscop* (text” were used. Pooled estimates and 95% confidence intervals were calculated assuming a random-effects model. Statistical heterogeneity was quantified using the I2 statistic. Level of evidence: IV Results: A total of 972 abstracts met the search criteria. After removal of duplicates and assessment of inclusion/exclusion criteria, 12 articles were selected for data extraction. The rate of superficial infection was 3.8% and residual shoulder/AC pain or hardware irritation occurred at a rate of 26.7%. The rate of coracoid/clavicle fracture was 5.3% and occurred most commonly with techniques utilizing bony tunnels. Loss of AC joint reduction occurred in 26

  3. 环杓关节脱位一例并文献复习%Cricoarytenoid Joint Dislocation:Report of One Case and Literature Review

    邹小华; 杜云峰; 刘艳秋; 高鸿

    2014-01-01

    环杓关节脱位是全麻插管的一种少见并发症,一般可以通过临床症状及纤维喉镜等检查确诊。早期复位通常能取得良好的疗效,若延误诊断及治疗时机则可能导致永久的发声异常。本文报道了1例全麻插管后出现发声困难、饮水呛咳等症状,但纤维喉镜和CT检查不支持环杓关节脱位,最终通过诊断性复位确诊并通过2次全麻下环杓关节复位取得较好疗效的患者,并对相关文献进行回顾性分析,以加强临床医师对该疾病的认识、提高诊治能力。%Cricoarytenoid joint dislocation,arare complication,can be usually diagnosed through clinical symptoms and fibrolaryngoscope et al. Early reduction can usually get a good effect,and delayed diagnoses and treatments may lead to per-manent vocal abnormalities. This article reports a case of dysphonia,drinking cough and other symptoms after anesthesia intuba-tion. Fibrolaryngoscope and CT did not support cricoarytenoid joint dislocation,the diagnosis was made by a diagnostic reset and 2 times of cricoarytenoid joint reduction achieved good curative effect. Relevant literatures were analyzed retrospectively to en-hance the understanding of the disease and improve clinicians′capacity of diagnosis and treatment.

  4. 不修复喙锁韧带的锁骨钩钢板固定治疗TossyⅡ型和Ⅲ型肩锁关节脱位的疗效对比%Curative Effect of Clavicular Hook Plate Fixation Without Fixing Coracoclavicular Ligament in the Treatment of Tossy Type II and Type III Dislocation of the Shoulder

    何炜; 何发胜; 张海波; 蔡克冬

    2015-01-01

    目的:探讨锁骨钩板(CHP)固定但不修复喙锁韧带治疗急性 Tossy Ⅱ、Ⅲ型肩锁关节脱位的疗效对比。方法选取2011年1月~2014年3月采用锁骨钩钢板内固定治疗的44例新鲜 Tossy Ⅱ、Ⅲ型肩锁关节脱位患者,均使用 CHP 复位固定肩锁关节,其中Ⅲ型共20例均未修复喙锁韧带,对比Ⅱ型及Ⅲ型两组患者在取出 CHP 后的疗效。在取出 CHP 后,随访3个月。结果44例患者中有35例患者均在术后1年半内在我科取出 CHP。参照 Karlsson 标准:Ⅱ型组优14例、良4例、差1例,优良率94.7%。Ⅲ型组优12例、良3例、差1例,优良率93.8%。两组优良率差异无统计学意义(P >0.05)。结论 CHP 是目前治疗 Tossy Ⅱ、Ⅲ型肩锁关节脱位的有效方法,对于Ⅲ型急性脱位可不必修复喙锁韧带,愈合后及时取出 CHP 可获得满意的效果。%Objective To investigate the comparative efficacy of clavicular hook plate(CHP)fixation without coracoclavicular ligament repair in the treatment of acute Tossy II and III acromioclavicular dislocation. Methods Forty-four cases of patients with fresh Tossy II and III acromioclavicular dislocation, who were treated by CHP internal fixation from January 2011 to March 2014,were selected. Al of them underwent CHP reduction to fix the acromioclavicular joint. The efficacy of patients from Tossy II group and Tossy III group was compared after CHP removal. The patients were fol owed up for 3 months after CHP removal. Results Of these 44 patients,35 cases removed CHP in our department within one and a half years after surgery.According to Karlsson criteria,there were 14 cases of excel ent grade,4 cases of good grade and 1 case of poor grade in the Tossy II group,indicating an excel ent and good rate of 94.7%. There were 12 cases of excel ent grade,3 cases of good grade and 1 case of poor grade,indicating an excel ent and good rate of 93.8% in the Tossy III group. The

  5. Neglected Traumatic Locked Anterior Shoulder Fracture-Dislocation

    Er, Mehmet Serhan; Eroglu, Mehmet; Erten, Recep Abdullah; Metineren, Hasan; Altinel, Levent

    2015-01-01

    Anterior shoulder dislocations are the most common major joint dislocations encountered in the emergency departments and fractures of proximal humerus can accompany with dislocations. Although the treatment of acute isolated traumatic anterior shoulder dislocation is generally simple, the treatment of neglected fracture-dislocations becomes more complicated. In this report, a 22-year-old male patient who had posttraumatic locked, shoulder fracture-dislocation is presented. Open reduction and ...

  6. 肩关节前脱位坐位复位法及其解剖学基础%Anterior Dislocation of Shoulder Joint Seat reset Method and Its Anatomical Basis

    韩七十三

    2015-01-01

    Objective To study and analysis the anterior dislocation of shoulder joint seat reset method and anatomical basis. Methods According to the clinical work, 27 cases of patients with symptoms of shoulder joint dislocation were under the treatment through seat reset technology by orthopaedic surgeons. Results Through the treatment of shoulder joint dislocation by seat reset method, 25 cases succeeded and 2 cases after two reset successful, this method was effective. Conclusion Shoulder joint relevant anatomy knowledge and master reset technology, was great helpful to improve treatment and anterior dislocation of shoulder joint, seat reset method was worth promoting.%目的:研究分析肩关节前脱位坐位复位法与解剖学基础。方法针对临床工作中的27例具有肩关节脱位症状的患者,骨科医生通过坐位复位技术对其进行治疗。结果通过对肩关节脱位的患者进行坐位复位法治疗,25例一次性就复位成功,另外2例经过两次复位成功,此方法效果显著。结论了解肩关节相关解剖学知识与掌握复位技术,对治疗和改善肩关节前脱位有很大帮助,坐位复位法值得推广。

  7. 37 Cases of Shoulder Joint Dislocation Treatment by Hippocrates Combined with Traditional Chinese Medicine External Treatment%Hippocrates 法结合中药外敷治疗肩关节脱位37例

    穆中杰; 王昌兴

    2014-01-01

    目的:总结运用手牵足蹬手法结合中药外敷治疗37例肩关节脱位的临床疗效。方法:采用手牵足蹬手法结合本科室骨伤熏洗2号方治疗肩关节脱位37例,其中喙突下脱位25例,盂下脱位11例,锁骨下脱位1例;单纯脱位33例,合并肱骨大结节小片撕脱骨折4例,所有患者均根据临床表现和肩关节X线片确诊。结果:本组病例痊愈30例,显效5例,好转2例,总有效率为100%。结论:手法整复结合本院自制骨伤熏洗2号方外敷治疗肩关节脱位疗效可靠,方法简单,经济实惠,值得临床推广。%Objective:to summarize the clinical efficacy of using Hippocrates combined with Chinese medicine external treatment of 37 cases of shoulder joint dislocation .Methods: from April 2012 to February 2013 by Hippocrates combining fractures fumigation Ⅱ in treating of 37 cases whose shoulder joint dislocation ,including 30 cases of male, 7 cases of female; Aged from 15 to 72 years, mean age (36.1 ±4.9) years;The shortest duration after 0.5 h, the longest 3 d;under coronoid process dislocation in 25 cases, jar dislo-cation in 11 cases, subclavian dislocation in 1 case;Pure dislocation in 33 cases, small footprint of the merger of the greater tuberosity avulsion fractures in 4 cases, all patients according to clinical manifestations and shoulder joint X -ray diagnosis.Results: all cases healed 30 cases, accounting for 81.08%;5 cases were markedly improved (13.51%), Improvement in 2 cases, accounting for 5. 41%;0 case ineffective;Total efficiency of 100%.Conclusion:Manual reduction combined with our homemade fractures fumigationⅡreally reliable curative effect , topical treatment of shoulder joint dislocation and the treatment method is simple , economical and practical, is worth popularization and application in the clinical practice .

  8. Subtalar dislocation

    Over a period of three years we have seen nine patients with subtalar dislocation, all of whom sustained violent trauma to the region of the ankle and hind foot. All but one patient were males. Clinically a subtalar dislocation resembles a complicated fracture dislocation of the ankle but a definitive diagnosis can only be made radiographically. The mechanism of injury and radiographic features of this injury are discussed. (orig.)

  9. Subtalar dislocation

    El-Khoury, G.Y.; Yousefzadeh, D.K.; Mulligan, G.M.; Moore, T.E.

    1982-05-01

    Over a period of three years we have seen nine patients with subtalar dislocation, all of whom sustained violent trauma to the region of the ankle and hind foot. All but one patient were males. Clinically a subtalar dislocation resembles a complicated fracture dislocation of the ankle but a definitive diagnosis can only be made radiographically. The mechanism of injury and radiographic features of this injury are discussed.

  10. Popliteal artery injury following traumatic knee joint dislocation in a 14-year-old boy: A case report and review of the literature

    Cvetković Slobodan

    2014-01-01

    Full Text Available Introduction. Posterior knee joint dislocation associated with injury of the popliteal artery in children is an extremely rare condition. Rapid diagnosis and treatment are essential for limb salvage and function. Case report. We reported a 14-year-old boy who suffered traumatic displacement of the right knee and contusion of the popliteal artery during motorcycle accident. The diagnosis was confirmed using Doppler and duplex ultrasonography and digital substraction transfemoral arteriography. The urgent surgical procedure was performed using posterior approach to the popliteal artery. During the surgical exploration, rupture of the posterior cruciate ligament associated with thrombosed popliteal artery have been found. The damaged popliteal artery was resected and replaced with autologous saphenous vein graft. The last stage of the procedure was a transosseous femoral fixation of posterior circuate ligament. A 3-year-follow-up after the surgery demonstrated intact arterial perfusion and very good function of the knee with a minimal difference as compared with the contralateral knee. Conclusion. Combined orthopedic and vascular injuries are very rare in children. They require combined treatment. [Projekat Ministarstva nauke Republike Srbije, br. 175008

  11. 电子喉镜下喉异物钳治疗环杓关节脱位临床疗效分析%Clinical effect of reposition of cricoarytenoid joint dislocation through foreign body forceps under electronic laryngoscope

    余文兴; 黄红星; 黄远

    2012-01-01

    Objective To explore the operative efficacy and skills of repositing cricoarytenoid joint dislocation through foreign body forceps under electronic laryngoscope. Methods 8 cases of cricoarytenoid joint dislocation caused by gastrointestinal endoscopy, nasogastric tube, tracheal intubation and neck trauma were included in this study. All cases were treated by foreign body forceps under electronic laryngoscope with local anaesthesia. Results Seven cases were re-posited successfully with one time and one case with two times, and their voice were back to normal with a following-up of 6 to 24 months after operation. There were no complications during or after surgery. Conclusion The treatment of cricoarytenoid joint dislocation with foreign body forceps under electronic laryngoscope is simple, safe, and have high success rate, and it may be useful for patients with cricoarytenoid joint dislocation.%目的 探讨经电子喉镜下喉异物钳治疗环杓关节脱位的疗效及复位技巧.方法 8例因上消化道电子内镜检查、鼻饲管、全麻下气管插管、颈部外伤等所致环杓关节脱位患者,在电子喉镜下喉异物钳进行环杓关节复位术.结果 7例1次、1例2次手术复位成功,术后随访6~24个月,声音恢复正常.结论 电子喉镜下喉异物钳进行环杓关节复位方法简单、准确、安全、快速,手术成功率高,在临床上具有一定应用价值.

