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Sample records for carpometacarpal joint dislocation

  1. Multiple carpometacarpal dislocations.

    OpenAIRE

    Kumar, A.; Olney, D B

    1994-01-01

    We present a case of dislocations of the carpometacarpal joints without associated fractures. Although carpometacarpal injuries are relatively uncommon, it is rare for multiple carpometacarpal dislocations to occur without associated fractures. The injury is difficult to diagnose because of swelling of the hand. A lateral radiograph of the wrist has been found to be mandatory to its precise diagnosis if suspected. In the case presented here early diagnosis and closed manipulation in the accid...

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

    LENUS (Irish Health Repository)

    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.

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

    LENUS (Irish Health Repository)

    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.

  4. Total carpometacarpal joint dislocation combined with trapezium fracture, trapezoid dislocation and hamate fracture

    DEFF Research Database (Denmark)

    Gvozdenovic, R; Vadstrup, Lars Soelberg

    2015-01-01

    Multiple metacarpal dislocations combined with carpal fracture - dislocations are rare injuries. We report a new combination of these injuries where fracture-dislocation of the base of the 1st metacarpal bone occurred simultaneously with a comminuted fracture of the trapezium, dislocation...... of the trapezoid and metacarpal joints (2nd to 5th) and an avulsion fracture of the hamate. This specific carpal injury has not been previously described and our description will contribute to understanding the mechanism of these complex injuries. The injury pattern in the case featured here was multifaceted...... and resulted from rupture of both transverse and longitudinal carpal columns. According to the Garcia-Elias classification of axial carpal disruptions, this particular injury mechanism was a combined axial-radial-ulnar type injury. These injuries are extremely rare and are only sporadically described...

  5. Multiple Volar Carpometacarpal Dislocations with Associated Carpal Tunnel Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    C Fletcher

    2015-09-01

    Full Text Available We report a rare injury involving volar fracture dislocations of the second to fifth carpometacarpal dislocations. Carpometacarpal dislocations are usually dorsally displaced and most commonly only involve the fourth and fifth joints. An associated carpal tunnel syndrome adds another dimension to the complexity and rarity of the injury in this index case. A high index of clinical suspicion and subsequent emergent management is of utmost importance to treat this unusual combination of injuries in order to avoid significant morbidity.

  6. Failed total carpometacarpal joint prosthesis of the thumb

    DEFF Research Database (Denmark)

    Hansen, Torben Bæk; Homilius, Morten

    2010-01-01

    Total joint prosthesis in carpometacarpal joint arthritis of the thumb often fails. Loosening of the implant is often treated by resection arthroplasty, and we reviewed 10 patients, mean age 54 years (range 47-63) who were treated by resection arthroplasty after a failed total joint prosthesis....... The male:female ratio was 1:4 and the mean duration of observation 32 months (range 6-52). In three patients the revised implant was a MOJE uncemented carpometacarpal joint prosthesis and in seven patients an Elektra uncemented one. At follow-up grip strength was reduced to less than 90% of the other hand...... in eight of 10 patients, but the mean Disabilities of the arm, shoulder, and hand (DASH) scores, self-reported pinch-grip-related function, and pain were comparable with our earlier published results with the Elektra carpometacarpal total joint prosthesis....

  7. Finite element analysis of thumb carpometacarpal joint implants

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, C.

    1995-11-01

    The thumb carpometacarpal joint is frequently replaced in women who have developed severe osteoarthritis of the hand. A new, privately developed implant design consists of two components, trapezial and metacarpal, each with a saddle-shaped articulating surface. A three dimensional finite element model of this implant has been developed to analyze stresses on the device. The first simulations using the model involve loading the implant with forces normal to the trapezial component. Preliminary results show contact stress distributions at the particulating surfaces of the implant.

  8. Thumb Carpometacarpal Joint Stabilization in Ehlers-Danlos Syndrome--Case Report.

    Science.gov (United States)

    Breahna, Anca Nicoleta; Meads, Bryce Maurice

    2015-10-01

    We report the case of an 18-years-old patient with thumb carpometacarpal ligament laxity due to Ehlers-Danlos syndrome who was treated with trapezial opening wedge osteotomy combined with volar ligaments reconstruction. Two years postoperatively she is pain free and the thumb carpometacarpal joint is stable. PMID:26388011

  9. Carpometacarpal dislocation of the thumb associated with fracture of the trapezium

    OpenAIRE

    Kose, Ozkan; Keskinbora, Mert; Guler, Ferhat

    2014-01-01

    Carpometacarpal dislocation (CMC) of the thumb associated with fracture of trapezium is an extremely rare injury, with only 12 cases that sustained similar injuries reported in the literature. In this article, another patient with this rare injury was reported, and all previously published cases were extensively reviewed. The presented case and all previously published cases had a longitudinally oriented trapezium fracture, which is naturally unstable and almost always associated with disloca...

  10. Men and women have similarly shaped carpometacarpal joint bones.

    Science.gov (United States)

    Schneider, M T Y; Zhang, J; Crisco, J J; Weiss, A P C; Ladd, A L; Nielsen, P; Besier, T

    2015-09-18

    Characterizing the morphology of the carpometacarpal (CMC) joint bones and how they vary across the population is important for understanding the functional anatomy and pathology of the thumb. The purpose of this paper was to develop a statistical shape model of the trapezium and first metacarpal bones to characterize the size and shape of the whole bones across a cohort of 50. We used this shape model to investigate the effects of sex and age on the size and shape of the CMC joint bones and the articulating surface area of the CMC joint. We hypothesized that women have similar shape trapezium and first metacarpal bones compared to men, following scaling for overall size. We also hypothesized that age would be a significant predictor variable for CMC joint bone changes. CT image data and segmented point clouds of 50 CMC bones from healthy adult men and women were obtained from an ongoing study and used to generate two statistical shape models. Statistical analysis of the principal component weights of both models was performed to investigate morphological sex and age differences. We observed sex differences, but were unable to detect any age differences. Between men and women the only difference in morphology of the trapezia and first metacarpal bones was size. These findings confirm our first hypothesis, and suggest that the women have similarly shaped trapezium and first metacarpal bones compared to men. Furthermore, our results reject our second hypothesis, indicating that age is a poor predictor of CMC joint morphology.

  11. [Systematization of the articular surfaces of the carpometacarpal joints (author's transl)].

    Science.gov (United States)

    el Bacha, A; Maillot, C

    1977-01-01

    A study, done on 100 hands, of the systematization of the articular surfaces of the carpometacarpal joints, clearly delineates the variability of circumference, dimesions, and relief of the articular facets. An attempt to draw general conclusions from this morphological study, in terms of arthrokinetics, leads to an understanding of the nature of the joints and the movements that are performed at this site.

  12. Osteoarthritis of the thumb carpometacarpal joint: Correlation of ultrasound appearances to disability and treatment response

    International Nuclear Information System (INIS)

    Aim: To evaluate grading of thumb carpometacarpal joint (CMCJ) osteoarthritis (OA) using ultrasound, correlating findings with disability and treatment response. Materials and methods: Patients with symptomatic thumb OA attending for ultrasound-guided CMCJ steroid injection and a group of asymptomatic controls were recruited prospectively. Thumb CMCJ ultrasound was graded (osteophytes, joint-space narrowing, capsule size, and measured capsule size), and a Disabilities of the Arm Shoulder and Hand (DASH) questionnaire was completed for each patient. Symptomatic patients then underwent injection with DASH repeated 6 weeks post-treatment. Ultrasound features were correlated with the initial DASH disability score and response as defined by change in DASH 6 weeks after treatment. Results: Thirty-one patients with symptomatic OA and 37 asymptomatic controls were recruited. With the exception of osteophytes (p = 0.017), no statistically significant correlation was demonstrated between severity of ultrasound features and patient disability. However, all features demonstrated statistically significant higher grades in the symptomatic group compared to controls. Ultrasound grading did not have statistical correlation with treatment response. Conclusion: No correlation was found between the majority of ultrasound features and the clinical severity of OA or likely response to treatment. However, these features are significantly more common in the symptomatic population

  13. Ligament reconstruction with tendon interposition arthroplasty for first carpometacarpal joint osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    Yang Yong; Huey Y.Tien; Kannan K.Kumar; Chen Shanlin; Li Zhongzhe; Tian Wen; Tian Guanglei

    2014-01-01

    Background Ligament reconstruction tendon interposition (LRTI) is the most commonly performed surgical procedure for first carpometacarpal joint osteoarthdtis.The purpose of this study was to examine the radiographic and clinical outcomes of LRTI arthroplasty and document the clinical results based on metacarpal subsidence.Methods From January 2008 to January 2011,19 patients (21 thumbs) underwent surgery for thumb carpometacarpal arthritis using ligament reconstruction tendon interposition arthroplasty with flexor carpi radialis (FCR) in Kleinert Kutz Hand Care Center of Louisville University,USA.The follow-up period was an average of 13.9 months.Pain,grip strength,tip pinch strength,range of motion,and radiographic measurements were recorded.Based on first metacarpal subsidence,the cases were classified in to mild,moderate,and severe.Clinical outcomes of the groups were evaluated and compared.Results Grip strength improved from 18.6 kg to 20.5 kg,and tip pinch strength increased from 4.4 kg to 4.5 kg after the surgery.Radial abduction and palmar abduction improved after surgery.Radial abduction increased from 55.7° to 60.6° and palmar abduction improved from 56.7° to 63.5° after the procedure.Visual analogue scores (VAS) were significantly reduced,from 6.6 to 0.5.Compared with the preoperative radiographs the first metacarpal had subsided about 54.6% of the arthroplasty space.The height of arthroplasty space and index of the arthroplasty space significantly decreased from 12.4 mm to 5.6 mm and from 0.27 to 0.12 respectively.Between the various groups (mild,moderate and severe metacarpal subsidence),there was no difference in grip strength,tip pinch strength,thumb range of motion,and VAS.Conclusions Ligament reconstruction tendon interposition arthroplasty resulted in excellent relief of pain and increase in range of motion.However,LRTI cannot maintain the arthroplasty space.Compared with the preoperative radiographs,the metacarpal subsided more than 50

  14. Epidemiology of Isolated Acromioclavicular Joint Dislocation

    Directory of Open Access Journals (Sweden)

    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.

  15. Dislocations

    Science.gov (United States)

    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 ...

  16. Osteoarthritis of the first carpometacarpal joint: a study of radiology and clinical epidemiology:

    DEFF Research Database (Denmark)

    Sonne-Holm, Stig; Jacobsen, J

    2006-01-01

    Epidemiological studies show an increased prevalence of osteoarthritis of the knee and hand with increased body mass index [BMI]. Osteoarthritis of the hip joint is not related to BMI. The connection between obesity and osteoarthritis cannot exclusively be explained by genetic factors or by the a......Epidemiological studies show an increased prevalence of osteoarthritis of the knee and hand with increased body mass index [BMI]. Osteoarthritis of the hip joint is not related to BMI. The connection between obesity and osteoarthritis cannot exclusively be explained by genetic factors...... or by the accumulation of tear and wear. Overweight occurs prior to knee joint degeneration, not as a result of diminished activity due to joint degeneration. Weight control seems to be an influential tool in the prophylaxis of overweight-specific joint degeneration....

  17. Dislocation of the proximal tibiofibular joint

    Directory of Open Access Journals (Sweden)

    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

  18. Double Dislocation of Interphalangeal Joints Accompanied with Contralateral Shoulder Dislocation: A Case Report.

    Science.gov (United States)

    Raval, Pradyumna Ramchandra; Jariwala, Arpit

    2016-02-01

    Dislocation of any joint is an orthopaedic emergency and needs immediate attention by the attending physician. A delay in reducing a dislocated joint can lead to disastrous complications both immediately as well as in the long run. Although anterior dislocation of a shoulder joint is by far the commonest dislocation encountered by any emergency care physician, other joints may also get dislocated. In certain cases two joints may get dislocated simultaneously. Such dislocation is known as a double dislocation. Double dislocation of the proximal interphalangeal joint and the distal interphalangeal joint in the same finger is a rare injury. High impact loading at the fingertip is the primary cause in most cases and it is often associated with younger individuals playing contact sports. The right little finger is the digit commonly involved and this injury is evident in football players more often than not. Although closed reduction is a preferred treatment, it may not be always successful. Time of presentation, tendon interposition, associated swelling and co-existent phalangeal fractures are certain key impediments to a successful closed reduction manoeuvre. In patients with an open injury, a thorough wash out and appropriate antibiotic cover is mandatory. We report a rare case of double dislocation of the interphalangeal joints accompanied with contralateral shoulder dislocation in an elderly man sustained after a fall which was treated successfully with closed reduction and early mobilization. PMID:27028386

  19. Treatment of thumb carpometacarpal osteoarthritis; quo vadis?

    NARCIS (Netherlands)

    Spaans, AJ

    2016-01-01

    The unique prehensile ability of the human hand is largely due to the biomechanical function of its complex first carpometacarpal (CMC1) joint. This makes the thumb the most important digit of the hand. The unique demands placed on the thumb regarding mobility, stability and transmission of force ma

  20. Dislocation of the Temporomandibular Joint and Relocation Procedures.

    Science.gov (United States)

    White, Thomas; Hedderick, Viki; Ramponi, Denise R

    2016-01-01

    Temporomandibular joint (TMJ) dislocation requires prompt medical attention due to the crucial impact of airway, nutrition acquisition, and communication. Recognition of this injury by the practitioner, based on clinical presentation and history, is paramount for identification of accurate diagnosis and prompt treatment of TMJ dislocation. Relocation or reduction methods vary on the basis of the severity of the injury and whether it is an acute or chronic dislocation. PMID:27482989

  1. Osteoarthritis of the carpometacarpal joint of the thumb: a new MR imaging technique for the standardized detection of relevant ligamental lesions

    International Nuclear Information System (INIS)

    To assess ligament lesions and subluxations of the carpometacarpal joints of the thumbs (CMC I) of asymptomatic volunteers and of patients with CMC I osteoarthritis using advanced magnetic resonance imaging (MRI). A total of 20 CMC I joints of 14 asymptomatic volunteers (6 x both sides) and 28 CMC I joints of 22 patients (6 x both sides) with symptomatic and X-ray-diagnosed osteoarthritis of CMC I joints were studied. During extension, flexion, abduction and adduction of the thumb, the anterior oblique (AOL), intermetacarpal (IML), posterior oblique (POL) and dorsal radial (DRL) ligaments were evaluated using 3-T MRI on two standard planes, and translation of metacarpal I (MC I) was assessed. The MRI demonstrated that ligament lesions of the AOL and IML are frequent. Isolated rupture of the AOL was found in 6 of 28 (21 %), combined rupture of the AOL + IML in 5 of 28 (18 %) and isolated IML rupture in 4 of 28 (14 %) joints. The patients had a significantly increased dorsal translation of MC I during extension with a median of 6.4 mm vs. 5.4 mm in asymptomatic volunteers (p < 0.05). MRIs of CMC I in two standardized planes frequently show combined ligament ruptures. The dorsal subluxation of MC I, which is increased in patients, correlates with OA severity based on X-ray and can be quantified by MRI. For joint-preserving surgical procedures and for prosthesis implantation of the CMC I, we recommend performing an MRI in two planes of the thumb - extension and abduction - to evaluate the ligaments and dorsal subluxation of MC I. (orig.)

  2. Osteoarthritis of the carpometacarpal joint of the thumb: a new MR imaging technique for the standardized detection of relevant ligamental lesions

    Energy Technology Data Exchange (ETDEWEB)

    Dumont, Clemens [University Medical Center Goettingen, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Georg-August-Universitaet, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Lerzer, Sebastian; Tezval, Mohammad; Stuermer, Klaus Michael [University Medical Center Goettingen, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Vafa, Morad Ali; Lotz, Joachim [University Medical Center Goettingen, Department of Diagnostic Radiology and Interventional Radiology, Goettingen (Germany); Dechent, Peter [University Medical Center Goettingen, MR-Research in Neurology and Psychiatry, Department of Cognitive Neurology, Goettingen (Germany)

    2014-10-15

    To assess ligament lesions and subluxations of the carpometacarpal joints of the thumbs (CMC I) of asymptomatic volunteers and of patients with CMC I osteoarthritis using advanced magnetic resonance imaging (MRI). A total of 20 CMC I joints of 14 asymptomatic volunteers (6 x both sides) and 28 CMC I joints of 22 patients (6 x both sides) with symptomatic and X-ray-diagnosed osteoarthritis of CMC I joints were studied. During extension, flexion, abduction and adduction of the thumb, the anterior oblique (AOL), intermetacarpal (IML), posterior oblique (POL) and dorsal radial (DRL) ligaments were evaluated using 3-T MRI on two standard planes, and translation of metacarpal I (MC I) was assessed. The MRI demonstrated that ligament lesions of the AOL and IML are frequent. Isolated rupture of the AOL was found in 6 of 28 (21 %), combined rupture of the AOL + IML in 5 of 28 (18 %) and isolated IML rupture in 4 of 28 (14 %) joints. The patients had a significantly increased dorsal translation of MC I during extension with a median of 6.4 mm vs. 5.4 mm in asymptomatic volunteers (p < 0.05). MRIs of CMC I in two standardized planes frequently show combined ligament ruptures. The dorsal subluxation of MC I, which is increased in patients, correlates with OA severity based on X-ray and can be quantified by MRI. For joint-preserving surgical procedures and for prosthesis implantation of the CMC I, we recommend performing an MRI in two planes of the thumb - extension and abduction - to evaluate the ligaments and dorsal subluxation of MC I. (orig.)

  3. In-game Management of Common Joint Dislocations

    OpenAIRE

    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...

  4. Galeazzi fracture with volar dislocation of the distal radioulnar joint.

    Science.gov (United States)

    Kim, Suezie; Ward, James P; Rettig, Michael E

    2012-11-01

    Galeazzi fracture dislocations are fractures of the distal one-third of the radial diaphysis with traumatic disruption of the distal radioulnar joint (DRUJ). This injury results in subluxation or dislocation of the ulnar head. We present a case of a Galeazzi fracture with a volar dislocation of the DRUJ. Open reduction of the DRUJ with Kirschner wire fixation in pronation was necessary to reduce the joint and maintain anatomic alignment. Repair of the triangular fibrocartilage complex was also necessary to maintain stability of the DRUJ.

  5. Posterior dislocation of the shoulder joint

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Cervical facet joint kinematics during bilateral facet dislocation

    OpenAIRE

    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...

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

    OpenAIRE

    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...

  9. Inferior glenohumeral joint dislocation with greater tuberosity avulsion

    Institute of Scientific and Technical Information of China (English)

    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.

  10. Traumatic Dislocation of the Elbow Joint

    NARCIS (Netherlands)

    J. de Haan (Jeroen)

    2011-01-01

    textabstractThis thesis addresses the major issues encountered in the diagnosis and treatment of adult elbow dislocation. Firstly, a literary review (Chapters Five and Eight) makes it clear that there is much uncertainty regarding trauma mechanism, biomechanics, and even anatomy (Chapter Two). Furth

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

  14. Temporomandibular joint dislocation and deafness from a cricket ball injury.

    Science.gov (United States)

    Murthy, P; Bandasson, C; Dhillon, R S

    1994-05-01

    Cricket is a national sport in some countries and can be potentially hazardous. We report an incident of a cricket ball impact to the chin, which resulted in posterior dislocation of both temporomandibular joints and bilateral mixed deafness. There appear to be no similar case reports in the literature.

  15. Recurrent Dislocation of the Shoulder Joint

    OpenAIRE

    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...

  16. Isolated Dislocation of Proximal Tibiofibular Joint

    OpenAIRE

    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 ...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Double figure-of-eight reconstruction technique for chronic anterior sternoclavicular joint dislocation.

    Science.gov (United States)

    Kawaguchi, Kohei; Tanaka, Sayo; Yoshitomi, Hiroki; Nagai, Ichiro; Sato, Wakyo; Karita, Tasturo; Kondo, Taiji

    2015-05-01

    Sternoclavicular joint dislocations account for figure-of-eight" using the ipsilateral gracilis tendon. Surgical outcome was successful, based on the Rockwood SC joint rating scale, and the patient maintained excellent stability even after 2 years. This new surgical technique offers superior stability, without harvest site morbidity, to patients with rare, severe, and chronic sternoclavicular joint dislocation. Level of evidence IV. PMID:24722676

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

    Science.gov (United States)

    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

  1. Simultaneous Dislocation of Radiocapitellar and Distal Radioulnar Joint

    OpenAIRE

    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...

  2. Rare double fracture-dislocation of the thumb: a case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Devinder Singh; Loveneesh G Krishna; Sunil Dhaka; Surender Kumar; Sumit Arora

    2013-01-01

    Simultaneous fracture/dislocation of the thumb carpometacarpal (CMC)joint and dislocation of the metacarpophalangeal (MCP)joint is considered as a rare injury pattern.We report an unusual case of dorsal dislocation of MCP joint of the thumb associated with extraarticular fracture of the base of the first metacarpal in a 28-year-old man.The dislocation of MCP joint had been missed during initial presentation at a peripheral centre.The patient made an uneventful recovery following open reduction and fixation with 1.25 mm Kirschner wire of the MCP joint along with repair of the ulnar collateral ligament.This injury pattern has not been previously reported to the best of our knowledge in the English-language based medical literature.

  3. Simultaneous dislocation of radiocapitellar and distal radioulnar joint.

    Science.gov (United States)

    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

  4. Simultaneous Dislocation of Radiocapitellar and Distal Radioulnar Joint

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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...

  7. Artrodese do punho com fixação mínima preservando as articulações carpometacarpianas Wrist arthrodesis with minimal internal fixation preserving the carpometacarpal joints

    Directory of Open Access Journals (Sweden)

    Arlindo Gomes Pardini Júnior

    2010-01-01

    structures. In general, the results are very satisfactory, particularly for pain relief, and in the majority of cases, there is considerable functional improvement. Various techniques are described, with different methods of internal fixation, most of which include the carpometacarpal joints (CMJ in the fusion. The objective of this study is to evaluate the results of wrist arthrodesis through a technique which is simpler, more biological, more inexpensive, and does not involve the carpometacarpal joints. METHODS: 15 patients with wrist arthrodesis were evaluated (6 with sequelae of trauma, 4 Rheumatoid Arthritis, 3 Kienbock's grade IV, 1 Preiser and 1 panarthrosis. The technique consisted of the use of an iliac bone plate and internal fixation with Kirschner wires, avoiding the carpometacarpal joints. RESULTS: The evaluation was based on consolidation time (93% in 7 weeks; movements of the fingers and pronosupination; pinch and grasp strength; functional evaluation through the DASH questionnaire, pain and patient satisfaction. In general, the results were similar to those of other, more aggressive techniques, and the non-inclusion of the carpometacarpal joints did not affect the final result. CONCLUSION: wrist arthrodesis with fixation using Kirschner wires and the use of an iliac bone plate, preserving the carpometacarpal joints, gives good or excellent results which are similar to those of other techniques described. However it presents major advantages over other methods: it is less aggressive, less expensive, and does not have the inconvenience and complications associated the use of plates and screws.

  8. Midline mandibulotomy for reduction of long-standing temporomandibular joint dislocation.

    Science.gov (United States)

    Rattan, Vidya; Rai, Sachin; Sethi, Amit

    2013-06-01

    Long-standing temporomandibular joint (TMJ) dislocation is an uncommon condition, and due to its rarity, no definitive guidelines have been developed for its management. Various reduction techniques ranging from indirect traction techniques to direct exposure of the TMJ have been used. Indirect traction techniques for reduction may fail in long-standing dislocation. Management of two cases of long-standing TMJ dislocation with midline mandibulotomy is discussed in which other indirect reduction techniques had failed. Midline osteotomy of the mandible can be used for reduction in difficult TMJ dislocations. An algorithm for the management of long-standing TMJ dislocation is proposed and related literature is reviewed.

  9. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation

    Directory of Open Access Journals (Sweden)

    Akinbami Babatunde O

    2011-06-01

    Full Text Available Abstract Background Virtually all the articles in literature addressed only a specific type of dislocation. The aim of this review was to project a comprehensive understanding of the pathologic processes and management of all types of dislodgement of the head of the mandibular condyle from its normal position in the glenoid fossa. In addition, a new classification of temporomandibular joint dislocation was also proposed. Method and materials A thorough computer literature search was done using the Medline, Cochrane library and Embase database. Key words like temporo-mandibular joint dislocation were used for the search. Additional manual search was done by going through published home-based and foreign articles. Case reports/series, and original articles that documented the type of dislocation, number of cases treated in the series and original articles. Treatment done and outcome of treatment were included in the study. Result A total of 128 articles were reviewed out which 79 were found relevant. Of these, 26 were case reports, 17 were case series and 36 were original articles. 79 cases were acute dislocations, 35 cases were chronic protracted TMJ dislocations and 311 cases were chronic recurrent TMJ dislocations. Etiology was predominantly trauma in 60% of cases and other causes contributed about 40%. Of all the cases reviewed, only 4 were unilateral dislocation. Various treatment modalities are outlined in this report as indicated for each type of dislocation. Conclusion The more complex and invasive method of treatment may not necessarily offer the best option and outcome of treatment, therefore conservative approaches should be exhausted and utilized appropriately before adopting the more invasive surgical techniques.

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

    OpenAIRE

    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 ...

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

    OpenAIRE

    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.

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

    OpenAIRE

    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...

  13. Surgical treatment of a concurrent type 5 acromioclavicular joint dislocation and a failed anterior glenohumeral joint stabilization.

    Science.gov (United States)

    Rashid, Abbas; Lawrence, Christopher; Tytherleigh-Strong, Graham

    2016-10-01

    Traumatic glenohumeral joint dislocation and acromioclavicular joint subluxations tend to occur in young active males. Use of the coracoid process either as a transfer in recurrent instability or in suspensory reconstructions of the coracoclavicular ligaments have gained popularity. However this requires careful consideration in the event of concomitant injuries if they both require surgery. PMID:27660658

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

    OpenAIRE

    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...

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

    International Nuclear Information System (INIS)

    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)

  16. Non-traumatic posterior atlanto-occipital joint dislocation

    OpenAIRE

    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...

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

    LENUS (Irish Health Repository)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  19. Manual treatment of dislocation of temporomandibular joint%颞下颌关节脱位的手法治疗

    Institute of Scientific and Technical Information of China (English)

    雷绍音; 陈永全

    2002-01-01

    Background: That the condylar process slides out of articular fossa and exceeds normal limit of articular motion and can not reduce automatically is called dislocation of temporomandibular joint. It is divided into unilateral and bilateral dislocation according to the part of dislocation. Or it is divided into acute, recurrent, and old dislocations according to the time of dislocation or into anterior, posterior, superior and lateral dislocations according the direction of dislocation of the condylar process. Manifestations of dislocation of temporomandibular joint include mandibular abnormal motion, opening of the mouth that can' t close with outflowing of the saliva, he mandible protrudes anteriorly, the cheeks become smooth, a pit can be palpated anterior to the antilobium.

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

    Directory of Open Access Journals (Sweden)

    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

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

    International Nuclear Information System (INIS)

    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)

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Science.gov (United States)

    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

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

    OpenAIRE

    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 ...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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. .

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

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    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.

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

    Science.gov (United States)

    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

  14. Unusual combined fracture dislocation of the wrist and metacarpophalangeal joints: a case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Mohamed Faouzi Hamdi

    2011-01-01

    Volar perilunate fracture dislocation is an extremely rare carpal injury, but associated with metacarpophalangeal joint dislocation of both the ipsilateral index and middle finger has never been reported. We report one case of a 28-year-old man following a high-energy trauma.After performing closed reduction of the metacarpophalangeal joint injury, open reduction of the wrist injury through volar approach was done, and a K-wire fixation was used to stabilize the scaphoid fracture and lunotriquetral joint. After a 16 months' follow-up period, the wrist regained a full range of motion without symptoms, and the fractured bone was strengthened in a good position.

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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

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

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    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.

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

    Science.gov (United States)

    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

  3. Bilateral anterior shoulder dislocation

    OpenAIRE

    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...

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

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

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    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.

  7. Bilateral Asymmetric Dislocations of Hip Joints: An Unusual Mechanism of Injury

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    Rajesh Kumar Kanojia

    2013-01-01

    Full Text Available Asymmetric bilateral dislocations of the hips are rare injuries. Among the small number of reports in the literature, most have attributed the cause to high-velocity motor crashes. These dislocations are often seen to be associated with fractures of the proximal femur or the acetabulum. We present a case of a 45-year-old man with bilateral asymmetric dislocation of hips which were purely ligamentous in nature, without any fracture. He sustained his injuries due to a fall while getting on a moving bus. It was an unusual mechanism of injury as compared to the other cases of asymmetric hip dislocations reported in published studies. Both hips were reduced under general anaesthesia within three hours of the trauma. Skin traction and non-weight-bearing rehabilitation were continued for six weeks. After 35 months of followup, the patient remains asymptomatic. Early diagnosis and timely reduction of such dislocations under anaesthesia are necessary for prevention of complications.

  8. The Functional Anatomy of the Carpometacarpal Complex in Anthropoids and Its Implications for the Evolution of the Hominoid Hand.

    Science.gov (United States)

    Selby, Michael S; Simpson, Scott W; Lovejoy, C Owen

    2016-05-01

    Previously, we described several features of the carpometacarpal joints in extant large-bodied apes that are likely adaptations to the functional demands of vertical climbing and suspension. We observed that all hominids, including modern humans and the 4.4-million-year-old hominid Ardipithecus ramidus, lacked these features. Here, we assess the uniqueness of these features in a large sample of monkey, ape, and human hands. These new data provide additional insights into the functional adaptations and evolution of the anthropoid hand. Our survey highlights a series of anatomical adaptations that restrict motion between the second and third metacarpals (MC2 and MC3) and their associated carpals in extant apes, achieved via joint reorganization and novel energy dissipation mechanisms. Their hamate-MC4 and -MC5 joint surface morphologies suggest limited mobility, at least in Pan. Gibbons and spider monkeys have several characters (angled MC3, complex capitate-MC3 joint topography, variably present capitate-MC3 ligaments) that suggest functional convergence in response to suspensory locomotion. Baboons have carpometacarpal morphology suggesting flexion/extension at these joints beyond that observed in most other Old World monkeys, probably as an energy dissipating mechanism minimizing collision forces during terrestrial locomotion. All hominids lack these specializations of the extant great apes, suggesting that vertical climbing was never a central feature of our ancestral locomotor repertoire. Furthermore, the reinforced carpometacarpus of vertically climbing African apes was likely appropriated for knuckle-walking in concert with other novel potential energy dissipating mechanisms. The most parsimonious explanation of the structural similarity of these carpometacarpal specializations in great apes is that they evolved independently. PMID:26916787

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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

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

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    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.

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

    Directory of Open Access Journals (Sweden)

    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. ARTHROSCOPIC TREATMENT OF ACROMIOCLAVICULAR JOINT DISLOCATION BY TIGHT ROPE TECHNIQUE (ARTHREX®)

    Science.gov (United States)

    GÓmez Vieira, Luis Alfredo; Visco, Adalberto; Daneu Fernandes, Luis Filipe; GÓmez Cordero, Nicolas Gerardo

    2015-01-01

    Presenting the arthroscopic treatment by Tight Rope - Arthrex® system for acute acromioclavicular dislocation and to evaluate results obtained with this procedure. Methods: Between August 2006 and May 2007, 10 shoulders of 10 patients with acute acromioclavicular dislocation were submitted to arthroscopic repair using the Tight Rope - Arthrex® system. Minimum follow-up was 12 months, with a mean of 15 months. Age ranged from 26 to 42, mean 34 years. All patients were male. Radiology evaluation was made by trauma series x-ray. The patients were assisted in the first month weekly and after three months after the procedure. Clinical evaluation was based on the University of California at Los Angeles (UCLA) criteria. Results: All patients were satisfied after the arthroscopic procedure and the mean UCLA score was 32,5. Conclusion: The arthroscopic treatment by Tight Rope – Arthrex® system for acute acromioclavicular dislocation showed to be an efficient technique. PMID:26998453

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

    Science.gov (United States)

    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

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

    OpenAIRE

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  20. Closed medial total subtalar joint dislocation without ankle fracture: a case report

    Science.gov (United States)

    2014-01-01

    Introduction Total subtalar dislocation without fracture of the ankle is a rare clinical entity; it is usually due to a traumatic high-energy mechanism. Standard treatment is successful closed reduction under general anesthesia followed by non-weight bearing and ankle immobilization with a below-knee cast for 6 weeks. Case presentation We present the case of a 30-year-old Moroccan woman who was involved in a road traffic accident. She subsequently received a radiological assessment that objectified a total subtalar dislocation without fracture of her ankle. She was immediately admitted to the operating theater where an immediate reduction was performed under sedation, and immobilization in a plaster boot was adopted for 8 weeks. The management of this traumatic lesion is discussed in the light of the literature. Conclusions Medial subtalar dislocation is a rare dislocation and is not commonly seen as a sports injury because it requires transfer of a large amount of kinetic energy. The weaker talocalcaneal and talonavicular ligaments often bear the brunt of the energy and are more commonly disrupted, compared to the relatively stronger calcaneonavicular ligament. Urgent reduction is important, and closed reduction under general anesthesia is usually successful, often facilitated by keeping the knee in flexion to relax the gastrocnemius muscle. Long-term sequelae include talar avascular necrosis and osteochondral fracture, as well as chronic instability and pain. PMID:25240955

  1. Atlantoaxial dislocation

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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 ...

  3. Traumatic Elbow Dislocations

    OpenAIRE

    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...

  4. The biomechanics of a thumb carpometacarpal immobilization splint: design and fitting.

    Science.gov (United States)

    Colditz, J C

    2000-01-01

    Splinting for the common osteoarthritis of the carpometacarpal (CMC) joint of the thumb is infrequently described in the literature, but the few splints that are described include one or both adjacent joints. This paper describes the design and biomechanics of a custom-molded thumb CMC immobilization splint that excludes the thumb metacarpophalangeal and wrist joints. The problem of the imbalance of extrinsic extensor/abductor forces against the intrinsic flexor/adductor forces is described. The accompanying weakening of the thumb CMC capsule allows dorsal shifting of the proximal end of the metacarpal, producing pain. The splint described in this paper 1) prevents motion of the first metacarpal in relation to the other metacarpals, 2) prevents tilting (flexion) of the first metacarpal during pinch, and 3) allows unrestricted thumb metacarpal and wrist joint motion. Attention to detail during construction is required for an accurate pattern, precise positioning of the CMC joint during molding, accurate molding around the first metacarpal, and well-distributed pressure. This design may also be used for protection following thumb CMC arthroplasty or thumb CMC sprain or strain and as a base for thumb metacarpophalangeal and/or interphalangeal mobilization splinting.

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

    OpenAIRE

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Diagnosis and treatment of simultaneous ipsilateral distal radioulnar joint dislocation associated with radial head dislocation%下尺桡脱位合并桡骨头脱位的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    李庭; 蒋协远; 刘亚波; 查晔军; 王满宜

    2011-01-01

    目的 探讨下尺桡脱位合并桡骨头脱位的的诊断和治疗.方法 本文报道的2个典型病例,一例是下尺桡背侧脱位同时合并桡骨头后脱位,另一例是下尺桡掌侧脱位合并桡骨头前脱位,均不合并尺桡骨干的骨折.用单纯桡骨头脱位或下尺桡脱位的机制不能很好地解释.对于急性损伤,应先在麻醉下试行闭合复位,如不成功可考虑切开复位.结果 根据目前研究,"绞锁损伤"的机制能比较好得解释这种损伤,骨间膜在前臂两骨之间起到一个"枢轴"的作用.早期诊断和治疗能达到良好的效果.结论 早期诊断和早期复位固定非常重要,需要和孟氏骨折、盖氏骨折或Essex-lopresti损伤等相鉴别.%Objective To describe two cases of simultaneous ipsilateral distal radioulnar joint ( DRUJ) dislocation with radial head dislocation and review literatures. and to discuss the diagnosis and treatment. Methods Two typical cases were reported in this study. One suffered an injury of simultaneous ipsilateral dorsal dislocation of DRUJ and posterior dislocation of radial head. The other was ipsilateral volar dislocation of DRUJ and anterior dislocation of radial head. Both of them had no fracture in ulnar or radial shaft.The mechanism of isolated dislocation of DRUJ or radial head cannot explain this kind of injury. If possible, we should try close reduction of the dislocation under anaesthesia. After the close reduction failed, we performed open reduction and internal fixation.Results Until now, the mechanism of " criss-cross" mjury seems reasonable. The interosseous membrane may play a role and function as a pivot between the two forearm bones. Early diagnosis and early treatment is critical in order to obtain a satisfactory result.Conclusions This kind of injury should he differentiated from Monteggia or Galeazzi fractures, or Essex-Lopresti injury. Early diagnosis and early treatment are the most important.

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

    Science.gov (United States)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

  10. Traumatic Elbow Dislocations

    NARCIS (Netherlands)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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

  12. Atlantoaxial Joint Interlocking Following Type II Odontoid Fracture Associated with Posterolateral Atlantoaxial Dislocation: a Case Report and Review of Published Reports.

    Science.gov (United States)

    He, Deng-Wei; Huang, Wen-Jun; Sheng, Xiao-Yong; Wu, Li-Jun; Fan, Shun-Wu

    2016-08-01

    A rare case of atlantoaxial lateral mass joint interlocking secondary to traumatic posterolateral C1,2 complete dislocation associated with type II odontoid fracture is herein reported and the impact of atlantoaxial joint interlocking on fracture reduction discussed. A 72-year-old man presented with traumatic atlantoaxial lateral mass joint interlocking without spinal cord signal change, the diagnosis being confirmed by radiography and 3-D reconstruction digital anatomy. Posterior internal fixation was performed after failure to achieve closed reduction by skull traction. After many surgical attempts at setting had failed because of interlocking of the lateral mass joints, reduction was achieved by compressing the posterior parts of the atlantal and axial screws. Odontoid bone union and C1,2 posterior bone graft fusion were eventually obtained by the 12-month follow-up. The patient had a complete neurological recovery with no residual neck pain or radiculopathy. PMID:27627726

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

    Science.gov (United States)

    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

  14. Multiligamentous injuries and knee dislocations.

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Neglected Traumatic Locked Anterior Shoulder Fracture-Dislocation

    OpenAIRE

    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 ...

  19. Subtalar dislocation

    Energy Technology Data Exchange (ETDEWEB)

    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.

  20. Subtalar dislocation

    International Nuclear Information System (INIS)

    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.)

  1. 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

    Institute of Scientific and Technical Information of China (English)

    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。

  2. 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

    Institute of Scientific and Technical Information of China (English)

    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 .

  3. Short-term effects of neurodynamic mobilization in 15 patients with secondary thumb carpometacarpal osteoarthritis

    OpenAIRE

    Villafañe, J. H.; Silva, G. B.; Fernández-Camero, Josué

    2011-01-01

    The purpose of this study is to evaluate whether neurodynamic mobilization of the median nerve improves pressure pain threshold (PPT) and pinch and grip strength in patients with secondary thumb carpometacarpal osteoarthritis (TCOA). Fifteen patients with secondary TCOA (13 women and 2 men) between 70 and 90 years old were received by neurodynamic therapy. All patients received median nerve mobilization of the dominant hand by sliding technique during 4 sessions over 2 weeks. The outcome meas...

  4. Bipolar dislocation of the clavicle

    Directory of Open Access Journals (Sweden)

    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.

  5. Bipolar dislocation of the clavicle.

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  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

    Institute of Scientific and Technical Information of China (English)

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

    International Nuclear Information System (INIS)

    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

  9. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  10. Simultaneous shoulder and elbow dislocation

    OpenAIRE

    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...

  11. The epidemiology of shoulder dislocations in Oslo

    OpenAIRE

    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...

  12. Treatment of wrist joint dislocation by movable external fixator and Anchor screws%可活动外固定支架结合Anchor钉治疗腕关节脱位

    Institute of Scientific and Technical Information of China (English)

    尹自飞; 韩培; 柴益民; 蒋垚

    2012-01-01

    目的 探讨应用可活动外固定支架结合Anchor钉治疗腕关节脱位的可行性及治疗效果.方法 对16例腕关节脱位患者进行腕关节可活动外固定支架固定,同时切开复位,加压空心钉固定骨折,Anchor钉修复腕骨间韧带和桡腕韧带,克氏针临时固定腕骨.结果 随访3~6个月,16例患者均基本恢复腕关节功能,未出现再脱位、舟骨月骨坏死等.采用Cooney评价标准:优7例,良7例,可2例.结论 可活动外固定支架结合Anchor钉治疗腕关节脱位可有效固定腕关节,韧带修复可靠,利于破损韧带愈合及促进早期逐步功能锻炼,疗效满意.%Objective To discuss feasibility and clinical result of wrist joint dislocation by movable external fixator and Anchor screw. Methods 16 cases of wrist joint dislocations were treated with movable external fixators, open reduction , and cannulated screws fixation of fracture. Anchor screws were used to repaire intercarpal and radiocarpal ligaments and Kirschner wire fixing fracture temperately. Results All cases were followed up for 3 ~ 6 months. 16 patients recoveried wrist joint functions basically, and no dislocations and osteonecrosis were found. Based on Cooney's clinical scoring system,the scores of our series were 7 excellent ,7 good and 2 fair. Conclusions Treatment of wrist joint dislocations by movable external fixator and Anchor screw can fix wrist joint effectively, repairing ligaments reliably and allow function movements early.

  13. A Bilateral Traumatic Hip Obturator Dislocation

    Science.gov (United States)

    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

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

    Science.gov (United States)

    .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) • ...

  15. Acromioclavicular joint dislocation: a comparative biomechanical study of the palmaris-longus tendon graft reconstruction with other augmentative methods in cadaveric models

    Directory of Open Access Journals (Sweden)

    Sengupta S

    2007-11-01

    Full Text Available Abstract Background Acromioclavicular injuries are common in sports medicine. Surgical intervention is generally advocated for chronic instability of Rockwood grade III and more severe injuries. Various methods of coracoclavicular ligament reconstruction and augmentation have been described. The objective of this study is to compare the biomechanical properties of a novel palmaris-longus tendon reconstruction with those of the native AC+CC ligaments, the modified Weaver-Dunn reconstruction, the ACJ capsuloligamentous complex repair, screw and clavicle hook plate augmentation. Hypothesis There is no difference, biomechanically, amongst the various reconstruction and augmentative methods. Study Design Controlled laboratory cadaveric study. Methods 54 cadaveric native (acromioclavicular and coracoclavicular ligaments were tested using the Instron machine. Superior loading was performed in the 6 groups: 1 in the intact states, 2 after modified Weaver-Dunn reconstruction (WD, 3 after modified Weaver-Dunn reconstruction with acromioclavicular joint capsuloligamentous repair (WD.ACJ, 4 after modified Weaver-Dunn reconstruction with clavicular hook plate augmentation (WD.CP or 5 after modified Weaver-Dunn reconstruction with coracoclavicular screw augmentation (WD.BS and 6 after modified Weaver-Dunn reconstruction with mersilene tape-palmaris-longus tendon graft reconstruction (WD. PLmt. Posterior-anterior (horizontal loading was similarly performed in all groups, except groups 4 and 5. The respective failure loads, stiffnesses, displacements at failure and modes of failure were recorded. Data analysis was carried out using a one-way ANOVA, with Student's unpaired t-test for unpaired data (S-PLUS statistical package 2005. Results Native ligaments were the strongest and stiffest when compared to other modes of reconstruction and augmentation except coracoclavicular screw, in both posterior-anterior and superior directions (p WD.ACJ provided additional

  16. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  17. 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

    Institute of Scientific and Technical Information of China (English)

    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

  18. Specific inferior dislocation of the hip: one case report

    Institute of Scientific and Technical Information of China (English)

    XU Chao

    2007-01-01

    @@ Hip joint dislocations are generally classified as anterior, posterior, and central dislocations. In 1970s, the anterior dislocation was divided into pubic type and obturator type.1 It is generally recognized that for anterior dislocation of the hip joint, the femoral head is located at anteriorinferior part of the acetabulum, characterized clinically as abduction, extorsion, slight flexion deformity, and longer limb than the opposite side. When posterior dislocation is present, the femoral head is located at posteriorsuperior part of the acetabulum and manifested clinically as flexion, adduction, intorsion, and shortening deformity.

