Dorsal Fracture-Dislocation of the Tarsal Navicular

2017 ◽  
Vol 107 (3) ◽  
pp. 226-230 ◽  
Author(s):  
Isidro Jimenez ◽  
Juan Pedro Rodriguez-Alvarez ◽  
Ricardo Navarro-Navarro
Keyword(s):  
Clinical Case ◽  
Case Reports ◽  
High Energy ◽  
Fracture Dislocation ◽  
Published Data ◽  
Excellent Outcome ◽  
Appropriate Treatment ◽  
Chopart Joint ◽  
Fracture Dislocations ◽  
Tarsal Navicular Bone

Fracture-dislocations of the tarsal navicular are rare and highly complex injuries to the midfoot. The only published data on this type of fracture are clinical case reports. These injuries are normally caused by high-energy trauma, and their pathophysiology and most appropriate treatment remain unclear. We report a clinical case of a dorsal fracture-dislocation of the tarsal navicular bone associated with a medial swivel dislocation of the Chopart joint caused by a bicycle fall in a 20-year-old healthy man. Open reduction and percutaneous pinning in a novel arrangement was performed, with an excellent outcome 18 months after the injury.

scholarly journals Evaluation of results of three and four-part fracture dislocations of proximal humerus in young adults using philos (proximal humerus internal locking system)

2018 ◽  
Vol 6 (2) ◽  
pp. 585
Author(s):  
Amit Thakur ◽  
Khalid Muzzafar ◽  
Sumeet Singh Charak ◽  
Bias Dev ◽  
Abdul Ghani
Keyword(s):  
Proximal Humerus ◽  
Young Patients ◽  
Soft Tissue Injuries ◽  
Functional Results ◽  
High Energy ◽  
High Rate ◽  
Fracture Dislocation ◽  
Rotator Cuff Insufficiency ◽  
Fracture Dislocations ◽  
Adequate Management

Background: The fractures of proximal humerus constitute about 5% of fractures in adults third in number to fracture colles and hip usually in elderly patients due to a low energy trauma. In young patients the fractures are mostly due to high energy trauma and as such are associate with other soft tissue injuries. A sub group of young patients have a three or four fracture dislocation of shoulder joint. The aim of this study was to find the results of fixation by PHILOS in these young patients.Methods: This study was done in a teritiary referral centre over a period of about 1 year. All patients were operated within three weeks. Open fractures, patients with age more than 50 years were excluded from the study. All patients underwent open reduction and fixation using commercially available PHILOS. A minimum of 6 months follows up was essential for inclusion into the study. Final functional results were evaluated by Constant Murley scoring.Results: 14 patients were included in the study. The average age of patients was 38.42years. All fractures united. We had 71.4% excellent or good results. The complications noted were shoulder stiffness in 3, inadequate post op reduction, rotator cuff insufficiency, head necrosis, secondary osteo arthritis 1 each.Conclusions: Despite the relatively high rate of complications encountered in the management of these complicated high-energy fractures, the PHILOS plating system could be considered an adequate management of these patients.

scholarly journals Nonoperative Treatment of Ulnar Carpometacarpal Fracture–Dislocations

2019 ◽  
Vol 09 (02) ◽  
pp. 160-163
Author(s):  
Isidro Jiménez ◽  
Juan Sánchez-Hernández ◽  
Dimosthenis Kiimetoglou
Keyword(s):  
Closed Reduction ◽  
Case Reports ◽  
Nonoperative Treatment ◽  
Fracture Dislocation ◽  
Joint Stability ◽  
Joint Dislocations ◽  
Secondary Dislocation ◽  
Fracture Dislocations ◽  
Cmc Joint