  12. Simultaneous shoulder and elbow dislocation

    Çobanoğlu, Mutlu; Yumrukcal, Feridun; KARATAŞ, Cengiz; Duygun, Fatih

    2014-01-01

    Ipsilateral shoulder and elbow dislocation is very rare and only six articles are present in the literature mentioning this kind of a complex injury. With this presentation we aim to emphasise the importance of assessing the adjacent joints in patients with trauma in order not to miss any accompanying pathologies. We report a case of a 43-year-old female patient with ipsilateral right shoulder and elbow dislocation treated conservatively. The patient reported elbow pain when first admitted to...

  13. The epidemiology of shoulder dislocations in Oslo

    Liavaag, S; Svenningsen, S; Reikerås, O.; Enger, M; Fjalestad, T; Pripp, A H; Brox, J I

    2011-01-01

    There are few previous studies on the incidence of shoulder dislocation in the general population. The aim of the study was to report the incidence of acute shoulder dislocations in the capital of Norway (Oslo) in 2009. Patients of all ages living in Oslo, sustaining a dislocation of the glenohumeral joint, were identified using electronic diagnosis registers, patient protocols, radiological registers of the hospitals, and the Norwegian Patient Register (NPR). The overall incidence rate was 5...

  14. 手牵足蹬配合呼吸放松疗法治疗肩关节脱位%Hand Drawing and Foot Pedaling with Breathing Relaxation Therapy for the Treatment of Dislocation of Shoulder Joint

    赵亮; 何斌斌; 陈肖; 温清波; 谢增军

    2012-01-01

    Objective To introduce the hand drawing and foot pedaling with breathing relaxation therapy in the treatment of dislocation of shoulder joint. Methods The causes, treatment methods and curative effects of the 89 cases of shoulder joint dislocation were analyzed retrospectively. Results All patients obtained successful reconstruction in acute stage by using the hand drawing and foot pedaling with breathing relaxation therapy. 2 to 8 months' follow - ups demonstrated that all 89 cases obtained clinical union. Conclusion The breathing relaxation therapy could create the most labor - saving opportunity for the reconstruction, and its combination with hand drawing and foot pedaling method could have a notably curative effect on dislocation of shoulder joint.%目的 探讨手牵足蹬配合呼吸放松疗法治疗肩关节脱位的效果.方法 回顾性分析89例肩关节脱位患者的病因、治疗方法和效果.结果 通过手牵足蹬配合呼吸放松疗法治疗肩关节脱位患者89例,脱位均能一次复位成功,随访2~8个月均完全治愈.结论 采用呼吸放松疗法,能够为复位创造最省力的时机,配合手牵足蹬手法治疗肩关节脱位疗效显著.

  15. Developmental Dislocation (Dysplasia) of the Hip (DDH)

    .org Developmental Dislocation (Dysplasia) of the Hip (DDH) Page ( 1 ) The hip is a “ball-and-socket” joint. In a normal hip, the ball at the ... American Academy of Orthopaedic Surgeons. .org Developmental Dislocation (Dysplasia) of the Hip cont. • Family history of DDH (parents or siblings) • ...

  16. A Bilateral Traumatic Hip Obturator Dislocation

    Karaarslan, Ahmet Adnan; Acar, Nihat; Karci, Tolga; Sesli, Erhan

    2016-01-01

    A case of a bilateral simultaneous traumatic obturator dislocation of both hip joints in an 18-year-old young man following a traffic accident is presented. We reduced the dislocated femoral heads immediately under general anesthesia followed by passive and active exercises and early full-weight bearing mobilization. After 5 years, the result was excellent. PMID:26977327

  17. Shoulder Joint Replacement

    ... en because of implant loosening, wear, infection, and dislocation. When this occurs, a second joint replacement surgery — called a revision surgery — may be necessary. Is Shoulder Joint Replacement for You? The decision to have ...

  18. Treatment of children′s heel open injuries with ankle joint dislocation%儿童足跟部开放性损伤伴踝关节脱位的治疗

    王磊; 王平均; 乔少林; 范克轩; 陈翰林; 孟勐; 黄东; 陆欢

    2015-01-01

    Objective To explore the treatment choice and effect of children′s heel open injuries with ankle joint dislocation.Meth-ods 10 cases of children's heel open injuries with ankle joint dislocation were studied.First,each patient underwent exhaustive debridement to the open injuries,with Kirschner wire fixation after the ankle joint dislocation being restored,and then the wounds were covered with dress-ings and VSD (vacuum sealing drainage)was used continuously.Two weeks later,the injured achilles tendons were reconstructed,and ple-rosis of the soft tissue defects were operated by reversed transferring of sural neurovascular fasciocutaneous flap or saphenous nerve nutritional vessels flap.Results The wounds healed well in all cases and the stitches were taken out on schedule.Six weeks after the skin flap repai-ring operation,Kirschner wires were removed and the children started rehabilitation training of ankle joint function.After the follow-up period of 6~16 months,the function of ankle joint was evaluated by Baird-Jackson grading standard:excellent in 7 cases,good in 2 cases,normal in 1 case,bad in 0 cases,with 90.0% excellent rate.The blood supply of all skin flaps was sufficient and the skin color was approximate normal.Conclusion Exhaustive debridement and fixed ankle joint restoration,together with later achilles tendon reconstruction and skin flap repairing operation,is a effective and reasonable treatment choice to children's heel open injuries with ankle joint dislocation.%目的:探讨儿童足跟部开放性损伤伴踝关节脱位的治疗方法和效果。方法10例足跟部开放性损伤伴踝关节脱位患儿急诊清创,踝关节复位后克氏针固定,行负压封闭引流(VSD)覆盖创面;2周后手术重建跟腱、腓肠神经营养血管皮瓣或隐神经营养血管皮瓣逆行转移覆盖软组织缺损创面。结果10例患者皮瓣愈合良好,按期拆线。皮瓣修复术后6周拔除固定踝关

  19. Neglected Anterior Dislocation of Shoulder: is surgery necessary? A Rare Case with review of literature

    Shah, Kunal; Ubale, Tushar; Ugrappa, Harish; Pilankar, Samir; Bhaskar, Atul; Kale, Satishchandra

    2015-01-01

    Introduction: Shoulder joint is the most frequently dislocated joint. However, it is rarely neglected and treatment is sought immediately. Delayed or neglected shoulder dislocations are difficult to manage and require extensive procedures to obtain good functional outcome. Very few cases are described in literature showing neglected shoulder dislocation with good functional range of movement. We report a case with 3 years of neglected anterior shoulder dislocation with preserved joint functio...

  20. Audit on necessity of radiographs in anterior shoulder dislocations

    K. Ahmadi, M.D; M. Mofidi, M.D.

    2008-01-01

    AbstractBackground and Purpose: Anterior shoulder dislocation is the most common major joint dislocation. In most cases, this dislocation is being relocated in emergency departments. Routinely, pre and post reduction radiographs are performed. This study was done to determine the necessity of radiographs in the emergency department for management of patients with suspected anterior shoulder dislocation.Materials and Methods: In this case series study, 116 patients suspected of anterior should...

  1. Hennipen 法治疗老年患者肩关节前脱位的临床疗效观察%Clinical effect of Hennipen method to treat elderly patients with anterior dislocation of the shoulder joint

    陈孙裕; 肖展豪; 李坚

    2016-01-01

    Objective To analyze the clinical curative effect of Hennipen method to treat elderly patients with anterior dislocation of shoulder joint.Methods Between February 2013 and June 2015,57 elderly patients with acute anterior dislocation of shoulder joint were colleted in our hospital.The patients aged from 65 to 81,with average age of 72.3 years.Hennipen method was used to replace the dislocation of shoulder joint.Visual analogue scale (VAS)scores and joint range of motion before and after treatment were recorded to evaluate its clinical effect.Results All cases were checked with X -ray to comfirm had been reducted,and had no complications,such as proximal humeral fractures,axillary nerve injured.1 case failed maneuver reduction,so was tracted and reseted again after anesthesia.Before treatment,the VAS scores was (5.4 ±0.9)points,which after treatment was (1.9 ±0.7)points, and the difference was significant(t =12.43,P <0.01).The range of motion of the shoulder joint was significantly improved.Conclusion Hennipen method is simple,to threat anterior dislocation of shoulder joint of elderly patients, it can effectively relieve pain,reduce complications,which is worthy of clinical promotion.%目的:分析 Hennipen 法治疗老年患者肩关节前脱位的临床疗效。方法收集厦门大学附属福州市第二医院治疗的急性肩关节前脱位老年患者57例,年龄65~81岁,平均72.3岁。所有患者采用Hennipen 法复位肩关节,治疗前后记录肩关节活动度,采用疼痛视觉模拟量表(VAS)评分,评估其临床效果。结果所有患者行 X 线检查,证实整复成功,未出现肱骨近端骨折、腋神经损伤等并发症,1例复位失败,改麻醉下牵引复位。治疗前 VAS 评分为(5.4±0.9)分,治疗后 VAS 评分为(1.9±0.7)分,治疗前后 VAS 评分差异有统计学意义(t =12.43,P <0.01)。治疗后患者关节活动度均明显改善。结论Hennipen 法复

  2. Arthroscopic findings after shoulder dislocation

    Medenica Ivica

    2009-01-01

    Full Text Available Background/Aim. Recurrent instability of the shoulder joint is frequently difficult to differentiate from diseased or injured rotator cuff or tendon of the forearm flexor (m. biceps brachii. Shoulder joint arthroscopy has been only recently introduced into instable shoulder joint lesion examination. The aim of this study was to present and analyze an arthroscopic finding on instable shoulder joint in order to determine causes and mechanisms of instability, as well as principles of surgical treatment. Methods. Arthroscopy of the shoulder joint was performed in 158 patients with at least one documented shoulder joint dislocation. These patients were divided into two groups. The group I included the patients with one to three dislocations, while the group II those with more than three dislocations. Preoperative diagnosis was based on anamnestic data and clinical examination using specific tests, and on the diagnosis of shoulder joint using radiography or computed tomography. Results. Out of the total number of the patients 138 (87.34% had injury of the anterior patellar brim, 119 (75.32% had failure of the anterior capsule, 126 (79.75% had compressive cartilage injury of the posterior part of the head of the upper arm bone (Hill-Sachs lesion, 102 (64.56% had insufficiency of glenohumeral tendon, 11 (6.96 had complete cut of the rotator cuff, 23 (14.56% had injury of the posterior patellar brim, 12 (7.59% had injury of the upper anterior-posterior patellar brim (SLAP. Conclusion. According to the obtained results it could be concluded that there is no a unique injury that leads to shoulder joint instability. It is necessary to point out to the significance of anamnesis and clinical examination in making diagnosis. Arthroscopic diagnostics is indicated in clinically unreliable findings as an additional method for determining operative treatment.