  19. Audit on necessity of radiographs in anterior shoulder dislocations

    OpenAIRE

    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...

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

    OpenAIRE

    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...

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

    Institute of Scientific and Technical Information of China (English)

    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

  2. Shoulder Joint Replacement

    Science.gov (United States)

    ... 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 ...

  3. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  4. 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

    Institute of Scientific and Technical Information of China (English)

    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

  5. Medial epiphyseal fracture-detachment of the sternoclavicular joint with posterior displacement in a judo athlete - equivalent of posterior sternoclavicular dislocation

    Directory of Open Access Journals (Sweden)

    Rui Pimenta

    2013-04-01

    Full Text Available Posterior sternoclavicular dislocation is a rare traumatic injury that presents a potential risk of injury to mediastinal structures. The diagnosis is fundamentally clinical and treatment is done on an emergency basis. The authors report the clinical case of a young judo athlete with post-traumatic medial epiphyseal fracture-detachment, with posterior displacement (lesion equivalent to posterior sternoclavicular dislocation at pediatric ages. He underwent open reduction and ligament repair by means of a mini-anchor.The radiological and clinical outcome was excellent, and the athlete returned to his sports activity without limitations. We discuss the particular features of this pathological condition, along with the different therapeutic approaches and their complications

  6. Arthroscopic findings after shoulder dislocation

    Directory of Open Access Journals (Sweden)

    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.

  7. 手术治疗腕关节骨折脱位并发腕管综合征的临床效果%Clinical effect of surgery treating wrist joint fracture dislocation associat-ed with carpal tunnel syndrome

    Institute of Scientific and Technical Information of China (English)

    吴滨滨; 李旭; 刘伟波

    2015-01-01

    Objective To investigate the clinical effect of the surgery treating wrist joint fracture dislocation associated with carpal tunnel syndrome. Methods Ninety patients with wrist joint fracture dislocation associated with carpal tunnel syndrome treated in our hospital from October 2011 to October 2014 were selected and divided into control group and study group.Control group was given non-surgical treatment and study group was given surgical treatment.The clinical efficacy between two groups was compared. Results After treatment,the excellent and good rate of control group was 62.5%and that of the study group was 82.0%,and there was a statistical difference between two groups (P<0.05).The study group was significantly better than the control group in the wrist joint mobility situation and median nerve recovery sit-uation,and there was a statistical difference (P<0.05). Conclusion Surgery treating wrist joint fracture dislocation asso-ciated with carpal tunnel syndrome has remarkable clinical effect and enables good postoperative recovery for patients, and surgical treatment is recommended to treat wrist joint fracture dislocation associated with carpal tunnel syndrome.%目的:探讨手术治疗腕关节骨折脱位并发腕管综合征的临床效果。方法选取本院2011年10月~2014年10月收治的腕关节骨折脱位并发腕管综合征患者90例,分为对照组与研究组,其中对照组采用非手术治疗,研究组采用手术方法治疗,比较两组患者的临床效果。结果治疗后,对照组的优良率为62.5%,研究组为82.0%,两组比较,差异有统计学意义(P<0.05);研究组患者的腕关节活动情况与正中神经恢复情况明显优于对照组,差异有统计学意义(P<0.05)。结论手术治疗腕关节骨折脱位并发腕管综合征的临床效果显著,患者术后恢复情况较好,建议采用手术治疗腕关节骨折脱位并发腕管综合征。

  8. Absence of Flexor Carpi Radialis during an Elective Carpometacarpal Arthroplasty of the Thumb: A Rare Anatomical Variation

    Directory of Open Access Journals (Sweden)

    Stratos S. Sofos

    2016-01-01

    Full Text Available Purpose. We present an extremely rare anatomical variation of unilateral flexor carpi radialis (FCR absence. This rare anatomical variation posed a clinical dilemma to us and we highlight the importance of the surgeon being aware of this anatomical variation of an important structure both as a reconstruction tool and as an anatomical landmark. Methods. This anatomical variation of the unilaterally absent FCR was found upon dissection during a carpometacarpal arthroplasty of the thumb. Results. Upon the discovery of an absent FCR tendon, we proceeded with a simple trapeziectomy. Conclusions. We present an extremely rare anatomical variation of unilateral FCR absence. This rare anatomical variation may pose clinical dilemmas to the operating surgeon who aims to utilise the FCR either for tendon transfer, for tendon graft, or, as seen in our case, in the reconstruction of a carpometacarpal excision at the thumb. We highlight this diagnosis of suspicion, which may influence the clinical procedure.

  9. Surgical hip dislocation: techniques for success.

    Science.gov (United States)

    Ricciardi, Benjamin F; Sink, Ernest L

    2014-01-01

    Surgical hip dislocation (SHD) is a versatile approach used to address both intra-articular and extra-articular pathology around the hip joint in both pediatric and adult patients. It allows anterior dislocation of the femoral head for direct visualization of the hip joint while preserving femoral head vascularity and minimizing trauma to the abductor musculature. Previously described indications for SHD include femoroacetabular impingement, deformity resulting from Legg-Calve-Perthes disease, slipped capital femoral epiphysis, periarticular trauma, benign lesions of the hip joint, and osteochondral lesions. In this review, we will describe current surgical techniques, indications, and clinical outcomes for SHD. PMID:25207733

  10. Lateral subtalar dislocation: Case report and review of the literature.

    Science.gov (United States)

    Veltman, Ewout S; Steller, Ernst Ja; Wittich, Philippe; Keizer, Jort

    2016-09-18

    A case of complicated lateral subtalar dislocation is presented and the literature concerning this injury is reviewed. Subtalar joint dislocations are rare and often the result of a high-energy trauma. Complications include avascular necrosis of the talus, infection, posttraumatic osteoarthritis requiring arthrodesis and chronic subtalar instability. Negative prognostic factors include lateral and complicated dislocations, total talar extrusions, and associated fractures. A literature search was performed to identify studies describing outcome after lateral subtalar joint dislocation. Eight studies including fifty patients could be included, thirty out of 50 patients suffered a complicated injury. Mean follow-up was fifty-five months. Ankle function was reported as good in all patients with closed lateral subtalar dislocation. Thirteen out of thirty patients with complicated lateral subtalar joint dislocation developed a complication. Avascular necrosis was present in nine patients with complicated injury. Four patients with complicated lateral subtalar dislocation suffered deep infection requiring treatment with antibiotics. In case of uncomplicated lateral subtalar joint dislocation, excellent functional outcome after closed reduction and immobilization can be expected. In case of complicated lateral subtalar joint dislocation immediate reduction, wound debridement and if necessary (external) stabilisation are critical. Up to fifty percent of patients suffering complicated injury are at risk of developing complications such as avascular talar necrosis and infection. PMID:27672576

  11. Subacute dislocation of the elbow following Galeazzi fracture-dislocation of the radius: A case report

    Directory of Open Access Journals (Sweden)

    Rajeev Aysha

    2011-12-01

    Full Text Available Abstract Introduction The Galeazzi fracture-dislocation was originally described by Sir Astley Cooper in 1822 but was named after Italian surgeon Ricardo Galeazzi in 1934. It is an injury classified as a radial shaft fracture with associated dislocation of the distal radioulnar joint and disruption of the forearm axis joint. The associated distal radioulnar joint injury may be purely ligamentous in nature, tearing the triangular fibrocartilaginous complex, or involve bony tissue (that is, ulnar styloid avulsions or both. We report this case because of the rare association of posterior dislocation of the elbow along with Galeazzi fracture-dislocation. To the best of our knowledge, this has not been previously reported in the English literature. Case presentation A 26-year-old Caucasian man presented to our department after a fall from a motorbike. He sustained a closed, isolated Galeazzi fracture-dislocation of the right forearm and no associated elbow injuries, and this necessitated open reduction and internal fixation of the radius. Post-operative radiographs films were satisfactory. However, clinical and radiological evidence of ipsilateral elbow dislocation was noted at a five-week follow-up, subsequently requiring open reduction of the joint and collateral ligament repair. Our patient was noted to have full elbow and forearm function at three months. Conclusions Although the Galeazzi fracture-dislocation has been classically described as involving only the distal radioulnar joint, traumatic forces can be transmitted to the elbow via the interosseous membrane of the forearm. This can lead to instability of the elbow joint. Therefore, we recommend that, in every case of forearm fracture, both elbow and wrist joints be assessed clinically as well as radiologically for subluxation or dislocation.

  12. 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

    Institute of Scientific and Technical Information of China (English)

    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

  13. Lisfranc fracture dislocation. Clinical case

    OpenAIRE

    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...

  14. Posterior sternoclavicular dislocation: an American football injury

    DEFF Research Database (Denmark)

    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 co...... 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....

  15. Isolated Proximal Tibiofibular Dislocation during Soccer

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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...

  17. 锁骨钩钢板置入治疗Rockwood Ⅲ型肩锁关节脱位%Clavicular hook plate implantation for the treatment of Rockwood type Ⅲ acromioclavicular joint dislocation

    Institute of Scientific and Technical Information of China (English)

    张建华; 聂宇; 周永焕; 王光勇; 敦先礼; 李有方; 周廷玉; 钟斌

    2012-01-01

    背景:多数学者主张手术治疗RockwoodⅢ型肩锁关节脱位,以恢复肩锁关节周围稳定结构的正常解剖,使之在无张力的条件下愈合.目的:观察锁骨钩板置入治疗RockwoodⅢ型肩锁关节脱位的临床疗效.方法:选择2005-12/2008-06宜昌市夷陵区医院骨科和五峰土家族自治县人民医院骨科收治的Rockwood Ⅲ型肩锁关节脱位患者56例,采用锁骨钩钢板置入进行治疗,分别于置入前、置入后1年取出内固定前、取出内固定后3个月采用目测类比评分、美国肩肘外科医师评分、Constant肩关节评分系统评分进行评定,比较钢板置入前后患者肩关节功能的变化及有无并发症发生.结果与结论:全部患者均顺利完成手术且获得随访,随访时间15~30个月,平均20个月.均在1年左右取出锁骨钩钢板,行喙锁韧带修复者32例,未行喙锁韧带修复者24例.取出内固定后肩锁关节脱位复发2例,均未行喙锁韧带修复.本组有2例出现肩痛、异物感,无内固定失败病例.术后1年取内固定前目测类比评分较术前降低,美国肩肘外科医师评分、Constant肩关节评分系统评分较术前升高(P < 0.01);取内固定后3个月目测类比评分较术后1年取内固定前降低,美国肩肘外科医师评分、Constant肩关节评分系统评分较术后1年取内固定前升高(P < 0.05).提示锁骨钩板置入治疗RockwoodⅢ型肩锁关节脱位,操作简单,创伤较小,是一种比较理想的内固定.%BACKGROUND: Surgical therapy has been frequently used to treat Rockwood type Ⅲ acromioclavicular joint dislocation to restore normal anatomy of stable structures around the acromioclavicular joint and heal free of tension.OBJECTIVE: To investigate the clinical effect of clavicular hook plate implantation on Rockwood type Ⅲ acromioclavicular joint dislocation.METHODS: A total of 56 patients with Rockwood type Ⅲ acromioclavicular joint dislocation were selected from

  18. 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

    Institute of Scientific and Technical Information of China (English)

    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

  19. 膝关节脱位合并动脉损伤10例报告%Diagnosis and treatment of dislocation of the knee joint with popliteal artery injury

    Institute of Scientific and Technical Information of China (English)

    程可可; 潘振宇; 喻爱喜; 陶圣祥; 卜祥鹏; 张浩

    2016-01-01

    目的:观察膝关节脱位合并动脉损伤诊治后的疗效。方法10例中,闭合性损伤6例,开放性损伤4例,伤后10 h 转运至我院,及时予以膝关节复位外固定器固定、修复断裂血管、小腿切开减压以及神经缝合、韧带重建等处理。结果患肢均得以保存。随访3个月至6年。2例在术后2年内重建交叉韧带,膝踝关节活动良好。4例合并腓总神经损伤者2例后期行踝关节融合术。1例小腿骨筋膜室综合征患者肌肉坏死后踝关节功能障碍,术后9个月行踝关节融合术。1例术后即重返工作。3例术后2年仍有关节疼痛和关节僵硬症状。1例术后3年失访。结论早期诊断,及时恢复血液供应,尽早重建膝关节交叉韧带,可以有效提高膝关节脱位合并动脉损伤的疗效。%Objective To study the curative effect / after the diagnosis and treatment of dislocation of the knee joint with popliteal artery injury. Methods In 10 patients, 6 cases had closed injury, 4 cases had open injury; 10 h after injury the patients were transported to our hospital. Timely reduction and external fixator fixation of knee joint, leg osteo-fascial compartment decompression, repair of broken blood vessels and nerve, ligament reconstruction treatment were performed. Results Limbs have been saved, in 1 case the wound healed after repeated debridement. In another case the wound healed after skin grafting of popliteal fossa posterior, the patient was followed up for 3 months to 6 years. 2 patients had anterior cruciate ligament reconstruction within 2 years after surgery. Knee and ankle joints were good in motility. Four patients had common peroneal nerve injury, one of them had ankle arthrodesis. 1 case of osteofascial compartment syndrome had muscle necrosis and posterior ankle joint dysfunction. Nine months after the surgery ankle arthrodesis was performed. 1 patient returned to work immediately after surgery. 2 years later there

  20. The comparison of quantitative evaluation for distal radioulnar joint dislocation between digital radiography and MSCT%DR和MSCT对下尺桡关节脱位定量评价的比较

    Institute of Scientific and Technical Information of China (English)

    胡纯; 周胜法; 陈伟; 何家维; 黄兆文

    2016-01-01

    目的:比较数字化X线摄片( DR)和多层螺旋CT( MSCT)对下尺桡关节( DRUJ)脱位定量评价的差异。方法选择74例均行DR和MSCT检查且DRUJ脱位的患者,由一位影像科副主任医师在PACS工作站上,借助DR片和MSCT后处理重建图像进行DRUJ脱位程度的测量,并进行统计学分析。结果74例患者中Colles骨折46例,Galeazzi骨折3例,Smith骨折6例,前臂其他骨折12例,7例没有骨折。其中DRUJ横向、纵向和掌或背侧半脱位分别是31例、17例和26例,DR片上测量横向、纵向和掌背侧脱位或半脱位间距分别是(5.5±2.3)mm、(8.5±2.6)mm、(5.7±1.6)mm, MSCT测量分别是(7.1±2.5)mm、(9.3±1.8)mm、(3.4±1.2)mm,两种测量方式间比较,纵向脱位间距没有统计学差异( P >0.05),相关性为0.71,横向、掌或背侧脱位间距间存在统计学差异( P <0.05),相关性为0.65和0.52。结论 DR和MSCT对DRUJ脱位或半脱位定量评价是可行的,但DR测量受到多种因素的影响,准确性不如MSCT,尤其在评价掌背侧半脱位时。%Objective To compare the difference of quantitative evaluation for distal radioulnar joint ( DRUJ) dislocation be-tween digital radiography ( DR) and multi-slice CT( MSCT) .Methods A total of 74 DRUJ dislocation patients underwent both DR and MSCT examination were collected in this study .One associate chief physician in radiology department measured the de-gree of DRUJ dislocation on the DR images and MSCT processed reconstruction images on PACS workstation .The data were ana-lyzed by statistics.Results For 74 patients, 46 cases had Colles’ fracture, 3 Galeazzi fracture, 6 smith fracture and 12 others’ forearm fracture and 7 cases had no fracture .Among them, 31 cases had DRUJ lateral dislocation , 17 had longitudinal dislocation and 26 had volar or distal subluxation .And the lateral , longitudinal and

  1. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  2. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  3. 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

    Institute of Scientific and Technical Information of China (English)

    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

  4. 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

    Institute of Scientific and Technical Information of China (English)

    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

  5. 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

    Institute of Scientific and Technical Information of China (English)

    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

  6. Dislocated shoulder - aftercare

    Science.gov (United States)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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 %.

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

    Institute of Scientific and Technical Information of China (English)

    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

    优,1例良。患者均对治疗效果满意。结论采用关节镜下四骨道四袢双束固定方法修复急性肩锁关节 Rockwood-Ⅴ型脱位,生物固定牢固,手术创伤小,并且避免了双袢单骨道应力过于集中、拉力线单薄等缺点,是治疗急性肩锁关节 Rockwood Ⅴ型损伤较好的方法。%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

  9. 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

    Institute of Scientific and Technical Information of China (English)

    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

  10. 锁骨钩钢板联合阔筋膜治疗陈旧性肩锁关节脱位%Management of chronic acromioclavicular joint dislocation with hook plate and fascia lata graft

    Institute of Scientific and Technical Information of China (English)

    祝李霖; 黄东; 吴伟炽; 刘晓春; 余超群

    2016-01-01

    目的 探讨锁骨钩钢板联合阔筋膜治疗陈旧性肩锁关节脱位的临床疗效.方法 回顾性分析2012年5月至2014年3月应用锁骨钩钢板联合阔筋膜治疗的16例RoekwoodⅢ型陈旧性肩锁关节脱位患者资料,男10例,女6例;年龄19~57岁,平均34.7岁;左侧7例,右侧9例.均为直接暴力致伤,受伤至手术时间为8 ~ 54周,平均12.4周.末次随访时采用上肢功能评分(DASH)及视觉模拟评分(VAS)评定肩部功能及疼痛情况,采用Karlsson评价标准评定疗效. 结果 术后切口均一期愈合,肩锁关节脱位均得到纠正,无血管、神经损伤.所有患者术后获6~18个月(平均12个月)随访.术后复查无钢板断裂、螺钉松动、关节再脱位等情况发生.末次随访时患者DASH评分[(25.42±8.34)分]及肩关节VAS评分[(2.22±1.70)分]均优于术前[(43.72±12.35)、(6.33±1.37)分],差异有统计学意义(P<0.05);按Karlsson评价标准评定疗效:优10例,良4例,可2例. 结论 锁骨钩钢板联合阔筋膜治疗陈旧性肩锁关节脱位可恢复肩关节动力平衡及稳定性,具有固定牢靠、术后关节活动早、并发症少等优点.%Objective To evaluate the therapeutic efficacy of hook plate and fascia lata graft in management of chronic acromioclavicular joint dislocation.Methods From May 2012 to March 2014,a total of 16 cases of chronic acromioclavicular joint dislocation (Rockwood type Ⅲ) were treated with hook plate and fascia lata graft.They were 10 men and 6 women,from 19 to 57 years of age (mean,34.7 years).Seven cases were at the left side and 9 at the right side.All injuries resulted from direct violence.The time from injury to surgery ranged from 8 to 54 weeks (mean,12.4 weeks).At the final follow-ups,the shoulder function was assessed using the Quick Version of the Disabilities of the Arm,Shoulder and Hand Score (DASH) and visual analogue scale (VAS),and the efficacy using Karlsson's evaluation system.Results All surgical wounds

  11. 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

    Institute of Scientific and Technical Information of China (English)

    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

  12. Use of cervical collar in temporomandibular dislocation.

    Science.gov (United States)

    Jaisani, Mehul R; Pradhan, Leeza; Sagtani, Alok

    2015-06-01

    Dislocation of the temporomandibular joint represents 3 % of all reported dislocated joints. In the last 3 decades many cases of TMJ dislocation have been reported with a wide variety of treatment options ranging from non-surgical conservative approaches to open joint procedures. The question remains whether one method is superior to the others. Conservative treatments are still the option in this part of the continent due to financial constraints and as well as due to availability of skilled manpower. A variety of conservative techniques have been described for reducing dislocations, all of which require 10-14 days of immobilization of the jaw post reduction so as to prevent further episodes of dislocation. Immobilization of the jaw can be done in the form of barrel bandage, barton bandage, head chin cap or maxillomandibular fixation using arch bars. We suggest the use of a cervical collar as a form of post reduction immobilization technique to overcome the inherent disadvantages of conventional forms of immobilization techniques.

  13. 不同方案治疗尺骨鹰嘴骨折并肘关节脱位的疗效观察%Observation on the curative effects of olecranal fracture and elbow joint dislocation treated by different schemes

    Institute of Scientific and Technical Information of China (English)

    王少营; 张琳琳; 徐彦鸽

    2016-01-01

    目的:观察不同方案治疗尺骨鹰嘴骨折并肘关节脱位的疗效。方法抽选2013年1月~2014年11月收治的尺骨鹰嘴骨折合并肘关节脱位患者86例,随机分为观察组和对照组,每组43例,对照组给予张力带固定治疗,观察组给予钢板内固定术治疗,观察比较两组患者术中出血量、手术时间、住院时间及骨折愈合时间,术后3个月时评估患者肘关节活动度,术后6个月时评价患者肘关节功能恢复情况并进行比较。结果观察组手术时间(41.87±16.24)min、术中出血量(30.57±21.46)mL、骨折愈合时间(5.87±0.58)周与对照组(32.67±15.91)min、(21.84±18.53)mL、(6.13±0.56)周比较,差异有统计学意义(P<0.05);观察组术后3个月肘关节活动度优良率90.7%显著高于对照组70.2%,差异有统计学意义(P<0.05);术后6个月观察组肘关节功能Mayo评分(84.21±8.76)分显著优于对照组(79.16±9.73)分,差异有统计学意义(P<0.05)。结论采用钢板内固定治疗尺骨鹰嘴并肘关节脱位骨折愈合快,患者预后肘关节功能恢复好。%Objective To observe the curative effects of olecranal fracture and elbow joint dislocation treated by different schemes. Methods 86 cases of patients with olecranal fracture and elbow joint dislocation treated in our hospital during January 2013 and November 2014 were selected as the study objects. They were randomly divided into observation group(n=43)and contrast group(n=43). Patients in the contrast group were given tension band fixation,while patients in the observation group were given internal fixation with steel plate. Compare the conditions of patients in both groups including the amount of bleeding,operation time,hospital stays time,healing time,elbow joint mobility three months after operation and the elbow joint functional recovery conditions six months after operations. Results:In the observation

  14. 肘关节骨折脱位的稳定性渐次评估与修复%Gradual stability evaluation and repairment of the elbow joint fracture-dislocation

    Institute of Scientific and Technical Information of China (English)

    张权; 陈文钧; 王世龙; 汤超亮; 张秉文

    2016-01-01

    目的:探讨渐次评估肘关节稳定性,分步修复稳定性结构在治疗肘关节骨折脱位中的意义。方法对2005年4月至2012年3月,在我院收治的41例肘关节骨折脱位患者进行回顾分析。术前评估,依据影像学评估骨性结构的破坏情况,判定肘关节失稳的主要因素,分主次、先后予以修复;术中评估,骨性结构修复后进行应力试验,评估关节囊韧带损伤情况分别予以修复。术后评估,评估肘关节整体稳定性,决定是否予以肘关节的辅助稳定,并及时予以康复锻炼,随访治疗效果。结果41例术前评估认定为复杂孟氏骨折10例;恐怖三联征14例;经尺骨鹰嘴前脱位9例;单纯冠状突骨折合并脱位4例;单纯桡骨头骨折合并脱位4例。术中评估,发现关节囊韧带复合体损伤者34例,其中23例骨性结构修复后肘关节仍失稳,并对其中的18例内外侧韧带损伤者实施修复。术后评估,进行骨性修复与软组织修复后,9例肘关节存在半脱位倾向与摇摆不稳,需要支具、石膏、克氏针等辅助固定。平均随访10.4个月,41例骨折均愈合。依据日本骨科学会( Japanese orthopedic association,JOA )肘关节功能评估表,优者12例,良者19例,可者7例,差者3例。结论渐次评估骨折脱位的肘关节稳定性,可以更全面地发现肘关节不稳的影响因素,有针对性地进行修复,从而能更好地恢复肘关节功能。%Objective To discuss the signiifcance of evaluating the gradual stability of the elbow joint with fracture-dislocation and repairing the bone and soft tissue structure step by step.Methods A total of 41 patients with elbow fracture-dislocation, treated in our hospital from April 2005 to March 2012, were studied retrospectively. Before the operation, the bone structure was evaluated according to the iconography to determine which type of injury was the main factor

  15. Secondary clavicle fracture after hook plate fixation for acromial clavicular joint dislocation%锁骨钩钢板治疗肩锁关节脱位并发骨折的探讨

    Institute of Scientific and Technical Information of China (English)

    许永康; 舒占坤; 张羽

    2015-01-01

    Background Dislocation of the acromio-clavicle (AC)joint is a common injury, accounting for 12% of shoulder girdle injuries.According to Rockwood classification,type Ⅰ and ⅡAC injuries prefer to conservative treatment;type Ⅳ-Ⅵ injuries are good indications for surgical treatment.Operative treatment for type Ⅲ injury is still controversial.Hook plate has been used by many surgeons as an internal fixation device to maintain the reduced AC joint in place.There are some complications that may occur in some cases,such as implant failure,loss of reduction and secondary clavicle fracture.This study is designed to evaluate the clinical outcome of patients treated by hook plate and explore the cause of secondary clavicle fracture.Methods From January 2008 to January 2014,73 patients who sustained clavicle fracture was operated and fixed by hook plate.The operation was performed under general anesthesia or regional cervical plexus nerve block.The incision was from distal third of clavicle down to corocoid.The acromial clavicular joint,distal third of clavicle,corocoid and corococlavicular ligament were exposed.Debridement of AC joint was performed and cartilage debris was removed.Corococlavicle ligament was explored and sutures were preload in the ligament. Acromial clavicular joint dislocation was reduced and proper hook plate was chosen.The plate was fixed by screws and sutures were tied.The acromial clavicular capsule was repaired.The wound was closed layer by layer.Post-operative care:the shoulder was protected in a sling for 3 weeks.Pendulum exercise began immediately after operation.Passive motion could be started as pain be tolerated. Results Seventy-three patients were included in this study.There were 47 males and 26 females.The patients suffered from fall in 37 cases,traffic accident in 1 7 cases and hit on the shoulder in 1 9 cases. According to Rockwood classification,type Ⅲ in 61 cases,type Ⅳ in 12 cases.The follow up time was from 1 to 34 months

  16. Hip joint replacement

    Science.gov (United States)

    ... 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, ...

  17. Results of Abductor Pollicis Longus Suspension Ligamentoplasty for Treatment of Advanced First Carpometacarpal Arthritis

    Science.gov (United States)

    Lee, Hyun-Joo; Kim, Poong-Taek; Deslivia, Maria Florencia; Lee, Suk-Joong; Nam, Sang-Jin

    2015-01-01

    Background Suspension ligamentoplasty using abductor pollicis longus (APL) tendon without bone tunneling, was introduced as one of the techniques for treatment of advanced first carpometacarpal (CMC) arthritis. The purpose of this study was to evaluate the radiologic and clinical results of APL suspension ligamentoplasty. Methods The medical records of 19 patients who underwent APL suspension ligamentoplasty for advanced first CMC arthritis between January 2008 and May 2012 were reviewed retrospectively. The study included 13 female and 6 male patients, whose mean age was 62 years (range, 43 to 82 years). For clinical evaluation, we assessed the grip and pinch power, radial and volar abduction angle, thumb adduction (modified Kapandji index), including visual analogue scale (VAS) and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Radiologic evaluation was performed using simple radiographs. Results The mean follow-up was 36 months (range, 19 to 73.7 months). Mean power improved from 18.3 to 27 kg for grip power, from 2.8 to 3.5 kg for tip pinch, and from 4.3 to 5.4 kg for power pinch. All patients showed decreased VAS from 7.2 to 1.7. Radial abduction improved from 71° preoperatively to 82° postoperatively. The modified Kapandji index showed improvement from 6 to 7.3, and mean DASH was improved from 41 to 17.8. The height of the space decreased from 10.8 to 7.1 mm. Only one case had a complication involving temporary sensory loss of the first dorsal web space, which resolved spontaneously. Conclusions The APL suspension ligamentoplasty for treatment of advanced first CMC arthritis yielded satisfactory functional results. PMID:26330961

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

    OpenAIRE

    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...

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

    OpenAIRE

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  1. Dislocation Formation in Alloys

    Science.gov (United States)

    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.

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

  4. Primary traumatic patellar dislocation

    Directory of Open Access Journals (Sweden)

    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.

  5. Audit on necessity of radiographs in anterior shoulder dislocations

    Directory of Open Access Journals (Sweden)

    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.

  6. Do normal hips dislocate?

    Science.gov (United States)

    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

  7. Open Galeazzi fracture with ipsilateral elbow dislocation.

    Science.gov (United States)

    Adanır, Oktay; Yüksel, Serdar; Beytemur, Ozan; Güleç, M Akif

    2016-08-01

    Combination of the Galeazzi fracture and dislocation of the elbow joint in same extremity is very rare. In this article, we report a 26-year-old male patient with a posterolateral dislocation of the elbow and ipsilateral volar type Galeazzi fracture. We performed closed reduction for the elbow dislocation during admission to the emergency department. Patient was taken to the operating room in the sixth hour of his application to emergency department and open wound on the ulnovolar region of the wrist was closed primarily after irrigation and debridement. We performed open reduction and internal fixation of the radial fracture with a dynamic compression plate. After fixation, we evaluated the stability of the elbow joint and distal radioulnar joint. Distal radioulnar joint was unstable under fluoroscopic examination and fixed with one 1.8 mm Kirschner wire in a pronated position. Then, elbow joint was stable. One year after surgery, patient had no pain or sings of instability. At the last follow-up, range of motion of the elbow was 10°-135° and forearm pronation and supination were 70°. PMID:27499325

  8. Open Galeazzi fracture with ipsilateral elbow dislocation.

    Science.gov (United States)

    Adanır, Oktay; Yüksel, Serdar; Beytemur, Ozan; Güleç, M Akif

    2016-08-01

    Combination of the Galeazzi fracture and dislocation of the elbow joint in same extremity is very rare. In this article, we report a 26-year-old male patient with a posterolateral dislocation of the elbow and ipsilateral volar type Galeazzi fracture. We performed closed reduction for the elbow dislocation during admission to the emergency department. Patient was taken to the operating room in the sixth hour of his application to emergency department and open wound on the ulnovolar region of the wrist was closed primarily after irrigation and debridement. We performed open reduction and internal fixation of the radial fracture with a dynamic compression plate. After fixation, we evaluated the stability of the elbow joint and distal radioulnar joint. Distal radioulnar joint was unstable under fluoroscopic examination and fixed with one 1.8 mm Kirschner wire in a pronated position. Then, elbow joint was stable. One year after surgery, patient had no pain or sings of instability. At the last follow-up, range of motion of the elbow was 10°-135° and forearm pronation and supination were 70°.

  9. Elbow Dislocation with Complete Triceps Avulsion

    Directory of Open Access Journals (Sweden)

    S. V. Karuppiah

    2014-01-01

    Full Text Available Radio-ulnar Fracture dislocation of the elbow is a high-energy trauma which can be associated with significant ligamentous injury in adults. We report an unusual triad of injury in a patient with avulsion injury of the triceps. This injury can be thought of as a variant of “terrible triad” with dislocation of radio-ulnar joint, radial head fracture, and medial collateral ligament injury with avulsion of the triceps. Elbow has to be stabilized with early repair of the ligaments for a successful outcome.

  10. 空心钉固定联合半腱肌肌腱重建喙锁韧带治疗Ⅲ度肩锁关节脱位%The clinical effect of coracoclavicular ligament reconstruction by hollow screw associated with semitendinosus ligament in grade Ⅲ acromioclavicular joint dislocation

    Institute of Scientific and Technical Information of China (English)

    周江军; 朱治宇; 赵敏; 吕仁发; 张立; 陈荣剑

    2012-01-01

    目的 探讨空心钉固定联合半腱肌肌腱重建喙锁韧带治疗Ⅲ度肩锁关节脱位的疗效.方法 对22例Ⅲ度肩锁关节脱位患者行空心钉固定联合半腱肌肌腱重建喙锁韧带治疗.结果 患者均获随访,时间10~32个月.肩关节功能恢复良好,局部畸形消失,未见复发.参照Karlsson疗效评定标准:A级18例,B级4例.结论 该手术方法设计符合生物力学的要求,方法简单,复位作用良好,是治疗Ⅲ度新鲜肩锁关节脱位有效方法.%Objective To study the effect of coracoclavicular ligament reconstruction by hollow screw associated with semitendinosus ligament in grade Ⅲ acromioclavicular joint dislocation. Methods 22 patients with grade Ⅲ acromio-clavicular joint dislocation were treated by hollow screw associated with semitendinosus ligament. Results 22 cases were follow up for 10 ~32 months. According to Karlsson criteria evaluation standard, the clinical outcomes were A in 18 cases, B in 4 cases. All cases had good shoulder joint function, the local deformity was disappeared, no recurrence cases were found. Conclusions Hollow screw associated with semitendinosus ligament is a simple and effective method for grade Ⅲ acromioclavicular joint dislocation. The operation method accords with biomechanics, and acromioclavicular joint reduction is good.

  11. 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

    Institute of Scientific and Technical Information of China (English)

    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

  12. The mid - and long - term clinical outcomes of open reduction and internal fixation for dislocation of hip joint combined with posterior wall or/and column fractures of acetabulum%髋关节后脱位并髋臼后壁(柱)骨折手术治疗结果分析

    Institute of Scientific and Technical Information of China (English)

    何长街; 刘志礼; 舒勇; 黄山虎

    2011-01-01

    目的 探讨髋臼后壁(柱)骨折伴髋关节脱位手术治疗的中远期疗效.方法 回顾性分析21例髋关节脱位伴髋臼骨折患者临床资料,其中20例髋臼脱位行闭合复位,1例行急诊切开复位内固定;所有合并的髋臼骨折均采用开放复位内固定术治疗.结果 完整随访19例,失访 2例,随访时间29~86个月.按髋关节功能恢复情况评分:优13例,良3例,可2例,差1例,优良率84.2%.结论 髋关节脱位伴髋臼骨折应尽早诊断,应尽快行髋关节复位,骨折应尽早开放复位内固定,早期功能锻炼,避免过早负重.%Objectives To investigate the mid - and long - term clinical outcomes of open reduction and internal fixation(ORIF) for treating the dislocation of hip joint with posterior wall or/and column fractures of acetabulum. Methods The clinic data of 21 patients with dislocation of hip joint and posterior wall fracture of acetabulum who were given close reduction( n = 20)or open reduction and internal fixation(ORIF) ( n = 1 ) for disclocation of hip joint and then were treated with ORIF for the fracture of acetabulum were retrospectively analyzed. Results A total of 19 patients were followed up for 29 to 86 mon. According to Letournel E's hip joint functional scoring system, clinical outcome was excellent in 13 patients,good in 3 patients,fair in 2 patients,and poor in one patient. The ratio of fineness of the midand long - term clinical outcomes was 84. 2%. Conclusion The dislocation of hip joint combined with posterior wall fracture of acetabulum should be diagnosed early, and reduction of the hip joint and ORIF should be performed as soon as possible. The positive functional exercise is necessary and the premature weight bearing on the hip joint should be avoided at early time.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Luxatio erecta: Inferior glenohumeral dislocation

    OpenAIRE

    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.

  15. Luxatio erecta: Inferior glenohumeral dislocation

    Directory of Open Access Journals (Sweden)

    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.

  16. Double dislocation of finger interphalangeal joints

    OpenAIRE

    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.

  17. Locked volar distal radioulnar joint dislocation

    Directory of Open Access Journals (Sweden)

    Fadi Bouri

    2016-01-01

    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.

  18. Humeral shaft fracture with ipsilateral shoulder dislocation

    OpenAIRE

    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 ...

  19. Irreducible lateral dislocation of the elbow.

    Directory of Open Access Journals (Sweden)

    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.

  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

    Institute of Scientific and Technical Information of China (English)

    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. Sternoclavicular dislocation: case report and surgical technique

    Directory of Open Access Journals (Sweden)

    Bernardo Barcellos Terra

    2015-08-01

    Full Text Available Abstract Sternoclavicular dislocations account for less than 5% of all dislocations of the scapular belt. Most cases of anterior dislocation of the sternoclavicular joint do not present symptoms. However, some patients may develop chronic anterior instability and remain symptomatic, and surgical treatment is indicated in these cases. There is a scarcity of reports in the literature relating to reconstruction using the long palmar tendon in cases of traumatic anterior instability. Although rare, these injuries deserve rapid diagnosis and efficient treatment in order to avoid future complications. The aim of this report was to report on a case of a motocross competitor who developed chronic traumatic anterior instability of the sternoclavicular joint and underwent surgical reconstruction using the autogenous long palmar tendon. The patient was a 33-year-old man with a history of anterior dislocation of the sternoclavicular subsequent to a fall during a maneuver in a motocross competition. Conservative treatment was instituted initially, consisting of use of a functional sling to treat the symptoms for 3 weeks, along with physiotherapeutic rehabilitation for 3 months. We chose to use a modification of the "figure of eight" technique based on the studies by Spencer and Kuhn. A longitudinal incision of approximately 10 cm was made at the level of the sternoclavicular joint. The graft from the ipsilateral long palmar tendon was passed through the orifices in the form of a modified "figure of eight" and its ends were sutured together. The patient was immobilized using an American sling for 4 weeks. After 6 months of follow-up, the patient no longer presented pain or instability when movement of the sternoclavicular joint was required. Minor discomfort and slight prominence of the sternoclavicular joint continued to be present but did not affect the patient's activities. Thus, the patient was able to return to racing 6 months after the operation. Our

  2. 双截骨术治疗大龄儿童先天性髋关节脱位的术后训练%Postoperative rehabilitation exercise of old children underwent bilateral osteotomy of congenital dislocation of hip joint(CDS)

    Institute of Scientific and Technical Information of China (English)

    李平生; 阮雄星; 何向阳; 郭文荣

    2002-01-01

    @@ Determining appropriate treatment timing is very important for congenital dislocation of hip joint(CDS).Early treatment will produce distal effect.Management of CDS in children aged more than 6 years is very difficult,functional recovery is affected.From May to June 2001,23 children aged 6~ 12 years and suffered from CDS were adopted.Modified Salter Pelvis osteotomy and rotation osteotomy above femor in combination with postoperative rehabilitation exercise were carried out,and favorable effect was obtained.Here is reported.

  3. Statistical characterization of dislocation ensembles

    Energy Technology Data Exchange (ETDEWEB)

    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.

  4. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  5. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  6. The EULAR-OMERACT rheumatoid arthritis MRI reference image atlas: the wrist joint

    DEFF Research Database (Denmark)

    Ejbjerg, B; McQueen, F; Lassere, M;

    2005-01-01

    This paper presents the wrist joint MR images of the EULAR-OMERACT rheumatoid arthritis MRI reference image atlas. Reference images for scoring synovitis, bone oedema, and bone erosions according to the OMERACT RA MRI scoring (RAMRIS) system are provided. All grades (0-3) of synovitis are......, capitate, and a metacarpal base. In these bones, grades 0-3 of bone oedema are illustrated, and for bone erosion, grades 0-3 and examples of higher grades are presented. The presented reference images can be used to guide scoring of wrist joints according to the OMERACT RA MRI scoring system...... illustrated in each of the three wrist joint areas defined in the scoring system-that is, the distal radioulnar joint, the radiocarpal joint, and the intercarpal-carpometacarpal joints. For reasons of feasibility, examples of bone abnormalities are limited to five selected bones: the radius, scaphoid, lunate...

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

    OpenAIRE

    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...

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

    OpenAIRE

    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...

  9. 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

    Institute of Scientific and Technical Information of China (English)

    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

  10. Quantitative calculation of dislocation mobility

    Energy Technology Data Exchange (ETDEWEB)

    Swaminarayan, S.; Preston, D.L.

    1999-07-01

    The authors present a new method to calculate the response of dislocations to applied stress. This new method, called the dislocation treadmill, can be used to study the effect of vacancies, interstitials, stresses, strain rate, temperature, etc., on the steady state velocity of the dislocation. The authors demonstrate the use of the method by calculating the response of a dislocation to a constant applied shear stress.

  11. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  12. Behavior of dislocations in silicon

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. Finite strain discrete dislocation plasticity

    NARCIS (Netherlands)

    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

  14. Dislocation triggers uninterpretability

    NARCIS (Netherlands)

    H. Zeijlstra

    2009-01-01

    In current minimalist analyses dislocation (Move/Agree) is motivated by Full Interpretation: Move/Agree is said to check uninterpretable features. In this paper I address several of the background assumptions behind such analyses, and discuss several problems that go with them. I this paper I first

  15. Surgical treatment of chronic mandibular dislocation--report of a case.

    Science.gov (United States)

    Bakardjiev, Angel G; Atanasov, Dimitar T

    2002-01-01

    Chronic dislocation of the temporomandibular jaw (TMJ) can result from lax joint ligaments and parafunctioning joints; it can also be a consequence of a systemic connective tissue disorder. The authors report a case of hypermobile joint syndrome in combination with mitral valve prolapse. The case was managed by osteosynthesis using modified titanium plate.

  16. 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

    Institute of Scientific and Technical Information of China (English)

    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。

  17. [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)].

    Science.gov (United States)

    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

  18. Acute finger injuries: part II. Fractures, dislocations, and thumb injuries.

    Science.gov (United States)

    Leggit, Jeffrey C; Meko, Christian J

    2006-03-01

    Family physicians can treat most finger fractures and dislocations, but when necessary, prompt referral to an orthopedic or hand surgeon is important to maximize future function. Examination includes radiography (oblique, anteroposterior, and true lateral views) and physical examination to detect fractures. Dislocation reduction is accomplished with careful traction. If successful, further treatment focuses on the concomitant soft tissue injury. Referral is needed for irreducible dislocations. Distal phalanx fractures are treated conservatively, and middle phalanx fractures can be treated if reduction is stable. Physicians usually can reduce metacarpal bone fractures, even if there is a large degree of angulation. An orthopedic or hand surgeon should treat finger injuries that are unstable or that have rotation. Collateral ligament injuries of the thumb should be examine with radiography before physical examination. Stable joint injuries can be treated with splinting or casting, although an orthopedic or hand surgeon should treat unstable joints.