Abstract Background Ulnar carpometacarpal (CMC) joint dislocations and fracture–dislocations are uncommon injuries that are often overlooked. Most authors advocate surgical stabilization in order to prevent a secondary dislocation assuming that these injuries are inherently unstable. Case Description This is a series of eight ulnar CMC joint dislocations and fracture–dislocations treated by closed reduction and splint immobilization after assessing the joint stability. Mean follow-up was 30.2 months, and minimum follow-up was 12 months. Satisfactory results were obtained in range of motion, grip strength, pain, DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire, and time to return to working activities. In the same period, the closed reduction and cast failed two (20%) cases that were referred for surgery. Literature Review There is little published literature on the nonoperative treatment of these injuries. Most of them are isolated case reports, whereas the largest series reports four cases. All of them have reported satisfactory results. Clinical Relevance Based on our results, we believe that if the diagnosis of an ulnar CMC joint dislocation or fracture–dislocation is early accomplished and a concentric and stable reduction is initially achieved, the nonoperative treatment may be a successful option to take into account but requiring a close follow-up for the first week.

scholarly journals Traumatic Lumbar Spondylolisthesis: A Systematic Review and Case Series

2018 ◽  
Vol 9 (7) ◽  
pp. 767-782 ◽  
Author(s):  
Mikhail Lew P. Ver ◽  
John R. Dimar ◽  
Leah Y. Carreon
Keyword(s):  
Systematic Review ◽  
Interbody Fusion ◽  
Case Reports ◽  
Case Series ◽  
High Energy ◽  
Acute Injury ◽  
Fracture Dislocation ◽  
Rare Injury ◽  
Neurologic Deficits ◽  
Traumatic Spondylolisthesis

Study Design: Systematic review and case series. Objectives: Any acute injury to the posterior elements of the lumbar spine resulting in listhesis is considered a traumatic spondylolisthesis. This rare injury caused by high-energy trauma is variably described in the literature as fracture-dislocation, where only case reports and series have been published. Our objectives were to propose evidence-based treatment recommendations and a new classification system for this injury. Methods: A systematic review of literature from PubMed, EMBASE, and Cochrane without time frame limitations was performed, which included 77 level IV and V articles and 9 patients as case series in the analysis. Results: A total of 125 cases were reviewed with mean age of 30.5 years. Half of the cases resulted from a vehicular accident. Back pain presented in 82%, while 50% had neurologic deficits. Operative treatment was performed in 93.6% (posterior decompression [PD] = 4%; posterior spinal fusion [PSF] = 43.2%; interbody fusion [IB] = 46.4%) with overall fusion rates of 74%. Binomial regression analysis for achieving solid fusion showed a 28.6× higher odds for IB compared to PSF ( P = .008, r2 = 0.633). Subanalysis of cases with disc injuries revealed higher fusion outcomes for IB (87%) compared to PSF (46%; P = .006), while there were no significant differences for patients without disc injury. Pain and neurological symptoms improved significantly on final follow-up ( P < .001). Overall complication rate was 22%. Conclusion: Operative management with reduction, decompression for neurologic deficits, instrumentation, and fusion is recommended for traumatic spondylolisthesis. Interbody fusion is recommended to achieve better fusion outcomes especially with preoperatively identified disc lesions.

scholarly journals High-Energy Transsyndesmotic Ankle Fracture Dislocation: A Case Report and Systematic Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yinshuan Deng ◽  
Chenhui Dong ◽  
Xiaojie Yang ◽  
Rui Liu ◽  
Feiyi Hou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Literature Review ◽  
Ankle Fracture ◽  
Clinical Case ◽  
High Energy ◽  
Fracture Dislocation ◽  
High Energy Trauma ◽  
Ovid Medline ◽  
Type Of Injury

High-energy trauma can cause transsyndesmotic ankle fracture dislocation. These fractures are quite rare. Here we present a clinical case of a male patient with this type of injury. A systematic review of PubMed, Ovid MEDLINE, and Embase electronic databases revealed only two prior publications on a similar topic. We discuss the typical clinical features of these injuries, the treatment of high-energy trauma which can cause transsyndesmotic ankle fracture dislocation, and its prognosis.

scholarly journals Irreducible Galeazzi Fracture-Dislocations

Hand ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 249-252 ◽  
Author(s):  
Nicholas J. Yohe ◽  
Jadie De Tolla ◽  
Marc B. Kaye ◽  
David M. Edelstein ◽  
Jack Choueka
Keyword(s):  
High Energy ◽  
Fracture Dislocation ◽  
Rare Injury ◽  
Root Cause ◽  
Energy Mechanism ◽  
Galeazzi Fracture ◽  
Pubmed Database ◽  
Fracture Dislocations ◽  
Tendon Entrapment ◽  
Age Range