  3. A Case Report: Ipsilateral Closed Talus Dislocation and Navicular Fracture

    Tolga Atay

    2014-02-01

    Full Text Available Dislocation of the subtalar joint dislocations are rare. Three joint axes associated with that (which, tibiotalar, subtalar and talonavicular talus bone dislocation totally high-energy trauma or sports competitions outcome occurs, and this trauma as a result of complications of neurovascular injury, the talus capsular structure damage, skin necrosis and ligament damage may occur. Result of late term complications are avascular necrosis and degenerative arthritis. Talus fractures often are associated with one of the malleolus fracture or dislocation of the talus. Isolated talus dislocations without malleolus and talus fractures are usually occurs in open wounds. In this case, closed talus dislocation and ipsilateral navicular bone of foot fracture are observed as a result of the high energy trauma without malleolar fractures or fracture of the talus. Closed Talus dislocations are rare in the literature and has very less informations.

  4. Lisfranc fracture dislocation. Clinical case

    Lora-Fernández Alberto Carlos; Cabarcas-Montes Gustavo

    2010-01-01

    The Lisfranc fracture dislocation is a serious lesion occur in tarsometatarsian joint and produce importants consequence, for anatomic complexiti of this foot area. The injury mechanisms ocasionality is asociated to automovilistic accidents. Our report of a clinical case into a patient endure fall since 8 meter altitud. Quirurgical manegement was make, open reduction and osteosíntesis with Kirschner nails. Favorable evolution and adecuate reponse to rehabilitation.RESUMENLa luxofractura de Li...

  5. Isolated Proximal Tibiofibular Dislocation during Soccer

    Casey Chiu

    2015-01-01

    Full Text Available Proximal tibiofibular dislocations are rarely encountered in the Emergency Department (ED. We present a case involving a man presenting to the ED with left knee pain after making a sharp left turn on the soccer field. His physical exam was only remarkable for tenderness over the lateral fibular head. His X-rays showed subtle abnormalities of the tibiofibular joint. The dislocation was reduced and the patient was discharged from the ED with orthopedic follow-up.

  6. Posterior sternoclavicular dislocation: an American football injury

    Marker, L B; Klareskov, B

    1996-01-01

    Posterior dislocation of the sternoclavicular joint is uncommon, accounting for less than 0.1% of all dislocations. Since 1824 a little more than 100 cases have been reported, and the majority in the past 20 years. A review of published reports suggests that this injury is seen particularly in...... connection with American football. A typical case is described. The importance of this injury is that there is often a delay in diagnosis with potentially serious complications....

  7. Unusual inferior dislocation of shoulder: reduction by two-step maneuver: a case report

    Patro Dilip K; Agarwal Dinesh K; Saseendar S; Menon Jagdish

    2009-01-01

    Abstract Dislocation of the shoulder is the commonest of all large joint dislocations. Inferior dislocation constitutes 0.5% of all shoulder dislocations. It characteristically presents with overhead abduction of the arm, the humerus being parallel to the spine of scapula. We present an unusual case of recurrent luxatio erecta in which the arm transformed later into an adducted position resembling the more common anterior shoulder dislocation. Such a case has not been described before in Engl...

  8. 肩关节镜带线锚钉内固定术治疗复发性肩关节脱位%Clinical Research of Arthroscopic Suture Anchor Fixation Treatment with Recurrent Shoulder Joint Dis-location

    沈烈军

    2014-01-01

    目的:探讨肩关节镜下带线锚钉内固定术治疗复发性肩关节脱位的效果。方法:选取复发性肩关节脱位患者76例,随机分为观察组与对照组各38例,观察组采用肩关节镜下带线锚钉内固定术治疗,对照组给予改良Bristow手术治疗。结果:观察组UCLA评分(33.13±1.49)分,VAS评分(0.54±0.49)分,外展90°位外旋角度(73.62±13.98)°,肩关节前屈上举角度为(157.24±17.38)°,优良率97.37%,均优于对照组的78.9%(P<0.05)。结论:肩关节镜下带线锚钉内固定术治疗复发性肩关节脱位,具有良好的应用价值,改善肩关节功能。%Objective To investigate the clinical effects of arthroscopic suture anchor fixation in the treat⁃ment with recurrent shoulder joint dislocation. Methods A total of 76 patients were included in study, were divided into observation group and control group randomly. Observation group were treated with arthroscopic su⁃ture anchor fixation, control group were treated with improved surgical bristow. Results In observation group after surgery, the UCLA score was (33.13±1.49), the VAS score was (0.54±0.49), the abduction and external rota⁃tion angle of 90° position was (73.62±13.98)°, the shoulder flexion angle was (157.24±17.38)°, the excellent rate was 97.37%. All indicators had significant differences compared with control group (P<0.05). Conclusion These results suggest that recurrent shoulder joint dislocation in the treatment of arthroscopic suture anchor fixa⁃tion has the exact value, can improve joint function.

  9. Application of MSCT and MRI in diagnosing Bankart injury of recurrent anterior dislocation of shoulder joint%MSCT、MRI联合运用在复发性肩关节前脱位Bankart病损中的应用价值

    易雪冰; 张德洲; 钟鉴

    2011-01-01

    目的:探讨MSCT、MRI联合运用在复发性肩关节前脱位Bankart病损中的应用价值.方法:回顾性分析经临床、影像证实的复发性肩关节前脱位Bankart病损10例患者的MSCT、MRI表现,主要观察肩关节盂唇前方的CT、MRI改变.结果:10例中,CT发现肩关节盂前下份撕脱性骨折4例,MRI发现肩关节前下盂唇撕脱性骨折1例;MRI发现肩关节盂唇损伤10例,CT不能显示;CT发现合并Hill-Sachs损伤6例,MRI发现Hill-Sachs损伤8例;CT未能发现肱骨头骨挫伤3例;MRI发现肩袖损伤6例,Slap损伤1例.结论:MSCT、MRI能够相互补充,清晰显示Bankart病损及其他合并病变,为临床诊断及治疗提供更加充分的资料.%Objective : To investlgate the application of MSCT and MRI in B ankart injury of recurrent anterior dislocation of shoulder joint Methods :Retrospectively analyse 10 cases Bankart injury of recurrent anterior dislocatlon of shoulder joint by clinic and radiology.Analysed the manifestations of shoulder joint an terior labrum articularis of spiralCT and MRI.Results : In 10 cases of Bankart injury of recurrent an terior dislocation of shoulder pint , there were 4 cases of avulsion fiacture of shoulder pint anterior labrum examined by CT , 1 case by MRI; 6 cases of Hill-Sachs injury were found examined by CT , 8 cases of Hill-Sachs injury and 3 cases of bone contusion of hum eralhead were found by MRI; 6 cases of rotator cuff injury and 1 case of slap injury were found exam ined by MRI.Conclusion :Spial CT and MRI can display Bankart injury and other coexisting lesion , which provide sufficient data for the clinic.

  10. 伴有骶髂关节完全性前脱位的骨盆骨折治疗%Management of pelvic injury associated with complete anterior sacroiliac joint dislocation

    吴宏华; 吴新宝; 李宇能; 杨明辉; 王满宜

    2015-01-01

    Objective:To investigate the management of pelvic injury associated with complete anterior sacroiliac joint dislocation.Methods:In the study, 6 cases of pelvic injury associated with complete an-terior sacroiliac joint dislocation treated in Beijing Jishuitan Hospital from February 2008 to June 2014 were analyzed.We described the history and severity of injury, emergency treatment, and fracture radio-logy.In all the cases, the surgical treatment and postoperative functional exercise were performed.We followed up all the cases on an average of 1.6 years, assessed the postoperative recovery and summed up the treatment experience.Results:All the 6 patients with fractures recovered without infection and nerve symptoms after surgery.Their X-rays showed good reduction of sacroiliac joints.All the cases were followed up on an average of 1.6 years.Six months after surgery, the Majeed scores were perfect in 2 cases, good in 2, fair in 1, and poor in 1.The patients with poor scores suffered persistent pain, and decreased physical activity, and when walking long distances, they needed a walking stick.The 2 patients with low scores could not resume the original work.Conclusion:Pelvic injury associated with complete anterior sacroiliac joint dislocation is a special type of the pelvic injury since the managements during the emergency phase are difficult.The surgery should be done as early as possible, and the anterior approach is available for the reduction and fixation.%目的:总结伴有骶髂关节完全性前脱位的骨盆骨折的治疗经验。方法:对北京积水潭医院2008年2月至2014年3月收治的6例伴有骶髂关节完全性前脱位骨盆骨折的资料进行回顾性分析,描述患者病史、损伤程度、急诊救治等特征,通过影像学判断损伤情况,给予手术治疗,术后功能锻炼,并对患者进行随访以评估术后恢复情况,总结治疗经验。结果:全部6例患者术后愈合良好,无感染和术后

  11. Clinical research on humerus surgical neck fracture joint shoulder dislocation%肱骨外科颈骨折并肩关节脱位的临床研究

    钟泽林; 陈琦翔

    2013-01-01

      目的:研究手术治疗肱骨外科颈骨折合并肩关节脱位的有效方法。方法:按照计算机数字表法将99例肱骨外科颈骨折合并肩关节脱位患者随机分为A、B、C三组,各33例,A组采用切开交叉克氏内固定治疗,B组采用切开钢板内固定治疗,C组采用切开外展支架固定治疗,比较三组患者术后3、7、14d VAS评分,比较患者下床活动时间、骨折愈合时间、平均治疗费用、并发症发生率,术后6个月肩关节功能。结果:A组患者术后3、7、14d明显低于B组和C组,组间比较差异具有统计学意义(P<0.05)。A组患者下床时间、骨折愈合时间、平均治疗费用、并发症发生率均低于B组和C组,Neer评分高于B组和C组,组间比较差异具有统计学意义(P<0.05)。结论:切开交叉克氏内固定治疗手法闭合整复失败的肱骨外科颈骨折合并肩关节脱位患者具有骨折愈合快,治疗成本和并发症发生率低等优点,可优先选用。%Objective:To study the effective method of treating humerus surgical neck fracture joint shoulder dislocation. Methods:According to the computer digital table method, 99 patients of humerus surgical neck fracture joint shoulder dislocation were randomly divided into A, B, C three groups, 33 in each group. Group A was given crossed-pin interior fixation, Group B was given open reduction and internal fixation, Group C was given open reduction upper limbs abducens support fixed treatment. Compare VAS scores in three groups postoperative 3, 7, 14 days, out-of-bed activity time, fracture healing time, average treatment costs, complications, and postoperative 6 months of shoulder joint function. Results:VAS scores in group A postoperative 3, 7, 14 days were obviously lower than that in group B and group C, with significant differences (P<0.05). Group A has lower bed time, fracture healing time, average treatment costs and complication rate were