  19. Airbag-induced thumb avulsion: two case reports

    OpenAIRE

    Stoel, Anne-Marie C. C.; Vanhaecke, Jeroen; Dezillie, Marleen; Oosterlinck, Dirk; Stockmans, Filip

    2014-01-01

    Although airbags are designed to save lives and protect victims from serious injuries, airbag deployment can cause unwanted lesions. In this case report, two cases are presented of young women who sustained an important fracture dislocation of the first carpometacarpal joint (CMC I joint) caused by airbag deployment during a car collision.

  20. Airbag-induced thumb avulsion: two case reports.

    Science.gov (United States)

    Stoel, Anne-Marie C C; Vanhaecke, Jeroen; Dezillie, Marleen; Oosterlinck, Dirk; Stockmans, Filip

    2015-03-01

    Although airbags are designed to save lives and protect victims from serious injuries, airbag deployment can cause unwanted lesions. In this case report, two cases are presented of young women who sustained an important fracture dislocation of the first carpometacarpal joint (CMC I joint) caused by airbag deployment during a car collision. PMID:25762890

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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

    Institute of Scientific and Technical Information of China (English)

    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。

  3. Curative effect observation of traditional Chinese medicine therapy for 30 cases of old posterior dislocation of ;elbow joint%中医疗法在30例陈旧性肘关节后脱位中的疗效观察

    Institute of Scientific and Technical Information of China (English)

    方展永

    2015-01-01

    目的:探讨使用中药熏洗结合手法整复治疗陈旧性肘关节后脱位的临床疗效。方法60例陈旧性肘关节后脱位患者随机分为观察组和对照组,各30例,对照组给予手法复位等常规治疗,观察组则在此基础上加用中药内服、熏洗和中医按摩等疗法。比较两组疗效。结果观察组的总有效率、治疗后肘关节功能评分(HSS评分)明显高于对照组(P<0.05);观察组的视觉模拟评分(VAS评分)明显低于对照组(P<0.05);观察组不良反应的发生率明显低于对照组(P<0.05)。结论采用手法复位配合中药内服、熏洗和中医按摩等方法治疗陈旧性肘关节后脱位具有良好疗效。%Objective To investigate the clinical effect of integrated fumigation and wash traditional Chinese medicine therapy in the treatment of old posterior dislocation of elbow joint. Methods A total of 60 pa-tients with old posterior dislocation of elbow joint were randomly divided into observation group and control group, with 30 cases in each group. The control group received conventional treatment as manual reposition, while the observation group was treated by additional oral administration of traditional Chinese medicine, fumigation and wash, and traditional Chinese medicine massage. Curative effects of the two groups were compared. Results The observation group had higher total effective rate and hospital for special surgery knee score (HSS score) after treat-ment than the control group (P<0.05). Visual analogue scale (VAS score) was lower in the observation group than the control group (P<0.05). The incidence of adverse reactions was lower in the observation group than the control group (P<0.05). Conclusion Combination of manual reposition, oral administration of traditional Chinese medi-cine, fumigation and wash, and traditional Chinese medicine massage can provide good effect in treating old pos-terior dislocation of elbow joint.

  4. Conjoined tendon and coracoacromial ligament transfer in the treatment of RockwoodIII acromioclavicular joint dislocation:anatomical and clinical validation%联合腱与喙肩韧带双束重建喙锁韧带修复RockwoodⅢ型肩锁关节脱位:解剖学及临床试验验证

    Institute of Scientific and Technical Information of China (English)

    王治洲; 伊力哈木•托合提; 徐超; 侯彦杰; 郭洪亮; 甘子明; 张爱红

    2015-01-01

      结果与结论:①尸体解剖形态学研究结果:试验获得了肩锁关节及其周围组织、肌皮神经较为详细的形态学参数,为该部位手术提供了解剖学资料。②临床病例分析结果:11例RockwoodⅢ型患者行联合腱外侧半肌腱与喙肩韧带内侧半肌腱双束共同重建喙锁韧带治疗肩锁关节脱位,随访2-24个月,平均美国肩肘外科协会评分为92.3分,平均Constant-Murley肩关节功能评分为90.4分,平均美国加州大学洛杉矶分校评分31.6分,平均目测类比评分1.4分,平均肩关节简明测试问卷肯定答案为8个,总体优良率为91%(10/11)。1例患者修复结果较差。课题通过解剖重建肩锁关节的静态稳定性结构(如喙锁韧带)和动态稳定性结构(如关节囊、斜方肌和三角肌)实现了肩锁关节的解剖复位。总而言之,联合腱与喙肩韧带双束重建喙锁韧带修复RockwoodⅢ型肩锁关节脱位是一种有效的修复方法。%BACKGROUND:There are many surgical methods for treatment of acromioclavicular joint dislocation. Through various internal fixation materials (such as hook plate, screws, K-wire, etc.), we can achieve the initial stability and restoration of the acromioclavicular joint. But these internal fixators can cause varying degrees of occupancy and damage to the acromioclavicular joint, and the joint reduction often miss after removal of the internal fixators. OBJECTIVE:To use conjoined tendon and coracoacromial ligament transfer for coracoclavicular ligament reconstruction in the repair of RockwoodIII acromioclavicular joint dislocation, to provide the theoretical foundation through the autopsy, and to analyze the clinical efficacy based on clinical fol ow-up results. METHODS:(1) Autopsy morphology research:From September 2012 to November 2012, total y 46 adult cadaveric human shoulders were dissected in the Department of Anatomy, Xinjiang Medical University. The anatomical

  5. Humeral shaft fracture with ipsilateral shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    Prateek Behera; Vishal Kumar; Sameer Aggarwal

    2014-01-01

    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.

  6. Humeral shaft fracture with ipsilateral shoulder dislocation

    Directory of Open Access Journals (Sweden)

    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.

  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

    Institute of Scientific and Technical Information of China (English)

    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. Multiple spontaneous dislocations in a patient with Ehlers-Danlos syndrome.

    Science.gov (United States)

    Dabbas, N; Saker, R; Blakeley, C

    2008-03-01

    Ehlers-Danlos syndrome (EDS) consists of a heterogeneous group of inherited connective tissue disorders, characterised by generalised joint hypermobility, hyperextensibility of the skin, dystrophic scars, and a tendency to excessive bleeding. Sequelae include recurrent low impact trauma dislocations, chronic joint pain, and early osteoarthritis. This report describes a case of multiple simultaneous dislocations at distant sites. We highlight the importance of paying consideration to the exposure of patients to large cumulative doses of ionising radiation to diagnose and confirm reduction of frequent dislocations, and ask whether radiographic confirmation is necessary on every occasion in this subset of patients. PMID:18299375

  9. Fractures and Dislocations About the Elbow and Their Adverse Sequelae: Contemporary Perspectives.

    Science.gov (United States)

    Horrigan, Patrick; Braman, Jonathan P; Harrison, Alicia

    2016-01-01

    Fractures and dislocations of the elbow can result in adverse outcomes. The elbow is a unique joint that allows for great mobility but is predisposed to instability, either simple or complex, in traumatic settings. Even simple elbow instability, in which no fracture is present, may be associated with tremendous soft-tissue injury. Surgical treatment is often required for complex instability in which various fractures are present. The treatment goals for fixation of elbow fractures and dislocations include stable fracture fixation, a stable concentrically reduced joint, and early range of motion. Continued pain, stiffness, and instability as well as heterotopic ossification are common sequelae of elbow fractures and dislocations. PMID:27049181

  10. Traumatic anterior hip dislocation in a 12-year-old child

    Institute of Scientific and Technical Information of China (English)

    Vinay Gupta; Maneet Kaur; Zile Singh Kundu; Aseem Kaplia; Deepinderjit Singh

    2013-01-01

    Hip dislocation in children can occur congenitally in isolation or in conjunction with other congenital abnormalities.Traumatic hip dislocations in children are relatively uncommon and anterior dislocation of hip joint is even rarer.We report such a case following unusual mode of injury in a 12-year-old child.The patient underwent successful emergent closed reduction of left hip.The clinical course and follow-up assessment of the patient was otherwise uneventful.At 2 years' follow-up there was no evidence of osteoarthritis,coxa magna,heterotrophic calcification,in congruency of the joints or avascular necrosis of the head of femur.

  11. 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

    Institute of Scientific and Technical Information of China (English)

    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

  12. Bilateral inferior dislocation of the hip-a case report

    Directory of Open Access Journals (Sweden)

    Bhagwat Kishan R

    2012-04-01

    Full Text Available 【Abstract】Inferior dislocation of the hip is the ra-rest type in hip dislocation. Very few cases have been re-ported in the anglophonic literature, most of which involved the pediatric age group. Surprisingly, we came across a 30-year-old patient with a bilateral inferior hip dislocation. He had sustained a road traffic accident and the attitude of both hip joints was flexion and abduction. The diagnosis was confirmed by radiographs which revealed the long axis of the femur at an angle of 110 (right degrees and 100 (left degrees respectively away from the axis. Closed reduction under sedation was successfully performed. Skin traction for a period of 6 weeks was advised and the follow-up re-vealed an excellent result. We present the details of this case, the first of its kind along with a review of the literature, discussing the various modes and mechanisms of injury inducing inferior dislocation of the hip. Key words: Hip dislocation; Joints; Femur

  13. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  14. Shoulder dislocation in patients older than 60 years of age

    Directory of Open Access Journals (Sweden)

    Rapariz Jose

    2010-01-01

    Full Text Available Purpose: Recurrent anterior shoulder dislocation in elderly patients is a little studied condition. The goal of this paper is to clarify the role of associated injuries with respect to loss of function and recurrence of dislocation. Materials and Methods: We have conducted a retrospective, descriptive study on 29 patients older than 60 years at the moment they suffered their first dislocation episode. All patients were assessed clinically (Constant test and by imaging testing (X-ray, MRI. Results: Nine (31.03% out of 29 patients had a recurrent dislocation. Four of them required reconstructive surgery to maintain joint stability. Injury to the anterior support (anterior labrum, anterior glenoid rim showed a statistically significant relation to the recurrence of dislocations. The occurrence or non-occurrence of a rotator cuff tear does have an impact on the shoulder function. The degree of rotator cuff involvement on the coronal plane does not significantly affect the shoulder′s functional outcome. The tear extension on the sagittal plane does cause impairment on the Constant test. Conclusions: Labrum and/or anterior glenoid involvement should be suspected in elderly patients presenting with recurrent shoulder dislocation. Recurrence is due to an injury in the anterior support or both (anterior and posterior, even though shoulder function gets impaired when a rotation cuff tear occurs with anterior extension on the sagittal plane. Evidence level: IV Case series.

  15. Inferior hip dislocation after falling from height: A case report

    Science.gov (United States)

    Tekin, Ali Çağrı; Çabuk, Haluk; Büyükkurt, Cem Dinçay; Dedeoğlu, Süleyman Semih; İmren, Yunus; Gürbüz, Hakan

    2016-01-01

    Introduction Traumatic inferior hip dislocation is the least common of all hip dislocations. Adult inferior hip dislocations usually occur after high-energy trauma, very few cases are reported without fracture. Presentation of case A 26-year-old female was brought to the emergency department with severe pain in the left hip, impaired posture and restricted movement following a fall from 15 m height. The hip joint was fixed in 90° flexion, 15° abduction, and 20° external rotation. No neurovascular impairment was determined. On radiologic examination, a left ischial type inferior hip dislocation was detected. Hemorrhagic shock which developed due to acute blood loss to thoracic and abdominal cavity and patient died at third hour after she was brought to the hospital. Discussion Traumatic hip dislocations have high morbidity and mortality rates due to multiple organ damage, primarily of the extremities, chest and abdomen. In the treatment of traumatic hip dislocation, closed reduction is recommended through muscle relaxation under general anesthesia or sedation. This procedure should be applied before any intervention for concomitant extremity injuries. A detailed evaluation on emergency presentation, a multi-disciplinary approach and early diagnosis with the rapid application of imaging methods could be life-saving for such patients. PMID:27058153

  16. Design rules for dislocation filters

    International Nuclear Information System (INIS)

    The efficacy of strained layer threading dislocation filter structures in single crystal epitaxial layers is evaluated using numerical modeling for (001) face-centred cubic materials, such as GaAs or Si1−xGex, and (0001) hexagonal materials such as GaN. We find that threading dislocation densities decay exponentially as a function of the strain relieved, irrespective of the fraction of threading dislocations that are mobile. Reactions between threading dislocations tend to produce a population that is a balanced mixture of mobile and sessile in (001) cubic materials. In contrast, mobile threading dislocations tend to be lost very rapidly in (0001) GaN, often with little or no reduction in the immobile dislocation density. The capture radius for threading dislocation interactions is estimated to be approximately 40 nm using cross section transmission electron microscopy of dislocation filtering structures in GaAs monolithically grown on Si. We find that the minimum threading dislocation density that can be obtained in any given structure is likely to be limited by kinetic effects to approximately 104–105 cm−2

  17. Design rules for dislocation filters

    Energy Technology Data Exchange (ETDEWEB)

    Ward, T.; Sánchez, A. M.; Beanland, R., E-mail: r.beanland@warwick.ac.uk [Department of Physics, University of Warwick, Coventry CV4 7AL (United Kingdom); Tang, M.; Wu, J.; Liu, H. [Department of Electronic and Electrical Engineering, University College London, Torrington Place, London WC1E 7JE (United Kingdom); Dunstan, D. J. [School of Physics and Astronomy, Queen Mary University of London, London E1 4NS (United Kingdom)

    2014-08-14

    The efficacy of strained layer threading dislocation filter structures in single crystal epitaxial layers is evaluated using numerical modeling for (001) face-centred cubic materials, such as GaAs or Si{sub 1−x}Ge{sub x}, and (0001) hexagonal materials such as GaN. We find that threading dislocation densities decay exponentially as a function of the strain relieved, irrespective of the fraction of threading dislocations that are mobile. Reactions between threading dislocations tend to produce a population that is a balanced mixture of mobile and sessile in (001) cubic materials. In contrast, mobile threading dislocations tend to be lost very rapidly in (0001) GaN, often with little or no reduction in the immobile dislocation density. The capture radius for threading dislocation interactions is estimated to be approximately 40 nm using cross section transmission electron microscopy of dislocation filtering structures in GaAs monolithically grown on Si. We find that the minimum threading dislocation density that can be obtained in any given structure is likely to be limited by kinetic effects to approximately 10{sup 4}–10{sup 5 }cm{sup −2}.

  18. Imaging of traumatic dislocation of the hip in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Vialle, Raphael; Pannier, Stephanie; Odent, Thierry; Glorion, Christophe [Necker Enfants-Malades Hospital, Department of Paediatric Orthopaedics, Paris Cedex 15 (France); Schmit, Pierre [Necker Enfants-Malades Hospital, Department of Paediatric Radiology, Paris (France); Pauthier, Francois [CHI Poissy Saint Germain en Laye, Department of Orthopaedic Surgery, Poissy (France)

    2004-12-01

    Traumatic hip dislocation in childhood is a rare consequence of violent trauma. After reduction, outcome is usually favourable although epiphyseal necrosis can occur. Reduction must be carried out as soon as possible and is achieved easily, although if the labrum is involved, surgery may be required to achieve complete reduction. To analyze a retrospective series of traumatic hip dislocations in children, describing the therapeutic and imaging strategy. A total of 42 patients were studied. Their mean age was 10 years 3 months. All relevant radiographic, CT, MRI and radionuclide bone scan examinations were reviewed. Special attention was paid to associated lesions. In 22 patients the dislocation was caused by low-energy trauma. Road traffic accidents accounted for 17 dislocations. An acetabular fracture was present in six patients and the femoral head was fractured in three. Reduction was easily achieved in 31 patients. In 11 patients the postreduction radiograph and CT showed joint space asymmetry secondary to labral entrapment. Only two patients developed epiphyseal necrosis. It has been difficult to define and evaluate accurate principles for a medical imaging strategy in this group of patients. Analysis of plain radiographs is essential before and after reduction of the joint, and it is important to perform postreduction CT in every patient whose joint space remains widened. A radionuclide bone scan should be performed between the second and third weeks after injury to assess epiphyseal vascularity. With the use of specific sequences, MRI may be an alternative modality to assess epiphyseal vitality. (orig.)

  19. Imaging of traumatic dislocation of the hip in childhood

    International Nuclear Information System (INIS)

    Traumatic hip dislocation in childhood is a rare consequence of violent trauma. After reduction, outcome is usually favourable although epiphyseal necrosis can occur. Reduction must be carried out as soon as possible and is achieved easily, although if the labrum is involved, surgery may be required to achieve complete reduction. To analyze a retrospective series of traumatic hip dislocations in children, describing the therapeutic and imaging strategy. A total of 42 patients were studied. Their mean age was 10 years 3 months. All relevant radiographic, CT, MRI and radionuclide bone scan examinations were reviewed. Special attention was paid to associated lesions. In 22 patients the dislocation was caused by low-energy trauma. Road traffic accidents accounted for 17 dislocations. An acetabular fracture was present in six patients and the femoral head was fractured in three. Reduction was easily achieved in 31 patients. In 11 patients the postreduction radiograph and CT showed joint space asymmetry secondary to labral entrapment. Only two patients developed epiphyseal necrosis. It has been difficult to define and evaluate accurate principles for a medical imaging strategy in this group of patients. Analysis of plain radiographs is essential before and after reduction of the joint, and it is important to perform postreduction CT in every patient whose joint space remains widened. A radionuclide bone scan should be performed between the second and third weeks after injury to assess epiphyseal vascularity. With the use of specific sequences, MRI may be an alternative modality to assess epiphyseal vitality. (orig.)

  20. CT findings of traumatic posterior hip dislocation after reduction

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Sung Kyoung; Park, Ji Seon; Ryu, Kyung Nam; Jin, Wook [Kyung Hee University Medical Center, Seoul (Korea, Republic of); Jin Wook

    2008-06-15

    To evaluate the CT images of reduced hips after posterior hip dislocation and to propose specific diagnostic criteria based on the CT results. We retrospectively reviewed the CT findings on 18 reduced hips from 17 patients with radiographs and clinical histories of traumatic posterior hip dislocations by evaluating 18 corresponding CT scans for joint space asymmetry, intra-articular abnormalities (intra-articular fat obliteration, loose bodies, and joint effusion), changes in posterior soft tissue (capsule, muscles, and adjacent fat), the presence, and location of fractures (acetabulum and femoral head). All 18 hips (100%) showed posterior soft tissue changes. In total, 17 hips (94.4%) had intra-articular abnormalities and 15 hips (83.3%) had joint space asymmetries. In addition, 17 hips (94.4%) had fractures involving the acetabula (15 cases, 88.2%) the femoral head (13 cases, 76.5%), or on both sides (11 cases, 64.7%). The most frequent fracture location was in he posterior wall (13/15, 86.7%) of the acetabulum and in the anterior aspect (10/13, 76.9%) of the femoral head. Patients with a prior history of posterior hip dislocation showed specific CT findings after reduction, suggesting the possibility of previous posterior hip dislocations in patients.

  1. Motor evoked potentials and spontaneous electromyography in reconstruction of pelvic fracture combined with sacroiliac joint dislocation%骨盆骨折合并骶髂关节脱位术中电生理监测技术的应用

    Institute of Scientific and Technical Information of China (English)

    陈艺; 林志雄; 黎文; 刘琦; 严广斌; 张姝江; 余楠生

    2013-01-01

    目的 探讨骨盆骨折合并骶髂关节脱位手术中应用电生理监测技术预防神经损伤的效果.方法 对需要手术治疗的骨盆骨折合并骶髂关节脱位患者,术中对术侧采用经颅电刺激运动诱发电位(TES-MEP)和自由肌电图(EMG)进行实时监测,观察其对坐骨神经和腰5神经根医源性损伤的预防效果.结果 骶髂关节复位固定时,术侧股二头肌、胫前肌、胫后肌MEP波幅下降,但波形均能引出.耻骨复位时,MEP波形稳定.因手术操作引发趾短伸肌、胫后肌短暂、高幅EMG反应,即刻提醒术者,避免频繁,粗暴骚扰神经组织.术后骶髂关节、耻骨复位良好,且未出现医源性神经损伤.结论 联合运用MEP和自由EMG实时监测能及时反映骨盆骨折合并骶髂关节脱位切开复位内固定术中坐骨神经及L5神经根受激惹情况和运动功能状态,提高手术精确性,值得在临床推广应用.%Objective To investigate the efficacy of nerve damage prevention using electrophysiological monitoring techniques during reconstruction of pelvic fracture combined with sacroiliac joint dislocation. Methods Intraoperative real-time monitoring by motor evoked potentials with trans-cranial electrical stimulation (TES-MEP) and spontaneous electromyogram (EMG) were performed during surgical treatment for the patient of pelvic fracture combined with sacroiliac joint dislocation. The preventive effects on iatrogenic injury of sciatic nerve and L5 nerve root were observed. Results The TES-MEP volatility of biceps femoris, tibialis anterior muscle and posterior tibial muscle dropped on the surgical side when resetting sacroiliac joint, but the waveform could be elicited. The TES-MEP waveform was stable when resetting pubis. Some short, high-amplitude EMG response appeared in extensor digitorum brevis and posterior tibial muscle due to surgical operation, so that the surgeons could be immediately aware of avoiding irritation for nerve tissues

  2. 肩关节前、后路手术治疗产瘫肩关节内旋挛缩伴盂肱关节后脱位%Surgical treatment of shoulder joint posterior dislocation secondary to internal rotation contractnre deformity in brachial plexus birth palsy

    Institute of Scientific and Technical Information of China (English)

    王树锋; 栗鹏程; 薛云皓; 李玉成; 孙燕琨

    2012-01-01

    目的 观察肩关节前路松解复位、后路关节囊紧缩治疗产瘫肩关节内旋挛缩畸形伴肩关节后脱位的临床效果. 方法 19例产瘫并发肩关节内旋挛缩畸形患者,经X线和CT检查确诊为盂肱关节半脱位伴假盂形成或完全脱位.男14例,女5例,年龄2.5 ~ 8.5岁,平均5岁.盂肱关节畸形按照改良的Water的标准进行分型,Ⅳ型15例,Ⅴ型4例.19例均行肩关节前路挛缩软组织松解、复位,同时行后路剥离关节囊与假盂的粘连并紧缩后下方关节囊,肩关节外旋0°位石膏固定4周. 结果 术后随访12 ~ 36个月,平均20个月.肩关节Mallet评分由术前平均(11.4±1.7)(7~16)分至术后(15.5±1.8)(13~19)分,两者差异有统计学意义(P<0.05);术后盂肱关节达到中心性复位的有16例;3例肱骨头仍向后脱位. 结论 对于产瘫肩关节内旋挛缩导致的肩关节脱位,前路松解复位、后路剥离关节囊与假盂粘连、紧缩后下侧关节囊,不但使脱位的盂肱关节达到中心复位,同时明显改善其肩关节的功能.%Objective To observe the functional recovery of shoulder joint and the reduction of posterior dislocated humeral head in children with shoulder joint internal rotation contracture and humeral head posterior dislocation secondary to brachial plexus birth palsy treated by a modified surgical procedure through the anterior combined posterior approach of the shoulder. Methods Ninteen patients,ranging in age from 2.5 to 8.5 years (average 5 years),suffered posterior dislocation of the shoulder joint secondary to internal rotation contracture in brachial plexus birth palsy. The gleno-humeral joint deformity was confirmed by X-ray and CT examination and classified as type Ⅳ in 15 eases and typeⅤin 4 cases according to the modified water's criteria.The surgical procedure was as follows:the contracture soft tissue around the anterior of shoulder joint was released firstly through the anterior approach

  3. Traumatic hip dislocations in children

    International Nuclear Information System (INIS)

    Objectives: To evaluate clinical features, treatment and relationship to the time period between dislocation, reduction and early complications of traumatic dislocation of hip in children. Methods: Case series conducted at Jinnah Post Graduate Medical Centre Karachi from July 2005 to August 2009. Children with traumatic hip dislocation up to fifteen years of age who presented in last four years were included in this study. Their clinical information, etiology, associated injuries, duration, method of reduction and early complications are evaluated through emergency room proforma and indoor record. Follow up of patient was updated in outpatient department. Results: We had eight patients, six boys and two girls. Youngest 2.4 years and eldest was 12 years with mean age of 6.2 +- 3.8 years. All presented with posterior hip dislocation. Etiology was road traffic accident in two and history of fall in remaining six patients. Average duration of time between dislocation and reduction was 19 hours range 3-72 hours. Dislocated hips were reduced under General Anaesthesia in two patients and under sedation analgesia in six patients. No complications were noted in eight cases with mean 18.75 +- 13.23 months follows up. Conclusion: Traumatic hip dislocation in children is not rare. Slight trauma causes dislocation in younger age and immediate closed reduction and Immobilization reduces complications. (author

  4. Nature of Dislocations in Silicon

    DEFF Research Database (Denmark)

    Hansen, Lars Bruno; Stokbro, Kurt; Lundqvist, Bengt;

    1995-01-01

    Interaction between two partial 90 degrees edge dislocations is studied with atomic-scale simulations using the effective-medium tight-binding method. A large separation between the two dislocations (up to 30 Angstrom), comparable to experimental values, is achieved with a solution of the tight...

  5. 后路单钉棒治疗骶髂关节脱位的生物力学特性及其有效性%Biomechanical properties and the effectiveness of posterior nail-rod for the treatment of sacroiliac joint dislocation

    Institute of Scientific and Technical Information of China (English)

    和利; 贾健; 梁彦; 葛振新; 马宝通

    2012-01-01

    BACKGROUND: Sacroiliac screw has been widely used in the treatment of the sacroiliac joint dislocation, but it cannot achieve strong mechanical intensity due to its poor biomechanical properties. OBJECTIVE: To explore the mechanical intensity and clinical efficacy of posterior nail-rod for the treatment of sacroiliac joint dislocation. METHODS: ㏕welve cadaveric pelvis specimens, six males and six females, were selected to make the sacroiliac joint dislocation model and pubic symphysis separation model by cutting off the sacroiliac joint ligaments and pubic symphysis structure. Specimens were randomly divided into two groups: iliosacral screw fixation group and pelvis posterior single nail-rod fixation group, specimens in the two groups were fixed with iliosacral screw and pelvis posterior single nail-rod respectively. ㏕he clinical indications of ingle nail-rod system were set up, and the clinical data of 16 sacroiliac joint dislocation patients were collected, Mears image evaluation standard and pelvic fractures Majeed curative effect were used to assess data statistics and score. RESULTS AND CONCLUSION: In the same load, the displacement, axial stiffness, ultimate-load and yield-load of the posterior single nail-rod group were larger than those of iliosacral screw group (P < 0.05). All the 16 patients were followed-up for an average of 23.2 months (3-45 months). According to Mears image standard, there were 13 cases of anatomical replacement, and 3 cases in satisfaction. Pelvic fractures Majeed score was 60 to 100 points, 82 points in average; the good rate of Ci type fracture was 82%, and good rate of C2 type fracture was 80%. Compared with iliosacral screw fixation, the single nail-rod fixation for the treatment of sacroiliac joint dislocation has reliable strength stiffness and clinical curative effect.%背景:目前骶髂螺钉广泛应用于治疗骶髂关节脱位,但是生物力学性能较差,不能达到坚强内固定.目的:探讨应用单钉棒治

  6. Unreduced elbow dislocation treated by Ilizarov method: A case report

    Directory of Open Access Journals (Sweden)

    Jovanović Vesna

    2010-01-01

    Full Text Available Introduction. Unreduced elbow dislocation is every elbow dislocation older than one week. It may be treated non-operatively (with prereduction traction or surgically. The treatment goals are: to reduce pain, to establish joint stability and movements. There are a lot of techniques described in literature, series are relatively small, mostly case reports. Multicentric studies have not been done. That is why there are no precisely defined therapeutic protocols. Every contribution in the field is valuable. Case Outline. A 43-year-old patient was admitted for the treatment of a three-month old unreduced elbow dislocation. Treatment has been done by Ilizarov method, using the reduction mechanism. The reduction process lasted two weeks. The Ilizarov device was removed two months after the operation, then physical therapy was started. Normal anatomical and functional findings were established five months following the operation. Conclusion. The presented method of treatment has been found as very useful, having in mind that it may solve two problems: difficult reduction and redislocation. Reduction may be done without the joint opening, step by step; retention of the reduced joint may be easily done. Physical therapy may be started without Ilizarov device removal, movements of flexion and extension may be improved without any lateral instability. There is no iatrogenic intraarticular damage, so there are no secondary joint degeneration, pains and invalidity.

  7. Percutaneous osteosynthesis of Galeazzi fracture-dislocation

    Directory of Open Access Journals (Sweden)

    Gadegone Wasudeo

    2010-01-01

    Full Text Available Background: A Galeazzi fracture is defined as a fracture of the radius associated with dislocation of the distal radio-ulnar joint (DRUJ. The conventional surgical technique of nailing does not give enough stability and open reduction, internal fixation with the plate is associated with numerous complications. The stacked nailing for the management of these injuries provides adequate stability, maintains the relationship of the DRUJ and promotes uneventful union by closed technique. The purpose of this study is to evaluate the results of simple, user-friendly, low cost elastic stacked nailing for the management of Galeazzi fracture dislocation. Materials and Methods: We treated 22 young adults with fresh Galeazzi fracture-dislocation of the forearm, from January 2004 to January 2008, by percutaneous fixation of fracture by stacked elastic nailing at our institute. There were 19 males and three females and the age group ranged from 20-56 years (average 35 years. Surgery was performed within 48 to 72 hours under the guidance of image intensifier. Medullary cavity was filled with two elastic titanium nails having unequal lengths and diameter. One nail acts as a reduction nail and the other acts as a stabilizing nail. The results were evaluated using Mikic criteria based on union, alignment, relationship of the DRUJ, and movements at the inferior radio ulnar joint, elbow and wrist. Results: In six cases, following radiological union, nails in the radius were extracted between six to nine months after operation because of discomfort complained by the patient at site of insertion. After one year follow-up, 18 patients had excellent, four had fair results. Conclusion: Closed reduction and internal fixation of Galeazzi fracture by two elastic rods re-establishes the normal relationship of the fractured fragments and the DRUJ without repair of the ligaments. The stability is achieved by the flexibility and elasticity of the nails, crowding of the

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

    Science.gov (United States)

    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

  9. Tratamento artroscópico da luxação acromio-clavicular pelo método "tight rope" (arthrex® Arthroscopic treatment of acromioclavicular joint dislocation by tight rope technique (arthrex®

    Directory of Open Access Journals (Sweden)

    Luis Alfredo Gómez Vieira

    2009-02-01

    Full Text Available OBJETIVO: Apresentar a técnica cirúrgica artroscópica pelo método "Tight Rope" e a avaliação dos resultados com esta técnica no tratamento da luxação acrômio-clavicular aguda. MÉTODOS: entre agosto de 2006 e maio de 2007, 10 ombros de 10 pacientes com luxação acrômio-clavicular aguda foram submetidos a tratamento artroscópcio pela técnica Tight Rope-Arthrex®. O seguimento mínimo foi de 12 meses, com média de 15 meses. A idade variou de 26 e 42 anos com média de 34 anos. Todos os pacientes eram do sexo masculino. Todos os pacientes foram atendidos na fase aguda da lesão sendo avaliados por radiologia simples (série trauma. Os pacientes foram acompanhados semanalmente no primeiro mês e a cada três meses após o procedimento artroscópico. A avaliação clínica foi feita por meio dos critérios da University of Califórnia at Los Angeles (UCLA. RESULTADOS: Todos os pacientes operados agudamente encontravam-se satisfeitos com os resultados do tratamento cirúrgico artroscópico com uma média de 32,5 pontos na escala de avaliação da UCLA. CONCLUSÃO: O tratamento artroscópico da luxação acrômio-clavicular aguda pelo método "Tight Rope" é uma técnica cirúrgica minimamente invasiva que mostrou-se eficiente para o tratamento destas lesões.OBJECTIVE: Presenting the arthroscopic treatment by Tight Rope - Arthrex® system for acute acromioclavicular dislocation and to evaluate results obtained with this procedure. METHODS: Between August 2006 and May 2007, 10 shoulders of 10 patients with acute acromioclavicular dislocation were submitted to arthroscopic repair using the Tight Rope - Arthrex® system. Minimum follow-up was 12 months, with a mean of 15 months. Age ranged from 26 to 42, mean 34 years. All patients were male. Radiology evaluation was made by trauma series x-ray. The patients were assisted in the first month weekly and after three months after the procedure. Clinical evaluation was based on the University

  10. 120 Cases of Shoulder Dislocation referred to Emergency Department during One Year; a Case Series Study

    Directory of Open Access Journals (Sweden)

    Payman Asadi

    2015-05-01

    Full Text Available Shoulder dislocation is identified as displacement of humerus head from the glenoid cavity of scapula bone, which makes up about 50% of total joint dislocations. Taking into account the importance of the side effects and disabilities caused by this type of dislocation and that it can be prevented, the present study was designed aiming to evaluate the epidemiologic characteristics of the patients with shoulder dislocation. In this retrospective cross-sectional study, all the patients referred to the emergency department (ED with complaint of shoulder dislocation throughout one year were evaluated. Demographic data and characteristics regarding the type of dislocation, presence of accompanying fractures, mechanism of dislocation, history of dislocation and the method of reduction were extracted from the patients’ profiles and recorded in a checklist designed for this purpose. Data were then statistically analyzed using SPSS version 19. Statistics showed that 120 patients with the mean age of 39.3 ± 21.2 years had been admitted to ED of the studied center in one year (79.2% male. The most common type of dislocation was anterior dislocation (95.8% and in the right shoulder (52.5% and the most common cause was falling on open arm (34.2%. Reduction method was non-operative in 93.3% of the cases and surgery in 6.7%. Based on the results of this study, in the studied population, most patients with shoulder dislocation were young men who had an anterior dislocation in their right shoulder because of falling on out stretched hand and treated with close reduction.

  11. Patellar Dislocations and Reduction Procedure.

    Science.gov (United States)

    Ramponi, Denise

    2016-01-01

    Acute patellar dislocations are a common injury occurring in adolescents involved in sports and dancing activities. This injury usually occurs when the knee is in full extension and sustains a valgus stress on the knee. The medial patellofemoral ligament is the medial restraint that assists in stabilizing the patella from lateral dislocations. The patella usually dislocates laterally and is usually not difficult to reduce after patient evaluation and prereduction radiographs. After postreduction radiographs confirm proper position of the patella postreduction and the absence of fractures, the patient is usually treated conservatively with initial immobilization, orthopedic referral, and physical therapy. PMID:27139130

  12. Buckling of dislocation in graphene

    Science.gov (United States)

    Yao, Yin; Wang, Shaofeng; Bai, Jianhui; Wang, Rui

    2016-10-01

    The buckling of dislocation in graphene is discussed through the lattice theory of dislocation and elastic theory. The approximate solution of the buckling is obtained based on the inner stress distribution caused by different structure of dislocations and is proved to be suitable by the simulation. The position of the highest buckling is predicted to be at the vertex of the pentagon far away from the heptagon. The buckling is strongly influenced by the internal stress and the distance between the extrusive area and stretching area, as well as the critical stress σc. The SW defect is proved to be unbuckled due to its strong interaction between extrusion and stretching.

  13. Moving Dislocations in Disordered Alloys.

    Energy Technology Data Exchange (ETDEWEB)

    Marian, J; Caro, A

    2006-11-18

    Using atomistic simulations of dislocation motion in Ni and Ni-Au alloys we report a detailed study of the mobility function as a function of stress, temperature and alloy composition. We analyze the results in terms of analytic models of phonon radiation and their selection rules for phonon excitation. We find a remarkable agreement between the location of the cusps in the {sigma}-v relation and the velocity of waves propagating in the direction of dislocation motion. We identify and characterize three regimes of dissipation whose boundaries are essentially determined by the direction of motion of the dislocation, rather than by its screw or edge character.

  14. 锁骨钩钢板加喙肩韧带转位重建喙锁韧带治疗肩锁关节脱位%Clavicular hook plate and coracoacromial ligament transferred to reconstruct coracoclavicular ligament in treatment of acromioclavicular joint dislocation

    Institute of Scientific and Technical Information of China (English)

    张峰; 陈晓波; 刘郑生; 韩雪

    2012-01-01

    目的 探讨锁骨钩钢板加喙肩韧带转位重建喙锁韧带治疗肩锁关节脱位的疗效.方法 选择河北满城县医院2008 年6月-2011 年4 月收治的肩锁关节脱位患者40 例的临床资料,其中20 例采用锁骨钩钢板加喙肩韧带转位重建喙锁韧带治疗( 研究组),20 例采用锁骨钩钢板加张力带治疗( 对照组),观察两组治疗效果.结果 两组术前术后均采用Lazzcano 标准评价肩关节功能,两组术后肩关节功能均较治疗前明显改善(P<0.05).研究组治疗后肩关节功能优良率高于对照组(P<0.05).两组切口均甲级愈合,均未出现螺钉松动和断裂.结论 锁骨钩钢板加喙肩韧带转位重建喙锁韧带治疗肩锁关节脱位较锁骨钩钢板加张力带治疗术后肩关节功能优良率高,且固定牢靠,安全有效.%Objective To study the therapeutic effect of combined clavicular hook plate and coracoclavicular ligament reconstruction on dislocation of acromiclavicular joint. Methods Forty patients with dislocation of acromioclavicular joint admitted to our hospital from June 2008 to April 2011 were divided into study group(n=20) and control group(n=20). Patients in study group were treated with combined clavicular hook plate and coracoacromial ligament reconstruction while those in control group were treated with combined clavicular hook plate and tension belt to observe their therapeutic effect. Results The shoulder function of patients in two groups before and after operation was assessed according to the Lazzcano standards, which was significantly better after operation than before operation(P<0.05). The excellent rate of shoulder function was significantly higher in study group than in control group after operation(P<0.05). The incisions healed quite well with no screw loosening and fracture. Conclusion Combined clavicular hook plate and coracoclavicular ligament reconstruction is a safe and effective procedure for dislocation of acromioclavicular

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

    Directory of Open Access Journals (Sweden)

    Patro Dilip K

    2009-11-01

    Full Text Available 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 English literature. Closed reduction by the two-step maneuver was successful with a single attempt. MRI revealed posterior labral tear and a Hill-Sachs variant lesion on the superolateral aspect of humeral head. Immobilisation in a chest-arm bandage followed by physiotherapy yielded excellent results. The case is first of its kind; the unusual mechanism, unique radiological findings and alternate method of treatment are discussed.

  16. Interferometric SAR and land deformation. Analysis using the dislocation model; Interferometric SAR to chikaku hendo. Dislocation model wo mochiita kaiseki

    Energy Technology Data Exchange (ETDEWEB)

    Matsushima, J.; Otaki, T.; Tanaka, A.; Miyazaki, Y. [Geological Survey of Japan, Tsukuba (Japan)

    1996-05-01

    The diastrophism by the earthquake-induced dislocation is investigated by interferometry (INSAR) which represents the diastrophism by the interference fringes of equiphase difference lines. A joint research group at Geographical Survey Institute and National Space Development Agency showed the diastrophism in the vicinity of the ground surfaces before and after the Hyogoken Nanbu Earthquake by the INSAR interference images in 1995. This paper discusses the effects of observation in the vision line direction from the satellite and dislocation parameters on the interference images. The dislocation model uses a slanted rectangular model in a semi-infinite medium, to calculate static displacements and strain distributions at the ground surface, when dislocation changes. It is found that the INSAR interference images, detecting displacements in the vision line direction from the satellite, significantly change as the vision line direction changes, and that the actual displacement cannot be given by the images alone. This paper also shows sensitivity of the interference images to the dislocation parameters. 3 refs., 9 figs., 1 tab.

  17. Determination of prevalence of glenoid bony lesions after recurrent anterior shoulder dislocation using the 3-D CT scan

    OpenAIRE

    Guity, Mohamad Reza; Akhlaghpour, Shaharam; Yousefian, Reza

    2014-01-01

    Background: Glenoid bone damages consisting of anterior rim erosion and bony avulsion are very important in decision making for treatment of recurrent dislocation in shoulder joint. This study was aimed to determine the prevalence of these damages in patients with anterior recurrent shoulder dislocation. Methods: The study was a cross-sectional study evaluating patients with unstable shoulder joint. Glenoid bone damage was assessed using three dimensional (CT) scan implementing either glenoid...

  18. An Alternate Conservative Management of Shoulder Dislocations and Subluxations

    OpenAIRE

    Sawa, Thomas M.

    1992-01-01

    This paper presents clinical observations/results of the application of an alternate method to traditional conservative management of subluxations and dislocations of the glenohumeral joint on major junior hockey players. The proposed program involves three stages: 1) rest and nutrition, 2) interferential current and faradic muscle stimulation, and 3) a traditional progressive-resistance weight-training program in conjunction with a specially designed orthosis. Current scientific theory on so...

  19. Management and Prognostic Factors for Delayed Reconstruction of Neglected Posterior Shoulder Fracture-Dislocation

    OpenAIRE

    Bekmezci; Altan

    2015-01-01

    Introduction Posterior fracture-dislocations of the shoulder are rare conditions. Misdiagnosis can occur in 50% - 80% of the patients. Due to the size of the lesion, stability of the joint could not be achieved with transfer of subscapular tendon or tuberosity. Case Presentation A 54-year-old male patient was referred to our hospital with a neglected posterior shoulder fracture-dislocation. Functional results of the patient, and t...

  20. Divergent dislocation of the elbow in a child (a case report.

    Directory of Open Access Journals (Sweden)

    Hemmadi S

    1991-10-01

    Full Text Available A rare case of simultaneous disruption of superior radio-ulnar joint and posterior dislocation of the same elbow in a 6 year old boy is presented. It was possible to achieve the stable reduction by means of closed manipulation, restoring normal function in 6 weeks time. The possible mode of injury is discussed. There are only 4 cases reported of such a divergent elbow dislocation in modern literature.

  1. Elbow dislocation with ipsilateral diaphyseal forearm bone fracture: A rare injury report with literature review

    Institute of Scientific and Technical Information of China (English)

    Vijay Goni; Prateek Behera; Umesh Kumar Meena; Nirmal raj Gopinathan; Narendranadh Akkina; R.H.H. Arjun

    2015-01-01

    Dislocation of the elbow along with shaft fractures of both bones of the ipsilateral forearm is a rare injury though elbow dislocation or fracture of the forearm bones may occur separately.Such injuries need a concentric reduction of the dislocation and an anatomical fixation of forearm bones for optimal functional outcomes.We report a case of elbow dislocation with fracture of the lateral condyle of the humerus along with fractures of shafts of the radius and ulna in a 44-year-old female.Closed reduction of the elbow and operative stabilization of all fractures were done with good clinical, radiological and functional outcomes in 2 years follow-up period.A significant degree of force is needed to produce a combined dislocation of a joint and fracture of bones around that joint and these complex injuries may be missed if the clinician is not aware of the possibility of such injuries.The fact that the previously reported cases had a posterolateral dislocation while our case had a posteromedial dislocation and a fracture of the lateral humeral condyle as well makes it unique in its presentation and worth reporting.We have also included an up to date literature review on this topic.