Background: Fractures of the radial shaft with disruption of the distal radial ulnar joint (DRUJ) or Galeazzi fractures are treated with reduction of the radius followed by stability assessment of the DRUJ. In rare instances, the reduction of the DRUJ is blocked by interposed structures requiring open reduction of this joint. The purpose of this study is to review all cases of irreducible Galeazzi fracture-dislocations reported in the literature to offer guidelines in the diagnosis and management of this rare injury. Methods: A search of the MEDLINE database, OVID database, and PubMed database was employed using the terms “Galeazzi” and “fracture.” Of the 124 articles the search produced, a total of 12 articles and 17 cases of irreducible Galeazzi fracture-dislocations were found. Results: The age range was 16 to 64 years (mean = 25 years). A high-energy mechanism of injury was the root cause in all cases. More than half of the irreducible DRUJ dislocations were not identified intraoperatively. In a dorsally dislocated DRUJ, a block to reduction in most cases (92.3%) was secondary to entrapment of one or more extensor tendons including the extensor carpi ulnaris, extensor digiti minimi, and extensor digitorum communis, with the remaining cases blocked by fracture fragments. Irreducible volar dislocations due to entrapment of the ulnar head occurred in 17.6% of cases with no tendon entrapment noted. Conclusions: In the presence of a Galeazzi fracture, a reduced/stable DRUJ needs to be critically assessed as more than half of irreducible DRUJs in a Galeazzi fracture-dislocation were missed either pre- or intraoperatively.

scholarly journals Perilunate instability: A rare variant

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110169
Author(s):  
Amanda Partap ◽  
Ian James Persad
Keyword(s):  
High Energy ◽  
Fracture Dislocation ◽  
Proximal Pole ◽  
Lunotriquetral Ligament ◽  
Fracture Dislocations ◽  
Ligament Disruption ◽  
Serious Injuries ◽  
High Degree ◽  
Lunate Fossa

Perilunate dislocations and perilunate fracture dislocations are rare injuries that occur as a result of high energy trauma. We describe a case of a volar fracture dislocation of the proximal pole of the scaphoid with an associated scapholunate and lunotriquetral ligament disruption as well as a lunate fossa fracture of the distal radius. These injuries are serious injuries that require a high degree of clinical acumen and radiographic scrutiny to allow for prompt treatment in order to avoid the sequelae of long-term complications that can arise. This case serves as a reminder of the complexity of these injuries and their associated mechanics.

scholarly journals Case Study: Trans-styloid, Trans-scaphoid, Trans-triquetral, and Perilunate Dislocation

2021 ◽  
Vol 11 (6) ◽  
Author(s):  
Nicholas Frane ◽  
Peter Regala ◽  
Brandon Klein ◽  
Joshua Mitgang ◽  
Gus Katsigiorgis
Keyword(s):  
Carpal Tunnel ◽  
Closed Reduction ◽  
Early Recognition ◽  
Case Reports ◽  
High Energy ◽  
Fracture Dislocation ◽  
Dominant Male ◽  
Chronic Instability ◽  
Perilunate Dislocation ◽  
Ligamentous Repair

Introduction: Perilunate dislocations are rare high-energy injuries, and the diagnosis is not infrequently missed at initial presentation. The combination of fractures resulting in a trans-styloid, trans-scaphoid, and trans-triquetral perilunate fracture dislocation is extremely rare. Early recognition and diagnosis of these injuries is prudent to restore patient function and prevent morbidity. This injury pattern may progress through several distinct phases often involving the greater or lesser arc. The injury begins with traumatic disruption of the scapholunate joint, followed by an ordered progression of injury to the capitolunate, lunotriquetral, and radiolunate joints. When the radiolunate joint is disrupted, the lunate often dislocates volar transposing into the carpal tunnel, associated with median nerve compression. These injuries have the potential to cause lifelong disability of the wrist. Early treatment may prevent or lessen the chance of median neuropathy, post-traumatic wrist arthrosis, chronic instability, and fracture nonunion. Non-operative treatment is not indicated and is associated with poor functional outcomes and recurrent dislocation. Open reduction and internal fixation (ORIF) with ligamentous repair after emergent closed reduction and splinting is indicated for acute injuries (<8 weeks after injury). Case Report: We report a case of a 48-year-old right hand dominant male with a trans-styloid, trans-scaphoid, trans-triquetral, and perilunate dislocation after mechanical fall from height. He was evaluated in the ER and provisionally treated with closed reduction and splinting. ORIF of scaphoid, radial styloid, and triquetrum was performed, with ligamentous repair of the scapholunate joint and carpal tunnel decompression. Conclusion: The combination of fractures/injuries in this case has been very rarely been published in case reports to date. It is necessary to recognize these wrist injuries. Great detail should be given to physical and radiog