  12. CHP和TB两种内固定方式治疗Tossy Ⅲ型肩锁关节脱位的疗效比较%Clinical effects of CHP and TB in treatment of Tossy Ⅲ type acromioclavicular joint dislocation

    孙泰岩

    2010-01-01

    目的:比较锁骨钩钢板(clavicular hook plate,CHP)与克氏针张力带(tension band,TB)治疗Tossy Ⅲ型肩锁关节脱位的临床疗效.方法:选择Tossy Ⅲ型肩锁关节脱位患者78例,根据自愿原则,其中42例使用CHP治疗,作为观察组;36例使用TB治疗,作为对照组.比较两组治疗5个月后肩关节功能及术后并发症情况.结果:观察组与对照组术后并发症比较,差异有统计学意义(P<0.05);肩关节功能恢复在优良方面两组比较,差异有统计学意义(P<0.05).结论:CHP治疗创伤小,疗效确切,并发症少,应作为治疗Tossy Ⅲ型肩锁关节脱位的首选方法.

  13. 改良椅背复位法治疗肩关节脱位的效果分析%Improved Chair Back Reduction Method for the Treatment of Dislocation of the Shoulder Joint Effect Analysis

    王顺兴; 陈远宁

    2013-01-01

    目的:通过用经过改良后的椅背复位法来治疗肩关节脱位,对治疗效果进行分析。方法:86例肩关节脱位患者随机分为两组,分别为改良组合未改良组。改良组的患者采用改良后的椅背复位法来治疗肩关节脱位,而未改良组采用传统的椅背复位法来治疗。治疗结束后,对两组患者的复位成功率、患者满意度进行统计调查。对两种方法进行评价分析。结果:治疗结束后,调查统计结果显示,改良组的1次性复位成功为42例,成功率为97.7%,2次复位成功为1例,成功率为2.3%;未改良组的一次性复位成功为31例,成功率为72.1%,2次复位成功为12例,成功率为27.9%。患者的满意度情况为,改良组的41例满意,满意度为95.3%,未改良组满意35例,满意度81.4%,以上统计P均小于0.05。结论:经过改良的椅背复位法治疗肩关节脱位的一次性治愈率高于未经改良组的患者,且满意度也高于未经改良组。%Objective:By using the improved method to reset back after treatment of shoulder dislocation, the treatment effect analysis. Methods:86 cases of shoulder joint dislocation were randomly divided into two groups, respectively, for improved combination of unimproved group. The modified group of patients using a modified back reset method to the treatment of shoulder dislocation, without improvement group using the traditional back reset method to treatment of. After the end of treatment, two groups of patients with the success rate reduction, patient satisfaction survey. On two methods for evaluation and analysis. Results:After treatment, the survey results show the modified group, 1 reduction for the success of 42 cases, the success rate was 97.7%, 2 reduction was successful for 1 patients, the success rate is 2.3%;unimproved group disposable reset successfully for 31 patients, the success rate was 72.1%, 2 reset successfully for 12 cases, the success rate is 27.9%. Patient

  14. Medial subtalar dislocation: Case report

    Manojlović Radovan

    2010-01-01

    Full Text Available Introduction. Subtalar dislocation (SI is a term that refers to an injury in which there is dislocation of the talonavicular and talocalcanear joint, although the tibiotalar joint is intact. Case Outline. A case of medial subtalar dislocation as a result of basketball injury, so-called 'basketball foot', is presented. Closed reposition in i.v. anaesthesia was performed with the patient in supine position and a knee flexed at 90 degrees. Longitudinal manual traction in line of deformity was carried out in plantar flexion. The reposition continued with abduction and eversion simultaneously increasing dorsiflexion. It was made in the first attempt and completed instantly. Rehabilitation was initiated after 5 weeks of immobilization. One year after the injury, the functional outcome was excellent with full range of motion and the patient was symptom-free. For better interpretation of roentgenogram, bone model of subtalar dislocation was made using the cadaver bone. Conclusion. Although the treatment of such injury is usually successful, diagnosis can be difficult because it is a rare injury, and moreover, X-ray of the injury can be confusing due to superposition of bones. Radiograms revealed superposition of the calcaneus, tarsal and metatarsal bones which was radiographically visualized in the anterior-posterior projection as one osseous block inward from the talus, and on the lateral view as in an osteal block below the tibial bone. Prompt recognition of these injuries followed by proper, delicately closed reduction under anaesthesia is crucial for achieving a good functional result in case of medial subtalar dislocation.

  15. Hip joint replacement

    ... may have problems with infection, loosening, or even dislocation of the new hip joint. Over time the artificial ... Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  16. Treatment Zygapophyseal Joints Dislocation of Inferior Thoracic Vertebra with Fixed-Point Oblique-Pulling Manipulation: A Report of 124 Cases

    JIN Cheng-zhong; LANG Bo-xu; FANG Zhen-yu; ZHU Han-ting

    2004-01-01

    以推拿手法治疗124例下胸椎关节突关节错位患者,先以滚揉松肌法和痛点弹拨法松解痛处肌肉,然后以定点斜扳整复法理筋平压法纠正关节错位,治疗3次后治愈94例,好转21例,未愈9例,总有效率为92.7%.%One hundred and twenty-four cases of articulations zyqapophysiales discocation of the inferior thoracic vertebra were treated first with Tuina manipulation of rolling-kneading to relax the affected muscles, next with that of tenderness-plucking to relax the tender muscles and next with that of fixed-point oblique-pulling to restore and treat the injured soft tissues and finally with that of palmpressing flatly to adjust the dislocation. The results showed that 94 cases were cured, 21 improved and 9 ineffective after three treatments. The total effective rate was 92.7 %.

  17. EFFECTIVENESS OF TRAUMATIC DISLOCATION OF KNEE JOINT COMBINED WITH MULTIPLE LIGAMENT INJURIES TREATED BY STAGES%分期治疗外伤性膝关节脱位合并多韧带损伤的疗效观察

    陈志伟; 刘春磊; 杨乐忠; 戴祝; 曹盛俊

    2011-01-01

    目的 观察分期治疗外性伤膝关节脱位合并多韧带损伤的临床疗效. 方法 2005年6月-2008年11月,收治13例外伤性膝关节脱位合并多韧带损伤患者.男9例,女4例;年龄18~54岁,平均30.7岁.致伤原因:运动伤8例,交通事故伤2例,高处哈落伤2例,扭伤1例.左侧3例,右侧10例.受伤至入院时间6 h~2 d,平均9h.8例前交叉韧带(anterior cruciate ligament,ACL)、后交叉韧带(posterior cruciate ligament,PCL)及内侧副韧带(medial collateral ligament,MCL)损伤,3例ACL、PCL及外侧副韧带(lateral collateral ligament,LCL)损伤,2例ACL、PCL、MCL及LCL损伤.10例外翻应力试验为++~+++,5例内翻应力试验为++~+++;13例前、后抽屉试验均为阳性,Lachman试验为++~+++.一期手术修复PCL、MCL、LCL及半月板,术后固定3~4周后开始功能锻炼,4~6个月后膝关节活动范围良好且存在前方不稳时二期于关节镜下重建ACL. 结果 两次手术后切口均Ⅰ期愈合,无感染及骨筋膜室综合征等并发症发生.患者均获随访,随访时间12~60个月,平均36个月.一期术后4周2例出现关节腔积液,经穿刺抽吸后缓解,其余患者均未出现膝关节不适.二期术后3个月1例外翻应力试验++,1例为+;1例内翻应力试验为+;1例Lachman试验++,1例为+;其余患者各试验均为阴性.二期术后12个月患膝关节屈曲达100~135°,平均123.4°;伸直达0~4°,平均2.3°.根据Lysholm膝关节功能评分标准评定:获优9例,良2例,可2例,优良率84.6%. 结论 分期治疗外伤性膝关节脱位合并多韧带损伤可获得较好的临床效果.%Objective To observe the effectiveness of traumatic dislocation of the knee joint combined with multiple ligament injuries treated by stages. Methods Between June 2005 and November 2008, 13 cases of traumatic dislocation of the knee joint combined with multiple ligament injuries were treated by stages, including 9 males and 4 females with an average age of 30

  18. Dislocated shoulder - aftercare

    Shoulder dislocation - aftercare; Shoulder subluxation - aftercare; Shoulder reduction - aftercare ... You most likely dislocated your shoulder from a sports injury or accident, such as a fall. You have likely injured (stretched or torn) some of the muscles, ...

  19. Dislocated shoulder - aftercare

    Shoulder dislocation - aftercare; Shoulder subluxation - aftercare; Shoulder reduction - aftercare ... Horn AE, Ufberg JW. Management of common dislocations. In: ... Extremity 6th ed. Philadelphia, PA: ElsevierMosby; 2011:chap 92.

  20. Distal clavicle osteolysis following fixation with a synthetic ligament

    Paul M.C Dearden

    2011-01-01

    Full Text Available We present a case of distal clavicle osteolysis following treatment of a chronic acromioclavicular joint dislocation with a synthetic ligament. The relevant literature is reviewed and discussed.

  1. Simultaneous shoulder and elbow dislocation

    Çobanoğlu, Mutlu; Yumrukcal, Feridun; Karataş, Cengiz; Duygun, Fatih

    2014-01-01

    Ipsilateral shoulder and elbow dislocation is very rare and only six articles are present in the literature mentioning this kind of a complex injury. With this presentation we aim to emphasise the importance of assessing the adjacent joints in patients with trauma in order not to miss any accompanying pathologies. We report a case of a 43-year-old female patient with ipsilateral right shoulder and elbow dislocation treated conservatively. The patient reported elbow pain when first admitted to emergency service but she was diagnosed with simultaneous ipsilateral shoulder and elbow injury and treated conservatively. As a more painful pathology may mask the additional ones, one should hasten to help before performing a complete evaluation. Any harm caused to the patient due to this reason would not be a complication but a malpractice. PMID:24859563

  2. Joint-sparing Corrections in Malunited Lisfranc Joint Injuries.

    Nery, Caio; Raduan, Fernando; Baumfeld, Daniel

    2016-03-01

    Lisfranc fracture-dislocations are very serious and potentially disabling injuries. Unfortunately, they are often misdiagnosed. Multiplanar midfoot deformities that result from these fracture-dislocations are precursors of joint degeneration and significant functional disabilities. Anatomic reduction with different types of internal fixation is an efficient method to reconstruct midfoot alignment and stability. Joint-preserving reconstruction techniques emerge as a viable alternative to corrective fusion as they achieve stable joint realignment with preserved motion. PMID:26915786

  3. Glenoid Dysplasia in the Recurrent Shoulder Dislocation: A Case Report

    Hamza Sucuoglu

    2016-01-01

    Glenoid dysplasia, which is often ignored, is a rare developmental anomaly. In most cases the patients remain asymptomatic. Although glenoid dysplasia has been diagnosed by incidentally on chest radiograph, also it has been described because of the developing instability of shoulder joint. Our young male patient who has recurrent dislocation of the shoulder-joint 4-5 times a year for last 5 years, dislocation has been reduced in the emergency department and he has been discharged from hospita...