  2. Primary ankle arthrodesis for neglected open weber B ankle fracture dislocation.

    LENUS (Irish Health Repository)

    Thomason, Katherine

    2014-07-01

    Primary ankle arthrodesis used to treat a neglected open ankle fracture dislocation is a unique decision. A 63-year-old man presented to the emergency department with a 5-day-old open fracture dislocation of his right ankle. After thorough soft tissue debridement, primary arthrodesis of the tibiotalar joint was performed using initial Kirschner wire fixation and an external fixator. Definitive soft tissue coverage was later achieved using a latissimus dorsi free flap. The fusion was consolidated to salvage the limb from amputation. The use of primary arthrodesis to treat a compound ankle fracture dislocation has not been previously described.

  3. Irreducible posterolateral dislocation of the knee: a case report.

    Science.gov (United States)

    Solarino, Giuseppe; Notarnicola, Angela; Maccagnano, Giuseppe; Piazzolla, Andrea; Moretti, Biagio

    2015-01-01

    Irreducible posterolateral dislocations of the knee are rare lesions, generally caused by high-energy trauma inducing rotational stress and a posterior and lateral displacement of the tibia. In these conditions, the interposition of abundant soft tissue inside the enlarged medial joint space prevents spontaneous reduction or non-surgical treatment by manipulation of the dislocation. Surgical treatment is therefore compulsory. We report the clinical case of a woman who suffered a subluxation of the knee while jogging. The case we describe is of interest because it shows that even less severe knee dislocations, like this subluxation caused by a low-velocity sports trauma, may present in an irreducible form requiring open surgery. Clinical-instrumental monitoring did not reveal any signs of vascular or nerve injury. Owing to the irreducibility of the lesion we were obliged to perform open surgery in order to free the joint from the interposed muscle tissue and repair medial capsule-ligament lesions. Repair of the damaged cruciate ligaments was deferred to a second stage, but ultimately rendered necessary by the persistence of joint instability and the need to address the patient's functional needs. In the literature, different one- and two-step surgical options, performed by arthroscopy or arthrotomy, are reported for such related problems. The Authors discuss these various options and examine and discuss their own decision taken during the surgical work-up of this case. PMID:26605258

  4. 关节镜下盂唇修补与关节囊复合部分肩胛下肌紧缩修复复发性肩关节前脱位%Arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture for recurrent anterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    徐斌; 涂俊

    2015-01-01

    BACKGROUND:Arthroscopic glenoid labrum repair is the main therapy for recurrent anterior shoulder dislocation, which cannot meet the demands of shoulder stability. How to strengthen the anterior shoulder stability is an issue that is always explored and pursued. OBJECTIVE:To explore the effectiveness of arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture for recurrent anterior shoulder dislocation. METHODS:Seventy patients admitted for recurrent anterior shoulder dislocation at the Department of Orthopedics, First Affiliated Hospital of Anhui Medical University in China from October 2010 to August 2013 were enroled, who received the arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture. Patients undergoing post-operative systematical rehabilitation were folowed up for Constant-Murley Score and the ROWE Score for Instability, and shoulder stability and motor functions were evaluated in patients. RESULTS AND CONCLUSION: The 70 patients were folowed-up for 11-46 months. Complications only appeared in one patient with acute pulmonary edema and five patients with elbow or forearm skin blisters, but al were cured by treatment. Anterior shoulder dislocation disappeared postoperatively in al patients. Sixty-five patients almost recovered in the range of motion of the shoulder, who were satisfied with normal life and work activity. Al the patients returned to work. At the last folow-up, the Constant-Murley score was improved from 71.2±5.3 to 94.3±4.9, and the ROWE score was increased from 32.1±4.2 to 95.1±4.7, both of which were better than before (P < 0.05). This study demonstrated arthroscopic glenoid labrum repair and combined joint capsule and partial subscapularis suture is better for recurrent anterior shoulder dislocation, which is conductive to shoulder stability and motor function recovery.%背景:复发性肩关节前脱位的修复目前以关节镜下盂唇修补为主,

  5. Unilateral Congenital Knee and Hip Dislocation with Bilateral Clubfoot – A rare Packaging disorder

    Directory of Open Access Journals (Sweden)

    Mukesh Tiwari

    2013-04-01

    Full Text Available ntroduction: Reduced intrauterine space gives rise to ‘packaging disorder’ which may involve joint dislocations or contractures. We present an unique case where mutiple joints were dislocated involving left congenital knee dislocation (CDK, bilateral congenital hip dislocation (CDH and congenital talipes equino varus (CTEVdeformities. Case Report: A preterm baby boy born to mother with diagnosed oligohydramios presented with left CDK bilateral DDH and CTEV. The knee dislocation was treated first with gradual streaching and weekly above knee cast. At 7th week good flexion was achieved at both knees and abduction splint for DDH (using double diaper with ponseti cast for CTEV was done. At one year follow up all joints were reduced and maintained well with baby able to stand with support. Conclusion: Packaging disorders may present with multiple dislocations and deformities. Early intervention with serial casting and manipulation minimises disability and prevents ambulatory problems. In our case there was a good response to manipulation and serial casting. This differs from cases with inherent pathology like arthrogryposis where response to treatment is not so good. Keywords: Congenital genu recurvatum, Develpmental dysplasia hip, CTEV, Clubfoot, serial manipulation, packaging disorders

  6. Simultaneous bilateral anterior shoulder dislocation: report of two cases and review of the literature

    Directory of Open Access Journals (Sweden)

    Tripathy Sujit Kumar

    2012-02-01

    Full Text Available 【Abstract】Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The most interesting part of a bilateral shoulder dislocation is about its injury mechanism as a synchronous and simultaneous force is needed to result in it. In cases of epilepsy or electrocution, the mechanism is different and the forceful contractions of the selective group of muscles result in the dislocation. This article reports two cases of bilateral simultaneous anterior shoulder joint dislocation that occurred after a road side accident and after an episode of convulsion in an epileptic patient. The dislocations were diagnosed early and reduced immediately with a proper postreduction rehabilitation. During their follow-up, both patients had sa-tisfactory functional outcome. This article emphasizes on the importance of shoulder examination in road side accident victims and epileptic patients. All orthopedic surgeons and emergency physicians should be aware of such unusual possibilities to have an early diagnosis and treatment. An early reduction and appropriate rehabilitation can provide satisfactory functional outcome. This article also briefly discusses the injury mechanisms, diagnoses and treatments of bilateral shoulder dislocation as reported in the literature. Key words: Shoulder dislocation; Epilepsy; Accidents, traffic

  7. Management of dislocated intraocular implants.

    Science.gov (United States)

    Chan, C K; Agarwal, A; Agarwal, S; Agarwal, A

    2001-12-01

    Implant dislocation may occur in the absence of appropriate capsular or zonular support (PCIOL) (11,35,53) or following traumatic injury to anterior ocular tissues (ACIOL). (11,19,20) Other factors (e.g., advanced patient age, high myopia, previous vitrectomy, pseudoexfoliation syndrome, and certain connective tissue disorders) also may predispose implant dislocation. (9,52) Although reported for all types of IOLs, implant dislocation is becoming more manageable because of the advancement of surgical techniques. A dislocated ACIOL or PCIOL may be explanted, exchanged, or repositioned. (11,48,71) Repositioning the dislocated PCIOL in the ciliary sulcus with modern vitreoretinal techniques provides an optimal environment for visual recovery. (11,71) Implant repositioning techniques generally may be categorized into the external or the internal approaches. (8,11) The former involves external suturing methods for a primary or secondary implant in the absence of adequate capsular or zonular support (15,16,31,42,56,60,61,64,66,73,76) and the latter is achieved through modern pars plana techniques. 8,11,62,69) Recently, several implant repositioning methods gaining increasing acceptance include the scleral loop fixation, (45) the snare approach, (43) the use of the 25-gauge implant forceps, (13) temporary haptic externalization, (8,11,36,71) and the use of perfluorocarbon liquids. (1,28,40,41,44) The temporary haptic externalization method combines the best features of the external and the internal approaches, avoids complex intraocular maneuvers, and allows precise scleral fixation of the dislocated IOL on a consistent basis. (8,11,71) Endoscopy provides the surgeon with optimal viewing of the anterior retropupillary anatomy that is often difficult to appreciate (e.g., capsular-zonular complex, ciliary sulcus, anterior retina, and vitreous base). (6,11) As a result, precise haptic placement is possible during the repositioning process. (6,11) However, a three

  8. Dislocations in Monolayers and Semiconductors.

    Science.gov (United States)

    Ren, Qiang

    1995-01-01

    Four different aspects of the properties of dislocations in monolayer and semiconductors have been investigated: (i) Using atomic relaxation techniques, dislocation dipoles of various sizes and orientations have been studied for monolayers with the Lennard-Jones potential (LJP) and the nearest-neighbour piecewise linear force (PLF) interactions. In the WP system the lower energy vacancy dipoles have over a wide range of angles an energy which is mainly a function of the vacancy content of the dipole. There is a competition between the elastic forces and the topological constraints which favour a five-fold coordinate vacancy (FCV) at the centre of each core. For the short range PLF system the lattice usually compresses upon the introduction of a dislocation, a consequence of the soft core of the interaction potential, and interstitial dipoles are lower in energy. For the long range LJP system the dislocations are mobile whereas for the PLF system they are pinned. The relevance of these results to existing theories of melting are discussed. (ii) Using generalized stacking-fault (GSF) energies obtained from first-principles density-functional calculations, a zero-temperature model for dislocations in silicon is constructed within the framework of a Peierls-Nabarro (PN) model. Core widths, core energies, PN pinning energies, and stresses are calculated for various possible perfect and imperfect dislocations. Both shuffle and glide sets are considered. 90^circ partials are shown to have a lower Peierls stress (PS) than 30 ^circ partials in accord with experiment. (iii) We have also studied by atomic relaxation techniques the properties of dislocations in silicon, modelled by the empirical potential of Stillinger and Weber. In order to compare with the preceding calculation no reconstruction is allowed. We find no evidence of dissociation in the shuffle dislocations. Within this model shuffle dislocations glide along their slipping planes. On the other hand, glide sets

  9. Position of the prosthesis and the incidence of dislocation following total hip replacement

    Institute of Scientific and Technical Information of China (English)

    HE Rong-xin; YAN Shi-gui; WU Li-dong; WANG Xiang-hua; DAI Xue-song

    2007-01-01

    Background Dislocation is the second most common complication of hip replacement surgery, and impact of the prosthesis is believed to be the fundamental reason. The present study employed Solidworks 2003 and MSC-Nastran software to analyze the three dimensional variables in order to investigate how to prevent dislocation following hip replacement surgery.Methods Computed tomography (CT) imaging was used to collect femoral outline data and Solidworks 2003 software was used to construct the cup model with variabilities. Nastran software was used to evaluate dislocation at different prosthesis positions and different geometrical shapes. Three dimensional movement and results from finite element method were analyzed and the values of dislocation resistance index (DRI), range of motion to impingement (ROM-I),range of motion to dislocation (ROM-D) and peak resisting moment (PRM) were determined. Computer simulation was used to evaluate the range of motion of the hip joint at different prosthesis positions.Results Finite element analysis showed: (1) Increasing the ratio of head/neck increased the ROM-I values and moderately increased ROM-D and PRM values. Increasing the head size significantly increased PRM and to some extent ROM-I and ROM-D values, which suggested that there would be a greater likelihood of dislocation. (2) Increasing the anteversion angle increased the ROM-I, ROM-D, PRM, energy required for dislocation (ENERGY-D) and DRI values,which would increase the stability of the joint. (3) As the chamber angle was increased, ROM-I, ROM-D, PRM, Energy-D and DRI values were increased, resulting in improved joint stability. Chamber angles exceeding 55(°-) resulted in increases in ROM-I and ROM-D values, but decreases in PRM, Energy-D, and DRI values, which, in turn, increased the likelihood of dislocation. (4) The cup, which was reduced posteriorly, reduced ROM-I values (2.1-5.3(°-)) and increased the DRI value (0.073). This suggested that the posterior high side

  10. Central acetabular fracture with dislocation treated by minimally invasive plate osteosynthesis.

    Science.gov (United States)

    2015-06-01

    Central acetabular fractures with dislocation are usually the result of high-energy trauma, resulting in joint incongruity, and are frequently associated with other injuries. Open reduction and internal fixation has been the standard treatment for acetabular fractures, but it is associated with extensive surgical trauma, and complications such as haematoma formation, iatrogenic nerve injury, and heterotopic ossification. We present the case of a 63-year-old female who sustained a central acetabular fracture of the hip with dislocation as a result of an automobile collision. Closed reduction of the dislocation was performed, and the fracture was managed by minimally invasive plate osteosynthesis using a specially prepared plate. At 01 year postoperatively, radiographs showed the fracture to have been well-healed with good congruity of the joint. However, heterotopic ossification of the joint was noted. The technique allowed reduction of the fracture with minimal surgical trauma.

  11. Posterior sternoclavicular Salter-Harris fracture-dislocation in a patient with unossified medial clavicle epiphysis.

    Science.gov (United States)

    Beckmann, Nicholas; Crawford, Lindsay

    2016-08-01

    Sternoclavicular injuries are relatively rare, composing less than 1 % of all musculoskeletal fractures or dislocations. When sternoclavicular injuries do occur, they typically present as an isolated dislocation of the sternoclavicular joint without associated fracture of the clavicle or manubrium. However, in patients with unfused medial clavicle physis, sternoclavicular joint injuries can present as a fracture-dislocation through the unfused physis. These physeal injuries are important to recognize as the displaced epiphysis can block reduction of the sternoclavicular joint. We present a case of a 15-year-old female basketball player presenting with suspected sternoclavicular joint injury after sustaining a direct blow to the left shoulder. An initial shoulder CT confirmed the presence of the clinically suspected posterior sternoclavicular dislocation without fracture identified. An MRI of the left sternoclavicular joint was then performed for suspected physeal fracture, which confirmed the presence of a fracture through the medial clavicle physis with anterior displacement of the unossified epiphysis, blocking reduction of the metaphysis. Given the findings on MRI, the pediatric orthropedic surgeon was able to counsel the family of the high likelihood of failed closed reduction of the sternoclavicular joint requiring conversion to open reduction and internal fixation. The patient underwent successful open reduction and internal fixation of the medial clavical physeal fracture after an initial gentle attempt at closed reduction was unsuccessful. PMID:27107998

  12. Dislocations and other topological oddities

    Science.gov (United States)

    Pieranski, Pawel

    2016-03-01

    We will show that the book Dislocations by Jacques Friedel, published half a century ago, can still be recommended, in agreement with the author's intention, as a textbook "for research students at University and for students at engineering schools as well as for research engineers". Indeed, today dislocations are known to occur not only in solid crystals but also in many other systems discovered more recently such as colloidal crystals or liquid crystals having periodic structures. Moreover, the concept of dislocations is an excellent starting point for lectures on topological defects occurring in systems equipped with order parameters resulting from broken symmetries: disclinations in nematic or hexatic liquid crystals, dispirations in chiral smectics or disorientations in lyotropic liquid crystals. The discussion of dislocations in Blue Phases will give us an opportunity to call on mind Sir Charles Frank, friend of Jacques Friedel since his Bristol years, who called these ephemeral mesophases "topological oddities". Being made of networks of disclinations, Blue Phases are similar to Twist Grain Boundary (TGB) smectic phases, which are made of networks of screw dislocations and whose existence was predicted by de Gennes in 1972 on the basis of the analogy between smectics and superconductors. We will stress that the book by Jacques Friedel contains seeds of this analogy.

  13. Dislocation-density function dynamics - An all-dislocation, full-dynamics approach for modeling intensive dislocation structures

    Science.gov (United States)

    Leung, H. S.; Ngan, A. H. W.

    2016-06-01

    It has long been recognized that a successful strategy for computational plasticity will have to bridge across the meso scale in which the interactions of high quantities of dislocations dominate. In this work, a new meso-scale scheme based on the full dynamics of dislocation-density functions is proposed. In this scheme, the evolution of the dislocation-density functions is derived from a coarse-graining procedure which clearly defines the relationship between the discrete-line and density representations of the dislocation microstructure. Full dynamics of the dislocation-density functions are considered based on an "all-dislocation" concept in which statistically stored dislocations are preserved and treated in the same way as geometrically necessary dislocations. Elastic interactions between dislocations in a 3D space are treated in accordance with Mura's formula for eigen stress. Dislocation generation is considered as a consequence of dislocations to maintain their connectivity, and a special scheme is devised for this purpose. The model is applied to simulate a number of intensive microstructures involving discrete dislocation events, including loop expansion and shrinkage under applied and self stress, dipole annihilation, and Orowan looping. The scheme can also handle high densities of dislocations present in extensive microstructures.

  14. The value on high frequency ultrasound in the diagnosing of congenital dislocation and dysplasia of the hip joint of infant%高频超声在婴幼儿先天性髋关节脱位和发育不良中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    李志威

    2011-01-01

    Objective: To explore the clinical value on high frequency ultrasound in the diagnosing of congenital dislocation and dysplasia of the hip joint of infants to offer help for clinical diagnosis and treatment. Methods: 421 infants (842 hips) who were under the age seven months were examined by Graf method of ultrasound examination in hip joint. The hip joint was classified with Graf method by observing the skeletal dysplasia, skeletal dysplasia boundary, soft skeletal dysplasia morphology, angels a and p. Results: Among 421 infants (842 hips) who were under the age of seven months, and there were 370 cases (740 hips) to be normal, there were 14 cases (28 hips) suffered from congenital subluxation of hip, 8 cases (16 hips) suffered from congenital dislocation of hip, 29 cases (58 hips) suffered from contracted congenital dysplasia of hip. Conclusion: Ultrasonic has the advantages of non-invasive and no radiation, what's more, it's convenient to use for checking, and with no contraindication, and it can be applied repeatedly. It is the first choice as screening for the infants, and it can help observing the effect of the clinical therapy.%目的:探索高频超声在婴幼儿先天性髋关节脱位和发育不良诊断中的临床价值,为临床的诊断治疗提供帮助.方法:对421例7个月以内的婴幼儿(842个髋关节)行Graf法髋关节超声检查,通过观察骨性髋臼、骨性髋臼外侧缘、软骨性髋臼形态及测量α、β角,对髋关节进行Graf分型,探讨高频超声作为新生儿髋关节发育不良筛查的诊断工具对临床治疗效果进行动态观察的价值.结果:检查7个月以下婴幼儿421例(842个髋关节),其中,正常髋关节370例(740个髋关节),婴幼儿先天性髋关节半脱位14例(28个髋关节),全脱位8例(16个髋关节),发育不良29例(58个髋关节).结论:超声波具有无创、无射线的特性,且检查方便,无禁忌证,可以重复应用,可作为对新生儿进行筛查工作的首

  15. Catatonia and jaw dislocation in the postoperative period with epidural morphine

    Directory of Open Access Journals (Sweden)

    Satyen Parida

    2011-01-01

    Full Text Available We report a case of temporomandibular joint dislocation occurring in the postoperative period in a patient, who developed catatonia following administration of a single dose of epidural morphine. The catatonic response to epidural morphine was delayed by several hours in the postoperative period, and might have resulted from intrathecal migration of the drug, through an initial dural puncture while locating the epidural space. The temporomandibular joint dislocation was diagnosed only after reversal of the effects of morphine with naloxone, when the patient complained of inability to fully close her mouth.

  16. [A Case of Traumatic Dislocation of the Penis].

    Science.gov (United States)

    Taguchi, Makoto; Inoue, Takaaki; Nishida, Teruhisa; Kawakita, Shigenari; Muguruma, Kouei; Murota, Takashi; Kinoshita, Hidefumi; Matsuda, Tadashi

    2016-08-01

    We report a rare case of a traumatic dislocation of the penis. The patient was a 39-year-old man who was ambulanced to our hospital because of a motorbike accident. He was diagnosed to have a pelvic fracture. He was admitted to our department because of his urinary retention and lower abdominal pain. Only the penile skin was left as the genital organ, and neither the penis nor the glans penis was palpable. As the computed tomography scan of the abdomen revealed the dislocation of the penis under the skin in the foreside of the pubic bone, urinary retention due to the traumatic dislocation of the penis was diagnosed, and a percutaneous cystostomy was performed. After improvement of his general condition, the patient was transferred to our department for the evaluation of the perineal region, including the lower urinary tract, and for the treatment of the traumatic dislocation of the penis. First, as hematoma and abscess in the left spermatic cord were suspected by magnetic resonance imaging of the pelvic region, removal of the hematoma and abscess in the left spermatic cord as well as an anterograde cystoscopy were performed under lumbar anesthesia, and the absence of urethral injury was confirmed. After infection control, repositioning of the penis was jointly performed with the Department of Plastic Surgery of our hospital under general anesthesia. After the operation, spontaneous urination was observed and erectile function was observed to be normal.

  17. Patellar dislocation with genu valgum treated by DFO.

    Science.gov (United States)

    Kwon, Jae Ho; Kim, Jong In; Seo, Dong-Hyun; Kang, Kyung-Woon; Nam, Ji Ho; Nha, Kyung-Wook

    2013-06-01

    Congenital habitual patellar dislocation is a rare condition of the knee where the patella dislocates during flexion and relocates during extension. The congenital form is permanent, irreducible, and presents at birth. It is characterized by a short quadriceps and a major patellofemoral dysplasia and short height. This article presents a rare case of a 27-year-old woman with recurring bilateral habitual dislocation of the patella after a failed previous proximal and distal realignment procedure. Clinical examinations of both knees revealed genu valgus knees and lateral joint pain that recurred after several previous operations. Radiographs of both knees showed patellar dislocation and genu valgum associated with patellofemoral dysplasia and osteoarthritis of the lateral compartment. Long-leg standing radiographs showed an anatomic tibiofemoral angle of right 13° and left 6° valgus and a mechanical tibiofemoral angle of right 8° and left 2° valgus and weight-bearing line of 65% on the right and 48% on the left. The authors performed a distal femoral closing wedging osteotomy to correct the valgus deformity, and then percutaneous lateral release and medial reefing were performed to stabilize the patellas of both knees simultaneously. PMID:23746026

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

    Directory of Open Access Journals (Sweden)

    Verleisdonk Egbert JMM

    2011-06-01

    Full Text Available 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 fixation, a hinged elbow fixator can be applied. The fixator provides stability to the elbow joint, and allows for early mobilization. The latter may be important for preventing stiffness of the joint. The aim of this study is to determine the effect of early mobilization with a hinged external elbow fixator on clinical outcome in patients with complex elbow dislocations with residual instability following fracture fixation. Methods/Design The design of the study will be a multicenter prospective cohort study of 30 patients who have sustained a complex elbow dislocation and are treated with a hinged elbow fixator following fracture fixation because of residual instability. Early active motion exercises within the limits of pain will be started immediately after surgery under supervision of a physical therapist. Outcome will be evaluated at regular intervals over the subsequent 12 months. The primary outcome is the Quick Disabilities of the Arm, Shoulder, and Hand score. The secondary outcome measures are the Mayo Elbow Performance Index, Oxford Elbow Score, pain level at both sides, range of motion of the elbow joint at both sides, radiographic healing of the fractures and formation of periarticular ossifications, rate of secondary interventions and complications, and health-related quality of life (Short-Form 36. Discussion The outcome of this study will yield quantitative data on the functional outcome in patients with a complex elbow dislocation and who are

  19. Treatment of neglected elbow dislocations with the help of hinged external fixator: Report of two cases

    Directory of Open Access Journals (Sweden)

    Özgür Karakoyun

    2014-06-01

    Full Text Available Elbow dislocations are cases that have to be treated in emergency conditions. Neglected elbow dislocations are seen very rarely and the treatment of such cases are more complicated than acute cases. We present two cases of neglected elbow dislocations treated with open reduction and hinged external fixators. Case 1: 23 year old female patient had a neglected posterior dislocation of left elbow with ipsilateral humeral shaft fracture caused by car accident. The patient was treated after 3 months of initial trauma. We have performed open reduction for the joint. After that we fixed the joint whit a hinged external fixator. The humeral shaft fracture was also fixed with the components of the external fixator. Case 2: 33 year male patient had a large bone and soft tissue defect around the left elbow accompanying with neglected medial elbow dislocation. He presented to our clinic with a delay of 2 months. The patient was treated with open reduction and hinged external fixator after reconstruction of bone defect of distal humerus. Conclusion: The treatment of neglected cases is quite challenging. Open reduction and external fixation has satisfactory results in treatment of late cases of elbow dislocation with the possibility of early rehabilitation. This method can be considered as an option for such cases. J Clin Exp Invest 2014; 5 (2: 443-446

  20. Atomistic simulations of dislocation processes in copper

    DEFF Research Database (Denmark)

    Vegge, T.; Jacobsen, K.W.

    2002-01-01

    We discuss atomistic simulations of dislocation processes in copper based on effective medium theory interatomic potentials. Results on screw dislocation structures and processes are reviewed with particular focus on point defect mobilities and processes involving cross slip. For example, the sta......We discuss atomistic simulations of dislocation processes in copper based on effective medium theory interatomic potentials. Results on screw dislocation structures and processes are reviewed with particular focus on point defect mobilities and processes involving cross slip. For example...

  1. Light scattering from dislocations in silicon

    Science.gov (United States)

    Monier, Vanessa; Capello, Luciana; Kononchuk, Oleg; Pichaud, Bernard

    2010-11-01

    Nondecorated glide dislocations in Czochralski grown silicon have been studied by laser scattering tomography technique. Dependence of intensity of scattered light on polarization of the incident light has been measured for different orientations of the dislocation line and Burgers vector. Detailed theory of light scattering by dislocation in silicon crystals is presented. It is shown that by combination of polarization and tomography measurements it is possible to determine slip system of nondecorated mixed dislocation in Si.

  2. Bilateral fracture dislocation of the shoulder (Presentation of a Case)

    OpenAIRE

    Kuzgun, Unal; Baskir, Orhan; Temelli, Yener; Yazicioglu, Onder; Temocin, Bahattin O.; Kokino, Misel

    2004-01-01

    The largest portion of the dislocations encountered in the adults comprises shoulder dislocations and 2.16% of these dislocations constitute posterior dislocations. It is possible to detect that a dislocation develops secondary to convulsions due to immediate loss of consciousness in the history of most of the posterior dislocations of the shoulder. Approximately 20 cases have been so far reported in literature regurding bilateral dislocations of the shoulder. Bilateral dislocation associated...

  3. Traumatic Knee Dislocation with Acute Artery Injury

    OpenAIRE

    Hüseyin Şahin1; Mustafa Uzkeser2; Ayhan Aköz; et al.

    2014-01-01

    Traumatic knee dislocation is very rare injury in patients presenting to the emergency room. The complications associated with knee dislocation such as amputation of extremities and die is required emergency response. We discussed a case, that he has only knee dislocation and popliteal artery injury and mortal as soon as possible.

  4. Scattering of phonons by dislocations

    International Nuclear Information System (INIS)

    By 1950, an explicit effort had been launched to use lattice thermal conductivity measurements in the investigation of defect structures in solids. This technique has been highly successful, especially when combined with the measurements of other properties such as optical absorption. One exception has been the study of dislocations. Although dislocations have a profound effect on the phonon thermal conductivity, the mechanisms of the phonon-dislocation interaction are poorly understood. The most basic questions are still debated in the literature. It therefore is pointless to attempt a quantitative comparison between an extensive accumulation of experimental data on the one hand, and the numerous theoretical models on the other. Instead, this chapter will attempt to glean a few qualitative conclusions from the existing experimental data. These results will then be compared with two general models which incorporate, in a qualitative manner, most of the proposed theories of the phonon-dislocation interaction. Until very recently, measurement of thermal conductivity was the only means available to probe the interaction between phonons and defects at phonon frequencies above the standard ultrasonic range of approx. = 109 Hz. The introductory paragraphs provide a brief review of the thermal-conductivity technique and the problems which are encountered in practice. There is also a brief presentation of the theoretical models and the complications that may occur in more realistic situations

  5. Financial Dislocations among Divorcing Families.

    Science.gov (United States)

    Little, Marilyn J.

    Extensive economic changes may be brought about by divorce. In an attempt to demonstrate that the degree of financial dislocation following divorce depends on three factors--custody arrangements, wife's employment, and social class--data on men's and women's employment, income, and support payments were gathered for 222 divorcing families. Total…

  6. Simultaneous bilateral anterior shoulder dislocation: report of two cases and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Sujit Kumar Tripathy; Ramesh Kumar Sen; Sameer Aggarwal; Sarvdeep Singh Dhatt; Naveen Tahasildar

    2011-01-01

    Bilateral shoulder dislocations are rare and almost always occur in the posterior direction. Simultaneous bilateral anterior shoulder dislocation is even rarer and only a few cases are stated in the literature. The most interesting part of a bilateral shoulder dislocation is about its injury mechanism as a synchronous and simultaneous force is needed to result in it. In cases of epilepsy or electrocution, the mechanism is different and the forceful contractions of the selective group of muscles result in the dislocation. This article reports two cases of bilateral simultaneous anterior shoulder joint dislocation that occurred after a road side accident and after an episode of convulsion in an epileptic patient. The dislocations were diagnosed early and reduced immediately with a proper postreduction rehabilitation. During their follow-up, both patients had satisfactory functional outcome. This article emphasizes on the importance of shoulder examination in road side accident victims and epileptic patients. All orthopedic surgeons and emergency physicians should be aware of such unusual possibilities to have an early diagnosis and treatment.An early reduction and appropriate rehabilitation can provide satisfactory functional outcome. This article also briefly discusses the injury mechanisms, diagnoses and treatments of bilateral shoulder dislocation as reported in the literature.

  7. Bilateral inferior dislocation of the hip——a case report

    Institute of Scientific and Technical Information of China (English)

    Kishan R Bhagwat; Bhavuk Garg; Sameer Aggarwal; Mandeep S Dhillon

    2012-01-01

    Inferior dislocation of the hip is the rarest type in hip dislocation.Very few cases have been reported in the anglophonic literature,most of which involved the pediatric age group.Surprisingly,we came across a 30-year-old patient with a bilateral inferior hip dislocation.He had sustained a road traffic accident and the attitude of both hip joints was flexion and abduction.The diagnosis was confirmed by radiographs which revealed the long axis of the femur at an angle of 110 (fight) degrees and 100 (left) degrees respectively away from the axis.Closed reduction under sedation was successfully performed.Skin traction for a period of 6 weeks was advised and the follow-up revealed an excellent result.We present the details of this case,the first of its kind along with a review of the literature,discussing the various modes and mechanisms of injury inducing inferior dislocation of the hip.

  8. Irreducible ankle fracture-dislocation due to tibialis anterior subluxation: a case report.

    Science.gov (United States)

    Natoli, Roman M; Summers, Hobie D

    2015-01-01

    Irreducible ankle fracture-dislocations are rare. Several cases of irreducible ankle fracture-dislocation have been reported in published studies secondary to the tibialis posterior tendon, deltoid ligament, or extensor digitorum longus tendon blocking the reduction. We report a case of irreducible ankle fracture-dislocation resulting from posteromedial subluxation of the tibialis anterior tendon around a medial malleolar fracture fragment. Ultimately, the ankle required open reduction of the incarcerated tendon to reduce the joint and proceed with internal fixation of the associated fracture. The patient's postoperative course was uncomplicated, and the tibialis anterior tendon was functioning at 10 months postoperatively, after which he did not return for follow-up examinations. To our knowledge, this is the first reported case of the tibialis anterior tendon blocking closed reduction of an ankle fracture-dislocation. PMID:25618805

  9. Open antero-lateral dislocation of the elbow. A case report

    Directory of Open Access Journals (Sweden)

    Roy Bibas R

    2002-01-01

    Full Text Available Abstract Background Open dislocations are infrequent, often associated with damage to the neuro vascular structures. We present an unusual case of an open antero-lateral dislocation of the elbow, which was not associated with any vascular or neural injury. Case presentation A 34 year female dance instructor sustained an open dislocation of her elbow. Surgical exploration was undertaken. No major neurovascular injury was present. There was almost complete disruption of all the muscular and ligamentous attachments to the distal humerus and the proximal radius and ulna, which were not formally repaired during surgery. The elbow was found to be very unstable, and was placed in a back slab. The functional recovery was complete in about six months, the patient regaining full range of elbow movement. Elbow dislocations without associate fractures are adequately treated by manipulation and reduction, in spite of the almost complete disruption of the soft tissues around the joint.

  10. Subtalar dislocation secondary to a low energy injury.

    Science.gov (United States)

    McKeag, Philip; Lyske, Jonathan; Reaney, Jonathan; Thompson, Neville

    2015-01-01

    An 18-year-old young man presented with an ankle injury, after landing on a supinated right foot following jumping while playing football. A plain X-ray revealed a medial subtalar dislocation. Despite obvious ankle deformity, the surrounding skin remained intact. Closed reduction of the subtalar joint was successfully performed under general anaesthesia in theatre. A CT of the ankle, after reduction, demonstrated a non-displaced fracture of the neck of the talus; no osteochondral defect was observed. This was successfully managed conservatively, with immobilisation of the ankle, in a non-weight bearing cast for 6 weeks. This case highlights that subtalar dislocation may follow a low-energy mechanism and that such injuries can be managed without open reduction. PMID:25650063

  11. Arthroplasty versus arthroscopy for recurrent anterior dislocation of the shoulder joint with severe bone defects:3-year follow-up%关节置换与关节镜下修复肩关节复发性前脱位伴重度骨缺损:3年随访对比

    Institute of Scientific and Technical Information of China (English)

    陈辉; 王群; 燕双喜; 董天云; 邹海兵

    2015-01-01

    背景:随着外科技术、重建材料技术的发展,关节置换在肩关节脱位中也得到了广泛应用,特别是各种定制型或装配型假体使得置换适应证明显提高。  目的:观察与随访关节镜与关节置换治疗肩关节复发性前脱位伴重度骨缺损的远期疗效。  方法:纳入肩关节复发性前脱位伴重度骨缺损患者144例,根据随机抽签分为治疗组与对照组,每组72例。对照组行关节镜下内固定治疗,治疗组行关节置换治疗。通过电话调查与复诊完成3年随访,记录患者Neer肩关节功能评分、肩关节活动度及并发症发生情况。  结果与结论:随访3年,治疗组的肩关节功能优良率90%明显高于对照组81%(P RESULTS AND CONCLUSION:After 3-year fol owed-up, the excel ent and good rate of shoulder function was significantly higher in the treatment group (90%) than in the control group (81%) (P<0.05). The magnitude of the flexion in the 3-year fol owed-up was apparently increased, while the lateral margin external rotation was decreased, which showed significant differences after intragroup comparison (P<0.05). Simultaneously, the magnitude of the flexion and the lateral margin external rotation in the treatment group had statistical y significant differences compared to the control group in the 3-year fol owed-up (P<0.05). The complications of wound infection, shoulder dislocation, and implant loosening in the treatment group during fol ow-up were significantly lower than in the control group (P<0.05). These findings verified that compared with arthroscopic surgery, arthroplasty for treating recurrent anterior dislocation of the shoulder joint with severe bone defects in long-term fol ow-up can effectively restore shoulder function and range of motion, and it has few complications, thereby effectively rebuilds shoulder joint.

  12. A Galeazzi-variant type fracture-dislocation in adults

    Institute of Scientific and Technical Information of China (English)

    Raju Vaishya; Sundar Kumar Shrestha; Abhishek Vaish

    2013-01-01

    Objective:Fracture of either radius or ulna with a dislocation either at the proximal or distal radioulnar joint (DRUJ) is not a common injury and is inherently unstable.Here we report a case series,with both-bone forearm fractures associated with dislocation of DRUJ,as a Galeazzi-variant type fracture-dislocation,and try to analyze this injury pattern.Methods:The study was based on 6 patients having Galeazzi-variant type fracture-dislocation of different age (20 to 45 years).All fractures were closed type.Two fractures involved the same level and three fractures were at different levels of radius and ulna shaft.After thorough examination and investigations they were treated with limited contact dynamic compression plate without additional fixation for DRUJ.Results:All cases were followed up for 24 weeks.The maximum incidence occurred in age group between 31 and 40 years.All the fractures of both radius and ulna were united in average time of 12 weeks.Range of motion of wrist and elbow,supination and pronation at final follow-up were normal.There was no subsequent re-subluxation or dislocation of the DRUJ in any of the cases.Conclusion:Galeazzi variant in adult is a new undescribed pattern of forearm with wrist injury.Stable open reduction and internal fixation of both-bone forearm fractures is mandatory,followed by 3 to 4 weeks of immobilization in a cast for the healing of disrupted DRUJ.

  13. A Galeazzi-variant type fracture-dislocation in adults

    Directory of Open Access Journals (Sweden)

    Vaishya Raju

    2013-12-01

    Full Text Available 【Abstract】Objective: Fracture of either radius or ulna with a dislocation either at the proximal or distal radio- ulnar joint (DRUJ is not a common injury and is inherently unstable. Here we report a case series, with both-bone fore- arm fractures associated with dislocation of DRUJ, as a Galeazzi-variant type fracture-dislocation, and try to ana- lyze this injury pattern. Methods: The study was based on 6 patients having Galeazzi-variant type fracture-dislocation of different age (20 to 45 years. All fractures were closed type. Two frac- tures involved the same level and three fractures were at different levels of radius and ulna shaft. After thorough examination and investigations they were treated with limi- ted contact dynamic compression plate without additional fixation for DRUJ. Results: All cases were followed up for 24 weeks. The maximum incidence occurred in age group between 31 and 40 years. All the fractures of both radius and ulna were united in average time of 12 weeks. Range of motion of wrist and elbow, supination and pronation at final follow-up were normal. There was no subsequent re-subluxation or dislo- cation of the DRUJ in any of the cases. Conclusion: Galeazzi variant in adult is a new undescribed pattern of forearm with wrist injury. Stable open reduction and internal fixation of both-bone forearm frac- tures is mandatory, followed by 3 to 4 weeks of immobiliza- tion in a cast for the healing of disrupted DRUJ. Key words: Dislocations; Radius fractures; Ulna fractures; Wrist injuries

  14. Arthroscopic findings after shoulder dislocation

    OpenAIRE

    Medenica Ivica; Radunović Aleksandar; Madžarac Dragan; Zorić Miodrag; Bokonjić Dubravko; Stojković Bratislav

    2009-01-01

    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 t...

  15. Preserving the Posttrapeziectomy Space with a Human Acellular Dermal Matrix Spacer: A Pilot Case Series of Patients with Thumb Carpometacarpal Joint Arthritis

    Directory of Open Access Journals (Sweden)

    Caroline A. Yao, MD

    2013-10-01

    Conclusions: HADM has been used extensively in other forms of reconstruction and has been shown to incorporate into surrounding tissues through neovascularization. Our early results illustrate that HADM can safely fill the dead space left by trapeziectomy.

  16. Radial head button holing: a cause of irreducible anterior radial head dislocation.

    Science.gov (United States)

    Shin, Su-Mi; Chai, Jee Won; You, Ja Yeon; Park, Jina; Bae, Kee Jeong

    2016-10-01

    "Buttonholing" of the radial head through the anterior joint capsule is a known cause of irreducible anterior radial head dislocation associated with Monteggia injuries in pediatric patients. To the best of our knowledge, no report has described an injury consisting of buttonholing of the radial head through the annular ligament and a simultaneous radial head fracture in an adolescent. In the present case, the radiographic findings were a radial head fracture with anterior dislocation and lack of the anterior fat pad sign. Magnetic resonance imaging (MRI) clearly demonstrated anterior dislocation of the fractured radial head through the torn annular ligament. The anterior joint capsule and proximal portion of the annular ligament were interposed between the radial head and capitellum, preventing closed reduction of the radial head. Familiarity with this condition and imaging findings will aid clinicians to make a proper diagnosis and fast decision to perform an open reduction. PMID:27502623

  17. Solute drag on perfect and extended dislocations

    Science.gov (United States)

    Sills, R. B.; Cai, W.

    2016-04-01

    The drag force exerted on a moving dislocation by a field of mobile solutes is studied in the steady state. The drag force is numerically calculated as a function of the dislocation velocity for both perfect and extended dislocations. The sensitivity of the non-dimensionalized force-velocity curve to the various controlling parameters is assessed, and an approximate analytical force-velocity expression is given. A non-dimensional parameter S characterizing the strength of the solute-dislocation interaction, the background solute fraction ?, and the dislocation character angle ?, are found to have the strongest influence on the force-velocity curve. Within the model considered here, a perfect screw dislocation experiences no solute drag, but an extended screw dislocation experiences a non-zero drag force that is about 10 to 30% of the drag on an extended edge dislocation. The solutes can change the spacing between the Shockley partials in both stationary and moving extended dislocations, even when the stacking fault energy remains unaltered. Under certain conditions, the solutes destabilize an extended dislocation by either collapsing it into a perfect dislocation or causing the partials to separate unboundedly. It is proposed that the latter instability may lead to the formation of large faulted areas and deformation twins in low stacking fault energy materials containing solutes, consistent with experimental observations of copper and stainless steel containing hydrogen.

  18. Posterior dislocation of the elbow as an unusual presentation after a total hip replacement: a case report

    Directory of Open Access Journals (Sweden)

    Periasamy Kumar

    2008-02-01

    Full Text Available Abstract Introduction Posterior dislocation of the elbow is usually associated with trauma to the joint with a reported incidence of 3%to 6%. Chronic instability is usually symptomatic following the initial injury. Case presentation We report a case of posterior dislocation of the elbow occurring in a patient while using her arm to lift herself using a monkey pole on the second day following a total hip replacement. The dislocation was reduced under sedation in the ward. There were no signs or symptoms suggesting any joint hypermobility syndrome in the patient. Follow up 4 months following the injury revealed a complete recovery in the range of motion and a pain free elbow. There were no signs and symptoms of any instability. Conclusion This is the first time such a case is reported in the literature. It certainly demonstrates that even in the absence of instability a patient can be predisposed to low energy dislocation of the elbow.

  19. [Anterior dislocation of the fibula resulting from surgical malreduction: a case report].

    Science.gov (United States)

    Wang, Z Y; Wu, X B

    2016-04-18

    Ankle joint fracture is one of the most common types of fracture. There are many researches on the injury mechanism, treatment principles and surgical techniques. A type of injury which combines posterior dislocation of fibula, known as the Bosworth injury, is relatively rare. In 1947, Bosworth first described this type of injury as an unusual ankle fracture dislocation with fixed posterior fracture dislocation of the distal part of the fibula. In this type of fracture, the proximal fibular shaft fragment locks behind the tibialis posterior tubercle. This rare ankle fracture variant is often not recognized in initial radiographs and requires a computed tomographic (CT) scan for verification. But there are already many reports, discussing the injury mechanism, treatment principles and surgical techniques. However, there are few reports of anterior dislocation of the fibula, caused by either injury or surgery. The mechanism of the injury is still not clear. This article reports a case of anterior dislocation of the fibula. We report a patient with left ankle open fracture (Lauge-Hansen pronation-external rotation stage III, Gustilo IIIA). Open reduction and internal fixation was done in the initial surgery, but ended up with poor reduction, resulting in fibula anterior dislocation, anterior dislocation of talus and tibia fibular dislocation. The fibula was dislocated anteriorly of the tibia, which rarely happened. The patient suffered severe ankle joint dysfunction. The second operation took out the original internal fixation, reduced the fracture, and reset the internal fixation. The function of ankle joint was improved obviously after operation. But because of the initial injury and the two operations, the soft tissue around the fracture was greatly damaged. 6 months after the second operation, and the fracture still not healed, so the bone graft was carried out in the third surgery. Two months after the third surgery, the function of the ankle was significantly

  20. Closed subtalar dislocation with non-displaced fractures of talus and navicular: a case report and review of the literature

    OpenAIRE

    Fotiadis, Elias; Lyrtzis, Christos; Svarnas, Theodoros; Koimtzis, Miltos; Akritopoulou, Kiriaki; Chalidis, Byron

    2009-01-01

    Closed subtalar dislocations associated with talus and navicular fractures are rare injuries. We report on a case of a 43-year-old builder man with medial subtalar dislocation that was further complicated by minimally displaced talar and navicular fractures. Successful closed reduction under general anesthesia was followed by non-weight bearing and ankle immobilization with a below-knee cast for 6 ;weeks. At 3 years post-injury, the subtalar joint was stable, the foot and ankle mobility was i...