scholarly journals Irreducible Volar DRUJ Dislocation with Distal Radius Fracture Dislocation

2019 ◽  
Vol 09 (02) ◽  
pp. 156-159
Author(s):  
Matthew T. Gulbrandsen ◽  
Jill G. Putnam ◽  
J. Tracy Watson ◽  
Michael D. McKee
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Closed Reduction ◽  
Open Reduction ◽  
Case Reports ◽  
Distal Radioulnar Joint ◽  
Fracture Dislocation ◽  
Radius Fracture ◽  
Level Of Activity ◽  
Fracture Dislocations

Abstract Background Volar dislocations of the distal radioulnar joint (DRUJ) are rare and often missed during initial evaluation. Chronic dislocations and disability can occur when DRUJ dislocations are unrecognized and not reduced. DRUJ dislocations often occur with other wrist injuries, which may complicate reduction. Closed reduction can fail to reduce DRUJ dislocations, in which case open reduction is necessary. Case Description This case describes a patient who had a volar dislocation of the DRUJ with an associated dorsal distal radius fracture dislocation. Initial attempts at closed reduction were unsuccessful which prompted surgical intervention. After open reduction and internal fixation of the distal radius fracture dislocation, closed reduction of the DRUJ remained unsuccessful. This prompted an open reduction of the DRUJ. Surgical exposure demonstrated that the extensor carpi ulnaris and the distal radius had prevented closed reduction of the DRUJ. Postoperatively, a splint was placed with the wrist in supination. The patient followed-up at the 2- and 4-month intervals with persistent subluxation. However, the patient also reported minimal pain and the ability to return to work and previous level of activity. Literature Review Current literature regarding irreducible volar DRUJ dislocations with distal radius fracture dislocations includes sparse case reports, which are reviewed in this report. Clinical Relevance This case illustrates successful treatment for an uncommon volar DRUJ dislocation associated with a dorsal distal radius fracture dislocation and can be utilized to help guide future treatment of similar complex cases.

scholarly journals An Unusual Localization of Lunate in a Transcaphoid Volar Lunate Dislocation: Current Concepts

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Grigorios Kastanis ◽  
George Velivasakis ◽  
Anna Pantouvaki ◽  
Manolis Spyrantis
Keyword(s):  
Early Recognition ◽  
Scaphoid Fracture ◽  
Styloid Process ◽  
High Energy ◽  
Fracture Dislocation ◽  
Loss Of Function ◽  
Perilunate Dislocation ◽  
Fracture Dislocations ◽  
Polytrauma Patients ◽  
Car Accident

Perilunate dislocation and fracture dislocations are rare injuries corresponding to 10% of all carpal injuries. They usually come with high-energy trauma, with associated injuries representing 61%. Volar lunate dislocation or fracture-dislocation accounts for 3% of perilunate injuries. We present a case of a 42-year-old polytrauma male, transmitted to our department 48 hours after a car accident with a trans-scaphoid volar lunate dislocation. During operation, the lunate was displaced volarly to the ulnar side of the wrist, forward to the styloid process of the distal ulna, while the scaphoid fracture appeared at the waist with comminution, and the proximal pole of the scaphoid protruded under the dorsal capsule. Carpal injuries are often missed out in polytrauma patients, and these injuries are underestimated because of the severity of the other visceral or extremity lesions. Untreated or improperly treated, those injuries lead to serious morbidity and loss of function. Therefore, good functional prognosis with decreased percentage of complications can be achieved following early recognition and early open surgical ligamentous complex repair.

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