  4. Scapular manipulation technique for reduction of traumatic anterior shoulder dislocations: experiences of an academic emergency department

    Baykal, B; Sener, S; Turkan, H

    2005-01-01

    Background: Shoulder dislocations account for almost 50% of all joint dislocations, which are most commonly anterior (90–98%) and occur due to trauma. This prospective study was conducted to report our experiences of using the scapular manipulation technique (SMT) to reduce traumatic anterior shoulder dislocations.

  5. The gauge theory of dislocations: A nonuniformly moving screw dislocation

    Lazar, Markus, E-mail: lazar@fkp.tu-darmstadt.d [Emmy Noether Research Group, Department of Physics, Darmstadt University of Technology, Hochschulstr. 6, D-64289 Darmstadt (Germany); Department of Physics, Michigan Technological University, Houghton, MI 49931 (United States)

    2010-07-05

    We investigate the nonuniform motion of a straight screw dislocation in infinite media in the framework of the translational gauge theory of dislocations. The equations of motion are derived for an arbitrarily moving screw dislocation. The fields of the elastic velocity, elastic distortion, dislocation density and dislocation current surrounding the arbitrarily moving screw dislocation are derived explicitly in the form of integral representations. We calculate the radiation fields and the fields depending on the dislocation velocities.

  6. A hinged external fixator for complex elbow dislocations: A multicenter prospective cohort study

    Verleisdonk Egbert JMM; Van Vugt Arie B; Van Thiel Tom PH; Van der Meulen Hub GWM; Sintenie Jan; Schipper Inger B; Roukema Gert R; Rhemrev Steven; Ham S John; Goslings J Carel; De Vries Mark R; Bronkhorst Maarten WGA; Tuinebreijer Wim E; Iordens Gijs IT; de Haan Jeroen

    2011-01-01

    Abstract Background Elbow dislocations can be classified as simple or complex. Simple dislocations are characterized by the absence of fractures, while complex dislocations are associated with fractures of the radial head, olecranon, or coronoid process. The majority of patients with these complex dislocations are treated with open reduction and internal fixation (ORIF), or arthroplasty in case of a non-reconstructable radial head fracture. If the elbow joint remains unstable after fracture f...

  7. The external rotation method for reduction of acute anterior shoulder dislocations

    Marinelli, Mario; de Palma, Luigi

    2009-01-01

    Background Shoulder dislocations account for almost 50% of all joint dislocations, and are most commonly anterior (90–98%) and occur due to trauma. This prospective study was conducted to report our experiences of using the external rotation method (ERM) in the reduction of acute anterior shoulder dislocation. Materials and methods Between August 2006 and April 2007, ERM was applied to 31 patients who presented with traumatic anterior shoulder dislocation to the Emergency Department of our Ho...

  8. Ipsilateral fracture dislocation of the shoulder and elbow: A case report and literature review

    Behr, Ian; Blint, Andy; Trenhaile, Scott

    2013-01-01

    Ipsilateral dislocation of the shoulder and elbow is an uncommon injury. A literature review identified nine previously described cases. We are reporting a unique case of ipsilateral posterior shoulder dislocation and anterior elbow dislocation along with concomitant intra-articular fractures of both joints. This is the first report describing this combination of injuries. Successful treatment generally occurs with closed reduction of ipsilateral shoulder and elbow dislocations, usually reduc...

  9. Audit on necessity of radiographs in anterior shoulder dislocations

    K. Ahmadi, M.D

    2008-01-01

    Full Text Available AbstractBackground and Purpose: Anterior shoulder dislocation is the most common major joint dislocation. In most cases, this dislocation is being relocated in emergency departments. Routinely, pre and post reduction radiographs are performed. This study was done to determine the necessity of radiographs in the emergency department for management of patients with suspected anterior shoulder dislocation.Materials and Methods: In this case series study, 116 patients suspected of anterior shoulder dislocation were referred to Hazrat Rasoul Akram and Haftome Tir Hospitals emergency departments in Tehran, and were investigated for a one year period. The emergency physicians evaluated and documented the possibility of dislocation or relocation, before obtaining radiographs. Outcome measures were the assessment of joint positions on the x-rays by an orthopedic surgeon.Results: 84 cases (72% were male and 32 cases (28% were female. Mean age of the patients was 31.5±8.5 yrs. Thirty (30 patients had recurrent dislocations without traumatic mechanism (group 1 and eighty six (86 patients had no prior dislocation or a blunt mechanism of injury (group 2. The accuracy of the emergency physician’s assessment in dislocations was 100% in group 1 and 98% in group 2. False assessments occurred only in patients with fractures. There is no significant difference between emergency physicians and orthopedic surgeons in the assessment of dislocations and relocations, when the emergency physicians did accuralty diagnose them.Conclusion: Our study showed that the physicians are highly accurate in clinical determination of anterior shoulder dislocation and relocation. Pre-reduction films should be obtained when the mechanism of injury is trauma. Post-reduction films should be obtained in fracture-dislocations or when the physicians are uncertain of correct relocation.

  10. Akut akromioklaviküler eklem çıkıklarında endobutton ile tesbit yöntemi

    Raif Özden; Vedat Uruç; İbrahim Gökhan Duman; Yunus Doğramacı; Aydıner Kalacı; Erkam Kömürcü

    2014-01-01

    Objective: Acromioclavicular (AC) joint dislocation is a common injury frequently affecting young athletes. The aim of this study is to evaluate postoperative functional results in cases diagnosed with acute AC joint dislocation stabilized with endobutton system. Methods: This fixation procedure has been applied on 10 patients. Indications of the technique included: a grade V AC joint dislocation (7 patients), and grade III AC joint dislocation (3 patient) according to Rockwood classifica...

  11. Dislocation-dynamics method

    Dislocation-Dynamics (DD) technique is identified as the method able to model the evolution of material plastic properties as a function of the microstructural transformation predicted at the atomic scale. Indeed, it is the only simulation method capable of taking into account the collective behaviour of a large number of dislocations inside a realistic microstructure. DD simulations are based on the elastic dislocation theory following rules inherent to the dislocation core structure often call 'local rules'. All the data necessary to establish the local rules for DD have to come directly from experiment or alternatively from simulations carried out at the atomic scale such as molecular dynamics or ab initio calculations. However, no precise information on the interaction between two dislocations or between dislocations and defects induced by irradiation are available for nuclear fuels. Therefore, in this article the DD technique will be presented and some examples are given of what can be achieved with it. (author)

  12. Dislocation Formation in Alloys

    Minami, Akihiko; Onuki, Akira

    2006-05-01

    An interaction between dislocations and phase transitions is studied by a phase field model both in two and three dimensional systems. Our theory is a simple extension of the traditional linear elastic theory, and the elastic energy is a periodic function of local strains which is reflecting the periodicity of crystals. We find that the dislocations are spontaneously formed by quenching. Dislocations are formed from the interface of binary alloys, and slips are preferentially gliding into the soft metals. In three dimensional systems, formation of dislocations under applied strain is studied in two phase state. We find that the dislocation loops are created from the surface of hard metals. We also studied the phase separation above the coexisting temperature which is called as the Cottrell atmosphere. Clouds of metals cannot catch up with the motion of dislocations at highly strained state.

  13. Collective behavior of dislocations

    Deformation of a crystal involves the motion of dislocations. Since dislocations interact, a short range and at long range, it is basic to understanding plasticity to establish if dislocations move singly or collectively. If deformation involves the collective motion of dislocations how does it manifest itself or equivalently how can it be measured? While a variety of techniques measure the positions of single dislocations before and after a stress is applied to a crystal, giving an average dislocation velocity, these techniques do not related directly to what happens during deformation, that is the collective behavior of dislocations. The mobile dislocation density is measured as follows: Lead-10% indium crystals are deformed at 4.2K, while in a magnetic field in the range Hc1 c2 where Hc1 is the lower critical field, H the applied field and Hc2 the upper critical field. During deformation changes n the flux are observed; the changes in flux are proportional to the mobile dislocation density. These changes in flux show the following characteristics: When the deformation process changes from elastic to plastic deformation there is a pronounced increase in flux noise, well above the background noise level. In addition superposed on this noise are pronounced bursts of magnetic flux, corresponding to dislocation bursts or avalanches of dislocations. A number of checks establish that these pulses are solely related to dislocations. These include the fact that they are not reproducible in terms of time from test to test, ruling out systematic instabilities in the circuit. Also, they occur when the crystal is unloaded and then reloaded at times, after plasticity is reinitiated, which are inconsistent with any time constant of the circuit. Finally, the measuring circuit shows no instabilities or ringing in this frequency range

  14. Primary traumatic patellar dislocation

    Tsai Chun-Hao

    2012-06-01

    Full Text Available Abstract Acute traumatic patellar dislocation is a common injury in the active and young adult populations. MRI of the knee is recommended in all patients who present with acute patellar dislocation. Numerous operative and non-operative methods have been described to treat the injuries; however, the ideal management of the acute traumatic patellar dislocation in young adults is still in debate. This article is intended to review the studies to the subjects of epidemiology, initial examination and management.

  15. Homogenization of dislocation dynamics

    In this paper we consider the dynamics of dislocations with the same Burgers vector, contained in the same glide plane, and moving in a material with periodic obstacles. We study two cases: i) the particular case of parallel straight dislocations and ii) the general case of curved dislocations. In each case, we perform rigorously the homogenization of the dynamics and predict the corresponding effective macroscopic elasto-visco-plastic flow rule.

  16. Homogenization of dislocation dynamics

    El Hajj, Ahmad; Ibrahim, Hassan; Monneau, Regis, E-mail: elhajj@cermics.enpc.fr, E-mail: ibrahim@cermics.enpc.fr, E-mail: monneau@cermics.enpc.fr [CERMICS, ENPC, 6 and 8 avenue Blaise Pascal, Cite Descartes, Champs sur Marne, 77455 Marne-la-Valle Cedex 2 (France)

    2009-07-15

    In this paper we consider the dynamics of dislocations with the same Burgers vector, contained in the same glide plane, and moving in a material with periodic obstacles. We study two cases: i) the particular case of parallel straight dislocations and ii) the general case of curved dislocations. In each case, we perform rigorously the homogenization of the dynamics and predict the corresponding effective macroscopic elasto-visco-plastic flow rule.