  1. Lattice dislocation in Si nanowires

    Energy Technology Data Exchange (ETDEWEB)

    Omar, M.S., E-mail: dr_m_s_omar@yahoo.co [Department of Physics, College of Science, University of Salahaddin, Arbil, Iraqi Kurdistan (Iraq); Taha, H.T. [Department of Physics, College of Science, University of Salahaddin, Arbil, Iraqi Kurdistan (Iraq)

    2009-12-15

    Modified formulas were used to calculate lattice thermal expansion, specific heat and Bulk modulus for Si nanowires with diameters of 115, 56, 37 and 22 nm. From these values and Gruneisen parameter taken from reference, mean lattice volumes were found to be as 20.03 A{sup 3} for the bulk and 23.63, 29.91, 34.69 and 40.46 A{sup 3} for Si nanowire diameters mentioned above, respectively. Their mean bonding length was calculated to be as 0.235 nm for the bulk and 0.248, 0.269, 0.282 and 0.297 nm for the nanowires diameter mentioned above, respectively. By dividing the nanowires diameter on the mean bonding length, number of layers per each nanowire size was found to be as 230, 104, 65 and 37 for the diameters mentioned above, respectively. Lattice dislocations in 22 nm diameter wire were found to be from 0.00324 nm for the 1st central lattice to 0.2579 nm for the last surface lattice. Such dislocation was smaller for larger wire diameters. Dislocation concentration found to change in Si nanowires according to the proportionalities of surface thickness to nanowire radius ratios.

  2. Conservative treatment of an anterior-lateral ankle dislocation without an associated fracture in a diabetic patient: a case report

    Directory of Open Access Journals (Sweden)

    Panagiotis K. Karampinas

    2012-06-01

    Full Text Available Anterior or anterior-lateral dislocation of the ankle is a rare condition that can be treated conservatively as well as any other similar types of ankle dislocations without associated fractures. We present a case report of an anterior-lateral ankle dislocation with a concomitant avulsion injury of the ankle's anterior capsule in a diabetic patient that was treated conservatively. At the patient's visit 12 months after the initial injury, he was asymptomatic with full range of motion of the ankle joint. To our knowledge, we could not identify this type of an injury in a diabetic patient that was treated successfully with conservative treatment in the existing literature.

  3. Anterior dislocation of shoulder in eclampsia:a case report

    Institute of Scientific and Technical Information of China (English)

    Seema Rawat; Sanjay Meena; Shreesh Kumar Gangari; Lalit Kumar Lohia

    2012-01-01

    This case report presents a 25-year-old female patient with anterior dislocation of right shoulder secondary to seizures as a complication of eclampsia.This is an unusual mechanism of injury,but similar to other uncontrolled muscular contractions caused by electroconvulsive therapy,etc.To the best of our knowledge only one such case has been reported in the English literature.Closed reduction under general anaesthesia was successfully achieved.High suspicion in patients complaining of pain over shoulder joint is necessary for early diagnosis of this condition.

  4. [Case report and literature review: elbow fracture dislocation in children].

    Science.gov (United States)

    Guzmdn, R; Rincón, D; Camacho, J

    2015-01-01

    Elbow dislocation in children is a very infrequent traumatic event which was first described by Stimson in 1900 and then by Tachdjian in 1990. Its estimated incidence ranges from 3% to 6% of all elbow injuries, peaking at 13-14 years. Elbow trauma is classified considering the direction in which the proximal radioulnar joint shifts with respect to the humerus, into posterior and anterior dislocation. The former is the most frequent and accounts for 95% of cases. Elbow fracture dislocation is an even rarer event. The incidence rate of avulsion fracture of the medial epicondyle is 25-36%, of the lateral condyle 4%, of the olecranon 1.7%, of the radial head 8%, of the coronoid process 3.5%, and others, 3.5%. At present there is no consensus in the literature on how to treat this type of lesions, particularly because some authors advocate nonsurgical management, while others propose surgical management as the definitive treatment. What is clear, however, is that a late diagnosis or untimely treatment may affect the child's growth and lead to serious complications. The purpose of this study is to share our experience and good results with the surgical management of these infrequent cases.

  5. A RARE CASE OF IPSILATERAL HIP AND KNEE DISLOCATION

    Directory of Open Access Journals (Sweden)

    Deepak

    2015-06-01

    Full Text Available High velocity road traffic accidents leads to complicated lower limb injuries. Such injuries demand highly experienced surgeon and are associated with high morbidity and mortality. Hip or knee dislocations are two different orthopaedic emergencies. Concomitant fracture dislocation of the hip and knee is rare and very few cases have been reported in the literature. A 45 year old man with history of fall from motorcycle came to the casualty. He had ipsilateral hip and knee dislocation. Immediately patient was shifted to operation theatre and closed reduction was performed under general anaesthesia. Reduction was confirmed under fluoroscopy and post-operative x-rays were taken. The functional results were excellent. After 2 months patient made an uncomplicated recovery and had satisfactory functional outcome with right hip having 110⁰ flexion and right knee flexes to 120⁰.There was no neurological deficit. The urgency, that the treating surgeon shows in managing these injuries, significantly affects the prognosis and outcome finally achieved by these patients (golden period in reducing the hip joint has been described to be 6 hours.

  6. Unusual patterns of Monteggia fracture-dislocation

    Directory of Open Access Journals (Sweden)

    Polychronidis Alexandros

    2006-11-01

    Full Text Available Abstract Background High-energy trauma may result in uncommon open injuries around the elbow joint. The management of these injuries can be difficult. Case description Fourteen patients were treated between 1999 and 2003 and their injuries consisted of Monteggia fracture-dislocations combined with segmental fractures of the ulna or fractures of the forearm bones and/or various more complex trauma such as neural injuries, bone comminution and severe soft tissue injuries around the elbow. Eight of them (57% were multiply injured with severe additional injuries. All patients underwent surgery within first 4–6 hours. Internal fixation, external fixation or a combination of both methods were used to stabilize fractures while open wounds had secondary closure. Results Additional operations were required in 6 patients. The functional results according to the Mayo Elbow Performance Index were excellent or good in eleven patients, and fair or poor in the remaining three. The patients with fair and poor results had suffered from severe neural and soft tissue trauma and/or multiple fractures of the upper extremity. Conclusion These injuries should be treated as an emergency. The surgeon should apply any available method that can provide stability to the bone fragments and safe handling of the soft tissues giving priority to internal fixation of the fractures. Severe osseous, soft tissue and neural trauma affect the functional results of the elbow region.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Rare Inferior Shoulder Dislocation (Luxatio Erecta)

    OpenAIRE

    Hakan Cift; Salih Soylemez; Murat Demiroglu; Korhan Ozkan; Vahit Emre Ozden; Ozkut, Afsar T.

    2015-01-01

    Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients’ ages were 78, 62, 65, and 76. All patients’ reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitat...

  9. A Numeric Study on Chaotic Dislocation Emission

    Institute of Scientific and Technical Information of China (English)

    HonglaiTan; WeiYang

    1996-01-01

    Crack tip atom-string model is devised to study non-linear features of dislocation emission processes under mode II loads.Dynamic analysis shows that the atom motion at the crack tip changes from periodic to chaotic as the stress intensity factor increases.Study on the dislocation emission band reveals the phenomenon of cloud-like drifting of the dislocation core ahead of the crack tip.

  10. Robust atomistic calculation of dislocation line tension

    Science.gov (United States)

    Szajewski, B. A.; Pavia, F.; Curtin, W. A.

    2015-12-01

    The line tension Γ of a dislocation is an important and fundamental property ubiquitous to continuum scale models of metal plasticity. However, the precise value of Γ in a given material has proven difficult to assess, with literature values encompassing a wide range. Here results from a multiscale simulation and robust analysis of the dislocation line tension, for dislocation bow-out between pinning points, are presented for two widely-used interatomic potentials for Al. A central part of the analysis involves an effective Peierls stress applicable to curved dislocation structures that markedly differs from that of perfectly straight dislocations but is required to describe the bow-out both in loading and unloading. The line tensions for the two interatomic potentials are similar and provide robust numerical values for Al. Most importantly, the atomic results show notable differences with singular anisotropic elastic dislocation theory in that (i) the coefficient of the \\text{ln}(L) scaling with dislocation length L differs and (ii) the ratio of screw to edge line tension is smaller than predicted by anisotropic elasticity. These differences are attributed to local dislocation core interactions that remain beyond the scope of elasticity theory. The many differing literature values for Γ are attributed to various approximations and inaccuracies in previous approaches. The results here indicate that continuum line dislocation models, based on elasticity theory and various core-cut-off assumptions, may be fundamentally unable to reproduce full atomistic results, thus hampering the detailed predictive ability of such continuum models.

  11. Massively-Parallel Dislocation Dynamics Simulations

    Energy Technology Data Exchange (ETDEWEB)

    Cai, W; Bulatov, V V; Pierce, T G; Hiratani, M; Rhee, M; Bartelt, M; Tang, M

    2003-06-18

    Prediction of the plastic strength of single crystals based on the collective dynamics of dislocations has been a challenge for computational materials science for a number of years. The difficulty lies in the inability of the existing dislocation dynamics (DD) codes to handle a sufficiently large number of dislocation lines, in order to be statistically representative and to reproduce experimentally observed microstructures. A new massively-parallel DD code is developed that is capable of modeling million-dislocation systems by employing thousands of processors. We discuss the general aspects of this code that make such large scale simulations possible, as well as a few initial simulation results.

  12. Hybrid Dislocated Control and General Hybrid Projective Dislocated Synchronization for Memristor Chaotic Oscillator System

    OpenAIRE

    Junwei Sun; Chun Huang; Guangzhao Cui

    2014-01-01

    Some important dynamical properties of the memristor chaotic oscillator system have been studied in the paper. A novel hybrid dislocated control method and a general hybrid projective dislocated synchronization scheme have been realized for memristor chaotic oscillator system. The paper firstly presents hybrid dislocated control method for stabilizing chaos to the unstable equilibrium point. Based on the Lyapunov stability theorem, general hybrid projective dislocated synchronization has been...

  13. Functional treatment versus plaster for simple elbow dislocations (FuncSiE: a randomized trial

    Directory of Open Access Journals (Sweden)

    Verleisdonk Egbert JMM

    2010-11-01

    Full Text Available 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. After reduction of a simple dislocation, treatment options include immobilization in a static plaster for different periods of time or so-called functional treatment. Functional treatment is characterized by early active motion within the limits of pain with or without the use of a sling or hinged brace. Theoretically, functional treatment should prevent stiffness without introducing increased joint instability. The primary aim of this randomized controlled trial is to compare early functional treatment versus plaster immobilization following simple dislocations of the elbow. Methods/Design The design of the study will be a multicenter randomized controlled trial of 100 patients who have sustained a simple elbow dislocation. After reduction of the dislocation, patients are randomized between a pressure bandage for 5-7 days and early functional treatment or a plaster in 90 degrees flexion, neutral position for pro-supination for a period of three weeks. In the functional group, treatment is started with early active motion within the limits of pain. Function, pain, and radiographic recovery will be evaluated at regular intervals over the subsequent 12 months. The primary outcome measure is the Quick Disabilities of the Arm, Shoulder, and Hand score. The secondary outcome measures are the Mayo Elbow Performance Index, Oxford elbow score, pain level at both sides, range of motion of the elbow joint at both sides, rate of secondary interventions and complication rates in both groups (secondary dislocation, instability, relaxation, health-related quality of life (Short-Form 36 and EuroQol-5D, radiographic appearance of the elbow joint (degenerative changes and heterotopic ossifications, costs, and cost-effectiveness. Discussion The successful

  14. Risk of dislocation using large- vs. small-diameter femoral heads in total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Plate Johannes F

    2012-10-01

    Full Text Available Abstract Background Dislocation remains a difficult problem in total hip arthroplasty. Large-diameter femoral heads may lower the incidence of dislocation by enhancing the jump distance and decreasing impingement, but their performance against small-diameter heads has not been assessed. This study compared the mid-term radiographic and functional outcomes of two matched cohorts of patients undergoing total hip arthroplasty who had a high pre-operative risk for dislocation and who received either small-diameter (26- or 28-millimeters or large-diameter (≥36-millimeters femoral heads. Methods All patients who received large-diameter heads (≥36-millimeter between 2002 and 2005, and who had pre-operative risk factors for dislocation, were identified in the institution’s joint registry. Forty-one patients (52 hips who received large-diameter heads were identified, and these patients were matched to 48 patients (52 hips in the registry who received small-diameter femoral heads. Results At mean final follow-up of 62 months (range, 49 to 101 months, both groups achieved excellent functional outcomes as measured by Harris Hip scores, with slightly better final scores in the large-diameter group (90 vs. 83 points. No patient showed any radiographic signs of loosening. No patient dislocated in the large-diameter femoral head group; the smaller-diameter group had a greater rate of dislocation (3.8%, 2 out of 52. Conclusions Large-diameter femoral head articulations may reduce dislocation rates in patients who have a high pre-operative risk for dislocation while providing the same functional improvements and safety as small-diameter bearings.

  15. Multiscale modeling of dislocation-precipitate interactions in Fe: From molecular dynamics to discrete dislocations.

    Science.gov (United States)

    Lehtinen, Arttu; Granberg, Fredric; Laurson, Lasse; Nordlund, Kai; Alava, Mikko J

    2016-01-01

    The stress-driven motion of dislocations in crystalline solids, and thus the ensuing plastic deformation process, is greatly influenced by the presence or absence of various pointlike defects such as precipitates or solute atoms. These defects act as obstacles for dislocation motion and hence affect the mechanical properties of the material. Here we combine molecular dynamics studies with three-dimensional discrete dislocation dynamics simulations in order to model the interaction between different kinds of precipitates and a 1/2〈111〉{110} edge dislocation in BCC iron. We have implemented immobile spherical precipitates into the ParaDis discrete dislocation dynamics code, with the dislocations interacting with the precipitates via a Gaussian potential, generating a normal force acting on the dislocation segments. The parameters used in the discrete dislocation dynamics simulations for the precipitate potential, the dislocation mobility, shear modulus, and dislocation core energy are obtained from molecular dynamics simulations. We compare the critical stresses needed to unpin the dislocation from the precipitate in molecular dynamics and discrete dislocation dynamics simulations in order to fit the two methods together and discuss the variety of the relevant pinning and depinning mechanisms. PMID:26871192

  16. Management of Open Fracture-Dislocation of the Ankle. A Case Report

    Directory of Open Access Journals (Sweden)

    Yaniel Truffin Rodriguez

    2014-12-01

    Full Text Available An open fracture-dislocation of the ankle is a rare injury. The case of a 57-year-old patient without a history of previous diseases who attended the emergency department of the Dr. Gustavo Aldereguía Lima University General Hospital in Cienfuegos after suffering a work-related accident is presented. To repair this serious injury, the surgical cleaning of the joint with antiseptic solutions was performed urgently, the fracture-dislocation was reduced and an osteosynthesis was carried out. Twelve weeks after surgery the patient returned to his previous work.

  17. "Dislocation"

    Institute of Scientific and Technical Information of China (English)

    Li Wei

    2006-01-01

    @@ Over the past five years since September 11, the international community has been highly focused on the increasingly serious terrorist threat. In order to strike the international terrorist force, with al Qaeda as its core, the United Nations Security Council has established a special counter-terrorism committee, drawing up 12 related resolutions, agreements and conventions; multilateral and bilateral counter-terrorism cooperation has been expanding and deepening unceasingly. Many countries have brought counter-terrorism into their national security strategy, established or revised relevant laws, increased the input of manpower, material resources, and funds, actively researched and developed new technology and strengthened all kinds of counter-terrorist measures. Theoretically, international society has created an "inescapable net" for terrorism.

  18. Dislocation

    Science.gov (United States)

    To help prevent injuries in children: Create a safe environment around your home. Help prevent falls by placing ... no substitute for close supervision, no matter how safe the environment or situation appears to be. Teach children how ...

  19. The temporomandibular joint

    International Nuclear Information System (INIS)

    Whilst the temporomandibular joint is in many ways unique, it is subject to all the diseases and disorders found in joints in other parts of the human skeleton. By far the most common disorder is injury, followed by arthropathy, acute and chronic dislocations, ankylosis, and in rare instances, neoplasms. The diagnosis and management of the temporomandibular joint are the primary responsibility of the oral surgeon. Nevertheless, this anatomical region is an area in which the cooperation of medical and dental disciplines may be required for the satisfactory conclusion of treatment. The more so when the disease process involves either associated psychosomatic illness or malignancy. The mainstay of the diagnosis is a careful radiological examination of the joint. There exists a delicate relationship between the dentition, the muscles of mastication, and the temporomandibular articulation, which is controlled by arthrokinetic reflex activity of the branches of the 5th cranial nerve. Imbalance between one or more of the components of this integrated system frequently leads to disturbances in function. Pain-dysfunction disorders constitute the larger part of temporomandibular joint disturbances generally encountered

  20. Distal radioulnar joint injuries

    Directory of Open Access Journals (Sweden)

    Binu P Thomas

    2012-01-01

    Full Text Available Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint , forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments.The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis.

  1. Temporomandibular joint examination reviewed

    Directory of Open Access Journals (Sweden)

    L. Guarda Nardini

    2011-09-01

    Full Text Available The temporo-mandibular joint (TMJ it’s a joint closely related to the skull base, the spine, and the jaws; all these anatomical structures must be taken in consideration when evaluating pain involving the tmj. In order to detect patients affected by pathology or dysfunctions of the tmj, physical examination is of great value in orienting the diagnosis. Inspection must consider the symmetry of the body, the dental status and the type of occlusion. Palpation is a way to assess contractiont involving the muscles of the masticatory system and of the neck. Auscultation, based on articular noise provides means to determine whether we are dealing with degeneration of the joint or a dislocation of the intrarticular disc. In order to confirm the diagnosis obtained with the clinical evaluation, it’s useful to perform imaging techniques as opt, tomography and TC of the tmj and electromyokineosiography – index of the mandibular functionality and of the muscles status. MRI and dynamic MRI are among the non invasive exams which give the greatest amount of information, regarding the disc position and the joint degeneration. Arthroscopy is an invasive technique that allows early diagnosis of degeneration and is helpful to reveal early inflammatory processes of the joint.

  2. Distal radioulnar joint injuries.

    Science.gov (United States)

    Thomas, Binu P; Sreekanth, Raveendran

    2012-09-01

    Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint, forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments. The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis. PMID:23162140

  3. Transoral atlantoaxial reduction plate fixation for irreducible atlantoaxial dislocation

    Institute of Scientific and Technical Information of China (English)

    YIN Qing-shui; AI Fu-zhi; ZHANG Kai; CHANG Yun-bing; XIA Hong; WU Zeng-hui; QUAN Ri; MAI Xiao-hong; LIU Jing-fa

    2006-01-01

    Objective:To design a clinically applicable transoralpharyngeal atlantoaxial reduction plate (TARP),introduce the operation procedure, and evaluate its preliminary clinical effects.Methods: A novel TARP system, including butterfly titanium alloy plate, self-locking screws, atlantoaxial reductor and other operational instruments was developed.This system was applied clinically on five patients with irreducible atlantoaxial dislocation of congenital or traumatic origin. During operation, the reduction was completed by the combined action of the plate and the atlantoaxial reductor after transoral joint release and cord decompression. Bone graft granules were implanted between the bilateral atlantoaxial joints and TARP was used to immobilize subsequently the atlas and axis.Results: Clinical application demonstrated that TARP could induce instant reduction and that the method was operationally feasible and its postoperational effect was satisfactory.Conclusions: The design of TARP is novel. The operational procedure is simple and easy to use.Furthermore, instant reduction can be completed during the operation and the fixation is relatively stable. TARP is an ideal alternative for irreducible atlantoaxial dislocation and may have excellent prospects for further clinical applications.

  4. Dislocated interests and climate change

    Science.gov (United States)

    Davis, Steven J.; Diffenbaugh, Noah

    2016-06-01

    The predicted effects of climate change on surface temperatures are now emergent and quantifiable. The recent letter by Hansen and Sato (2016 Environ. Res. Lett. 11 034009) adds to a growing number of studies showing that warming over the past four decades has shifted the distribution of temperatures higher almost everywhere, with the largest relative effects on summer temperatures in developing regions such as Africa, South America, southeast Asia, and the Middle East (e.g., Diffenbaugh and Scherer 2011 Clim. Change 107 615-24 Anderson 2011 Clim. Change 108 581; Mahlstein et al 2012 Geophys. Res. Lett. 39 L21711). Hansen and Sato emphasize that although these regions are warming disproportionately, their role in causing climate change—measured by cumulative historical CO2 emissions produced—is small compared to the US and Europe, where the relative change in temperatures has been less. This spatial and temporal mismatch of climate change impacts and the burning of fossil fuels is a critical dislocation of interests that, as the authors note, has ‘substantial implications for global energy and climate policies.’ Here, we place Hansen and Sato’s ‘national responsibilities’ into a broader conceptual framework of problematically dislocated interests, and briefly discuss the related challenges for global climate mitigation efforts.

  5. Formation of disorientations in dislocation structures during plastic deformation

    DEFF Research Database (Denmark)

    Pantleon, W.

    2002-01-01

    Disorientations developing during plastic deformation in dislocation structures are investigated. Based on expected mechanisms for the formation of different types of dislocation boundaries (statistical trapping of dislocations or differently activated slip systems) the formation of the disorient...

  6. Evaluation of mobile dislocation density based on distribution function of dislocation segments

    Institute of Scientific and Technical Information of China (English)

    周志敏; 孙艳蕊; 周海涛

    2004-01-01

    A function is offered to represent the distribution of reduced length of dislocation segments. The segment distribution of materials, e. g. , MgO and Cu, can be well described by taking appropriate values of parametersm and n. Based on this function, a model for evaluating the mobile dislocation density is developed. Provided the total dislocation density and applied stress are known, the mobile dislocation density could be readily assessed by using this model. For pure copper the mobile dislocation density and strain rates at deferent strains are evaluated. The calculated results are consistent with the known experimental data.

  7. Dislocation-Free Czochralski Silicon Crystal Growth without the Dislocation-Elimination-Necking Process

    Science.gov (United States)

    Hoshikawa, Keigo; Huang, Xinming; Taishi, Toshinori; Kajigaya, Tomio; Iino, Takayuki

    1999-12-01

    Dislocation-free silicon crystals have been grown successfully from heavily-boron-doped silicon melts by the Czochralski method without the dislocation-elimination-necking process (Dash neck). A dislocation-free silicon seed of orientation with a boron concentration of about 4×1019 atoms/cm3 was used to grow a silicon crystal with the same boron concentration. No dislocation was generated in the seed during the dipping process, and no misfit dislocation occurred in the grown crystal. These results show that shoulder and body growth can be started immediately after the seeding process.

  8. Dislocation pinning effects on fracture behavior: Atomistic and dislocation dynamics simulations

    Science.gov (United States)

    Noronha, S. J.; Farkas, D.

    2002-10-01

    We introduce an approach in which results from atomistic simulations are combined with discrete dislocation dynamics simulations of crack-tip plasticity. The method is used to study the effects of dislocation pinning due to grain boundaries or secondary particles on the fracture behavior of aluminum. We find that the fracture resistance is reduced with decreasing pinning distance. The results show that the pinning of the dislocations causes a net decrease in the shear stress projected on the slip plane, preventing further dislocation emission. Semibrittle cleavage occurs after a certain number of dislocations is emitted.

  9. A simulating analysis of the effects of increased joint stiffness on muscle loading in a thumb

    Directory of Open Access Journals (Sweden)

    Cutlip Robert G

    2009-12-01

    Full Text Available Abstract Background The development of osteoarthritis (OA in the hand results in increased joint stiffness, which in turn affects the grip strength. The goal of the present study is to theoretically analyze the muscle forces in a thumb in response to the increased joint stiffness. Methods The thumb was modeled as a linkage system consisting of a trapezium, a metacarpal bone, a proximal and a distal phalanx. Nine muscles were included in the model: flexor pollicis longus (FPL, extensor pollicis longus (EPL, extensor pollicis brevis (EPB, abductor pollicis longus (APL, flexor pollicis brevis (FPB, abductor pollicis brevis (APB, the transverse head of the adductor pollicis (ADPt, the oblique head of the adductor pollicis (ADPo, and opponens pollicis (OPP. Numerical tests were performed using an inverse dynamic approach. The joints were prescribed to an angular motion at one degree-of-freedom (DOF each time with all other DOFs of the joints being mechanically constrained, while the muscle forces in response to the joint motions were predicted. The normal joint stiffness was assumed to be 0.05, 0.10, and 0.15 N m/rad for interphalangeal (IP, metacarpophalangeal (MCP, and carpometacarpal (CMC joint, respectively. The joint stiffness was assumed to increase by 50% and 100%, simulating the biomechanical consequences of OA. Results Our simulations indicated that the increase in joint stiffness induced substantial increases in muscle forces, especially in the EPL and FPL muscles in response to IP, MCP, or CMC extension/flexion motions. Conclusions Because the strength of the muscles in the fingers is limited, the muscles will not be able to overcome joint resistance if joint stiffness is increased to its limit due to OA. This may contribute to the reduced range of motion typically seen in OA.

  10. Dislocation generation during early stage sintering.

    Science.gov (United States)

    Sheehan, J. E.; Lenel, F. V.; Ansell, G. S.

    1973-01-01

    Discussion of the effects of capillarity-induced stresses on dislocations during early stage sintering. A special version of Hirth's (1963) theoretical calculation procedures modified to describe dislocation nucleation on planes meeting the sintering body's neck surface obliquely is shown to predict plastic flow at stress levels know to exist between micron size metal particles in the early stages of sintering.

  11. Simulations of dislocation dynamics in aluminum interconnects

    NARCIS (Netherlands)

    Nicola, L; Van der Giessen, E; Needleman, A; Zavaliangos, A; Tikare,; Olevsky, EA

    2002-01-01

    A discrete dislocation simulation of plastic deformation in metallic interconnects caused by thermal stress is carried out. The calculations are carried out using a two dimensional plane strain formulation with only edge dislocations. A boundary value problem is formulated and solved for the evoluti

  12. Statistics of dislocation pinning at localized obstacles

    Science.gov (United States)

    Dutta, A.; Bhattacharya, M.; Barat, P.

    2014-10-01

    Pinning of dislocations at nanosized obstacles like precipitates, voids, and bubbles is a crucial mechanism in the context of phenomena like hardening and creep. The interaction between such an obstacle and a dislocation is often studied at fundamental level by means of analytical tools, atomistic simulations, and finite element methods. Nevertheless, the information extracted from such studies cannot be utilized to its maximum extent on account of insufficient information about the underlying statistics of this process comprising a large number of dislocations and obstacles in a system. Here, we propose a new statistical approach, where the statistics of pinning of dislocations by idealized spherical obstacles is explored by taking into account the generalized size-distribution of the obstacles along with the dislocation density within a three-dimensional framework. Starting with a minimal set of material parameters, the framework employs the method of geometrical statistics with a few simple assumptions compatible with the real physical scenario. The application of this approach, in combination with the knowledge of fundamental dislocation-obstacle interactions, has successfully been demonstrated for dislocation pinning at nanovoids in neutron irradiated type 316-stainless steel in regard to the non-conservative motion of dislocations. An interesting phenomenon of transition from rare pinning to multiple pinning regimes with increasing irradiation temperature is revealed.

  13. Interactions between Dislocations and Grain Boundaries

    NARCIS (Netherlands)

    Soer, Wouter Anthon

    2006-01-01

    Dislocations (line defects) and grain boundaries (planar defects) are two types of lattice defects that are crucial to the deformation behavior of metals. Permanent deformation of a crystalline material is microscopically associated with the nucleation and propagation of dislocations, and extensive

  14. Dislocation patterning in a two-dimensional continuum theory of dislocations

    Science.gov (United States)

    Groma, István; Zaiser, Michael; Ispánovity, Péter Dusán

    2016-06-01

    Understanding the spontaneous emergence of dislocation patterns during plastic deformation is a long standing challenge in dislocation theory. During the past decades several phenomenological continuum models of dislocation patterning were proposed, but few of them (if any) are derived from microscopic considerations through systematic and controlled averaging procedures. In this paper we present a two-dimensional continuum theory that is obtained by systematic averaging of the equations of motion of discrete dislocations. It is shown that in the evolution equations of the dislocation densities diffusionlike terms neglected in earlier considerations play a crucial role in the length scale selection of the dislocation density fluctuations. It is also shown that the formulated continuum theory can be derived from an averaged energy functional using the framework of phase field theories. However, in order to account for the flow stress one has in that case to introduce a nontrivial dislocation mobility function, which proves to be crucial for the instability leading to patterning.

  15. A nonsingular solution of the edge dislocation in the gauge theory of dislocations

    International Nuclear Information System (INIS)

    A (linear) nonsingular solution for the edge dislocation in the translational gauge theory of defects is presented. The stress function method is used and a modified stress function is obtained. All field quantities are globally defined and the solution agrees with the classical solution for the edge dislocation in the far field. The components of the stress, strain, distortion and displacement fields are also defined in the dislocation core region and they have no singularity there. The dislocation density, moment and couple stress for an edge dislocation are calculated. The solutions for the stress and strain fields obtained here are in agreement with those obtained by Gutkin and Aifantis through an analysis of the edge dislocation in the strain gradient elasticity. Additionally, the relation between the gauge theory and Eringen's so-called nonlocal theory of dislocations is given

  16. Irreducible Anterior Shoulder Dislocation Associated With Displaced Fracture of the Greater Tuberosity: An Analysis of Seven Cases

    Directory of Open Access Journals (Sweden)

    Morteza Nakhaei Amroodi

    2015-11-01

    Full Text Available Background: Although anterior shoulder dislocation is the most prevalent type of body dislocation, irreducible anterior shoulder dislocation is seldom reported in the literature, which is usually due to physical obstacles. Objectives: This study presents our findings regarding the causes of irreducibility of anterior shoulder dislocation associated with displaced fracture of the greater tuberosity. Patients and Methods: CT scans, open reduction of the joint, and internal fixation of the tuberosity was performed in seven patients with irreducible anterior shoulder dislocation associated with displaced fracture of the greater tuberosity. Results: As confirmed by intraoperative findings, the CT scans showed the cause of irreducible shoulder dislocation in six cases was the interposition of the long head of biceps (LHB in the anterior of the head that was displaced from the fracture line between the greater and lesser tuberosities. In another case, the greater and lesser tuberosities were attached to each other and were separated from the head. This fractured part was trapped. Conclusions: We suggest that performing CT scans in all cases of anterior shoulder dislocations with displaced fracture of the greater tuberosity can help surgeons to diagnose the accompanying fractures and possible complications, such as irreducibility. If the fracture line passes through the bicipital groove or in the case of a shield fracture, possible irreducibility should be borne in mind.

  17. Recurrent Dislocation of the Patella

    Science.gov (United States)

    Benítez, Gustavo

    2015-01-01

    Purpose: To evaluate results of medial patellofemoral ligament (MPFL) reconstruction associated with lateral release and advancement of vastus medialis in recurrent dislocation of the patella. Methods: We retrospectively evaluated 11 patients with a mean follow-up of 19 months. Mean age was 23, mainly women. We did MPFL reconstruction with semitendinosus or gracilis tendon depending on BMI, associated with advancement of vastus medialis and lateral release. Results: Mean Kujala score improved from 46,54 pts. preoperative to 88,36 postoperative. Our main complication was 1 patient with rigid knee, who required movilization under anesthesia and arthroscopic arthrolisis to improve her outcome. Conclusion: The combination of this techniques are a good alternative to treat patients with recurrent patella disclocation, with good short and mid-term results. Biomechanic intra and postop complications of MPFL reconstruction are related to patellar fixation, anatomic positioning of femoral tunnel and knee position of the graft fixation.

  18. Evolution, Interaction, and Intrinsic Properties of Dislocations in Intermetallics: Anisotropic 3D Dislocation Dynamics Approach

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Qian [Iowa State Univ., Ames, IA (United States)

    2008-01-01

    The generation, motion, and interaction of dislocations play key roles during the plastic deformation process of crystalline solids. 3D Dislocation Dynamics has been employed as a mesoscale simulation algorithm to investigate the collective and cooperative behavior of dislocations. Most current research on 3D Dislocation Dynamics is based on the solutions available in the framework of classical isotropic elasticity. However, due to some degree of elastic anisotropy in almost all crystalline solids, it is very necessary to extend 3D Dislocation Dynamics into anisotropic elasticity. In this study, first, the details of efficient and accurate incorporation of the fully anisotropic elasticity into 3D discrete Dislocation Dynamics by numerically evaluating the derivatives of Green's functions are described. Then the intrinsic properties of perfect dislocations, including their stability, their core properties and disassociation characteristics, in newly discovered rare earth-based intermetallics and in conventional intermetallics are investigated, within the framework of fully anisotropic elasticity supplemented with the atomistic information obtained from the ab initio calculations. Moreover, the evolution and interaction of dislocations in these intermetallics as well as the role of solute segregation are presented by utilizing fully anisotropic 3D dislocation dynamics. The results from this work clearly indicate the role and the importance of elastic anisotropy on the evolution of dislocation microstructures, the overall ductility and the hardening behavior in these systems.

  19. Increasing preoperative dislocations and total time of dislocation affect surgical management of anterior shoulder instability

    Science.gov (United States)

    Denard, Patrick J.; Dai, Xuesong; Burkhart, Stephen S.

    2015-01-01

    Purpose: Our purpose was to determine the relationship between number of preoperative shoulder dislocations and total dislocation time and the need to perform bone deficiency procedures at the time of primary anterior instability surgery. Our hypothesis was that need for bone deficiency procedures would increase with the total number and hours of dislocation. Materials and Methods: A retrospective review was performed of primary instability surgeries performed by a single surgeon. Patients with 25% glenoid bone loss were treated with Latarjet reconstruction. Number of dislocations and total dislocation time were examined for their relationship with the treatment method. Results: Ten arthroscopic Bankart repairs, 13 arthroscopic Bankart plus remplissage procedures, and 9 Latarjet reconstructions were available for review. Total dislocations (P = 0.012) and total hours of dislocation (P = 0.019) increased from the Bankart, to the remplissage, to the Latarjet groups. Patients with a total dislocation time of 5 h or more were more likely to require a Latarjet reconstruction (P = 0.039). Patients with only 1 preoperative dislocation were treated with an isolated Bankart repair in 64% (7 of 11) of cases, whereas those with 2 or more dislocations required a bone loss procedure in 86% (18 of 21) of cases (P = 0.013). Conclusion: Increasing number of dislocations and total dislocation time are associated with the development of glenoid and humeral head bony lesions that alter surgical management of anterior shoulder instability. The necessity for the addition of a remplissage to an arthroscopic Bankart repair or the use of a Latarjet reconstruction increases with only 1 recurrent dislocation. Level of evidence: Level III, retrospective comparative study. PMID:25709237

  20. TRAUMATIC HIP DISLOCATION IN CHILDREN YOUNGER THAN 3 YEARS : A SERIES OF 3 CASES

    Directory of Open Access Journals (Sweden)

    Navin

    2015-03-01

    Full Text Available The musculoskeletal anatomy of children is qui te different from that of adults. The capsule, periosteum and other soft tissues surrounding the joints is very pliable and dislocations can occur even following trivial injuries . However dislocation occurring in a child population is a rare entity. There are a few case reports of hip dislocations in children < 3 years. We present here a series of 3 cases of paediatric hip dislocations which presented to us for management. The age of the children were between 24 - 27 months. Incidentally all 3 patients were b oys and all 3 were right sided dislocations. None of them had any associated fractures. Two of them had a fall from height and one child fell off a slide. All 3 patients presented within 5 hours following injury. Closed reduction under anaesthesia was perf ormed and post reduction the children were immobilized in a broom - stick plaster for 6 weeks. All children were followed up with serial x - rays and a MRI done immediately following reduction then at 6 and 18 months. There was no evidence of chondrolysis or a vascular necrosis in any of the children at the last follow - up. They all had full range of movements with no limitation of function. We conclude that with early recognition and early reduction of the hip within the golden period (6 hours the occurrence of complications can be prevented.

  1. A new autoreduction method for anterior shoulder dislocation: the GONAIS method.

    Science.gov (United States)

    Gonai, Shiro; Kamio, Yoshito; Matsuoka, Tomoyuki; Harunari, Manabu; Saito, Yutaka; Takuma, Kiyotsugu

    2016-01-01

    Although techniques for autoreduction of anterior shoulder dislocation have been developed, no reports have detailed an autoreduction method using the zero position and traction on the affected arm. Therefore, we developed a new autoreduction technique using the zero position and gentle autotraction. The objective of this study is to present our experience with a new method for autoreduction of anterior shoulder dislocation called the GONAIS (a backronym for “Grasp a waist-high object, Opposite arm assists, Nonsedated, Autoreduction/autotraction, Immobilize the grasped object, and Squatting and stooping”) method. A 41-year-old healthy woman with a history of left shoulder dislocation presented to the emergency department with left shoulder pain while attaching her seatbelt. The X-ray examination revealed subcoracoid dislocation of the left shoulder. The patient tried the GONAIS method after simple guidance and demonstration. Although she felt pain once when weakening traction, she achieved autoreduction successfully in only 2 min and 50 s. Clinical examination after autoreduction revealed normal neurovascular findings and appearance of the shoulder. The X-ray revealed glenohumeral joint reduction and no fracture. Here, our patient using the GONAIS method achieved shoulder autoreduction in a short time. The GONAIS method does not require lying down or sitting on the ground, does not necessarily require the opposite arm, and is minimally invasive. This method would likely be helpful for those who cannot quickly reach a hospital for treatment of anterior shoulder dislocation. PMID:26168697

  2. Treatment of cervical dislocation with locked facets

    Institute of Scientific and Technical Information of China (English)

    YU Ze-sheng; James J.Yue; WEI Feng; LIU Zhong-jun; CHEN Zhong-qiang; DANG Geng-ting

    2007-01-01

    Background Lower cervical dislocation with locked facets is common in cervical injury. The locked facets include unilateral and bilateral types. Different successful closed reduction rates has been achieved between unilateral and bilateral types by using rapid skull traction, which was commonly used to reduce the cervical dislocation. It is important to investigate a suitable management specific to patients with different types of cervical locked facets.Methods A total of 38 patients with cervical dislocation with locked facet due to cervical injury treated by rapid skull traction and operation from 1988 to 2005 were reviewed. Rapid skull traction was used in all the patients. Successful closed reduction rate was 88.0% in patients with bilateral cervical locked facets and that was 15.4% in those with unilateral cervical locked facets. These data were then statistically compared by Chi-square test. Patients who were reduced successfully underwent anterior cervical discectomy and fusion at the injured level, and those who failed in closed reduction received posterior open reduction and fixation.Results In this series, there was statistically significant difference (P<0.05) in the rate of successful closed skull traction reduction between unilateral and bilateral locked facets dislocation. Unilateral cervical locked facets dislocation was not easily reduced by skull traction which was suitable for reduction of bilateral cervical locked facets dislocation. However,unilateral cervical locked facets dislocation can be reduced by posterior open reduction.Conclusions Unilateral cervical locked facets dislocation should be treated immediately with posterior open reduction and instrumentation. Bilateral cervical locked facets dislocation can be reduced by rapid skull traction firstly and anterior cervical discectomy and interbody fusion later.

  3. Distribution of distances between dislocations in different types of dislocation substructures in deformed Cu-Al alloys

    Energy Technology Data Exchange (ETDEWEB)

    Trishkina, L., E-mail: trishkina.53@mail.ru; Zboykova, N.; Koneva, N., E-mail: koneva@tsuab.ru; Kozlov, E. [Tomsk State University of Architecture and Building, 2 Solyanaya St., Tomsk, 634003 (Russian Federation); Cherkasova, T. [Tomsk State University of Architecture and Building, 2 Solyanaya St., Tomsk, 634003 (Russian Federation); National Research Tomsk Polytechnic University, 50 Lenin Ave., Tomsk, 634050 (Russian Federation)

    2016-01-15

    The aim of the investigation was the determination of the statistic description of dislocation distribution in each dislocation substructures component forming after different deformation degrees in the Cu-Al alloys. The dislocation structures were investigated by the transmission diffraction electron microscopy method. In the work the statistic description of distance distribution between the dislocations, dislocation barriers and dislocation tangles in the deformed Cu-Al alloys with different concentration of Al and test temperature at the grain size of 100 µm was carried out. It was established that the above parameters influence the dislocation distribution in different types of the dislocation substructures (DSS): dislocation chaos, dislocation networks without disorientation, nondisoriented and disoriented cells, in the walls and inside the cells. The distributions of the distances between dislocations in the investigated alloys for each DSS type formed at certain deformation degrees and various test temperatures were plotted.

  4. Dislocations in SmS single crystals

    International Nuclear Information System (INIS)

    Single crystals of SmS with NaCl structure are grown by zone melting in a sealed molybdenum tube. Dislocations introduced during cleaving the crystal are investigated by transmission electron microscopy. The dislocations have Burgers vector of 1/2 and their glide plane is (11-bar0), i.e. the slip system is (11-bar0) as in alkali-halide NaCl-type crystals. The slip seems to be governed by the Peierls mechanism for the screw dislocation. (author)

  5. Mechanisms for decoration of dislocations by small dislocation loops under cascade damage conditions

    DEFF Research Database (Denmark)

    Trinkaus, H.; Singh, B.N.; Foreman, A.J.E.

    1997-01-01

    In metals under cascade damage conditions, dislocations are frequently found to be decorated with a high density of small clusters of self-interstitial atoms (SIAs) in the form of dislocation loops, particularly during the early stages of the microstructural evolution in well annealed pure metals....... This effect may arise as a result of either (a) migration and enhanced agglomeration of single SIAs in the form of loops in the strain field of the dislocation or (b) glide and trapping of SIA loops (produced directly in the cascades) in the strain field of the dislocation, In the present paper, both...... of these possibilities are examined. It is shown that the strain field of the dislocation causes a SIA depletion in the compressive as well as in the dilatational region resulting in a reduced rather than enhanced agglomeration of SIAs. (SIA depletion may, however, induce enhanced vacancy agglomeration near dislocations...

  6. Soft Tissue Aspects of the Shoulder Joint

    OpenAIRE

    Khoschnau, Shwan

    2012-01-01

    The aim of this thesis was to study different aspects of the soft tissues of the shoulder joint. The variation in the quality of the tendons and ligaments can be explained by genetic factors. To test the hypothesis that collagen 1 α1 Sp1 polymorphism is related to the occurrence of cruciate ligament ruptures and shoulder dislocations, a total of 358 patients (233 patients with cruciate ligament ruptures and 126 with shoulder dislocations) were included in the study. We found a decreased risk ...

  7. Bilateral Galeazzi fracture-dislocations: a case report of early rehabilitation.

    Science.gov (United States)

    Komura, Shingo; Nonomura, Hidehiko; Satake, Takashi; Yokoi, Tatsuo

    2012-08-01

    A 24-year-old man had bilateral Galeazzi fracture-dislocations due to a motorcycle accident. The right radius fracture was a simple fracture and was fixed with a limited contact dynamic compression plate. The left radius fracture was a comminuted fracture and was fixed with a long locking compression plate in the bridging plate fashion while maintaining reduction with a temporary external fixator. Postoperative computed tomography under passive rotation of both forearms showed acceptable congruency of the distal radioulnar joints, and early rehabilitation of forearm rotation was started at 2 weeks after the operation. At 13-month follow-up, bone union of both fractures was achieved, and forearm motion was almost restored to normal. Moreover, no subluxation or dislocation of either distal radioulnar joint was observed.

  8. Dislocation and void segregation in copper during neutron irradiation

    DEFF Research Database (Denmark)

    Singh, Bachu Narain; Leffers, Torben; Horsewell, Andy

    1986-01-01

    were distributed between these walls. The dislocation walls were practically free of voids and generally had a void-denuded zone along them. The density of dislocations (loops and segments) was very low in the region containing voids (i. e. between the dislocation walls). Even with this low dislocation...

  9. Luxations carpo-métacarpiennes dorsales du quatrième et cinquième métacarpiens sans fracture

    Science.gov (United States)

    Aliou, Bah; Adi, El Alaoui

    2016-01-01

    The frequency of the interesting carpometacarpal dislocation spacing is 1.93% of all injuries of the wrist and carpus. The first observations would return to Cooper and Roux in the nineteenth century. Traumatic carpometacarpal dislocations without fractures are rare. If left untreated, these lesions can lead to joint instability and early joint degeneration. We report a case of a dorsal carpometacarpal dislocation of and fourth and fifth metacarpals in a young man of 46 years, right-handed, security officer, who after a sudden nervousness lends a hand against the wall resulting in a total pain and functional impairment of his right hand. The clinical examination and radiological assessment (standard radiography and CT scan) confirm the diagnosis. We reduce its emergency dislocation by simply pulling on the axis with direct manual pressure on the bases of the metacarpals. His hand was immobilized for 6 weeks followed by rehabilitation. At 1 year follow-up, he showed no pain and returned all its activities without any discomfort. PMID:27231504

  10. Increasing preoperative dislocations and total time of dislocation affect surgical management of anterior shoulder instability

    OpenAIRE

    Denard, Patrick J.; Xuesong Dai; Burkhart, Stephen S.

    2015-01-01

    Purpose: Our purpose was to determine the relationship between number of preoperative shoulder dislocations and total dislocation time and the need to perform bone deficiency procedures at the time of primary anterior instability surgery. Our hypothesis was that need for bone deficiency procedures would increase with the total number and hours of dislocation. Materials and Methods: A retrospective review was performed of primary instability surgeries performed by a single surgeon. Patient...

  11. A nonsingular solution of the edge dislocation in the gauge theory of dislocations

    OpenAIRE

    Lazar, Markus

    2002-01-01

    A (linear) nonsingular solution for the edge dislocation in the translational gauge theory of defects is presented. The stress function method is used and a modified stress function is obtained. All field quantities are globally defined and the solution agrees with the classical solution for the edge dislocation in the far field. The components of the stress, strain, distortion and displacement field are also defined in the dislocation core region and they have no singularity there. The dislo...

  12. Volar luksation af anden og tredje metacarp erkendt tre måneder efter fald under fodboldspil

    DEFF Research Database (Denmark)

    Mørup-Petersen, Anne; Ryge, Camilla; Engelund, Dorte

    2015-01-01

    Volar dislocation of the second and third carpometacarpal joint is extremely rare and most often caused by high-energy trauma. In this case a 15-year-old boy fell on his hand while playing soccer. The injury was undiagnosed for three months, perhaps due to an ipsilateral forearm fracture. He was ...... was treated with open reduction and Kirchner wire fixation for nine weeks. At two years follow-up he had a painfree hand with a 20% reduction in grip strength....

  13. Stress Field of Straight Edge Dislocation in Magnetic Field

    Institute of Scientific and Technical Information of China (English)

    LIU Zhao-long; HU Hai-yun; FAN Tian-you

    2007-01-01

    To study the changes in mechanical properties of materials within magnetic fields and the motion of dislocations,stress fields of dislocation in magnetic field need to be calculated.The straight edge dislocation is of basic importance in various defects.The stress field of straight edge dislocation in an external static magnetic field is determined by the theory of elasticity and electrodynamics according to the Volterra dislocation model for continuous media.This reduces to the known stress field when the magnet field is zero.The results can be used for further study on the strain energy of dislocations and the interactions between dislocations in magnetic fields.

  14. Posteromedial impingement (POMI) of the ankle: MR imaging features

    International Nuclear Information System (INIS)

    Full text: The purpose of this study is to describe the normal MR Imaging appearance of the supporting ligaments of the first carpometacarpal joint in asymptomatic volunteers and the ligamentous injury in patients following dislocation. Three healthy volunteers underwent MR Imaging of the first carpometacarpal joint in order to describe the normal ligaments and optimise the scanning technique for assessment of this joint. Six patients underwent MR Imaging after injury to the ligament. All patients were injured after a fall in which the thumb was subluxed during hyperextension.The Anterior Oblique Ligament (AOL) was evaluated for abnormal morphology and signal intensity, including the site of the injury and the degree of tearing. Joint alignment was assessed for instability. The four ligaments felt to contribute to the stability of the first joint were reliably identified. The normal ligament is a continuous band of low signal running from one bone attachment to another. With injury, there is disruption of the ligament, hyperintensity and perforated stripping. The AOL was shown to be consistently injured after dislocation close to the metacarpal side. MR Imaging allows accurate evaluation of injuries of the AOL of the first carpometacarpal joint and identifies patients who would benefit from surgical reconstruction. Copyright (2002) Blackwell Science Pty Ltd

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

    OpenAIRE

    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...

  16. Hip dysplasia and congenital hip dislocation

    Energy Technology Data Exchange (ETDEWEB)

    Lingg, G.; Nebel, G.; von Torklus, D.

    1981-11-01

    In human genetics and orthopedics quite different answers have been given to the question of hereditary transmission and frequency of hip dysplasia in families of children with congenital hip dislocation. We therefore have made roentgenometric measurements of 110 parents of children with congenital hip dislocation. In 25% we found abnormal flat acetabulae, whereas 12% had pathologic deep hips. This may propose a new concept of morphology of congenital hip dysplasia.

  17. Atomistic modeling of dislocation-interface interactions

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jian [Los Alamos National Laboratory; Valone, Steven M [Los Alamos National Laboratory; Beyerlein, Irene J [Los Alamos National Laboratory; Misra, Amit [Los Alamos National Laboratory; Germann, T. C. [Los Alamos National Laboratory

    2011-01-31

    Using atomic scale models and interface defect theory, we first classify interface structures into a few types with respect to geometrical factors, then study the interfacial shear response and further simulate the dislocation-interface interactions using molecular dynamics. The results show that the atomic scale structural characteristics of both heterophases and homophases interfaces play a crucial role in (i) their mechanical responses and (ii) the ability of incoming lattice dislocations to transmit across them.

  18. Tratamento da luxação paralítica do quadril na paralisia cerebral tetraparética espástica com osteotomia do fêmur e do ilíaco sem abertura da cápsula articular (capsuloplastia Hip dislocation treatment in cerebral palsy patients with spastic quadriplegia with femoral and pelvic osteotomies, without opening of the joint capsule (capsuloplasty

    Directory of Open Access Journals (Sweden)

    Fernando Farcetta Junior

    2010-01-01

    Full Text Available OBJETIVO: Mostrar o planejamento pré-operatório, e os resultados do tratamento cirúrgico da luxação paralítica do quadril em pacientes com paralisia cerebral. A técnica utilizada foi a osteotomia derrotatória e varizante do fêmur proximal, associada à osteotomia do ilíaco tipo Dega, sem abertura da cápsula articular. MÉTODOS: Realizamos um estudo retrospectivo de 10 quadris em oito pacientes com paralisia cerebral tipo tetraparesia espástico, submetidos a tratamento cirúrgico entre 2003 e 2005 com a mesma técnica cirúrgica. Foram avaliados parâmetros clínicos e radiográficos pré e pós-operatórios, bem como o planejamento pré-operatório com uso do intensificador de imagem. Os parâmetros clínicos analisados foram: dor, dificuldade de higiene e dificuldade de posicionamento. Os parâmetros radiológicos foram os índices de Reimers, índice acetabular e ângulo cervicodiafisário. Estes resultados foram submetidos a análise estatística. RESULTADOS: Obtivemos bons resultados com esta técnica. Com um seguimento médio de três anos, todos os quadris estavam reduzidos na última consulta, com alto grau de satisfação dos familiares, em relação ao tratamento. Além disso, mostramos que o planejamento pré-operatório com uso do intensificador de imagem nos permite a redução e estabilização desses quadris sem a necessidade de capsuloplastia. CONCLUSÃO: Os autores concluíram que no tratamento da luxação do quadril dos pacientes com paralisia cerebral tetraparéticos espásticos com o planejamento pré-operatório, não é necessária a capsuloplastia para estabilização da articulação coxofemoral.OBJECTIVES: To show the preoperative planning and the results of surgical treatment for paralytic hip dislocation in children with cerebral palsy. The techniques used were proximal femoral varus derotation osteotomy and Dega osteotomy without opening of the joint capsule. METHODS: We performed a retrospective review of

  19. Total hip arthroplasty in paralytic dislocation from poliomyelitis.

    Science.gov (United States)

    Laguna, Rafael; Barrientos, Jesús

    2008-02-01

    This article presents a case of a patient with degenerative hip disease in paralytic dislocation by poliomyelitis. Poliomyelitis is an acute infection disease caused by a group of neurotrophic viruses, which has a special affinity by the anterior horns cells of the spinal cord and for certain motor nuclei of the brain stem. Paralysis is a flaccid type and characteristically paralysis is asymmetrical. It is said that the joints of the affected limb by poliomyelitis are protected from the development of osteoarthritis. Hip dislocation in poliomyelitis is an acquired deformity caused by flaccid paralysis and the resulting muscular imbalance. In young children, when the gluteus maximus and medius muscles are paralyzed and the hip flexors and adductors are of normal strength, eventual luxation of the hip is almost inevitable. Hip osteoarthritis in a limb with poliomyelitis is an unusual entity because these limbs do not support excessive loads. In patients who present with the residual effects of poliomyelitis including degenerative disease and hip dysplastic, surgery is one of the most difficult challenges faced by reconstructive surgeons. In such cases, surgeons should attempt to optimize the component position and choice, surgical approach, and soft tissue tensioning because stability of the prosthesis can be problematic. PMID:19292189

  20. Empirical potential simulations of interstitial dislocation loops in uranium dioxide

    Science.gov (United States)

    Le Prioux, Arno; Fossati, Paul; Maillard, Serge; Jourdan, Thomas; Maugis, Philippe

    2016-10-01

    Stoichiometric circular shaped interstitial dislocation loop energies are calculated in stoichiometric UO2 by empirical potential simulation. The Burgers vector directions studied are and . The main structural properties of each type of interstitial dislocation loop are determined, including stacking fault energy. Defect energies are compared and a maximum size for stable dislocation loops before transition to dislocation loops is given. A model of dislocation loop energy based on elasticity theory is then fitted on the basis of these simulation results.

  1. Denervation of the wrist joint.

    Science.gov (United States)

    Buck-Gramcko, D

    1977-01-01

    A collective review was made of the results of denervation of the wrist joint for painful restrictiorn of motion done in 313 patients and follow-up studies on 195 (average 4.1 years, ranging from 9 months to 14 years). Complete denervation was done in only 30, partial denervation in the others being done after testing with local anesthetic blocks. Sixty-nine of the patients retained a moble wrist without pain or with slight pain with heavy work. No evidence of Charcot-like joints was seen. Poorest results followed when the operation was done for sequelae of intra-articular fracture of the radius, fracture dislocations, unstable ligamentous support, joint surface destruction, or for those required to do heavy manual labor. Arthrodesis was done secondarily in nine patients. PMID:839055

  2. Irreducible Anteromedial Dislocation of Radial Head with Biceps Tendon Interposition

    Directory of Open Access Journals (Sweden)

    Vicente J. Climent-Peris

    2016-01-01

    Full Text Available The case presents an isolated irreducible anteromedial dislocation of radial head due to biceps tendon interposition on a 14-year-old female patient. After an unsuccessful closed reduction, a lateral approach of the left elbow was carried out through Kocher’s interval. Given that no pathology was found on the radiohumeral joint, the approach was extended distally. This revealed that the biceps tendon was displaced laterally around the radial neck, preventing the reduction. Once the tendon was taken back to its anatomical position, the radial head reduction was performed successfully. The patient achieved a complete functional recovery. Possible injury mechanisms are discussed, as well as the importance of identifying such a rare injury.

  3. Unstable elbow dislocations: a case report of a new surgical technique

    Directory of Open Access Journals (Sweden)

    Harris Mark

    2016-01-01

    Full Text Available This case report describes our first clinical experience of a previously described new surgical technique for the treatment of unstable simple elbow dislocations. The technique utilises a central strip of the distal triceps tendon which is harvested proximally at the musculotendonous junction and left attached at its insertion on the olecranon. The strip is the passed through the olecranon fossa and attached to the coronoid process to stabilise the joint. We encountered an early postoperative complication that led to a modification of our technique and ultimately an excellent recovery of a stable pain free joint with a full range of movement.

  4. The neuropathic joint.

    Science.gov (United States)

    Sequeira, W

    1994-01-01

    Neuropathic arthritis is a destructive arthropathy frequently associated with loss of proprioception. A third of patients, however, may have no demonstrable neurological deficit. Patients with diabetes, syphilis, syringomyelia and other neuropathies are particularly prone to developing this joint disease. The diagnosis of Charcot's joints should be considered in anyone who develops what appears to be a severe osteoarthritis or a transverse fracture of the tibia or fibula after minor trauma. Scoliosis with particularly destructive changes on radiography should prompt a search for syringomyelia or syphilis. The most common radiographic abnormalities are those of distension in 3D (Dislocation, Destruction and Degeneration). An atrophic form with resorption of the proximal humerus, most frequently described in syringomyelia, has been observed in diabetes. Loss of the distal end of the clavicle has not been described before in the neuropathies. These changes coupled with speckled calcification or shards of bone in the periarticular soft tissue confirm the diagnosis. Infection and CPPD crystal disease can be difficult to exclude. The joint fluid may be inflammatory and infection may be a complication. Treatment includes anti-inflammatories and splinting. Indications for surgery are limited. PMID:8070170

  5. Quantum dynamics of a single dislocation

    Science.gov (United States)

    de Gennes, Pierre-Gilles

    We discuss the zero temperature motions of an edge dislocation in a quantum solid (e.g., He4). If the dislocation has one kink (equal in length to its Burgers vector b) the kink has a creation energy U and can move along the line with a certain transfer integral t. When t and U are of comparable magnitude, two opposite kinks can form an extended bound state, with a size l. The overall shape of the dislocation in the ground state is then associated with a random walk of persistence length l (along the line) and hop sizes b. We also discuss the motions of kinks under an applied shear stress σ: the glide velocity is proportional to exp(-σ*/σ), where σ* is a characteristic stress, controlled by tunneling processes. Mouvements quantiques d'une dislocation. On analyse le mouvement à température nulle d'une dislocation coin dans un solide quantique (He4). La dislocation peut avoir un cran (d'énergie U) dans son plan de glissement. Le cran peut avancer ou reculer le long de la dislocation par effet tunnel, avec une certaine intégrale de transfert t. Deux crans de signe opposé peuvent former un état lié. En présence d'une contrainte extérieure σ, la ligne doit avancer avec une vitesse ~exp(-σ*/σ) où σ* est une contrainte seuil, contrôlée par l'effet tunnel.

  6. Hybrid Dislocated Control and General Hybrid Projective Dislocated Synchronization for Memristor Chaotic Oscillator System

    Directory of Open Access Journals (Sweden)

    Junwei Sun

    2014-01-01

    Full Text Available Some important dynamical properties of the memristor chaotic oscillator system have been studied in the paper. A novel hybrid dislocated control method and a general hybrid projective dislocated synchronization scheme have been realized for memristor chaotic oscillator system. The paper firstly presents hybrid dislocated control method for stabilizing chaos to the unstable equilibrium point. Based on the Lyapunov stability theorem, general hybrid projective dislocated synchronization has been studied for the drive memristor chaotic oscillator system and the same response memristor chaotic oscillator system. For the different dimensions, the memristor chaotic oscillator system and the other chaotic system have realized general hybrid projective dislocated synchronization. Numerical simulations are given to show the effectiveness of these methods.

  7. Congenital Deficiency of Distal Ulna and Dislocation of the Radial Head Treated by Single Bone Forearm Procedure

    Directory of Open Access Journals (Sweden)

    Paragjyoti Gogoi

    2014-01-01

    Full Text Available Congenital deficiency of part of distal ulna affecting the distal radio-ulnar joint is a rare disorder. It is even rarer to find the association of proximal radio-ulnar joint dislocation along with distal ulnar deficiency. This type of congenital forearm anomaly is difficult to treat. Conversion to a single bone forearm in the expense of pronation-supination movement is a viable option. By doing so the elbow and wrist can be stabilized; however movement is possible in only one plane. We are describing here a girl of 8 years having proximal radio-ulnar joint dislocation along with deficiency of distal ulna treated by converting into a single bone forearm.

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

    Directory of Open Access Journals (Sweden)

    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

  9. Salam: Of Dislocation, Marginality and Flexibility

    Directory of Open Access Journals (Sweden)

    Efenita M. Taqueban

    2012-12-01

    Full Text Available This paper reconstructs the life stories of residents of SalamCompound. The compound serves as entry point for many Muslim migrants who leave the southern Philippines. Salam is both a refuge and a halfway point. A sense of dislocation permeates the stories. Dislocation begins with the movement away from a homeland that is familiar and defining of identity. The dislocation is, in a sense, an escape, a desperate project to avoid armed conflict in the southern Philippines or a desperate enterprise in search of work.Salam is a halfway point for transients prospecting for overseas work, the staging area for a global labor exodus. The sense of dislocation is not unlike locating oneself in the margins, portrayed in the residents’ negotiated identitiesand spaces, constantly challenged, implicitly regulated. Dislocation is also depicted as flexibility, portrayed by the residents making do and their everyday creative resistance and struggle in new locations in the city. Gathered throughethnographic method, the stories offer a glimpse into the lives of the residents of the compound, how they negotiate around social constructions of identities — resisting and accommodating internal and external forces that impinge ontheir lives, revealing a rich and poignant tapestry of family relations, community ironies and an ever-impinging world beyond its walls.

  10. Joint ventures

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig

    Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret......Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret...

  11. High dislocation density of tin induced by electric current

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Yi-Han; Liang, Chien-Lung; Lin, Kwang-Lung, E-mail: matkllin@mail.ncku.edu.tw [Department of Material Science and Engineering, National Cheng Kung University, Tainan 70101, Taiwan, R. O. C (China); Wu, Albert T. [Department of Chemical and Material Engineering, National Central University, Jhongli 32001, Taiwan, R. O. C (China)

    2015-12-15

    A dislocation density of as high as 10{sup 17} /m{sup 2} in a tin strip, as revealed by high resolution transmission electron microscope, was induced by current stressing at 6.5 x 10{sup 3} A/ cm{sup 2}. The dislocations exist in terms of dislocation line, dislocation loop, and dislocation aggregates. Electron Backscattered Diffraction images reflect that the high dislocation density induced the formation of low deflection angle subgrains, high deflection angle Widmanstätten grains, and recrystallization. The recrystallization gave rise to grain refining.

  12. Joint ventures

    NARCIS (Netherlands)

    M.N. Hoogendoorn (Martin)

    2009-01-01

    textabstractEen veel voorkomende wijze van samenwerking tussen ondernemingen is het uitvoeren van activiteiten in de vorm van een joint venture. Een joint venture is bijna altijd een afzonderlijke juridische entiteit. De partners in de joint venture voeren gezamenlijk de zeggenschap uit. In internat

  13. Coracoclavicular joint

    International Nuclear Information System (INIS)

    The coracoclvicular joint, a rear abnormality which may be the cause of pain in the shoulder and limitation of motion of the shoulder joint, is discussed. A case of coracoclvicular joint with shoulder pain was observed in 65 yrs old Korean male

  14. A Comparative Study on the Close Reduction of Arytenoid Dislocation under Indirect and Direct Laryngoscope

    Institute of Scientific and Technical Information of China (English)

    王志斌; 刘秋润

    2002-01-01

    Summary: To assess the curative effects of different reduction techniques on the dislocation ofcricoarytenoid joint caused by intubation, indirect laryngoscope (IL) and direct laryngoscope (DL)were utilized for the closed reduction of the displaced arytenoid under local anesthesia. 23 patientswho underwent the reduction for dislocated arytenoid under IL or DL from January 1991 to June2001 were reviewed. The data were collected on the duration of the laryngeal injury, times of re-ceiving reduction, side-effects after the treatment and the period for voice to return to normal.The relationship between the duration of the laryngeal lesion and the period of the voice rehabilita-tion was examined. 13 patients received the reduction under IL and 10 patients under DL. Exceptthe times of the reduction, which showed significant difference, no differences were found betweenIL group and DL group in the course and the period of voice rehabilitation, as well as sore throatafter the manipulation. The patients' voice recovery was positively related to their course of dis-ease in both IL and DL group. It is concluded that the recovery of normal voice is obviously affect-ed by the duration of arytenoid dislocation. The reduction under IL is as effective as under DL inthe treatment of arytenoid dislocation. Reduction by DL is better suit the patients with long timecourse of disease.

  15. Rare Inferior Shoulder Dislocation (Luxatio Erecta

    Directory of Open Access Journals (Sweden)

    Hakan Cift

    2015-01-01

    Full Text Available Although shoulder dislocations have been seen very frequently, inferior dislocation of shoulder constitutes only 0.5% of all shoulder dislocations. We share our 4 patients with luxatio erecta and present their last clinical control. 2 male and 2 female Caucasian patients were diagnosed as luxatio erecta. Patients’ ages were 78, 62, 65, and 76. All patients’ reduction was done by traction-abduction and contour traction maneuver in the operating room. The patients had no symptoms and no limitation of range of motion of their shoulder at their last control. Luxatio erecta is seen rarely, and these patients may have neurovascular injury. These patients should be carefully examined and treated by the orthopaedic and traumatology surgeons.

  16. Micromechanics and dislocation theory in anisotropic elasticity

    CERN Document Server

    Lazar, Markus

    2016-01-01

    In this work, dislocation master-equations valid for anisotropic materials are derived in terms of kernel functions using the framework of micromechanics. The second derivative of the anisotropic Green tensor is calculated in the sense of generalized functions and decomposed into a sum of a $1/R^3$-term plus a Dirac $\\delta$-term. The first term is the so-called "Barnett-term" and the latter is important for the definition of the Green tensor as fundamental solution of the Navier equation. In addition, all dislocation master-equations are specified for Somigliana dislocations with application to 3D crack modeling. Also the interior Eshelby tensor for a spherical inclusion in an anisotropic material is derived as line integral over the unit circle.

  17. Electron paramagnetic resonance at dislocations in germanium

    Energy Technology Data Exchange (ETDEWEB)

    Pakulis, E.J.

    1982-06-01

    The first observation of the paramagnetic resonance of electrons at dislocations in germanium single crystals is reported. Under subband gap optical excitation, two sets of lines are detected: four lines about the <111> axes with g/sub perpendicular to/ = 0.34 and g/sub parallel/ = 1.94, and 24 lines with g/sub perpendicular to/ = 0.73 and g/sub parallel/ = 1.89 about <111> axes with the six-fold 1.2/sup 0/ distortion. This represents the first measurement of the disortion angle of a dislocation dangling bond. The possibility that the distortion results from a Peierls transition along the dislocation line is discussed.

  18. Successful Conservative Management of a Dislocated IUD

    Directory of Open Access Journals (Sweden)

    Hasan Ali Inal

    2015-01-01

    Full Text Available Background. Intrauterine contraceptive devices (IUDs are widely utilized all over the world owing to their low cost and high efficacy. Uterine perforation is a rare complication that may occur at IUD insertion resulting in extrauterine location of the IUD. Traditionally, surgical removal of dislocated IUDs has been recommended. Case. A 68-year-old patient who had an IUD (Lippes loop inserted 32 years ago and whose routine examination incidentally revealed a dislocated IUD in the abdominal cavity. The patient remained asymptomatic during three years of follow-up and the IUD was left in place. Conclusion. Asymptomatic patients, whose vaginal examinations and ultrasonography or X-ray results reveal a dislocated IUD, may benefit from conservative management.

  19. Dislocation filtering in GaN nanostructures.

    Science.gov (United States)

    Colby, Robert; Liang, Zhiwen; Wildeson, Isaac H; Ewoldt, David A; Sands, Timothy D; García, R Edwin; Stach, Eric A

    2010-05-12

    Dislocation filtering in GaN by selective area growth through a nanoporous template is examined both by transmission electron microscopy and numerical modeling. These nanorods grow epitaxially from the (0001)-oriented GaN underlayer through the approximately 100 nm thick template and naturally terminate with hexagonal pyramid-shaped caps. It is demonstrated that for a certain window of geometric parameters a threading dislocation growing within a GaN nanorod is likely to be excluded by the strong image forces of the nearby free surfaces. Approximately 3000 nanorods were examined in cross-section, including growth through 50 and 80 nm diameter pores. The very few threading dislocations not filtered by the template turn toward a free surface within the nanorod, exiting less than 50 nm past the base of the template. The potential active region for light-emitting diode devices based on these nanorods would have been entirely free of threading dislocations for all samples examined. A greater than 2 orders of magnitude reduction in threading dislocation density can be surmised from a data set of this size. A finite element-based implementation of the eigenstrain model was employed to corroborate the experimentally observed data and examine a larger range of potential nanorod geometries, providing a simple map of the different regimes of dislocation filtering for this class of GaN nanorods. These results indicate that nanostructured semiconductor materials are effective at eliminating deleterious extended defects, as necessary to enhance the optoelectronic performance and device lifetimes compared to conventional planar heterostructures. PMID:20397703

  20. Dislocation evolution with rheological forming of metal

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    It is known that some internal defects exist in metal materials. Preliminary attempt to relate dislo cation evolution with metal rheological forming was done. By the attempt, it is learned that the evolution of dislocation density p( x, y, t ) is essentially the change of n independent internal variables qα (α = 1, 2, …n ) with material. The preliminary research in theory and experiments showed that dislocations piling-up could be avoided. One can improve the internal microstructure and mechanical properties of products by rheological forming method.

  1. Ipsilateral open anterior hip dislocation and open posterior elbow dislocation in an adult

    Directory of Open Access Journals (Sweden)

    Kumar Sunil

    2014-02-01

    Full Text Available 【Abstract】Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been described in English language-based medical literature. Primary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted in good clinical outcome in our patient. At 18 months follow-up, no signs of avascular necrosis of the femoral head or infection were observed.

  2. Ipsilateral open anterior hip dislocation and open posterior elbow dislocation in an adult

    Institute of Scientific and Technical Information of China (English)

    Sunil Kumar; Akhilesh Rathi; Sunil Sehrawat; Vikas Gupta; Jatin Talwar; Sumit Arora

    2014-01-01

    Open anterior dislocation of the hip is a very rare injury,especially in adults.It is a hyperabduction,external rotation and extension injury.Its combination with open posterior dislocation of the elbow has not been described in English language-based medical literature.Primary resuscitation,debridement,urgent reduction of dislocation,and adequate antibiotic support resulted in good clinical outcome in our patient.At 18 months followup,no signs of avascular necrosis of the femoral head or infection were observed.

  3. Management and Prognostic Factors for Delayed Reconstruction of Neglected Posterior Shoulder Fracture-Dislocation

    Directory of Open Access Journals (Sweden)

    Bekmezci

    2015-12-01

    Full Text Available Introduction Posterior fracture-dislocations of the shoulder are rare conditions. Misdiagnosis can occur in 50% - 80% of the patients. Due to the size of the lesion, stability of the joint could not be achieved with transfer of subscapular tendon or tuberosity. Case Presentation A 54-year-old male patient was referred to our hospital with a neglected posterior shoulder fracture-dislocation. Functional results of the patient, and technical informations were explained in this case report. The reverse Hill-Sachs lesion involved 40% of the articular surface. Depressed and malunited fragment was elevated, and fixated to the humeral head. Conclusions Glenohumeral joint reduction with reconstruction of the humeral head seems to be possible even in a neglected locked posterior shoulder fracture-dislocation. If the depressed osteochondral fragment is still spheric, signs of the avascular necrosis are absent on CT, and malunion of the fragment has occurred, it is quite possible to reconstruct the head. Although results of the case are good, it is worthwhile to follow these patients for long-term complications.

  4. Benign joint hypermobility syndrome in soldiers; what is the effect of military training courses on associated joint instabilities?

    Directory of Open Access Journals (Sweden)

    Kamran Azma

    2014-01-01

    Full Text Available Background: Hypermobile joints are joints with beyond normal range of motion and may be associated with joint derangements. This study aimed to evaluate the prevalence of benign joint hypermobility syndrome (BJHS among soldiers and effect of training courses on related joint instabilities. Materials and Methods: In a prospective cohort study on 721 soldiers of Iran Army in Isfahan in 2013 the prevalence of joint hypermobility was obtained by using Beighton criteria. Soldiers divided in two groups of healthy and suffered based on their scores. The prevalence of ankle sprain, shoulder and temporomandibular joint (TMJ dislocations identified before beginning service by history-taking and reviewing paraclinical documents. After 3 months of military training, a recent occurrence of mentioned diseases was revaluated in two groups. The collected data were analyzed using SPSS-20 software using Independent-T and Chi-square tests. Results: The frequency of BJHS before military training was 29.4%. After passing military training period, the incidence of ankle sprain was significantly higher in suffered group achieving the minimum Beighton score (BS of 4 (4.3%, P = 0.03, 5 (5.5%, P = 0.005 and also 6 out of 9 (6.5%, P = 0.01. The incidence of TMJ dislocation was not significantly different based on a minimum score of 4, while it was higher in suffered group when considering the score of 5 (2.1% and 6 (2.6% for discrimination of two groups (P = 0.03. There was no significant difference between two groups in case of shoulder dislocation anyway. Conclusion: Military training can increase the incidence of ankle sprains and TMJ dislocations in hypermobility persons with higher BS in comparison with healthy people. Therefore, screening of joint hypermobility may be useful in identifying individuals at increased risk for joint instabilities.

  5. GNDs in nonlocal plasticity theories : lessons from discrete dislocation simulations

    NARCIS (Netherlands)

    Vand der Giessen, E; Needleman, A

    2003-01-01

    Solutions to simple boundary value problems using discrete dislocation plasticity exhibit key features associated with an accumulation of geometrically necessary dislocations: size effects and long-range stresses. Comparisons of the predictions of nonlocal plasticity theories with the discrete dislo

  6. Midterm results after operatively stabilised shoulder dislocations in elderly patients

    OpenAIRE

    Maier, Marcus; Geiger, Emanuel V.; Ilius, Christine; FRANK, JOHANNES; Marzi, Ingo

    2008-01-01

    Anterior shoulder dislocation is frequently seen in young patients. The therapeutic regime in elderly patients after shoulder dislocation is less clearly defined. The aim of this study was to compare the clinical benefit of operative stabilisation following anterior shoulder dislocation in young versus elderly patients. Seventy-two patients with anterior shoulder dislocations were allocated into two groups. Group 1 (> 40 years of age) consisted of 23 patients, and group 2 (

  7. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    OpenAIRE

    Patil, Mallanagouda N

    2013-01-01

    Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence. Case Report: 35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand). He complained of...

  8. Dislocations in magnetohydrodynamic waves in a stellar atmosphere.

    Science.gov (United States)

    López Ariste, A; Collados, M; Khomenko, E

    2013-08-23

    We describe the presence of wave front dislocations in magnetohydrodynamic waves in stratified stellar atmospheres. Scalar dislocations such as edges and vortices can appear in Alfvén waves, as well as in general magnetoacoustic waves. We detect those dislocations in observations of magnetohydrodynamic waves in sunspots in the solar chromosphere. Through the measured charge of all the dislocations observed, we can give for the first time estimates of the modal contribution in the waves propagating along magnetic fields in solar sunspots.

  9. Dislocations in magnetohydrodynamic waves in a stellar atmosphere

    CERN Document Server

    Ariste, A López; Khomenko, E

    2013-01-01

    We describe the presence of wavefront dislocations in magnetohydrodynamic waves in stratified stellar atmospheres. Scalar dislocations such as edges and vortices can appear in Alfv\\'en waves, as well as in general magneto-acoustic waves. We detect those dislocations in observations of magnetohydrodynamic waves in sunspots in the solar chromosphere. Through the measured charge of all the dislocations observed, we can give for the first time estimates of the modal contribution in the waves propagating along magnetic fields in solar sunspots.

  10. Bilateral posterior shoulder dislocation after electrical shock: A case report

    OpenAIRE

    Ismail Emre Ketenci; Tahir Mutlu Duymus; Ayhan Ulusoy; Hakan Serhat Yanik; Serhat Mutlu; Mehmet Oguz Durakbasa

    2015-01-01

    Introduction: Posterior dislocation of the shoulder is a rare and commonly missed injury. Unilateral dislocations occur mostly due to trauma. Bilateral posterior shoulder dislocations are even more rare and result mainly from epileptic seizures. Electrical injury is a rare cause of posterior shoulder dislocation. Injury mechanism in electrical injury is similar to epileptic seizures, where the shoulder is forced to internal rotation, flexion and adduction. Presentation of case: This report...

  11. Sidewall penetration of dislocations in ion-implanted bipolar transistors

    International Nuclear Information System (INIS)

    Phosphorus-doped emitters have been formed by either conventional diffusion or implantation, anneal, and drive-in processes. Transmission electron microscopy and measurements of transistor characteristics were made to evaluate the two processes. Comparison of structures with similar dislocation densities indicated that the dislocations in the implanted structures penetrated the emitter-base sidewall, whereas the dislocations in the diffused structure were confined to the emitter region. The transistor with extended dislocations exhibited high leakage current and excess popcorn noise generating

  12. Magnetic resonance imaging of hip joint cartilage and labrum

    Directory of Open Access Journals (Sweden)

    Christoph Zilkens

    2011-09-01

    Full Text Available Hip joint instability and impingement are the most common biomechanical risk factors that put the hip joint at risk to develop premature osteoarthritis. Several surgical procedures like periacetabular osteotomy for hip dysplasia or hip arthroscopy or safe surgical hip dislocation for femoroacetabular impingement aim at restoring the hip anatomy. However, the success of joint preserving surgical procedures is limited by the amount of pre-existing cartilage damage. Biochemically sensitive MRI techniques like delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC might help to monitor the effect of surgical or non-surgical procedures in the effort to halt or even reverse joint damage.

  13. Analysis of large dislocation populations in deformed metals

    DEFF Research Database (Denmark)

    Hansen, N.; Hughes, D.A.

    1995-01-01

    and finer scale as the strain is increased. These configurations of dislocation boundaries are analyzed on the basis of the LEDS hypothesis for dislocation structures and agreement is found. The strengthening effect of dislocation boundaries is discussed and equations are suggested for the relationship...... between now stress and microstructural parameters....

  14. Disorientations in dislocation structures: Formation and spatial correlation

    DEFF Research Database (Denmark)

    Pantleon, W.

    2002-01-01

    During plastic deformation, dislocation boundaries are formed and orientation differences across them arise. Two different causes lead to the formation of two kinds of deformation-induced boundaries: a statistical trapping of dislocations in incidental dislocation boundaries and a difference in t...

  15. Bypassing of a barrier by dissociated and superlattice dislocations

    DEFF Research Database (Denmark)

    Bhushan, Karihaloo

    1975-01-01

    Very simple procedures are used to calculate the upper and lower bounds for the applied stress required for the leading extended (superlattice) dislocation in a group of n coplanar screw dislocations of like sign with Burgers vector b to bypass a noncoplanar perfect screw dislocation with Burgers...... vector mb (m...

  16. [Open total dislocation of the talus].

    Science.gov (United States)

    Grabski, R S; Sosiński, R

    1992-01-01

    A case of 35 years old patient with open, total, fixed dislocation of the talus reduced with heel traction is presented. The Sudeck syndrome subsided after one year. Weight bearing was not allowed for 7 months. An examination after 2.5 years revealed minor osteoarthritis, full range of movement in the foot but limited walking capability. PMID:7555299

  17. Dislocation Microstructures in Fatiqued Copper Polycrystals

    DEFF Research Database (Denmark)

    Winter, A.T.; Pedersen, Ole Bøcker; Rasmussen, K.V.

    1981-01-01

    Dislocation structures characteristic of persistent slip bands were observed in the interior of polycrystalline copper after fatigue. At low strain amplitudes, within the plateau on the cyclic stress-strain curve, only structures identical to those seen in single crystals were observed. This allows...

  18. Completion of a Dislocated Metric Space

    Directory of Open Access Journals (Sweden)

    P. Sumati Kumari

    2015-01-01

    Full Text Available We provide a construction for the completion of a dislocated metric space (abbreviated d-metric space; we also prove that the completion of the metric associated with a d-metric coincides with the metric associated with the completion of the d-metric.

  19. Missed isolated volar dislocation of the scaphoid

    DEFF Research Database (Denmark)

    Kolby, Lise; Larsen, Søren; Jørring, Stig;

    2007-01-01

    A patient presented with volar dislocation of the scaphoid, the diagnosis of which had been missed for two weeks. He was treated with open reduction through a combined volar and dorsal approach with decompression of the median nerve, internal fixation, and a cast for eight weeks. One year postope...

  20. Dislocations in stripes and lattice Dirac fermions

    NARCIS (Netherlands)

    Mesaroš, Andrej

    2010-01-01

    The central topic in this thesis is the effect of topological defects in two distinct types of condensed matter systems. The first type consists of graphene and topological insulators. By studying the long-range effect of lattice defects (dislocations and disclinations) we find that the graphene ele

  1. Dislocation plasticity effects on interfacial fracture

    NARCIS (Netherlands)

    van der Giessen, E.; Needleman, A.

    2003-01-01

    Analyses are reviewed where plastic flow in the vicinity of an interfacial crack is represented in terms of the nucleation and glide of discrete dislocations. Attention is confined to cracks along a metal-ceramic interface, with the ceramic idealized as being rigid. Both monotonic and fatigue loadin

  2. Kinetics of dislocation step ensembles and edge dislocation climb in supersaturated solution of radiation-induced point defects

    International Nuclear Information System (INIS)

    Formation kinetics of step ensemble on the linear edge dislocation under conditions when supersaturated solution of radiation-induced point defects - vacancies and interstitials - was created in a material inder the effect of irradiation, is investigated. With regard to microscopic processes in dislocation nuclei the concentration of steps on the dislocation is found in a self-consistent way. Conditions under which the dislocations can be considered as discrete discharges for point defects so that the distance between dislocation steps exceeds considerably the average length of point defect free pass along the dislocation line are determined. The dislocation climb rate for the cases of material irradiation and annealing, which are of practical value, is found. Considerably nonlinear dependence of the dislocation climb rate on point defect supersaturation in material and its strong dependence on the temperature is demonstrated

  3. Assessment of hardening due to dislocation loops in bcc iron: Overview and analysis of atomistic simulations for edge dislocations

    Science.gov (United States)

    Bonny, G.; Terentyev, D.; Elena, J.; Zinovev, A.; Minov, B.; Zhurkin, E. E.

    2016-05-01

    Upon irradiation, iron based steels used for nuclear applications contain dislocation loops of both and ½ type. Both types of loops are known to contribute to the radiation hardening and embrittlement of steels. In the literature many molecular dynamics works studying the interaction of dislocations with dislocation loops are available. Recently, based on such studies, a thermo-mechanical model to threat the dislocation - dislocation loop (DL) interaction within a discrete dislocation dynamics framework was developed for ½ loops. In this work, we make a literature review of the dislocation - DL interaction in bcc iron. We also perform molecular dynamics simulations to derive the stress-energy function for loops. As a result we deliver the function of the activation energy versus activation stress for loops that can be applied in a discrete dislocation dynamics framework.

  4. Causal Stroh formalism for uniformly-moving dislocations in anisotropic media: Somigliana dislocations and Mach cones

    CERN Document Server

    Pellegrini, Yves-Patrick

    2016-01-01

    In this work, Stroh's formalism is endowed with causal properties on the basis of an analysis of the radiation condition in the Green tensor of the elastodynamic wave equation. The modified formalism is applied to dislocations moving uniformly in an anisotropic medium. In practice, accounting for causality amounts to a simple analytic continuation procedure whereby to the dislocation velocity is added an infinitesimal positive imaginary part. This device allows for a straightforward computation of velocity-dependent field expressions that are valid whatever the dislocation velocity ---including supersonic regimes--- without needing to consider subsonic and supersonic cases separately. As an illustration, the distortion field of a Somigliana dislocation of the Peierls-Nabarro-Eshelby-type with finite-width core is computed analytically, starting from the Green tensor of elastodynamics. To obtain the result in the form of a single compact expression, use of the modified Stroh formalism requires splitting the Gr...

  5. Interaction of 〈1 0 0〉 dislocation loops with dislocations studied by dislocation dynamics in α-iron

    Energy Technology Data Exchange (ETDEWEB)

    Shi, X.J.; Dupuy, L. [CEA, DEN, SRMA, F-91191 Gif-sur-Yvette (France); Devincre, B. [Laboratoire d’Etude des Microstructures, CNRS-ONERA, 29 av. de la Division Leclerc, 92322 Châtillon Cedex (France); Terentyev, D. [SCK–CEN, Nuclear Materials Science Institute, Boeretang 200, B-2400 Mol (Belgium); Vincent, L. [CEA, DEN, SRMA, F-91191 Gif-sur-Yvette (France)

    2015-05-15

    Highlights: • Interactions between edge dislocations and radiation-induced loops were studied by dislocation dynamics. • Dislocation dynamics results are directly compared to molecular dynamics results. • The complex elementary reactions are successfully reproduced. • The critical shear stress to overcome individual loops if reproduced quantitatively. - Abstract: Interstitial dislocation loops with Burgers vector of 〈1 0 0〉 type are formed in α-iron under neutron or heavy ion irradiation. As the density and size of these loops increase with radiation dose and temperature, these defects are thought to play a key role in hardening and subsequent embrittlement of iron-based steels. The aim of the present work is to study the pinning strength of the loops on mobile dislocations. Prior to run massive Dislocation Dynamics (DD) simulations involving experimentally representative array of radiation defects and dislocations, the DD code and its parameterization are validated by comparing the individual loop–dislocation reactions with those obtained from direct atomistic Molecular Dynamics (MD) simulations. Several loop–dislocation reaction mechanisms are successfully reproduced as well as the values of the unpinning stress to detach mobile dislocations from the defects.