  17. Do normal hips dislocate?

    Alshameeri, Zeiad; Rehm, Andreas

    2014-11-01

    There have been a small number of case reports describing late normal-hip dislocations in children who were later diagnosed with developmental dysplasia of the hip. Here, we contest the assumption that normal hips can dislocate. We argue that (as in our case) the ultrasound scans in all published case reports on late dislocated normal hips did not show results that were entirely normal and therefore, so far, there has been no convincing evidence of a dislocation of a normal hip. We also want to highlight the importance of meticulous ultrasound and clinical assessments of high-risk children by an experienced orthopaedic surgeon. PMID:25144883

  18. Dislocations in yttrium orthovanadate

    Eakins, D. E.; LeBret, J. B.; Norton, M. G.; Bahr, D. F.

    2004-06-01

    Dislocation structures in single crystals of yttrium orthovanadate have been identified by transmission electron microscopy. Electron diffraction was used to predict possible Burgers vectors for the dislocations. Results suggest vectors of the type {1}/{2}[1 1 1] or {1}/{4}[0 2 1] . Arguments for the likelihood of each possible vector have been presented.

  19. Double dislocation of finger interphalangeal joints

    Jahangiri, Saqib Aziz; Mestha, Prabhakar; McNally, Scarlett

    2012-01-01

    A 62-year-old, right-hand-dominant man who had dementia and lived in an Elderly Mentally Infirm (EMI) nursing home was admitted through Accident & Emergency (A&E) department following unwitnessed injury to the left little finger.

  20. 肩关节镜下应用带线锚钉内固定方法治疗复发性肩关节脱位%Arthroscopic Application with Anchor Fixation Method in the Treatment of Recurrent Dislocation of the Shoulder Joint

    周吉湘

    2013-01-01

    Objective To explore the effect of arthroscopic application with anchor fixation method in the treatment of recurrent dislocation of the shoulder joint. Methods 80recurrent dislocation of the shoulder joint patients were randomly divided into 2 groups,control group were treated conservatively, the observation group routine arthroscopic operation treatment.Observation of effect of operation and clinical indexes. Results The total efficiency of the observation group 95%,better than the control group,with significant difference. Conclusion Effect of arthroscopic application with anchor fixation method in the treatment of recurrent dislocation of the shoulder joint is significant.%  目的探讨肩关节镜下应用带线锚钉内固定方法治疗复发性肩关节脱位的疗效。方法将在我院治疗的80名复发性肩关节脱位随机分为2组,常规组40例进行保守治疗,观察组40例行关节镜手术治疗。观察手术效果等临床指标。结果观察组总有效率为95%,优于常规组82.5%,差异有统计学意义(P<0.05)。结论肩关节镜下应用带线锚钉内固定方法治疗复发性肩关节脱位的疗效显著。

  1. Glenoid Dysplasia in the Recurrent Shoulder Dislocation: A Case Report

    Hamza Sucuoglu

    2016-02-01

    Full Text Available Glenoid dysplasia, which is often ignored, is a rare developmental anomaly. In most cases the patients remain asymptomatic. Although glenoid dysplasia has been diagnosed by incidentally on chest radiograph, also it has been described because of the developing instability of shoulder joint. Our young male patient who has recurrent dislocation of the shoulder-joint 4-5 times a year for last 5 years, dislocation has been reduced in the emergency department and he has been discharged from hospital with shoulder strap and rest. Finally when he admitted to our outpatient clinic with recurrent shoulder dislocation, the diagnosis of glenoid dysplasia is revealed by X-ray examination. We present the diagnose of glenoid dysplasia with clinical and radiological findings which should be kept in mind in patients with recurrent dislocations of shoulder as in our case.

  2. Humeral shaft fracture with ipsilateral shoulder dislocation

    Behera Prateek; Kumar Vishal; Aggarwal Sameer

    2014-01-01

    【Abstract】Although fracture of the humeral shaft or dislocation of the shoulder joint is a common injury, a simutaneous injury is rare. We present such a case combined with head injury which took precedence over the skeletal injuries. The postoperative rehabilitation was slowed down by the head injury. This case report makes us aware of some problems when managing the patient with this rare injury and helps us understand the management options better. Also the need for proper follow-up ...

  3. Tamponade following sternoclavicular dislocation surgical fixation.

    Bensafi, H; Laffosse, J-M; Taam, S A; Molinier, F; Chaminade, B; Puget, J

    2010-05-01

    The authors report a case of posterior sternoclavicular dislocation surgically reduced and stabilized with tenodesis, according to the Burrows technique completed by temporary wire fixation. The patient presented postoperative pericardiac tamponade appearing progressively from brachiocephalic blood vessels bleeding. Emergency drainage was surgically placed associated with removal of the material, thus curing the patient. This complication, although exceptional, formally contraindicates the use of wire fixation in surgery of the sternoclavicular joint. PMID:20488152

  4. Irreducible lateral dislocation of the elbow.

    Chhaparwal M

    1997-01-01

    Full Text Available A rare case of an irreducible post-traumatic lateral dislocation of elbow is presented. The mechanism of injury was fall on a flexed elbow with trauma on its medial aspect resulting in pronation of the forearm. At open reduction, the brachialis muscle was in the form of a tight band which prevented reduction. The ulnar nerve was entrapped in the joint.

  5. Luxatio erecta: Inferior glenohumeral dislocation

    Baba Asif; Bhat Javid; Paljor S; Mir Naseer; Majid Suhail

    2007-01-01

    Inferior dislocation of the shoulder, also called luxatio erecta, is a rare form of the otherwise common shoulder dislocation. It accounts for less than 0.5% of all shoulder dislocations. A case involving the inferior dislocation of the shoulder is reported. A brief review of the presentation and management of the condition is described.

  6. Luxatio erecta: Inferior glenohumeral dislocation

    Baba Asif

    2007-01-01

    Full Text Available Inferior dislocation of the shoulder, also called luxatio erecta, is a rare form of the otherwise common shoulder dislocation. It accounts for less than 0.5% of all shoulder dislocations. A case involving the inferior dislocation of the shoulder is reported. A brief review of the presentation and management of the condition is described.

  7. Efficacy Analysis of Elbow Flexion and Shoulder Squaring Method as well as Hand Pulling and Foot Pedaling Method on Shoulder Joint Dislocation%屈肘肩顶法与手牵足蹬法治疗肩关节脱位的疗效分析

    陈洁; 姜为民; 李雪峰; 梁林; 刘义杰

    2014-01-01

    目的:比较屈肘肩顶法与手牵足蹬法对于复位肩关节脱位的疗效。方法2012年1月~2012年12月,共治疗肩关节前脱位72例,常规运用了两种手法复位治疗方法,将其分为两组,分别采用屈肘肩顶法(n=36)和手牵足蹬法(n=36)复位。结果采用屈肘肩顶法有6例首次复位失败,采用手牵足蹬法有10例首次复位失败,最终所有患者肩关节功能恢复佳。2组治疗方法比较,屈肘肩顶法较手牵足蹬法复位效率更高,但肩关节功能和活动度恢复无明显差别。结论屈肘肩顶法和手牵足蹬法治疗肩关节前脱位均可获得较好的肩关节功能和活动度,而屈肘肩顶法在复位成功率方面具有优越性,值得临床推广。%Objective To compare the two methods of shoulder joint dislocation therapy as elbow flexion and shoulder squaring, and the therapy of hand pulling and foot pedaling. Methods By two conservative therapies, we treated 72 patients with shoulder joint dislocation who were divided into two groups as 36 patients taking elbow flexion and shoulder squaring method and 36 patients taking hand pulling and foot pedaling method from January to December in 2012. Results There were 6 patients with failure of restoration of shoulder dislocation by first time through elbow flexion and shoulder squaring method, and 10 patients through hand pulling and foot pedaling. Finally, shoulder joints of all patients got well. Hand pulling and foot pedaling method was better than elbow flexion and shoulder squaring method by comparing on restoration of shoulder joint dislocation, but no significant differences on shoulder function and action. Conclusion Either elbow flexion and shoulder squaring or hand pulling and foot pedaling has good shoulder joint function and action. But elbow flexion and shoulder squaring method is superior in restoration of shoulder joint dislocation, which is worth to popularization.

  8. 手法治疗肩关节脱位并发症的早期预防及护理%Early prevention and nursing of complications of shoulder joint dislocation patients treated by manual therapy

    程俊阳; 张凤清; 方军

    2016-01-01

    总结了手法治疗肩关节脱位并发症的早期预防和护理方法,为进一步探讨有效的肩关节脱位并发症防治手法提供借鉴。%It summarized the early prevention and nursing of complications of shoulder j oint dislocation patients treated by manual therapy,so as to further provide references for the effective preventions and treatment of complications of patients with shoulder j oint dislocation.

  9. GPU accelerated dislocation dynamics

    Ferroni, Francesco; Tarleton, Edmund; Fitzgerald, Steven

    2014-09-01

    In this paper we analyze the computational bottlenecks in discrete dislocation dynamics modeling (associated with segment-segment interactions as well as the treatment of free surfaces), discuss the parallelization and optimization strategies, and demonstrate the effectiveness of Graphical Processing Unit (GPU) computation in accelerating dislocation dynamics simulations and expanding their scope. Individual algorithmic benchmark tests as well as an example large simulation of a thin film are presented.

  10. Acute traumatic patellar dislocation.

    Duthon, V B

    2015-02-01

    Inaugural traumatic patellar dislocation is most often due to trauma sustained during physical or sports activity. Two-thirds of acute patellar dislocations occur in young active patients (less than 20 years old). Non-contact knee sprain in flexion and valgus is the leading mechanism in patellar dislocation, accounting for as many as 93% of all cases. The strong displacement of the patella tears the medial stabilizing structures, and notably the medial patellofemoral ligament (MPFL), which is almost always injured in acute patellar dislocation, most frequently at its femoral attachment. Lateral patellar glide can be assessed with the knee in extension or 20° flexion. Displacement by more than 50% of the patellar width is considered abnormal and may induce apprehension. Plain X-ray and CT are mandatory to diagnose bony risk factors for patellar dislocation, such as trochlear dysplasia or increased tibial tubercle-trochlear groove distance (TT-TG), and plan correction. MRI gives information on cartilage and capsulo-ligamentous status for treatment planning: free bodies or osteochondral fracture have to be treated surgically. If patellar dislocation occurs in an anatomically normal knee and osteochondral fracture is ruled out on MRI, non-operative treatment is usually recommended. PMID:25592052

  11. Estudo comparativo da eminectomia e do uso de miniplaca na eminência articular para tratamento da luxação recidivante da articulação temporomandibular Comparative study of eminectomy and use of bone miniplate in the articular eminence for the treatment of recurrent temporomandibular joint dislocation

    Álvaro B. Cardoso

    2005-02-01

    Full Text Available AA luxação da articulação temporomandibular ocorre quando o côndilo mandibular move-se para fora da cavidade glenóide e permanece travado anteriormente à eminência articular, sendo sua ocorrência repetitiva (luxação recidivante geralmente associada a hipermobilidade mandibular e a inclinação da eminência articular. OBJETIVO: Neste estudo avaliou-se, clínica e radiograficamente, a técnica de eminectomia e do uso de miniplaca na eminência articular para tratamento da luxação recidivante da articulação temporomandibular de pacientes operados no Hospital Universitário Osvaldo Cruz (HUOC/UPE, no período de janeiro de 2001 a setembro de 2003. FORMA DE ESTUDO: Retrospectivo. MATERIAL E MÉTODO: A amostra foi composta por 11 pacientes. A cirurgia de eminectomia foi realizada em nove articulações de cinco pacientes, enquanto a cirurgia para colocação de miniplaca na eminência articular em 11 articulações de seis pacientes. A obtenção dos dados foi efetuada através da análise de prontuários e de nova consulta pós-operatória. RESULTADOS: Os resultados mostraram não haver maiores complicações pós-operatórias para as duas técnicas. A abertura bucal máxima foi maior nos pacientes operados pela técnica de eminectomia e nenhum dos pacientes apresentou recorrência da luxação. CONCLUSÃO: Concluiu-se que as duas técnicas mostraram-se eficientes para o tratamento da luxação recidivante da articulação temporomandibular.Dislocation of the temporomandibular joint occurs when the mandibular condyle exits the glenoidal cavity and remains anteriorly locked to the articular eminence. It is repetitive (recurrent dislocation, usually associated with mandibular hypermobility and inclination of the articular eminence. AIM: This study intended to clinically and radiologically assess the technique of eminectomy and the use of a miniplate on the articular eminence for the treatment of recurrent dislocation of the

  12. The Control Study of Treatment for Shoulder Joint Dislocation by Abduction, Lifting, Push and Squeeze%外展上举旋转推挤法治疗肩关节脱位的对照研究

    陈巍; 李彬; 李宣隆; 汪永泉; 吴滨

    2015-01-01

    目的:比较外展上举推挤法和手牵足蹬复位法治疗肩关节脱位的疗效,探索一种更加安全、有效的复位手法。方法2011年7月至2014年7月,收治肩关节前脱位患者123例,年龄19~82岁,其中120例按随机数字表法分为A组(实验组60例)和B组(对照组60例)。实验组采用外展上举推挤复位法;对照组采用传统手牵足蹬复位法,余3例同时伴有其他部位损伤或特殊类型脱位而不能采用Hippocrates复位者为C组,直接采用外展上举推挤法。结果对照组60例成功复位56例,1例导致医源性外科颈骨折而最终改为手术治疗,3例复位不能而采用外展上举推挤法后成功复位;实验组共60例均完成良好复位。结论外展上举推挤法整复肩关节脱位成功率高,患者痛苦少,复位方法易掌握,尤其对Hippocrates法不能成功复位者仍能取得较好复位效果。%Objective To compare the clinical effect between abduction, lifting, push and squeeze method and Hippocrates, explore a safer and more effective way of replacement for shoulder joint dislocation. Methods From July 2011 to July 2014, 123 patients with anterior dislocation of shoulder joint, ranging in age from 19 to 82.The patients were randomly divided into group A (treatment group, 60 cases) and group B (control group, 60 cases). Treatment group were treated by abduction, lifting, push and squeeze. Control group were treated with Hippocrates. The other three cases with other injuries and special dislocation were put in group C, and they were treated by abduction, lifting, push and squeeze directly. Results 56 patients in control group got replacement.1 patient was operated

  13. Statistical characterization of dislocation ensembles

    El-Azab, A; Deng, J; Tang, M

    2006-05-17

    We outline a method to study the spatial and orientation statistics of dynamical dislocation systems by modeling the dislocations as a stochastic fiber process. Statistical measures have been introduced for the density, velocity, and flux of dislocations, and the connection between these measures and the dislocation state and plastic distortion rate in the crystal is explained. A dislocation dynamics simulation model has been used to extract numerical data to study the evolution of these statistical measures numerically in a body-centered cubic crystal under deformation. The orientation distribution of the dislocation density, velocity and dislocation flux, as well as the dislocation correlations have been computed. The importance of the statistical measures introduced here in building continuum models of dislocation systems is highlighted.

  14. The clinical effect of reposition by manual reduction at different postures in 70 patients with anterior dislocation of shoulder joint%不同体位手牵足蹬法治疗肩关节前脱位70例临床疗效

    姚丽; 应盛国

    2015-01-01

    Objective: To observe the clinical effect of reposition by manual reduction at different postures in patients with the primary anterior dislocation of shoulder joint.Methods:Seventy patients with the primary anterior dislocation of shoulder joint were collected and divided into a prone position group with 35 cases and a supine position one with 35 ones according to the different postures. The treatment effects of two groups were evaluated with the reference of the standard of shoulder joint reposition.Results: The reposition rate without anesthetic and total reposition rate were 71.43% (25/35) and 94.29% (33/35) in the prone position group and 62.86% (22/35) and 80.00% (28/35) in the supine group. The difference between two groups had the statistical signiifcance (P<0.05).Conclusion: In the treatment of anterior dislocation of shoulder joint, the effect of Hippocrates (manual reduction) is obviously better in the prone posture than in the supine posture.%目的:观察不同体位手牵足蹬法治疗原发性肩关节前脱位的临床疗效.方法:收集原发性肩关节前脱位患者70例,根据不同体位分为俯卧位手牵足蹬法复位治疗(俯卧位组)35例和仰卧位手牵足蹬法复位治疗(仰卧位组) 35例.参照肩关节复位标准评价两组疗效.结果:观察组无麻药复位率为71.43%(25/35),总复位率为94.29%(33/35);对照组无麻药复位率为62.86%(22/35),总复位率为80.00%(28/35),组间差异有统计学意义(P<0.05).结论:俯卧位手牵足蹬法治疗肩关节前脱位疗效优于仰卧位手牵足蹬法.

  15. First-time anterior shoulder dislocations: should they be arthroscopically stabilised?

    Sedeek, Sedeek Mohamed; Bin Abd Razak, Hamid Rahmatullah; Ee, Gerard WW; Tan, Andrew HC

    2014-01-01

    The glenohumeral joint is inherently unstable because the large humeral head articulates with the small shadow glenoid fossa. Traumatic anterior dislocation of the shoulder is a relatively common athletic injury, and the high frequency of recurrent instability in young athletes after shoulder dislocation is discouraging to both the patient and the treating physician. Management of primary traumatic shoulder dislocation remains controversial. Traditionally, treatment involves initial immobilis...

  16. Comparison of four different reduction methods for anterior dislocation of the shoulder

    Guler, Olcay; Ekinci, Safak; Akyildiz, Faruk; Tirmik, Uzeyir; Cakmak, Selami; Ugras, Akin; Piskin, Ahmet; Mahirogullari, Mahir

    2015-01-01

    Background Shoulder dislocations account for almost 50 % of all major joint dislocations and are mainly anterior. Objective The aim is a comparative retrospective study of different reduction maneuvers without anesthesia to reduce the dislocated shoulder. Methods Patients were treated with different reduction maneuvers, including various forms of traction and external rotation, in the emergency departments of four training hospitals between 2009 and 2012. Each of the four hospitals had differ...

  17. Dislocation Dynamics During Plastic Deformation

    Messerschmidt, Ulrich

    2010-01-01

    The book gives an overview of the dynamic behavior of dislocations and its relation to plastic deformation. It introduces the general properties of dislocations and treats the dislocation dynamics in some detail. Finally, examples are described of the processes in different classes of materials, i.e. semiconductors, ceramics, metals, intermetallic materials, and quasicrystals. The processes are illustrated by many electron micrographs of dislocations under stress and by video clips taken during in situ straining experiments in a high-voltage electron microscope showing moving dislocations. Thus, the users of the book also obtain an immediate impression and understanding of dislocation dynamics.

  18. To Observe the Clinical Effect of Stimson Reduction Method Cooperate with Zhuang Medicated Thread Moxibustion in Treating Adults with Acute Anterior Dislocation of Shoulder Joint%Stimson复位法配合壮医药线点灸治疗青壮年肩关节前脱位疗效观察

    于小中; 洪定钢; 王效柱

    2013-01-01

    Objective:To observe the clinical effect of Stimson reduction method cooperate with Zhuang medicated thread moxibus-tion in treating adults with acute anterior dislocation of shoulder joint. Methods:36 cases of patients with Stimson reduction method are reset, and cooperate with Zhuang medicated thread moxibustion therapy in the treatment of intraoperative and postoperative. Re-sults:36 patients were all one-time success, with no use of anesthesia, patients were followed up for 6 months, the shoulder joint function of the patients recovered well, the total efficiency was 100%. Conclusion:Using Stimson reduction method cooperate with Zhuang medicated thread moxibustion in treating adults with acute anterior dislocation of shoulder joint is simple and effective, avoiding the use of anesthesia, and worth further clinical application.%  目的:观察Stimson复位法配合壮医药线点灸治疗青壮年急性肩关节前脱位的临床疗效。方法:对36例青壮年急性肩关节前脱位采用Stimson复位法进行复位,并在术中及术后配合患肩壮医药线点灸治疗。结果:36例患者全部一次性复位成功,无一例使用麻醉,随访半年,患者肩关节功能均恢复良好,总有效率100%。结论:采用Stimson复位法配合壮医药线点灸治疗青壮年急性肩关节前脱位操作方法简单,疗效肯定,避免了使用麻醉,值得临床进一步推广应用。

  19. Dislocation-dislocation and dislocation-twin reactions in nanocrystalline Al by molecular-dynamics simulation.

    Yamakov, V.; Wolf, D.; Phillpot, S. R.; Gleiter, H.; Materials Science Division; Forschungszentrum Karlsruhe

    2003-08-15

    We use massively parallel molecular dynamics simulations of polycrystal plasticity to elucidate the intricate dislocation dynamics that evolves during the process of deformation of columnar nanocrystalline Al microstructures of grain size between 30 and 100 nm. We analyze in detail the mechanisms of dislocation-dislocation and dislocation-twin boundary reactions that take place under sufficiently high stress. These reactions are shown to lead to the formation of complex twin networks, i.e. structures of coherent twin boundaries connected by stair-rod dislocations. Consistent with recent experimental observations, these twin networks may cause dislocation pile-ups and thus give rise to strain hardening.