  6. A rare paediatric trauma: Lateral condyle humerus fracture with concomitant postero-medial elbow dislocation.

    Directory of Open Access Journals (Sweden)

    Monappa Naik

    2015-12-01

    Full Text Available The association of elbow dislocation with fracture of the lateral condyle in paediatrics is considered very rare and only a few isolated cases have been reported in the literature. Due to its rarity, some of the authors have classified this injury as a complex elbow injury and have deemed them technically demanding to repair. A ten-year-old boy presented to us with a lateral condyle humerus fracture [Milch type 2] with concomitant postero-medial elbow dislocation following a fall on his outstretched hand. At 34 months of follow-up, the child regained a full range of motions around the elbow joint without any deformities.This combination injury, although rare, is not technically different or difficult to treat. [Hand Microsurg 2015; 4(3.000: 75-78

  7. The gauge theory of dislocations: static solutions of screw and edge dislocations

    OpenAIRE

    Lazar, Markus; Anastassiadis, Charalampos

    2009-01-01

    Abstract We investigate the T(3)-gauge theory of static dislocations in continuous solids. We use the most general linear constitutive relations bilinear in the elastic distortion tensor and dislocation density tensor for the force and pseudomoment stresses of an isotropic solid. The constitutive relations contain six material parameters. In this theory both the force and pseudomoment stresses are asymmetric. The theory possesses four characteristic lengths ...

  8. Cervical facet dislocation adjacent to the fused motion segment.

    Science.gov (United States)

    Yokoyama, Kunio; Kawanishi, Masahiro; Yamada, Makoto; Tanaka, Hidekazu; Ito, Yutaka; Kuroiwa, Toshihiko

    2016-01-01

    This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER) of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI) performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B). Cervical computed tomography (CT) indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D). In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation. PMID:26933361

  9. Cervical facet dislocation adjacent to the fused motion segment

    Science.gov (United States)

    Yokoyama, Kunio; Kawanishi, Masahiro; Yamada, Makoto; Tanaka, Hidekazu; Ito, Yutaka; Kuroiwa, Toshihiko

    2016-01-01

    This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER) of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI) performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B). Cervical computed tomography (CT) indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D). In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation. PMID:26933361

  10. Cervical facet dislocation adjacent to the fused motion segment.

    Science.gov (United States)

    Yokoyama, Kunio; Kawanishi, Masahiro; Yamada, Makoto; Tanaka, Hidekazu; Ito, Yutaka; Kuroiwa, Toshihiko

    2016-01-01

    This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER) of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI) performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B). Cervical computed tomography (CT) indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D). In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation.

  11. Cervical facet dislocation adjacent to the fused motion segment

    Directory of Open Access Journals (Sweden)

    Kunio Yokoyama

    2016-01-01

    Full Text Available This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B. Cervical computed tomography (CT indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D. In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation.

  12. Elbow dislocation with irreparable fracture radial head

    Directory of Open Access Journals (Sweden)

    Dilip Tanna

    2013-01-01

    Full Text Available Background: Treatment of elbow dislocation with irreparable radial head fracture needs replacement of radial head to achieve stability of elbow. An alternate method in cases of elbow dislocation with radial head fracture can be resection of radial head with repair of medial collateral ligament. We report a retrospective analysis of cases of elbow dislocation with irreparable radial head treated by excision head of radius and repair of MCL. Materials and Methods: Nine patients of elbow dislocation with associated irreparable fractures of the head of the radius were included in this analysis (6 F:3 M, Age: 35-47 years. Radial head excision was done through the lateral approach and MCL was sutured using no 3 Ethibond using medial approach. Above elbow plaster was given for 6 weeks and gradual mobilization was done thereafter. All patients were assessed at final followup using Mayo elbow performance score (MEPS. Results: Mean followup was 19.55 ± 7.12 months (range 14-36 months. There was no extension deficit when compared to opposite side with mean range of flexion of 138.8° ± 6.97° (range 130 -145°. Mean pronation was 87.7° ± 4.4° (range 80-90° and mean supination was 87.7 ± 4.62° (range 80-90°. The mean MEPS was 98.8 ± 3.33 (range 90-100. No patient had pain, sensory complaints, subluxation or redislocation. All were able to carry out their daily activities without disability. Conclusion: Radial head excision with MCL repair is an acceptable option for treatment of patients with elbow dislocation and irreparable radial head fracture.

  13. Dislocation dynamics. II. Applications to the formation of persistent slip bands, planar arrays, and dislocation cells

    International Nuclear Information System (INIS)

    The dynamic organization of dislocations into spatially heterogeneous substructures is demonstrated by applying the principles of dislocation dynamics that were outlined in the preceding paper. Here it is shown that the formation of persistent slip bands is a consequence of the competition between dipole formation and annihilation of dislocations of opposite Burgers vectors in the absence of temperature-enhanced climb recovery under cyclic stress conditions. Planar arrays, which are also uniaxial structures, are shown to arise from enhanced dislocation multiplication and the formation of stable dipole configurations along a slip plane at lower temperatures where climb is unimportant. Biaxial dislocation systems experience additional degrees of freedom compared with uniaxial systems because of available motion along additional slip systems. It is demonstrated that for a system of orthogonal slip directions at high temperatures in which climb and glide motion are competitive, dislocation cellular structures form as a result of immobile dipole and junction formation and by the internal elastic strain energy minimization caused by long-range self-shielding. It is shown that the internal elastic strain energy is reduced by the self-organization process. However, the short-range nonlinear processes (i.e., dipole and junction formation) are shown not to allow absolute elastic energy minimization

  14. Elbow joint stability following experimental osteoligamentous injury and reconstruction

    DEFF Research Database (Denmark)

    Deutch, Søren R; Jensen, Steen Lund; Tyrdal, Stein;

    2003-01-01

    Elbow joint dislocation was simulated in cadaveric specimens to quantify laxity induced by radial head and coronoid process lesions, either alone or in combination with collateral ligament insufficiency. The effects of lateral ligament reconstruction and radial head prosthesis replacement were also...

  15. Stress-free states of continuum dislocation fields : Rotations, grain boundaries, and the Nye dislocation density tensor

    NARCIS (Netherlands)

    Limkumnerd, Surachate; Sethna, James P.

    2007-01-01

    We derive general relations between grain boundaries, rotational deformations, and stress-free states for the mesoscale continuum Nye dislocation density tensor. Dislocations generally are associated with long-range stress fields. We provide the general form for dislocation density fields whose stre

  16. Pattern of fractures and dislocations in a tertiary care hospital, north east Karnataka

    Directory of Open Access Journals (Sweden)

    Bhaskara K, Padmanabha T S, Nandini T, Sindhu

    2014-11-01

    Full Text Available Background: Trauma including accidents are today’s world concern forming a major non-communicable epidemic accounting for mortality and morbidity. The aim of the study was to determine and account the types of fractures and dislocations presented to Bidar Institute of Medical Sciences (BRIMS, Bidar, Karnataka, India. Methods and Material: This study is of retrospective in nature with a review of hospital inpatient case sheets of orthopaedic department in our hospital presented between July 2011 to Dec 2011. The data gathered was analysed by percentages. Results: Out of 132 cases analysed males (82.56%, outnumbered female (17.42%; 67.42 % of cases were between 18-45 years age group; femur (22.17 % was the most commonly involved bone followed by tibia (13.21%, foot (10.85%; tibia & fibular (8.96% involvement. Less common were spine (0.47%, vertebra (0.94% and scapula (0.94%. Fracture-dislocation was more common in lower limb (59.91% – ankle joint was most common-50% compared to upper limb (30.66%- shoulder joint: 12.5%. Conclusions: Among of 132 cases admitted 212 fractures & dislocation was noted. Male (82.56% was more common than females (17.42%. Age group most commonly involved was between 18-45 years (67.42%. Fracture was more common in femur (22.17% & dislocation was common in hip (42.86% because of high velocity injury. Approach towards the prevention of accidents by effective safety education, good roads and early intervention which is the need of the hour. Effective drugs should be made available in the casuality so that crush injuries are managed without complications like septicemia and tetanus.

  17. Closed reduction of displaced or dislocated mandibular condyle fractures in children using threaded Kirschner wire and external rubber traction.

    Science.gov (United States)

    Kim, J H; Nam, D H

    2015-10-01

    Most surgeons agree that closed treatment provides the best results for condylar fractures in children. Nevertheless, treatment of the paediatric mandibular condyle fracture that is severely displaced or dislocated is controversial. The purpose of this study was to investigate the long-term clinical and radiological outcomes following the treatment of displaced or dislocated condylar fractures in children using threaded Kirschner wire and external rubber traction. This procedure can strengthen the advantage of closed reduction and make up for the shortcomings of open reduction. From March 1, 2005 to December 25, 2011, 11 children aged between 4 and 12 years with displaced or dislocated mandibular condyle fractures were treated using threaded Kirschner wire and external rubber traction under portable C-arm fluoroscopy. All patients had unilateral displaced or dislocated condylar fractures. The follow-up period ranged from 24 to 42 months (mean 29.3 months). Normal occlusion and pain-free function of the temporomandibular joint, without deviation or limitation of jaw opening, was achieved in all patients. This closed reduction technique in displaced or dislocated condylar fractures in children offers a reliable solution in preventing the unfavourable sequelae of closed treatment and the open technique, such as altered morphology, functional disturbances, and facial nerve damage. PMID:26117724

  18. Hand osteoarthritis: Differential diagnosis with inflammatory joint diseases and treatment policy

    Directory of Open Access Journals (Sweden)

    Yu. A. Olyunin

    2015-01-01

    Full Text Available Osteoarthritis (OA usually affects certain joint groups selectively and the hand joints (HJ are one of its classical locations. Hand OA is widespread in the population. In their practice rheumatologists encounter HJ injury in OA in 38% of cases. It is conventional to identify three main types of hand OA. These are 1 interphalangeal OA that may or may not be accompanied by nodulation; 2 first carpometacarpal OA; and 3 erosive OA. At the same time, the rate of clinical forms ranges from 2.0 to 6.2%; it is 4.7 to 20.4% in the elderly. Nonsteroidal antiinflammatory drugs (NSAIDs are most commonly used to relieve pain that is the main manifestation of the disease. The risk for NSAID-related adverse gastrointestinal (GI events is substantially reduced by the drugs that exert their effects mainly on cyclooxygenase 2. These include nimesulide in particular. Undesirable GI effects may be also considerably minimized by using NSAIDs that have both their gastroprotective and antiinflammatory activities. By suppressing pain and inflammatory changes, the recently designed NSAID amtolmetin guacil simultaneously exerts a protective effect on the GI mucosa, by elevating its nitric oxide levels.

  19. Photoluminescence of Dislocations in Nitrogen Doped Czochralski Silicon

    Institute of Scientific and Technical Information of China (English)

    LI Dong-Sheng; YANG De-Ren; E.Leoni; S.Binetti; S.Pizzini

    2004-01-01

    @@ We investigate optical properties of dislocations in nitrogen-doped and nitrogen-free Czochralski silicon. The dislocations are formed during crystal growth, but not formed during deformation. The results show that in nitrogen-doped samples, a broad band replaced the D1 band of dislocation, regardless of dislocation density. The replacement ofD1 band is caused by the non-irradiation combination induced by oxygen precipitation. Moreover,a new emission at 0.975 eV is observed in both the nitrogen-free and doped samples when the dislocation density is lower than 104 cm-2.

  20. Thermally activated dislocation motion including inertial effects in solid solutions

    International Nuclear Information System (INIS)

    Dislocation motion through an array of obstacles is considered in terms of the potential energy of the dislocation as it moves through the array. The obstacles form a series of potential wells and barriers which can trap the dislocations. The effect of thermal fluctuations and of a viscous drag on the motion of the dislocation is investigated by analogy with Brownian motion in a field of force. The rate of escape of a trapped dislocation is found to depend on the damping coefficient only for a large viscous drag. The probability that a dislocation will be trapped by a well or barrier is found to depend on the damping coefficient for a small viscous drag. This inertial effect determines how far a dislocation will travel after breaking away from an obstacle

  1. Sports-related shoulder dislocations: a state-hospital experience.

    Science.gov (United States)

    Hazmy, C H Wan; Parwathi, A

    2005-07-01

    This retrospective study was conducted in a state hospital set-up and aimed at identifying the incidence of sports-related shoulder dislocations and their characteristics and the sports events involved. All patients with shoulder dislocation related to sporting activities admitted to the hospital from January 1999 to December 2002 were included in the study. There were 18 sports-related shoulder dislocations out of 106 all shoulder dislocations admitted during this 4-year period. The average age of the patients was 25.4 years. All but two were male. All were anterior dislocations. Recurrent dislocation constitutes 78% of the cases with an average of 3 times re-dislocation. Rugby and badminton were the major contributors to the injuries followed by volleyball, soccer and swimming. Conservative treatment was successfully instituted for 88% of the patients and 12% opted for surgical intervention.

  2. Unstable elbow dislocations: the description and cadaveric feasibility study of a new surgical technique

    Directory of Open Access Journals (Sweden)

    Harris Mark

    2015-01-01

    Full Text Available Introduction: A small proportion of simple elbow dislocations are grossly unstable and joint congruence is not maintained after reduction. In this rare situation operative treatment is indicated. We describe a new intra articular reconstruction that utilises a slip of triceps tendon to provide immediate stability to the elbow. Methods: We assessed 20 cadaveric elbows, measuring the length of triceps tendon available and required to complete the reconstruction. We then sequentially sectioned the ligamentous stabilisers of an elbow before performing the new technique. We measured the displacement and angulation possible at the elbow before and after the reconstruction. Results: All 20 elbows had sufficient triceps tendon length to complete the new technique. Prior to the reconstruction greater than 30 mm of joint distraction and 90 degrees varus or valgus angulation was possible. Following the reconstruction it was not possible to re-dislocate the elbow. Only 2 mm of joint distraction and 10 degrees of varus or valgus angulation were possible with the triceps graft fixed in position. Discussion: This novel technique elegantly avoids many of the problems associated with current methods. We have demonstrated that it is technically feasible and easy to perform with minimal equipment requirements or costs.

  3. Femoral head fracture without hip dislocation

    Institute of Scientific and Technical Information of China (English)

    Aditya K Aggarwal; Ashwani Soni; Daljeet Singh

    2013-01-01

    Femoral head fractures without dislocation or subluxation are extremely rare injuries.We report a neglected case of isolated comminuted fracture of femoral head without hip dislocation or subluxation of one year duration in a 36-year-old patient who sustained a high energy trauma due to road traffic accident.He presented with painful right hip and inability to bear full weight on right lower limb with Harris hip score of 39.He received cementless total hip replacement.At latest follow-up of 2.3 years,functional outcome was excellent with Harris hip score of 95.Such isolated injuries have been described only once in the literature and have not been classified till now.The purpose of this report is to highlight the extreme rarity,possible mechanism involved and a novel classification system to classify such injuries.

  4. On impurity segregation on dislocations in metals

    OpenAIRE

    Netchaev, Yu.; Mukhina, L.

    1993-01-01

    Thermodynamic and crystallo-chemistry considerations are given about the possibility of existing linear distribution laws for some impurities in metals between bulk solution and near-dislocation segregation regions (NDSR) with composition and structure close to the corresponding intermetallic compound. The solutions of Fe in Al are considered. NDSR composition can be close to FeAl3. The experimental data on the solubilities are treated within the model developed to determine the effective bin...

  5. Painful Spastic Hip Dislocation: Proximal Femoral Resection

    OpenAIRE

    Albiñana, Javier; Gonzalez-Moran, Gaspar

    2002-01-01

    The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despit...

  6. Surgical management of intraocular lens dislocations

    Directory of Open Access Journals (Sweden)

    Adem Gul

    2015-10-01

    Full Text Available ABSTRACTPurpose:To report and compare the surgical, visual, and anatomical outcomes following treatment of dislocated intraocular lenses (IOLs.Methods:The medical records of 28 eyes of 28 patients were evaluated. Age, gender, pre-and postoperative best-corrected visual acuity (BCVA, surgical methods, and complications were recorded.Results:Pre-and postoperative BCVA ranged from counting fingers to 20/32 and from counting fingers to 20/25, respectively. Late-onset dislocations were the most frequently observed complication. The most frequent surgical method was IOL repositioning in 15 of 28 patients, followed by IOL exchange in 11 patients, and IOL removal in 2 patients. Only 1 patient required surgical re-intervention with IOL capture.Conclusions:Visual acuity improved following the use of either IOL repositioning or IOL exchange. No superiority of one method over the other was observed. In the present retrospective case series, management of dislocated IOLs with repositioning or exchange of the primary implant conferred comparable surgical and visual outcomes.

  7. Application of MRI in indirect temporomandibular joint injury without condylar fracture

    Institute of Scientific and Technical Information of China (English)

    WANG Mei-hao; WU En-fu; FANG Yi-ming; LI Jin-lin; WANG Jing-xiao; YUAN Xiang-zhi; DENG Yong; LI Jian-ce; YANG Yun-jun; CHEN Wei-jian

    2007-01-01

    Objective: To discuss the application of MRI in indirect temporomandibular joint injury without condylar fracture. Methods: MRI examination on temporomandibular joint was conducted in 28 patients with indirect injury to temporomandibular joint without condylar fracture. The scanning sequence included T1WI, PDWI on oblique sagittal section at both open and closed mouth positions,and T1WI,T2WI on oblique coronal section. The MRI appearance was analyzed by 2 senior radiologists. Results: Among the 56 temporomandibular joints of 28 patients, 35 joints exhibited pathological changes on MRI, in which there were 9 bone injuries, 21 articular disc dislocation, 24 intracapsular hematocele and hydrops. Conclusions: MRI can clearly reveal bone injury, articular disc dislocation as well as articular capsule abnormality in the indirect injury of temporomandibular joint without condylar fracture. It is highly advocated in clinical use.

  8. Brachial artery injury due to closed posterior elbow dislocation: case report☆

    Science.gov (United States)

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; do Val Sella, Guilherme; Checchia, Caio Santos; Checchia, Sergio Luiz

    2016-01-01

    An association between closed posterior elbow dislocation and traumatic brachial artery injury is rare. Absence of radial pulse on palpation is an important warning sign and arteriography is the gold-standard diagnostic test. Early diagnosis is essential for appropriate treatment to be provided. This consists of joint reduction and immobilization, along with urgent surgical restoration of arterial flow. Here, a case (novel to the Brazilian literature) of an association between these injuries (and the treatment implemented) in a 27-year-old male patient is reported. These injuries were sustained through physical assault. PMID:27069896

  9. Brachial artery injury due to closed posterior elbow dislocation: case report☆

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2016-04-01

    Full Text Available An association between closed posterior elbow dislocation and traumatic brachial artery injury is rare. Absence of radial pulse on palpation is an important warning sign and arteriography is the gold-standard diagnostic test. Early diagnosis is essential for appropriate treatment to be provided. This consists of joint reduction and immobilization, along with urgent surgical restoration of arterial flow. Here, a case (novel to the Brazilian literature of an association between these injuries (and the treatment implemented in a 27-year-old male patient is reported. These injuries were sustained through physical assault.

  10. Contribution to the study of screw dislocations; Contribution a l'etude des dislocations helicoidales

    Energy Technology Data Exchange (ETDEWEB)

    Grilhe, J. [Commissariat a l' Energie Atomique, Fontenay aux Roses (France). Centre d' Etudes Nucleaires

    1965-03-01

    The aim of this work is to study the germination, growth and properties of screw dislocations. In the introduction (first chapter), we describe briefly the main experimental results obtained by various authors (observations of screws by Amelinckx and Bontinck in ionic crystals, by Dash in silicon crystals and by Thomas and Whelan in aluminium based alloys). We then make a few considerations concerning characteristic geometry of screws and the various methods used for calculating the energy of a dislocation. In the second chapter we study the problems involving only slip of the screw around its cylinder. We calculate the equilibrium step as a function of the forces acting on the extremities. We determine the critical stress required to disrupt the screw and study the interactions between the screw and other dislocations of the lattice. In the third chapter we consider the problem of the stability when the dislocation can climb by absorption or emission of vacancies. We study separately the stability of the size which only involves volume diffusion and the stability of the shape which depends only on the rearrangement of the vacancies along the dislocation. In chapter four we put forward a germination model for the screws: since the vacancies are not absorbed by the screw dislocations, they form clusters which take up a spiral form. The formation of these spirals is studied from the geometrical point of view in face-centered cubic systems. In chapter five we make use of the results obtained in chapters two and three for studying the growth of the spirals. (author) [French] Le but de ce travail est d'etudier la germination, la croissance et les proprietes des dislocations helico ales. Dans l'introduction (premier chapitre), nous exposons brievement les principaux resultats experimentaux obtenus par differents auteurs (observations d'helice par Amelinckx et Bontinck dans les cristaux ioniques, par Dash dans des cristaux de silicium et par Thomas et

  11. Joint pain

    Science.gov (United States)

    ... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: gout (especially ...

  12. Estudo comparativo entre ressecção do trapézio e interposição tendinosa com e sem ligamentoplastia no tratamento da artrose carpometacarpiana do polegar Comparative study between trapezium resection and tendon interposition with and without ligament plasty in the management of carpometacarpal arthrosis of the thumb

    Directory of Open Access Journals (Sweden)

    Arlindo Gomes Pardini Junior

    2008-03-01

    opponency, movements of the metacarpophalangeal joint, pinching and pressure strength, radiographic measurement of the distance between the first metacarpian and the scaphoid, and measurement of the angle between the first and the second metacarpian. Subjective evaluation was done with a DASH questionnaire, an analogical-digital scale to evaluate pain and patient satisfaction. RESULTS AND CONCLUSION: After application of the criteria described and using Student t test for statistical analysis, the authors concluded that the ligament reconstruction has no advantage over the simple tendon interposition in carpometacarpal arthrosis of the thumb.

  13. Treatment of a Fracture-dislocation of the Ankle Using RALCA® External Fixator

    Directory of Open Access Journals (Sweden)

    Yaniel Truffin Rodriguez

    2016-06-01

    Full Text Available The association of ankle fractures with a dislocation modifies their therapeutic management since the joint must not remain in such abnormal position for more than six hours and therefore, urgent surgical treatment is needed. The case of a 30-year-old woman treated at the Dr. Gustavo Aldereguía Lima Hospital in Cienfuegos is presented. The patient presented with a severe fracture-dislocation of the right ankle with a supra-syndesmotic fibular fracture, a syndesmotic injury, a deltoid ligament injury and a tibial plafond fracture resulting from a bicycle fall. The fracture-dislocation was stabilized by using a RALCA® external mini-fixator. Full recovery was achieved five months after surgery. In our service, we may not have the devices most commonly used for fixation of ankle injuries at a given moment; therefore, external fixation becomes a viable option to correct this type of fractures. For this reason, we decided to present this case that demonstrates the effectiveness of the RALCA® external fixator.

  14. Patella Dislocation with Vertical Axis Rotation: The “Dorsal Fin” Patella

    Science.gov (United States)

    Gamble, David; Carrothers, Andrew D.; Khanduja, Vikas

    2015-01-01

    A 44-year-old woman presented following minor trauma to her right knee. While dancing she externally rotated around a planted foot and felt sudden pain in her right knee. She presented with her knee locked in extension with a “dorsal fin” appearance of the soft tissues tented over the patella. This was diagnosed as a rare case of an intraarticular patella dislocation, which was rotated 90 degrees about the vertical axis. Closed reduction in the emergency room was unsuccessful but was achieved in theatre under general anaesthetic with muscle relaxation. Postreduction arthroscopy demonstrated that no osteochondral or soft tissue damage to the knee had been sustained. In patients presenting with a knee locked in extension with tenting of skin over the patella (the “dorsal fin” appearance), intra-articular patella dislocation should be suspected. Attempts to reduce vertical patella dislocations under sedation with excessive force or repeatedly without success should be avoided to prevent unnecessary damage to the patellofemoral joint. In this clinical situation we recommend closed reduction under general anaesthetic followed by immediate knee arthroscopy under the same anaesthetic to ensure that there is no chondral damage to the patella or femoral trochlea and to rule out an osteochondral fracture. PMID:25883819

  15. Patella Dislocation with Vertical Axis Rotation: The “Dorsal Fin” Patella

    Directory of Open Access Journals (Sweden)

    David Gamble

    2015-01-01

    Full Text Available A 44-year-old woman presented following minor trauma to her right knee. While dancing she externally rotated around a planted foot and felt sudden pain in her right knee. She presented with her knee locked in extension with a “dorsal fin” appearance of the soft tissues tented over the patella. This was diagnosed as a rare case of an intraarticular patella dislocation, which was rotated 90 degrees about the vertical axis. Closed reduction in the emergency room was unsuccessful but was achieved in theatre under general anaesthetic with muscle relaxation. Postreduction arthroscopy demonstrated that no osteochondral or soft tissue damage to the knee had been sustained. In patients presenting with a knee locked in extension with tenting of skin over the patella (the “dorsal fin” appearance, intra-articular patella dislocation should be suspected. Attempts to reduce vertical patella dislocations under sedation with excessive force or repeatedly without success should be avoided to prevent unnecessary damage to the patellofemoral joint. In this clinical situation we recommend closed reduction under general anaesthetic followed by immediate knee arthroscopy under the same anaesthetic to ensure that there is no chondral damage to the patella or femoral trochlea and to rule out an osteochondral fracture.

  16. Riemann–Cartan Geometry of Nonlinear Dislocation Mechanics

    KAUST Repository

    Yavari, Arash

    2012-03-09

    We present a geometric theory of nonlinear solids with distributed dislocations. In this theory the material manifold-where the body is stress free-is a Weitzenböck manifold, that is, a manifold with a flat affine connection with torsion but vanishing non-metricity. Torsion of the material manifold is identified with the dislocation density tensor of nonlinear dislocation mechanics. Using Cartan\\'s moving frames we construct the material manifold for several examples of bodies with distributed dislocations. We also present non-trivial examples of zero-stress dislocation distributions. More importantly, in this geometric framework we are able to calculate the residual stress fields, assuming that the nonlinear elastic body is incompressible. We derive the governing equations of nonlinear dislocation mechanics covariantly using balance of energy and its covariance. © 2012 Springer-Verlag.

  17. Interaction of two edge dislocations in free-space propagation

    Institute of Scientific and Technical Information of China (English)

    He De; Gao Zeng-Hui; Yan Hong-Wei; Lü Bai-Da

    2011-01-01

    This paper studies in detail the interaction of two edge dislocations nested in a Gaussian beam propagating in free space. It shows that in free-space propagation the edge dislocations are unstable and vanish, and two noncanonical vortices with opposite topological charge take place when off-axis distances c1 and c2 of two edge dislocations are nonzero, and the condition k2w80 + 32c1c2(w20 - 2c1c2)z2 > 0 is fulfilled (k-wave number, w0-waist width). A noncanonical vortex appears when one off-axis distance is zero. However, one edge dislocation is stable when two edge dislocations are perpendicular and one off-axis distance is zero. Two perpendicular edge dislocations both with zero off-axis distance are also stable. The analytical results are illustrated by numerical examples.

  18. Lens dislocation has a possible relationship with laser iridotomy.

    Science.gov (United States)

    Mutoh, Tetsuya; Barrette, Kevin F; Matsumoto, Yukihiro; Chikuda, Makoto

    2012-01-01

    We report our recent experience of four eyes with spontaneous lens dislocation in four patients with no history of trauma or any systemic disease associated with zonular dialysis. Lens dislocation developed with 0.5 to 6 months following laser iridotomy. All patients were male and two eyes were complicated with acute primary angle closure glaucoma preoperatively. Case 1 showed bilateral lens dislocation, while cases 2 and 3 involved unilateral lens dislocation. Cases 2 and 3 showed lenses completely dislocated into the vitreous cavity. All cases needed lens removal and scleral fixation of intraocular lenses. Final visual acuity was 1.2 in all cases. We suspect that laser iridotomy may induce localized zonular dialysis that results in progressive zonular weakness, leading to lens dislocation. PMID:23271880

  19. Mechanism of Strain Rate Effect Based on Dislocation Theory

    Institute of Scientific and Technical Information of China (English)

    QIN Kun; Gang Li-Ming; HU Shi-Sheng

    2009-01-01

    Based on dislocation theory,we investigate the mechanism of strain rate effect.Strain rate effect and dislocation motion are bridged by Orowan's relationship,and the stress dependence of dislocation velocity is considered as the dynamics relationship of dislocation motion. The mechanism of strain rate effect is then investigated qualitatively by using these two relationships although the kinematics relationship of dislocation motion is absent due to complicated styles of dislocation motion.The process of strain rate effect is interpreted and some details of strain rate effect are adequately discussed.The present analyses agree with the existing experimental results.Based on the analyses,we propose that strain rate criteria rather than stress criteria should be satisfied when a metal is fully yielded at a given strain rate.

  20. Pattern formation in a minimal model of continuum dislocation plasticity

    Science.gov (United States)

    Sandfeld, Stefan; Zaiser, Michael

    2015-09-01

    The spontaneous emergence of heterogeneous dislocation patterns is a conspicuous feature of plastic deformation and strain hardening of crystalline solids. Despite long-standing efforts in the materials science and physics of defect communities, there is no general consensus regarding the physical mechanism which leads to the formation of dislocation patterns. In order to establish the fundamental mechanism, we formulate an extremely simplified, minimal model to investigate the formation of patterns based on the continuum theory of fluxes of curved dislocations. We demonstrate that strain hardening as embodied in a Taylor-type dislocation density dependence of the flow stress, in conjunction with the structure of the kinematic equations that govern dislocation motion under the action of external stresses, is already sufficient for the formation of dislocation patterns that are consistent with the principle of similitude.

  1. Scapular dislocation from trivial trauma: a rare case

    Directory of Open Access Journals (Sweden)

    Landge Vikrant

    2012-04-01

    Full Text Available 【Abstract】Dislocation of the scapula between the ribs and into the thoracic cage is a very rare event. Scapulothoracic dissociation though has been reported, usually occurs after a severe injury and is often associated with other serious injuries like brachial plexus or chest injury, etc. Ainscow has described a rare type that may occur due to slight violence with a pre-existing condition. Cases of isolated scapular dislocation after minor trauma have not been reported frequently in the literature. It is a distinct clinical entity and needs to be differentiated from other similar conditions. Here, we present a case of painless scapular dislocation associated with trivial trauma followed by spon-taneous reduction in a 10 years old girl. The patient had a recurrence of the dislocation before presenting to us. But she did not have any pre-existing condition for scapular dislocation. Key words: Scapula; Thorax; Shoulder dislocation

  2. Proximal tibiofibular joint: Rendezvous with a forgotten articulation.

    Science.gov (United States)

    Sarma, Amitav; Borgohain, Bhaskar; Saikia, Bishwajeet

    2015-01-01

    The proximal tibiofibular joint (PTFJ) is a plane type synovial joint. The primary function of the PTFJ is dissipation of torsional stresses applied at the ankle and the lateral tibial bending moments besides a very significant tensile, rather than compressive weight bearing. Though rare, early diagnosis and treatment of the PTFJ dislocation are essential to prevent chronic joint instability and extensive surgical intervention to restore normal PTFJ biomechanics, ankle and knee function, especially in athletes prone to such injuries. PTFJ dislocations often remain undiagnosed in polytrauma scenario with ipsilateral tibial fracture due to the absence of specific signs and symptoms of PTFJ injury. Standard orthopedic textbooks generally describe no specific tests or radiological signs for assessment of the integrity of this joint. The aim of this paper was to review the relevant clinical anatomy, biomechanics and traumatic pathology of PTFJ with its effect on the knee emphasizing the importance of early diagnosis through a high index of suspicion. Dislocation of the joint may have serious implications for the knee joint stability since fibular collateral ligament and posterolateral ligament complex is attached to the upper end of the fibula. Any high energy knee injury with peroneal nerve palsy should immediately raise the suspicion of PTFJ dislocation especially if the mechanism of injury involved knee twisting in flexion beyond 80° and in such cases a comparative radiograph of the contralateral side should be performed. Wider clinical awareness can avoid both embarrassingly extensive surgeries due to diagnostic delays or unnecessary overtreatment due to misinformation on the part of the treating surgeon. PMID:26538753

  3. Proximal tibiofibular joint: Rendezvous with a forgotten articulation

    Directory of Open Access Journals (Sweden)

    Amitav Sarma

    2015-01-01

    Full Text Available The proximal tibiofibular joint (PTFJ is a plane type synovial joint. The primary function of the PTFJ is dissipation of torsional stresses applied at the ankle and the lateral tibial bending moments besides a very significant tensile, rather than compressive weight bearing. Though rare, early diagnosis and treatment of the PTFJ dislocation are essential to prevent chronic joint instability and extensive surgical intervention to restore normal PTFJ biomechanics, ankle and knee function, especially in athletes prone to such injuries. PTFJ dislocations often remain undiagnosed in polytrauma scenario with ipsilateral tibial fracture due to the absence of specific signs and symptoms of PTFJ injury. Standard orthopedic textbooks generally describe no specific tests or radiological signs for assessment of the integrity of this joint. The aim of this paper was to review the relevant clinical anatomy, biomechanics and traumatic pathology of PTFJ with its effect on the knee emphasizing the importance of early diagnosis through a high index of suspicion. Dislocation of the joint may have serious implications for the knee joint stability since fibular collateral ligament and posterolateral ligament complex is attached to the upper end of the fibula. Any high energy knee injury with peroneal nerve palsy should immediately raise the suspicion of PTFJ dislocation especially if the mechanism of injury involved knee twisting in flexion beyond 80° and in such cases a comparative radiograph of the contralateral side should be performed. Wider clinical awareness can avoid both embarrassingly extensive surgeries due to diagnostic delays or unnecessary overtreatment due to misinformation on the part of the treating surgeon.

  4. Benign Joint Hypermobility Syndrome – not so ‘Benign’

    Directory of Open Access Journals (Sweden)

    Yathish GC

    2015-05-01

    Full Text Available Benign joint hypermobility syndrome (BJHS was earlier considered as a mild or trivial entity, but nowadays it is reported as a multisystem hereditary connective tissue disorder with serious morbidities. In fact, the term ‘Benign’ has been removed, renaming the disease as ‘Joint Hypermobility Syndrome’ (JHS. In addition to the well-known musculoskeletal consequences of joint pain and instability, it can cause chronic widespread pain, gastrointestinal dysmotility, anxiety, phobic states and dysautonomia. We present here the case of a 53-year-old lady who presented with history of irritable bowel syndrome, elbow dislocation, repeated knee injuries, and instability resulting in severe secondary osteoarthritis (OA.

  5. Has the management of shoulder dislocation changed over time?

    OpenAIRE

    Chalidis, Byron; Sachinis, Nick; Dimitriou, Christos; Papadopoulos, Pericles; Samoladas, Efthimios; Pournaras, John

    2006-01-01

    Anterior shoulder dislocation is a disabling injury affecting all ages, young and old alike. Recently, the treatment of traumatic shoulder dislocation has included immobilisation for varying periods of time followed by physiotherapy. This study is the first in this country to address the demographic data and recurrence rates of shoulder dislocation. Three hundred and eight patients (170 men and 138 women) were followed up for an average of 5.9 years. The most frequent mechanism of injury was ...

  6. Shoulder dislocation in patients older than 60 years of age

    OpenAIRE

    Rapariz Jose; Martin-Martin Silvia; Pareja-Bezares Antonio; Ortega-Klein Jose

    2010-01-01

    Purpose: Recurrent anterior shoulder dislocation in elderly patients is a little studied condition. The goal of this paper is to clarify the role of associated injuries with respect to loss of function and recurrence of dislocation. Materials and Methods: We have conducted a retrospective, descriptive study on 29 patients older than 60 years at the moment they suffered their first dislocation episode. All patients were assessed clinically (Constant test) and by imaging testing (X-ray, MRI). ...

  7. Bilateral locked posterior shoulder dislocation in a footballer.

    OpenAIRE

    Ryan, J; Whitten, M

    1997-01-01

    Posterior dislocation of the shoulder is an uncommon injury, accounting for between 2% and 4% of all shoulder dislocations. It occurs most frequently in patients following convulsions or direct anterior force to the shoulder. It is a particularly uncommon injury in sport. This paper reports an unusual case of bilateal locked posteriorly dislocated shoulders in a previously healthy young man who fell while playing football.

  8. Fracture line index of fibular stalk and the ankle joint bone in the classification of the ankle joint trauma

    International Nuclear Information System (INIS)

    Objective: To evaluate the fracture line index of fibular stalk and the ankle joint bone in the classification of the ankle joint trauma. Methods: Measure fracture line index of fibular stalk and the ankle joint in 217 adult cases of fracture and dislocation of ankle joint. And the cases were classified by the results of the measurement. Results: Measurement was unavailable in 9 cases of tearing fracture. In 31 cases, the lesions could not be particularly classified. And in the rest 176 cases the trauma were precisely classified. The over all successful rate was 81.6%. Conclusion: Fracture line index of fibular stalk and the ankle joint bone are valuable in classification of the trauma of the angle joint. While the specificity of this method is low in differentiating the adducting and abducting fracture of the medial angle, in which a combined investigation is recommended

  9. Bilateral anterior shoulder fracture-dislocation : A case report and a review of the literature

    OpenAIRE

    Dinopoulos, H. T.; Giannoudis, P. V.; Smith, R. M.; Matthews, S.J.

    1999-01-01

     We report an unusual case of bilateral anterior shoulder dislocation following trauma. Previously reported cases were either of bilateral dislocations or bilateral fracture dislocations. In our case the patient suffered bilateral anterior dislocation with a three part fracture dislocation on the right. A review of the literature is presented.

  10. A Case of Simultaneous Bilateral Anterior Shoulder Dislocation

    Directory of Open Access Journals (Sweden)

    Mallanagouda N Patil

    2013-04-01

    Full Text Available Introduction: Anterior dislocation of shoulder is commonest dislocation one encounters in day to day Orthopaedic practice. But bilateral shoulder dislocations are relatively uncommon frequently posterior and secondary to violent muscle contraction. Simultaneous bilateral anterior dislocations of shoulder following trauma is rare occurrence. Case Report: 35 year old male presented to emergency department with history fall by tripping on a stone (fall on outstretched hand. He complained of pain and difficulty in moving both the shoulders. On clinical examination, patient’s both upper limbs were abducted and externally rotated. Bilaterally shoulder contour was lost with flattening. Other classical signs of shoulder dislocation viz, Bryants test, Callway sign, Hamilton’s ruler test were positive. Diagnosis was confirmed on X rays. Both shoulders were reduced in emergency operation theater under general anaesthesia by Kocher’s method and were immobilised in sling. Conclusion: Though bilateral shoulder dislocations are commonly posterior, usually either secondary to convulsions or electric shock, anterior dislocation has to be kept in mind , especially in post traumatic injuries. This bilateral dislocation also presents with practical problems immobilization and day to day care of patients. Keywords: Simultaneous, bilateral, shoulder dislocation, traumatic.

  11. Mobility of edge dislocations in stressed iron crystals during irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Korchuganov, A. V., E-mail: avkor@ispms.ru; Zolnikov, K. P.; Kryzhevich, D. S. [Institute of Strength Physics and Materials Science SB RAS, Tomsk, 634055 (Russian Federation); National Research Tomsk State University, Tomsk, 634050 (Russian Federation); Chernov, V. M. [A.A. Bochvar High-Technology Scientific Research Institute for Inorganic Materials, Moscow, 123098 (Russian Federation); Psakhie, S. G. [Institute of Strength Physics and Materials Science SB RAS, Tomsk, 634055 (Russian Federation); National Research Tomsk Polytechnic University, Tomsk, 634050 (Russian Federation); Skolkovo Institute of Science and Technology, Skolkovo, 143025 (Russian Federation)

    2015-10-27

    The behavior of a/2(111)(110) edge dislocations in iron in shear loading and irradiation conditions was studied by means of molecular dynamics simulation. Edge dislocations were exposed to shock waves formed by atomic displacement cascades of different energies. It was shown that starting from a certain threshold amplitude shock waves cause displacement of edge dislocations in the loaded samples. Calculations showed that the larger the shear load and the amplitude of the shock wave, the greater the displacement of dislocations in the crystallite.

  12. Dislocations and torsion in graphene and related systems

    Energy Technology Data Exchange (ETDEWEB)

    Juan, Fernando de [Instituto de Ciencia de Materiales de Madrid, CSIC, Cantoblanco, 28049 Madrid (Spain); Cortijo, Alberto [Department of Physics, Lancaster University, Lancaster, LA1 4YB (United Kingdom); Vozmediano, Maria A.H., E-mail: vozmediano@icmm.csic.e [Instituto de Ciencia de Materiales de Madrid, CSIC, Cantoblanco, 28049 Madrid (Spain)

    2010-04-01

    A continuum model to study the influence of dislocations on the electronic properties of condensed matter systems is described and analyzed. The model is based on a geometrical formalism that associates a density of dislocations with the torsion tensor and uses the technique of quantum field theory in curved space. When applied to two-dimensional systems with Dirac points like graphene we find that dislocations couple in the form of vector gauge fields similar to these arising from curvature or elastic strain. We also describe the ways to couple dislocations to normal metals with a Fermi surface.

  13. High-resolution three-dimensional imaging of dislocations.

    Science.gov (United States)

    Barnard, J S; Sharp, J; Tong, J R; Midgley, P A

    2006-07-21

    Dislocations and their interactions govern the properties of many materials, ranging from work hardening in metals to device pathology in semiconductor laser diodes. However, conventional electron micrographs are simply two-dimensional projections of three-dimensional (3D) structures, and even stereo microscopy cannot reveal the true 3D complexity of defect structures. Here, we describe an electron tomographic method that yields 3D reconstructions of dislocation networks with a spatial resolution three orders of magnitude better than previous work. We illustrate the method's success with a study of dislocations in a GaN epilayer, where dislocation densities of 1010 per square centimeter are common.

  14. Predicting High Temperature Dislocation Physics in HCP Crystal Structures

    Energy Technology Data Exchange (ETDEWEB)

    Hunter, Abigail [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Carpenter, John S. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Martinez Saez, Enrique [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-05-09

    This report applies models and experiments to answer key questions about the way materials deform; specifics regarding phase field dislocations dynamics; as well as high temperature rolling experiments.

  15. Interfacial dislocation motion and interactions in single-crystal superalloys

    Energy Technology Data Exchange (ETDEWEB)

    Liu, B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Raabe, D. [Max Planck Inst. fur Eisenforshung. Dusseldorf (Germany); Roters, F. [Max Planck Inst. fur Eisenforshung. Dusseldorf (Germany); Arsenlis, A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2014-10-01

    The early stage of high-temperature low-stress creep in single-crystal superalloys is characterized by the rapid development of interfacial dislocation networks. Although interfacial motion and dynamic recovery of these dislocation networks have long been expected to control the subsequent creep behavior, direct observation and hence in-depth understanding of such processes has not been achieved. Incorporating recent developments of discrete dislocation dynamics models, we simulate interfacial dislocation motion in the channel structures of single-crystal superalloys, and investigate how interfacial dislocation motion and dynamic recovery are affected by interfacial dislocation interactions and lattice misfit. Different types of dislocation interactions are considered: self, collinear, coplanar, Lomer junction, glissile junction, and Hirth junction. The simulation results show that strong dynamic recovery occurs due to the short-range reactions of collinear annihilation and Lomer junction formation. The misfit stress is found to induce and accelerate dynamic recovery of interfacial dislocation networks involving self-interaction and Hirth junction formation, but slow down the steady interfacial motion of coplanar and glissile junction forming dislocation networks. The insights gained from these simulations on high-temperature low-stress creep of single-crystal superalloys are also discussed.