  20. Dislocation of the fibular head in an unusual sports injury: a case report

    Ahmad Riaz

    2008-05-01

    Full Text Available Abstract Introduction One of the primary functions of the proximal tibiofibular joint is slight rotation to accommodate rotational stress at the ankle. Proximal tibiofibular joint dislocation is a rare injury and accounts for less than 1% of all knee injuries. This dislocation has been reported in patients who had been engaged in football, ballet dancing, equestrian jumping, parachuting and snowboarding. Case presentation A 20-year-old man was injured whilst playing football. He felt a pop in the right knee and was subsequently unable to bear weight on it. The range of movement in his knee joint was limited. Anterior-posterior and lateral X-rays of the knee revealed anterolateral dislocation of the proximal tibiofibular joint. Comparison views confirmed the anterolateral dislocation. He had a failed manipulation under anaesthesia and the joint needed an open reduction in which the fibular head was levered back into place. Operative findings revealed a horizontal type of joint. Conclusion An exceedingly rare dislocation of a horizontal type of proximal tibiofibular joint was presented following a football injury. This dislocation was irreducible by a closed method.

  1. Supersonic Dislocation Bursts in Silicon

    Hahn, E. N.; Zhao, S.; Bringa, E. M.; Meyers, M. A.

    2016-06-01

    Dislocations are the primary agents of permanent deformation in crystalline solids. Since the theoretical prediction of supersonic dislocations over half a century ago, there is a dearth of experimental evidence supporting their existence. Here we use non-equilibrium molecular dynamics simulations of shocked silicon to reveal transient supersonic partial dislocation motion at approximately 15 km/s, faster than any previous in-silico observation. Homogeneous dislocation nucleation occurs near the shock front and supersonic dislocation motion lasts just fractions of picoseconds before the dislocations catch the shock front and decelerate back to the elastic wave speed. Applying a modified analytical equation for dislocation evolution we successfully predict a dislocation density of 1.5 × 1012 cm‑2 within the shocked volume, in agreement with the present simulations and realistic in regards to prior and on-going recovery experiments in silicon.

  2. [Spasm of the adductor muscles, pre-dislocations and dislocations of the hip joints in children and adolescents with cerebral palsy. Clinical observations on aetiology, pathogenesis, therapy and rehabilitation. Part II. The importance of the iliopsoas tendon, its tenotomy, of the coxa valga antetorta, and correction through osteotomy turning the hip into varus (author's transl)].

    Fettweis, E

    1979-02-01

    The following factors besides spasm and contraction of the adductor muscles contribute to the occurrence of dislocations of the hip in spastic paralysis: Spasm and contraction of the iliopsoas muscle and enhanced valgus position and antetorsion. The author holds the opinion that in case of malformation of the proximal end of the femur, it is not only the indirect action of the spastic musculature via the proximal femur-epiphyseal cartilage which is responsible for this phenomen in accordance with the law on functional adaption through longitudinal growth (Pauwels), but also the direct traction of the iliopsoas tendon. A clue in this direction is the often very pronounced elongation or enlargement of the trochanter minor. The author demonstrates the pathogenetic importance of iliopsoas contracture and malpositioning of the neck of the femur by means of analyses of the course in two patients. The following principles of treatment are postulated for spastic dislocation of the hip: Elimination of the pathogenetic factors through myotenotomy of the adductor muscles and complete resection of the obturator nerve, with observation of strict aftertreatment criteria, tenotomy of the iliopsoas, repositioning and osteotomy with turning into varus. Osteotomy without previous elimination of the pathogenetically acting muscular forces does not appear useful. Likewise, permanent re-positioning by means of muscle-relaxing operation cannot be sufficiently safe-guarded without additional osteotomy once the dislocation has taken place. In twelve patients with spastic dislocation of the hip, treated in accordance with these guidelines (two without osteotomy) aged 6 6/12 and 19 5/12 years, a roentgenologically good result was obtained in half of the cases, whereas the functional result was satisfactory not only with these patients but also with part of the other patients. If surgical treatment is instituted early enough, and if the experiences described here are taken into consideration

  3. 解剖钢板治疗65例肩关节脱位合并肱骨大结节骨折效果分析%The effect analysis on anatomic plate for 65 cases with shoulder joint dislocation and humeral grea-ter tubercle fracture

    夏卫民

    2016-01-01

    Objective:To analyze and explore the clinical effect of anatomic plate for shoulder joint dislocation with hu-meral greater tubercle fracture. Methods:Sixty - five cases with shoulder joint dislocation and humeral greater tubercle fracture were selected and treatment by anatomic plate. For 3 ~ 4 weeks of rehabilitation,and a 6 - month follow - up for all patients. To evaluate and analyze the clinical treatment effect. Results:Plan and dysfunction is meliorative,range of motion,anatomical re-duction return to normal. 45 cases in 65 cases of patient are better,11 patients are good,the total rate is 86. 15% . Conclusion:The effect of anatomic plate for shoulder joint dislocation and humeral greater tubercle fracture was significant.%目的:分析和探讨解剖钢板治疗肩关节脱位合并肱骨大结节骨折的临床治疗效果。方法:应用解剖钢板治疗65例肩关节脱位合并肱骨大结节骨折患者。术后进行为期3~4周的康复训练,随访6个月。评价分析临床治疗效果。结果:解剖钢板治疗法临床疗效显著,疼痛、功能障碍、肩关节活动范围、解剖复位均恢复正常。65例患者中,优45例,良11例,总优良率为86.15%。结论:解剖钢板治疗肩关节脱位合并肱骨大结节骨折的临床治疗效果显著,具有一定的临床实用价值。

  4. Finite strain discrete dislocation plasticity

    Deshpande, VS; Needleman, A; Van der Giessen, E

    2003-01-01

    A framework for carrying out finite deformation discrete dislocation plasticity calculations is presented. The discrete dislocations are presumed to be adequately represented by the singular linear elastic fields so that the large deformations near dislocation cores are not modeled. The finite defor

  5. Behavior of dislocations in silicon

    Sumino, Koji [Nippon Steel Corp., Chiba Prefecture (Japan)

    1995-08-01

    A review is given of dynamic behavior of dislocations in silicon on the basis of works of the author`s group. Topics taken up are generation, motion and multiplication of dislocations as affected by oxygen impurities and immobilization of dislocations due to impurity reaction.

  6. Phonon-dislocation interaction

    Thermal conductivity measurements on LiF crystals in the temperature range 0.04 to 30 K have demonstrated that, throughout this range, thermal phonons interact with dislocations via a dynamic or resonant process which is highly frequency- and phonon-mode dependent. The results of earlier work are consistent with this interpretation

  7. 先天性髋关节脱位术后康复训练38例体会%Experience of postoperative rehabilitation training on 38 cases of congenital dislocation of hip joint

    闫庆荣; 丁新友

    2003-01-01

    @@ BACKGROUND: Postoperative long-tern immobilization ofdislocation of hip joint may lead to degradation of ligament structure, decreasing of intensity and decline of stress ability. Besides tissue proliferation, organization and adhesion in the course of repairing will lead to dysfunction of hip jolt even stiffness. So planned rehabilitation training on hip joint is very necessary.

  8. Clinical outcomes of the combined lumb-saero-iliac fixation in treatment of sacroiliac joint fractures and dislocation%腰骶髂联合固定治疗骶髂关节骨折脱位的疗效分析

    郭新钾; 孙兆云; 李雪芹; 董长军

    2011-01-01

    Objective To evaluate the clinical outcomes of the combined lumb-sacio-iliac fixation in treatment of sacroiliac joint fractures and dislocation. Methods From Jul 2007 to Jan 2010,11 patients(6 males and S females) with sacroiliac joint fractures and dislocation were treated with operation combined lumb-sacro-iliac fixation. According to the classification of Tile, 11 patients were classified as type C . This fixation combined a posterior pedicle screw system which fixed L5 / S1 with a ilium screw which fixed the posterior iliac spine after replacement by drafting affected leg and bracing or rejoining the screw. Results All 11 patients were followed up 12~20 months after surgery, with an average of 16.5 months. Postoperative X-ray showed satisfactory reduction of sacroiliac joint fractures and dislocation. No iatrogenic complications of neurovascular injury occurred. Patients now walk unassistedly without pain in the waist or legs, and with no shortening of lower limbs or claudication. By considering symptom and satisfactory scores, the Majeed functional assessment revealed that patients had 9 excellent and 2 good at 12 months after surgery. Conclusion The combined lumb-sacro-iliac fixation allowed early mobilization and ambulation, with general applicability and definite safety,is an effective surgical technique for the treatment of sacroiliac joint fractures and dislocation.%目的 探讨应用腰骶髂联合固定治疗骶髂关节骨折脱位的临床效果.方法 对2007年7月~2010年1月收治的11例骶髂关节骨折脱位的骨盆骨折患者进行手术治疗.男6例,女5例;年龄21~60岁,平均36岁.11例均为Tile C型骨盆骨折.采用后路腰骶髂切口,椎弓根钉棒系统固定L5/S1椎体和髂骨螺钉固定髂骨,配合患肢牵引和器械的撑开、合拢纠正垂直及分离移位.结果 11例患者术后获得12~20个月随访,平均16.5个月.术后X线片均示骶髂关节骨折脱位复位固定满意,骨盆后环形态恢

  9. Dislocation following total knee arthroplasty: A report of six cases

    Villanueva Manuel

    2010-01-01

    Full Text Available Background: Dislocation following total knee arthroplasty (TKA is the worst form of instability. The incidence is from 0.15 to 0.5%. We report six cases of TKA dislocation and analyze the patterns of dislocation and the factors related to each of them. Materials and Methods: Six patients with dislocation of knee following TKA are reported. The causes for the dislocations were an imbalance of the flexion gap (n=4, an inadequate selection of implants (n=1, malrotation of components (n=1 leading to incompetence of the extensor mechanism, or rupture of the medial collateral ligament (MCC. The patients presented complained of pain, giving way episodes, joint effusion and difficulty in climbing stairs. Five patients suffered posterior dislocation while one anterior dislocation. An urgent closed reduction of dislocation was performed under general anaesthesia in all patients. All patients were operated for residual instability by revision arthroplasty after a period of conservative treatment. Results: One patient had deep infection and knee was arthrodesed. Two patients have a minimal residual lag for active extension, including a patient with a previous patellectomy. Result was considered excellent or good in four cases and fair in one, without residual instability. Five out of six patients in our series had a cruciate retaining (CR TKA designs: four were revised to a posterior stabilized (PS TKA and one to a rotating hinge design because of the presence of a ruptured MCL. Conclusion: Further episodes of dislocation or instability will be prevented by identifying and treating major causes of instability. The increase in the level of constraint and correction of previous technical mistakes is mandatory.

  10. Humeral shaft fracture with ipsilateral shoulder dislocation

    Behera Prateek

    2014-02-01

    Full Text Available 【Abstract】Although fracture of the humeral shaft or dislocation of the shoulder joint is a common injury, a simutaneous injury is rare. We present such a case combined with head injury which took precedence over the skeletal injuries. The postoperative rehabilitation was slowed down by the head injury. This case report makes us aware of some problems when managing the patient with this rare injury and helps us understand the management options better. Also the need for proper follow-up and rehabilitation is emphasized.