  16. Congenital dislocation of the patella – clinical case☆

    Science.gov (United States)

    Miguel Sá, Pedro; Raposo, Filipa; Santos Carvalho, Manuel; Alegrete, Nuno; Coutinho, Jorge; Costa, Gilberto

    2015-01-01

    Congenital patellar dislocation is a rare condition in which the patella is permanently dislocated and cannot be reduced manually. The patella develops normally as a sesamoid bone of the femur. This congenital dislocation results from failure of the internal rotation of the myotome that forms the femur, quadriceps muscle and extensor apparatus. It usually manifests immediately after birth, although in some rare cases, the diagnosis may be delayed until adolescence or adulthood. Early diagnosis is important, thereby allowing surgical correction and avoiding late sequelae, including early degenerative changes in the knee. A case of permanent dislocation of the patella is presented here, in a female child aged seven years. PMID:26962496

  17. Orientation dependence of shock induced dislocations in tantalum single crystals

    International Nuclear Information System (INIS)

    A planar shock wave with a peak pressure of 6.2 GPa and duration of 1.7 μs followed by a lateral release wave generates profuse dislocations in single crystalline tantalum. Three orientations [100], [110], [111] were tested to examine the orientation dependence of the dislocation generation. The dislocations were characterised by transmission electron microscopy. The Burgers vectors and morphology of the primary dislocations in the specimens with different orientations showed a distinct orientation dependence and will be discussed in light of the model of slip behaviour in one-dimensional strain of C.S. Smith [1

  18. Reduction of Anterior Shoulder Dislocation in Emergency Department; Is Entonox® Effective?

    Directory of Open Access Journals (Sweden)

    Babak Mahshidfar

    2011-12-01

    Full Text Available Introduction: An appropriate procedural sedation and analgesia (PSA is crucial to reduce a dislocated shoulder successfully in emergency department. This study compares sedative effect of inhalational Entonox® (En to intra-venous (IV Midazolam plus Fentanyl (F+M. Methods: 120 patients with recurrent anterior shoulder dislocation were randomly assigned into two groups. 60 patients (group F+M received 0.1 mg/kg IV Midazolam plus 3µg/kg IV Fentanyl and 60 patients (group En received Entonox® with self administration face mask on an on-demand basis. Traction/counter-traction method was used to reduce the dislocated shoulder joint in both groups. Results: 48 out of 60 (80% patients in group F+M and 6 out of 60 (10% patients in group En had successful reduction (p < 0.0001. The mean pain score reduction was 6.3 ± 1.2 for group F+M and 3 ± 0.9 for group En (p < 0.0001. There was a statistically significant difference in mean patient satisfaction (assessed with Likert score between two groups (4.45 ± 0.6 for group F+M and 2.3 ± 1 for group En; p < 0.0001. Duration of entire procedure (since the beginning of PSA up to the end of successful or unsuccessful reduction was shorter in Group F+M, but successful reductions occurred earlier in group En. No major side effect such as airway compromise, retracted respiratory depression, or circulatory failure was occurred in any group. Conclusion: Entonox® may not be an appropriate agent to help reducing a dislocated shoulder.

  19. ECU tendon ''dislocation'' in asymptomatic volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Petchprapa, Catherine N. [New York University Langone Medical Center, Hospital for Joint Diseases, Department of Radiology, New York, NY (United States); Meraj, Seema [Zwanger-Pesiri Radiology Group, Lindenhurst, NY (United States); Jain, Nidhi [New York University School of Medicine, New York University Langone Medical Center, Department of Radiology, New York, NY (United States)

    2016-06-15

    Assess extensor carpi ulnaris (ECU) tendon position in the ulnar groove, determine the frequency of tendon ''dislocation'' with the forearm prone, neutral, and supine, and determine if an association exists between ulnar groove morphology and tendon position in asymptomatic volunteers. Axial proton density-weighted MR was performed through the distal radioulnar joint with the forearm prone, neutral, and supine in 38 asymptomatic wrists. The percentage of the tendon located beyond the ulnar-most border of the ulnar groove was recorded. Ulnar groove depth and length was measured and ECU tendon signal was assessed. 15.8 % of tendons remained within the groove in all forearm positions. In 76.3 %, the tendon translated medially from prone to supine. The tendon ''dislocated'' in 0, 10.5, and 39.5 % with the forearm prone, neutral and supine, respectively. In 7.9 % prone, 5.3 % neutral, and 10.5 % supine exams, the tendon was 51-99 % beyond the ulnar border of the ulnar groove. Mean ulnar groove depth and length were 1.6 and 7.7 mm, respectively, with an overall trend towards greater degrees of tendon translation in shorter, shallower ulnar grooves. The ECU tendon shifts in a medial direction when the forearm is supine; however, tendon ''dislocation'' has not been previously documented in asymptomatic volunteers. The ECU tendon medially translated or frankly dislocated from the ulnar groove in the majority of our asymptomatic volunteers, particularly when the forearm is supine. Overall greater degrees of tendon translation were observed in shorter and shallower ulnar grooves. (orig.)

  20. Hip Dislocation and Physis Separation Related to the Delayed Diagnosis of Septic Arthritis - Case Re

    Directory of Open Access Journals (Sweden)

    Mehmet Gokalp

    2013-10-01

    Full Text Available If the diagnosis of the hip septic arthritis is delayed, serious complications such as the arthrosis in joint, the separation of epiphyseal, osteomyelitis and sepsis can develop. The presence of the accompanying infectious diseases contributes to the delay of the diagnosis. In order to get rid of the late period sequelaes of septic arthritis, the required tests should be asked for the differential diagnosis of this disease in each patient presenting with hip pain. In this paper we presented 13 years old pediatric patient who was treated with the diagnosis of pneumonia developed joint dislocation together with the physis separation of the femoral head because of delayed diagnosis of accompanying hip septic arthritis.

  1. [Acute perilunar dislocations: algorithm for treatment].

    Science.gov (United States)

    Towfigh, H

    2001-01-01

    In most cases, perilunar dislocations of the wrist are caused by high speed accidents. Usually these injuries occur by a fall on the dorsiflexed superextension of the hand. The instability caused by injuries of various erticular structures (ligament, bone) show various developmental stages. Clinical symptoms are reduced and painful movement, instability of the carpus, snapping and swelling. The diagnosis is established by X-ray, cinematography, arthrography MRT or CT. Perilunar instability with or without associated fractures and particularly de Quervain must be reduced and treated operatively including suture of the ligament and stabilization of the fracture. PMID:11824286

  2. 髌骨习惯性脱位的手术治疗%Operation Treatment of Habitual Patellar Dislocation

    Institute of Scientific and Technical Information of China (English)

    鱼红进; 刘兴国; 宋明辉; 齐奉军

    2013-01-01

    目的:探讨髌骨习惯性脱位的手术治疗方法。方法:自2004年2月~2011年4月期间,应用外侧松解、内侧紧缩、股内侧肌止点下移、外侧1/2半髌韧带止点或胫骨结节内移、半腱肌肌腱转位及内侧筋膜瓣牵拉治疗12例(15膝)习惯性髌骨脱位的患者。结果:随访3个月~3年,患者关节功能良好,髌骨脱位无复发,无关节疼痛或关节不稳等情况,优良率86%。结论:应用联合术式治疗髌骨习惯性脱位的方法效果肯定,易于操作。%To investigate operation method of treatment of habitual patellar dislocation .Mtehods:From February 2004 to April 2011 , application of lateral release , medial vastus medialis muscle contraction , check point down ,lateral 1/2 half patellar ligament insertion points or tibial tubercle transfer , semitendinosus tendon transposition and fascial flap of medial traction therapy in 12 cases (15 knees) in patients with recurrent dislocation of the patella .Results:Follow-up of 3 months ~3 years, good joint function of the patients with patellar dislocation , no recurrence , no joint pain or joint instability , the excellent and good rate was 86%.Conclusion:the effect of combined application of certain methods of surgical treatment of habitual patellar dislocation , easy to operate .

  3. Combined common peroneal and tibial nerve injury after knee dislocation: one injury or two? An MRI-clinical correlation.

    Science.gov (United States)

    Reddy, Chandan G; Amrami, Kimberly K; Howe, Benjamin M; Spinner, Robert J

    2015-09-01

    OBJECT Knee dislocations are often accompanied by stretch injuries to the common peroneal nerve (CPN). A small subset of these injuries also affect the tibial nerve. The mechanism of this combined pattern could be a single longitudinal stretch injury of the CPN extending to the sciatic bifurcation (and tibial division) or separate injuries of both the CPN and tibial nerve, either at the level of the tibiofemoral joint or distally at the soleal sling and fibular neck. The authors reviewed cases involving patients with knee dislocations with CPN and tibial nerve injuries to determine the localization of the combined injury and correlation between degree of MRI appearance and clinical severity of nerve injury. METHODS Three groups of cases were reviewed. Group 1 consisted of knee dislocations with clinical evidence of nerve injury (n = 28, including 19 cases of complete CPN injury); Group 2 consisted of knee dislocations without clinical evidence of nerve injury (n = 19); and Group 3 consisted of cases of minor knee trauma but without knee dislocation (n = 14). All patients had an MRI study of the knee performed within 3 months of injury. MRI appearance of tibial and common peroneal nerve injury was scored by 2 independent radiologists in 3 zones (Zone I, sciatic bifurcation; Zone II, knee joint; and Zone III, soleal sling and fibular neck) on a severity scale of 1-4. Injury signal was scored as diffuse or focal for each nerve in each of the 3 zones. A clinical score was also calculated based on Medical Research Council scores for strength in the tibial and peroneal nerve distributions, combined with electrophysiological data, when available, and correlated with the MRI injury score. RESULTS Nearly all of the nerve segments visualized in Groups 1 and 2 demonstrated some degree of injury on MRI (95%), compared with 12% of nerve segments in Group 3. MRI nerve injury scores were significantly more severe in Group 1 relative to Group 2 (2.06 vs 1.24, p knee dislocations

  4. Partial arthroscopic trapeziectomy with ligament reconstruction to treat primary thumb basal joint osteoarthritis.

    Science.gov (United States)

    Desmoineaux, P; Delaroche, C; Beaufils, P

    2012-11-01

    Since the outcome of partial trapeziectomy is not always satisfactory, we proposed using arthroscopy to perform partial trapeziectomy and to perform ligament reconstruction with the abductor pollicis longus tendon. A tendon strip was left intact at its insertion at the base of the first metacarpal and then slipped into the trapeziectomy space. It was fixed into a blind tunnel at the base of the second metacarpal with a bioabsorbable interference screw. Forty-nine patients were surgically treated between 2006 and 2009. With an average follow-up of 3.6 years, 83.5% of patients were satisfied with the procedure; 96% of thumbs were stable and 74% were pain free. The average recovery time was 4.5 months. There were four cases of radial nerve branch irritation and one case of flexor carpi radialis tendinitis; there were no cases of complex regional pain syndrome. This minimally-invasive technique is a less-aggressive treatment approach for thumb carpometacarpal joint arthritis, which simplify postoperative recovery. PMID:23098774

  5. Surgical dislocation of the hip in patients with femoroacetabular impingement: Surgical techniques and our experience

    Directory of Open Access Journals (Sweden)

    Mladenović Marko

    2015-01-01

    Full Text Available Background/Aim. Arthrosis of the hip is the most common cause of a hip joint disorders. The aim of this study was to present our experience in the application of a safe surgical dislocation of the hip in patients with minor morphological changes in the hip joint, which, through the mechanism of femoroacetabular impingement, cause damage to the acetabular labrum and adjacent cartilage as an early sign of the hip arthrosis. Methods. We have operated 51 patients with different morphological bone changes in the hip area and resultant soft tissue damage of the acetabular labrum and its adjacent cartilage. Surgical technique that we applied in this group of patients, was adapted to our needs and capabilities and it was minimaly modified compared to the original procedure. Results. The surgical technique presented in this paper, proved to be a good method of treatment of bone and soft tissue pathomorphological changes of the hip in patients with femoroacetabular impingement. We had no cases with avascular necrosis of the femoral head, and two patients had nonunion of the greater trochanter, 9 patients developed paraarticular ossification, without subjective symptoms, while 3 patients suffered from postoperative pain in the groin during more energetic physical activities. Conclusion. Utilization of our partly modified surgical technique of controlled and safe dislocation of the hip can solve all the bone and soft tissue problems in patients with femoroacetibular impingement to stop already developed osteoarthritis of the hip or to prevent mild form of it.

  6. A computational method for dislocation-precipitate interaction

    Science.gov (United States)

    Takahashi, Akiyuki; Ghoniem, Nasr M.

    A new computational method for the elastic interaction between dislocations and precipitates is developed and applied to the solution of problems involving dislocation cutting and looping around precipitates. Based on the superposition principle, the solution to the dislocation-precipitate interaction problem is obtained as the sum of two solutions: (1) a dislocation problem with image stresses from interfaces between the dislocation and the precipitate, and (2) a correction solution for the elastic problem of a precipitate with an initial strain distribution. The current development is based on a combination of the parametric dislocation dynamics (PDD) and the boundary element method (BEM) with volume integrals.The method allows us to calculate the stress field both inside and outside precipitates of elastic moduli different from the matrix, and that may have initial coherency strain fields. The numerical results of the present method show good convergence and high accuracy when compared to a known analytical solution, and they are also in good agreement with molecular dynamics (MD) simulations. Sheared copper precipitates (2.5 nm in diameter) are shown to lose some of their resistance to dislocation motion after they are cut by leading dislocations in a pileup. Successive cutting of precipitates by the passage of a dislocation pileup reduces the resistance to about half its original value, when the number of dislocations in the pileup exceeds about 10. The transition from the shearable precipitate regime to the Orowan looping regime occurs for precipitate-to-matrix elastic modulus ratios above approximately 3-4, with some dependence on the precipitate size. The effects of precipitate size, spacing, and elastic modulus mismatch with the host matrix on the critical shear stress (CSS) to dislocation motion are presented.

  7. Slip patterns and preferred dislocation boundary planes

    DEFF Research Database (Denmark)

    Winther, G.

    2003-01-01

    The planes of deformation induced extended planar dislocation boundaries are analysed in two different co-ordinate systems, namely the macroscopic system defined by the deformation axes and the crystallographic system given by the crystallographic lattice. The analysis covers single and polycryst......The planes of deformation induced extended planar dislocation boundaries are analysed in two different co-ordinate systems, namely the macroscopic system defined by the deformation axes and the crystallographic system given by the crystallographic lattice. The analysis covers single...... and polycrystals of fcc metals in three deformation modes (rolling, tension and torsion). In the macroscopic system, boundaries lie close to the macroscopically most stressed planes. In the crystallographic system, the boundary plane depends on the grain/crystal orientation. The boundary planes in both co......-ordinate systems are rationalised based on the slip. The more the slip is concentrated on a slip plane, the closer the boundaries lie to this. The macroscopic preference arises from the macroscopic directionality of the slip. The established relations are applied to (a) prediction of boundary planes from slip...

  8. Extensor Mechanism Disruption in Knee Dislocation.

    Science.gov (United States)

    O'Malley, Michael; Reardon, Patrick; Pareek, Ayoosh; Krych, Aaron; Levy, Bruce A; Stuart, Michael J

    2016-05-01

    Disruption of the knee extensor mechanism is a challenging injury with no clear consensus on optimal treatment. Although rare in the setting of knee dislocations, these injuries should not be overlooked. Acute, complete rupture of either the quadriceps or patellar tendon necessitates primary repair with or without augmentation. Surgical management may also be required in the setting of a partial tear if a significant extensor lag is present or nonoperative treatment has failed. Tendon augmentation is used during primary repair if the native tissue is inadequate or after a failed primary repair. The purpose of this study is to evaluate extensor mechanism disruption incidence, injury patterns, associated injuries, and surgical options, including a novel tendon augmentation technique. This procedure consists of primary patellar or quadriceps tendon repair with semitendinosus autograft augmentation utilizing a distal or proximal patellar socket. Advantages of repair with tendon augmentation include accelerated rehabilitation, decreased risk of patellar fracture from transverse or longitudinal bone tunnels, and less hardware complications. We recommend consideration of this technique for selected cases of acute extensor mechanism disruption in the setting of tibiofemoral dislocation. PMID:26636488

  9. Congenital dislocation of the hip. A review.

    Science.gov (United States)

    Sherk, H H; Pasquariello, P S; Watters, W C

    1981-08-01

    Congenital dislocation of the hip usually results from capsular stretching caused by fetal malposition and crouching late in the third trimester. Early recognition of hip dislocation or instability soon after birth permits prompt treatment. Ortolani's and Barlow's maneuvers, respectively, reduce into and displace from the acetabulum a femoral head that is insecurely contained therein. The diagnosis of CDH in the first month of life usually depends on these clinical components of the physical examination of the newborn, because similar device, in this age group can usually maintain the displaced hip in sufficient flexion and abduction to permit reduction and normal development. By 3 months of age, the nuclei of the pelvis and upper femur have ossified enough to permit radiologic diagnosis of CDH. Problems related to treatment increase as the child grows older. In infants up to 6 months of age, closed methods with a harness usually succeed. Beyond 6 months, the soft tissues shorten and prevent easy reduction. These patients almost always require pre-reduction traction. An adductor tenotomy also facilitates reduction and apparently lessens compressive forces on the femoral head, an important consideration in preventing avascular necrosis of the head. Children over 1 year old develop bony changes, such as excessive femoral valgus and anteversion and deformity of the acetabulum. Treatment in these patients requires realignment of bony deformities with femoral or pelvic osteotomies in addition to the measures noted previously. The gentleness and high success rate of early treatment make early diagnosis of CDH an important consideration in infants and newborns.

  10. Concept of healing of recurrent shoulder dislocation.

    Science.gov (United States)

    D'Angelo, Donato

    2014-01-01

    This paper presents the main surgical techniques applied in the treatment of anterior recurrent shoulder dislocation, aiming the achievement of the normality of articulate movements. This was obtained by combining distinct surgical procedures, which allowed the recovery of a complete functional capacity of the shoulder, without jeopardizing the normality of movement, something that has not been recorded in the case of the tense sutures of the surgical procedures of Putti-Platt, Bankart, Latarjet, Dickson-O'Dell and others. The careful review of the methods applied supports the conclusion that recurrent shoulder dislocation can be cured, since cure has been obtained in 97% of the treated cases. However, some degree of limitation in the shoulder movement has been observed in most of the treated cases. Our main goal was to achieve a complete shoulder functional recovery, by treating simultaneously all of the anatomical-pathological lesions, without considering the so-called essential lesions. The period of post-operatory immobilization only last for the healing of soft parts; this takes place in a position of neutral shoulder rotation, since the use of vascular bone graft eliminates the need for long time immobilization, due to the shoulder stabilization provided by rigid fixation of the coracoid at the glenoid edge, as in the Latarjet's technique. Our procedure, used since 1959, comprises the association of several techniques, which has permitted shoulder healing without movement limitation. That was because of the tension reduction in the sutures of the subescapularis, capsule, and coracobraquialis muscles. PMID:26229839

  11. Joint purpose?

    DEFF Research Database (Denmark)

    Pristed Nielsen, Helene

    2013-01-01

    Starting from Crenshaw´s point that antiracism often fails to interrogate patriarchy and that feminism often reproduces racist practices (1991: 1252), this paper asks: What are the theoretical reasons for believing that feminism and anti-racism can be regarded as fighting for the joint purpose of...

  12. Joint imaging

    International Nuclear Information System (INIS)

    Joint imaging is a proven diagnostic procedure which has become indispensable to the detection and treatment of different joint diseases in almost all disciplines. The method is suited for early diagnosis of joint affections both in soft tissue and bone which cannot be detected by X-ray or other procedures. The local activity accumulation depends on the rate of metabolism and is visualized in the scan, which in turn enables the extension and floridity of focal lesions to be evaluated and followed-up. Although joint scans may often give hints to probabilities relevant to differential diagnosis, the method is non-specific and only useful if based on the underlying clinical picture and X-ray finding, if possible. The radiation exposure is very low and does not represent a hazard in cases of adequate assessment of indication. In pregnant women and children the assessment of indication has to be based on very strict principles. The method is suited for out-patient diagnosis and can be applied in all installations equipped with a gamma camera and a technetium generator. (orig.)

  13. Moment tensors of a dislocation in a porous medium

    Science.gov (United States)

    Wang, Zhi; Hu, Hengshan

    2016-06-01

    A dislocation can be represented by a moment tensor for calculating seismic waves. However, the moment tensor expression was derived in an elastic medium and cannot completely describe a dislocation in a porous medium. In this paper, effective moment tensors of a dislocation in a porous medium are derived. It is found that the dislocation is equivalent to two independent moment tensors, i.e., the bulk moment tensor acting on the bulk of the porous medium and the isotropic fluid moment tensor acting on the pore fluid. Both of them are caused by the solid dislocation as well as the fluid-solid relative motion corresponding to fluid injection towards the surrounding rocks (or fluid outflow) through the fault plane. For a shear dislocation, the fluid moment tensor is zero, and the dislocation is equivalent to a double couple acting on the bulk; for an opening dislocation or fluid injection, the two moment tensors are needed to describe the source. The fluid moment tensor only affects the radiated compressional waves. By calculating the ratio of the radiation fields generated by unit fluid moment tensor and bulk moment tensor, it is found that the fast compressional wave radiated by the bulk moment tensor is much stronger than that radiated by the fluid moment tensor, while the slow compressional wave radiated by the fluid moment tensor is several times stronger than that radiated by the bulk moment tensor.

  14. Rows of Dislocation Loops in Aluminium Irradiated by Aluminium Ions

    DEFF Research Database (Denmark)

    Henriksen, L.; Johansen, A.; Koch, J.;

    1967-01-01

    Single-crystal aluminium specimens, irradiated with 50-keV aluminium ions, contain dislocation loops that are arranged in regular rows along <110 > directions. ©1967 The American Institute of Physics......Single-crystal aluminium specimens, irradiated with 50-keV aluminium ions, contain dislocation loops that are arranged in regular rows along directions. ©1967 The American Institute of Physics...

  15. Concerts of earthquakes and transverse dislocations in the Caucasus

    Science.gov (United States)

    Pirouzian, S. A.

    1992-02-01

    The geologic-geophysical phenomenon of simultaneous fairly strong tremors or "concerts" of earthquakes in the territory of the Caucasus is considered. The tectonic interpretation of the phenomenon is proposed from the viewpoint of simultaneous activity of different parts of a seismogenic fault or the system of correlated disjunctive dislocations and especially, the transverse dislocations in the Caucasus.

  16. Pediatric open elbow dislocation without fracture: A case report

    Directory of Open Access Journals (Sweden)

    Gökhan Polat

    2014-01-01

    CONCLUSION: Pediatric elbow dislocations are rare injuries and the management of these injuries can be technically demanding due to concurrent neurovascular injuries. An open dislocation without fracture is very rare and it should be treated with immediate intervention, an effective teamwork and good rehabilitation.

  17. Work softening in nanocrystalline materials induced by dislocation annihilation

    DEFF Research Database (Denmark)

    Ungar, Tamas; Li, Li; Tichy, Geza;

    2011-01-01

    Cold rolling reduces the quantity of dislocation densities in Ni–18% Fe alloys prepared by electrochemical deposition. The dislocation density evolution proposed earlier for the linearly decreasing work-hardening rate during stage III is revisited. The solution of the differential equation predicts...

  18. Surface versus bulk nucleation of dislocations during contact

    NARCIS (Netherlands)

    Nicola, L.; Bower, A. F.; Kim, K.-S.; Needleman, A.; Van der Giessen, E.

    2007-01-01

    The indentation of single crystals by a periodic array of flat rigid contacts is analyzed using discrete dislocation plasticity. Plane strain analyses are carried out with the dislocations all of edge character and modeled as line singularities in a linear elastic solid. The limiting cases of fricti

  19. Dislocation morphology in deformed and irradiated niobium. [Neutron irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Chang, C. P.

    1977-06-01

    Niobium foils of moderate purity were examined for the morphology of dislocations or defect clusters in the deformed or neutron-irradiated state by transmission electron microscopy. New evidence has been found for the dissociation of screw dislocations into partials on the (211) slip plane according to the Crussard mechanism: (a/2) (111) ..-->.. (a/3) (111) + (a/6) (111).

  20. Isolated posterior dislocation of the radial head in an adult.

    Directory of Open Access Journals (Sweden)

    Negi A

    1992-07-01

    Full Text Available Isolated posterior dislocation of the radial head was detected on X-ray in a patient following a vehicular accident. Such a dislocation without an associated fracture is extremely rare in adults. Immobilization of the elbow in full pronation and 90 degrees flexion for 4 weeks normalized the position of the head of the radius.

  1. Method to reduce dislocation density in silicon using stress

    Science.gov (United States)

    Buonassisi, Anthony; Bertoni, Mariana; Argon, Ali; Castellanos, Sergio; Fecych, Alexandria; Powell, Douglas; Vogl, Michelle

    2013-03-05

    A crystalline material structure with reduced dislocation density and method of producing same is provided. The crystalline material structure is annealed at temperatures above the brittle-to-ductile transition temperature of the crystalline material structure. One or more stress elements are formed on the crystalline material structure so as to annihilate dislocations or to move them into less harmful locations.

  2. Dislocated ankle fracture complicated by near total distal ischaemia

    Science.gov (United States)

    Duygun, Fatih; Sertkaya, Omer; Aldemir, Cengiz; Dogan, Ali

    2013-01-01

    Total arterial ischaemia is rarely seen following a dislocated ankle fracture but if it does and intervention is not made, it can lead to serious morbidity. We present a 39-year-old woman with almost total occlusion in the arteria tibialis and arteria dorsalis pedis following a dislocated ankle fracture as a result of a bicycle fall. PMID:24248319

  3. Modern Treatment Methods of Habitual Shoulder Dislocation (Literature Review

    Directory of Open Access Journals (Sweden)

    Dlyasin N.G.

    2010-09-01

    Full Text Available In the literature review the groups of the most applicable surgical interventions in treatment of patients with habitual shoulder dislocation are cited. The tendency to increase an application of arthroscopic operations seek to eliminate some realizing factors of dislocation of the humeral head is observed

  4. Dislocation structure produced by an ultrashort shock pulse

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Tomoki, E-mail: t-matsu@mapse.eng.osaka-u.ac.jp; Hirose, Akio [Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871 (Japan); Sano, Tomokazu [Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, Suita, Osaka 565-0871 (Japan); JST, CREST, Suita, Osaka 565-0871 (Japan); Arakawa, Kazuto [JST, CREST, Suita, Osaka 565-0871 (Japan); Department of Material Science, Interdisciplinary Faculty of Science and Engineering, Shimane University, Matsue, Shimane 690-8504 (Japan)

    2014-11-14

    We found an ultrashort shock pulse driven by a femtosecond laser pulse on iron generates a different dislocation structure than the shock process which is on the nanosecond timescale. The ultrashort shock pulse produces a highly dense dislocation structure that varies by depth. According to transmission electron microscopy, dislocations away from the surface produce microbands via a network structure similar to a long shock process, but unlike a long shock process dislocations near the surface have limited intersections. Considering the dislocation motion during the shock process, the structure near the surface is attributed to the ultrashort shock duration. This approach using an ultrashort shock pulse will lead to understanding the whole process off shock deformation by clarifying the early stage.

  5. Scapular dislocation from trivial trauma: a rare case

    Institute of Scientific and Technical Information of China (English)

    Landge Vikrant; Vaishya Raju; Aggarwal Anurag

    2012-01-01

    Dislocation of the scapula between the ribs and into the thoracic cage is a very rare event.Scapulothoracic dissociation though has been reported,usually occurs after a severe injury and is often associated with other serious injuries like brachial plexus or chest injury,etc.Ainscow has described a rare type that may occur due to slight violence with a pre-existing condition.Cases of isolated scapular dislocation after minor trauma have not been reported frequently in the literature.It is a distinct clinical entity and needs to be differentiated from other similar conditions.Here,we present a case of painless scapular dislocation associated with trivial trauma followed by spontaneous reduction in a l0 years old girl.The patient had a recurrence of the dislocation before presenting to us.But she did not have any pre-existing condition for scapular dislocation.

  6. Dislocation Model and Morphology Simulation of bcc fcc Martensitic Transformation

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    By using molecular dynamics computer simulation at atomic level, the effects of single dislocation and dipole dislocations on nucleation and growth of martensitic transformation have been studied. It was found that only the location of tension or compression stress fields of the dislocations are favorable for martensite nucleation in NiAl alloy and the dislocations can move to accommodate partly the transformation strain during the nucleation and growth of martensite. Combined with the molecular dynamics simulation, a two dimensional simulation for martensite morphology based on a dislocation model bas been performed. Many factors related to martensitic transformation were considered, such as supercooling, interface energy, shear strain, normal strain and hydrostatic pressure. Different morphologies of martensites, similar to lath, lenticular, thin plate, couple-plate and lenticular couple-plate martensites observed in Fe-C and Fe-Ni-C alloys, were obtained.

  7. Scapular dislocation from trivial trauma: a rare case.

    Science.gov (United States)

    Landge, Vikrant; Vaishya, Raju; Aggarwal, Anurag

    2012-01-01

    Dislocation of the scapula between the ribs and into the thoracic cage is a very rare event. Scapulothoracic dissociation though has been reported, usually occurs after a severe injury and is often associated with other serious injuries like brachial plexus or chest injury, etc. Ainscow has described a rare type that may occur due to slight violence with a pre-existing condition. Cases of isolated scapular dislocation after minor trauma have not been reported frequently in the literature. It is a distinct clinical entity and needs to be differentiated from other similar conditions. Here, we present a case of painless scapular dislocation associated with trivial trauma followed by spontaneous reduction in a 10 years old girl. The patient had a recurrence of the dislocation before presenting to us. But she did not have any pre-existing condition for scapular dislocation.

  8. A Comparison of Starting Wages and Job Satisfaction for Reemployed Dislocated Workers Participating in the Rock County Dislocated Worker Program.

    Science.gov (United States)

    Borremans, Robert T.

    Following the economic recession of the early 1980's and the consequent high levels of unemployment in Rock County, a program was created at the Blackhawk Technical Institute (BTI) to assist dislocated workers reentering the labor force. The Rock County Dislocated Worker Program was intended as a comprehensive program with two principal activities…

  9. Computer simulation of dislocation core structure of metastable left angle 111 right angle dislocations in NiAl

    Energy Technology Data Exchange (ETDEWEB)

    Xie, Z.Y. (Dept. of Materials Science and Engineering, Virginia Polytechnic Inst. and State Univ., Blacksburg, VA (United States)); Vailhe, C. (Dept. of Materials Science and Engineering, Virginia Polytechnic Inst. and State Univ., Blacksburg, VA (United States)); Farkas, D. (Dept. of Materials Science and Engineering, Virginia Polytechnic Inst. and State Univ., Blacksburg, VA (United States))

    1993-10-01

    The atomistic structure of dislocation cores of left angle 111 right angle dislocations in NiAl was simulated using embedded atom method potentials and molecular statics computer simulation. In agreement with previous simulation work and experimental observations, the complete left angle 111 right angle dislocation is stable with respect to the two superpartials of 1/2 left angle 111 right angle separated by an antiphase boundary. The structure of the latter configuration, though metastable, is of interest in the search for ways of improving ductility in this material. The structure of the complete dislocation and that of the metastable superpartials was studied using atomistic computer simulation. An improved visualization method was used for the representation of the resulting structures. The structure of the partials is different from that typical of 1/2 left angle 111 right angle dislocations in b.c.c. materials and that reported previously for the B2 structure using model pair potentials. (orig.)

  10. Evolution of dislocation cells during plastic deformation

    Institute of Scientific and Technical Information of China (English)

    ZHOU Zhi-min; SUN Yan-rui; ZHOU Hai-tao

    2005-01-01

    In recent years,materials with ultrafine grain size(UFG) have attracted much attention.By using severe plastic deformation(SPD) techniques,materials with fine grain size as small as 200-250 nm have been obtained.However,the nature of the grain boundaries has not been theoretically understood.It is still an unsolved question whether or not finer grain sizes down to 100 nm could be reached.A semi-quantitative model for the evolution of dislocation cells in plastic deformation was proposed.The linear stability analysis of this model leads to some interesting results,which facilitate the understanding of the formation of cell structures and of the factors determining the lower limit of the cell size of SPD materials.

  11. [Bilateral Dislocation Fracture of the Humeral Head (Right AO 11C3.3; Left AO 11A1.3) without Direct Trauma Due to First Clinical Manifestation of Seizure - a Case Report and Review of the Literature].

    Science.gov (United States)

    Ploeger, M M; Pennekamp, P H; Müller, M C; Kabir, K; Burger, C; Wirtz, D C; Schmolders, J

    2015-12-01

    The incidence of fractures among epileptics is frequent and mostly occurs by direct trauma due to falls caused by seizures. The risk of fractures is estimated to be 50 % higher in epileptics than in the general population. Most of the fractures affect the proximal femora and the hip joint. Dorsal shoulder dislocations occur frequently in epileptics. If they occur bilaterally, this is pathognomonic for seizuring. Besides this, shoulder dislocation and bilateral dislocation fractures of the humeral head, however, are far more rare even among epileptics but pathognomonic for seizure. In this case report we present a female patient with bilateral dislocation fracture of the humeral head due to first clinical manifestation of a tonic-clonic seizure without direct trauma.

  12. Delayed rupture of flexor tendons in zone V complicated by neuritis 18 years following Galeazzi fracture-dislocation.

    Science.gov (United States)

    Nagy, Mathias Thomas; Ghosh, Sabyasachi; Shah, Bhavik; Sankar, Thangasamy

    2014-04-16

    We report a rare case of an 84-year-old woman who presented with delayed, complete rupture of superficial (flexor digitorum superficialis) and deep flexor tendons (flexor digitorum profundus) of the third, fourth and fifth digits of the right hand in zone V of the flexor tendons. The patient, who was otherwise healthy, active and independent, incurred a closed fracture of her right wrist 18 years ago, which was treated conservatively. Current X-rays and operative findings confirmed a malunited Galeazzi fracture-dislocation with volar dislocation of the ulna from the distal radioulnar joint. She underwent surgical treatment to improve her hand function and agonising neuritis symptoms, as she was unable to use her middle, ring and little fingers and had developed severe neuritis of the ulnar nerve. Exploration and repair of the flexor tendons, nerve decompressions and Darrach procedure were performed. On follow-up, the patient showed improvement in hand function with the neuritis completely resolved.

  13. Concept of healing of recurrent shoulder dislocation

    Directory of Open Access Journals (Sweden)

    Donato D'Angelo

    2014-08-01

    Full Text Available This paper presents the main surgical techniques applied in the treatment of anterior recurrent shoulder dislocation, aiming the achievement of the normality of articulate movements. This was obtained by combining distinct surgical procedures, which allowed the recovery of a complete functional capacity of the shoulder, without jeopardizing the normality of movement, something that has not been recorded in the case of the tense sutures of the surgical procedures of Putti-Platt, Bankart, Latarjet, Dickson-O'Dell and others.The careful review of the methods applied supports the conclusion that recurrent shoulder dislocation can be cured, since cure has been obtained in 97% of the treated cases. However, some degree of limitation in the shoulder movement has been observed in most of the treated cases.Our main goal was to achieve a complete shoulder functional recovery, by treating simultaneously all of the anatomical–pathological lesions, without considering the so-called essential lesions.The period of post-operatory immobilization only last for the healing of soft parts; this takes place in a position of neutral shoulder rotation, since the use of vascular bone graft eliminates the need for long time immobilization, due to the shoulder stabilization provided by rigid fixation of the coracoid at the glenoid edge, as in the Latarjet's technique.Our procedure, used since 1959, comprises the association of several techniques, which has permitted shoulder healing without movement limitation. That was because of the tension reduction in the sutures of the subescapularis, capsule, and coracobraquialis muscles.

  14. Treatment of congenital radial head dislocation with a computer-assisted hexapod external fixator: A case report

    Directory of Open Access Journals (Sweden)

    Özgür Karakoyun

    2015-09-01

    Full Text Available Congenital dislocation of the radial head (CDRH, a congenital anomaly of the elbow, can cause symptoms such as joint stiffness, snapping, locking, or pain, however the diagnosis is sometimes made incidentally from x-rays. The treatment goal is to ameliorate the symptoms and obtain a joint with a full range of motion. This paper presents a case of unilateral CDRH that was asymptomatic until adolescence, when locking and snapping developed. Several treatment options are described in the literature. Although the conventional and computer-assisted external fixator systems are used in several clinical pictures such as extremity deformities, joint contractures and fixation of acute fractures etc a computer-assisted external fixator system has not been used for CDRH. We successfully performed ulnar dorsal translation and a lengthening osteotomy with a computer-assisted external fixator to reduce the radial head indirectly and had satisfactory functional and clinical results. J Clin Exp Invest 2015; 6 (3: 301-305

  15. Destructive post-traumatic chondrolysis of the subtalar joint: a case report and review of the literature

    OpenAIRE

    Kumar, Vishwajeet; Debnath, Ujwal K; Karmegam, Anand; Hariharan, K.

    2013-01-01

    Injuries to the subtalar joint are often associated with fractures of the talus or calcaneum. These injuries often lead to degenerative changes resulting in pain, restriction of movement and difficulty in weight bearing. This can cause significant deformity and disability for the patient. Occult injury of the subtalar joint has been described as an isolated event or in association with a subluxation/dislocation of this joint. They are difficult to assess with plain radiography therefore, they...

  16. Lens dislocation has a possible relationship with laser iridotomy

    Directory of Open Access Journals (Sweden)

    Mutoh T

    2012-12-01

    Full Text Available Tetsuya Mutoh,1,2 Kevin F Barrette,2 Yukihiro Matsumoto,1 Makoto Chikuda11Department of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya City, Saitama, Japan; 2Department of Ophthalmology, Boston University School of Medicine, Boston, MA, USAAbstract: We report our recent experience of four eyes with spontaneous lens dislocation in four patients with no history of trauma or any systemic disease associated with zonular dialysis. Lens dislocation developed with 0.5 to 6 months following laser iridotomy. All patients were male and two eyes were complicated with acute primary angle closure glaucoma preoperatively. Case 1 showed bilateral lens dislocation, while cases 2 and 3 involved unilateral lens dislocation. Cases 2 and 3 showed lenses completely dislocated into the vitreous cavity. All cases needed lens removal and scleral fixation of intraocular lenses. Final visual acuity was 1.2 in all cases. We suspect that laser iridotomy may induce localized zonular dialysis that results in progressive zonular weakness, leading to lens dislocation.Keywords: lens dislocation, laser iridotomy, primary angle closure glaucoma

  17. Possible precisioning of radiodiagnosis of upper ankle joint injuries

    International Nuclear Information System (INIS)

    The necessity is stressed of making pictures of traumas of the upper ankle joint in three projections. For this purpose a device was constructed for standard adjusting positions of the leg for two anteroposterior and one lateral projections according to the inclination of outer edge of the leg. The reliability of even the first examinations and checks of repositions of dislocations was greatly enhanced. (author)

  18. Dislocations in extruded Co-49.3 at. pct Al

    Science.gov (United States)

    Yaney, D. L.; Nix, W. D.; Pelton, A. R.

    1986-01-01

    Polycrystalline Co-49.3 at. pct Al, which had been extruded at 1505 K, was examined using transmission electron microscopy. Diffraction contrast analysis showed that b = 100 as well as b = 111 line dislocations contribute to elevated temperature deformation in CoAl. Therefore, it was concluded that sufficient slip systems exist in CoAl to allow for general plasticity in the absence of diffusional mechanisms. Line dislocations of the type b = 001 were observed on both 110 and 100 planes while b = 111 line dislocations were observed on 1 -1 0 planes.

  19. Discrete Dislocation Dynamics Study of Strained-Layer Relaxation

    Science.gov (United States)

    Schwarz, K. W.

    2003-10-01

    Numerical simulations are performed to follow the evolution of an initial density of dislocation loops in an infinite strained layer to the point where the dislocations have stopped moving. Several unexpected results are obtained. First, many of the threading arms are either annihilated or prematurely immobilized by hardening interactions such as jogging and junction formation. Second, the remaining dislocation arms are eventually trapped by stress fluctuations that arise more from local overrelaxation than from the blocking mechanisms usually considered. Third, the degree of relaxation that can be attained depends strongly on the initial density of threading arms.

  20. Intra-articular distribution pattern after ultrasound-guided injections in wrist joints of patients with rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Boesen, Mikael [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark)], E-mail: parker@frh.regioh.dk; Jensen, Karl Erik [State Hospital, Department of Radiology, MRI Division, Copenhagen (Denmark)], E-mail: karl.erik.Jensen@rh.regionh.dk; Torp-Pedersen, Soren [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark); Cimmino, Marco A. [Rheumatologic Clinic, Department of Internal Medicine, University of Genoa (Italy)], E-mail: cimmino@unige.it; Danneskiold-Samsoe, Bente; Bliddal, Henning [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Copenhagen (Denmark)

    2009-02-15

    Objective: To investigate the distribution of an ultrasound-guided intra-articular (IA) injection in the wrist joint of patients with rheumatoid arthritis (RA). Methods: An ultrasound-guided IA drug injection into the wrist joint was performed in 17 patients with 1 ml methylprednisolone (40 mg/ml), 0.5 ml Lidocaine (5 mg/ml) and 0.15 ml gadolinium (Omniscan 0.5 mmol/ml). The drug solution was placed in the central proximal part of the wrist between the distal radius and the lunate bone. Coronal and axial MRI sequences were performed after the injection to visualize the distribution. Carpal distribution (radio-carpal, inter-carpal, and carpo-metacarpal) as well as radio-ulnar distribution was recorded. Full distribution in one compartment was given the value 1, partial distribution 0.5 and no distribution 0. A sum of the total distribution for all four compartments was calculated and correlated to the clinical parameters and the MRI OMERACT scores. Results: No uniform pattern was seen in the distribution of the contrast. Only two patients had full contrast distribution to all four compartments, and the mean distribution count for all patients was 2.4 (range 0.5-4). The distribution count correlated with the MRI OMERACT synovitis score (r = 0.60, p = 0.014), but not with the erosions, bonemarrow oedema scores or any clinical parameters. Conclusion: The distribution of contrast on MRI showed patient specific and random patterns after IA injections in active RA wrist joints. The degree of distribution increased with the MRI synovitis score, while no association was found with the erosion- and bonemarrow oedema score. These results indicate that a single injection into a standard injection site in the proximal part of the wrist cannot be assumed to distribute - and treat - the whole joint.