• Title/Summary/Keyword: 2Avulsion fracture

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Diagnosis of Coxofemoral Joint Luxation in a Whooper Swan (Cygnus Cygnus) Using Computed Tomography and Radiography

  • Jinho Jang;Jong-pil Seo;Hyohoon Jeong;Seyoung Lee;YoungMin Yun
    • Journal of Veterinary Clinics
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    • v.41 no.2
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    • pp.139-142
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    • 2024
  • A wild Whooper swan (Cygnus Cygnus) with limping due to an injured left pelvic limb in an accident was rescued on the seashore and transferred to the Jeju Wildlife Rescue Center on November 23rd, 2020. On physical examination, its body condition score was 1 out of 5 due to starvation and dehydration. The left coxofemoral joint was also examined by careful palpating and estimating the damage. Moderated soft tissue swelling and crepitus surrounding the hip joint were confirmed. Radiography and computed tomography (CT) were used together for an accurate diagnosis of the joint. By radiographs readings, it was difficult to accurately confirm the condition of the proximal femur due to superimposition of the synsacrum and internal organs. However, signs such as avulsion fracture of the femoral head and a few fragments around the joint were revealed by CT imaging. Besides, through three-dimensional (3D) image analysis of CT, the dislocated area and condition of the left hip joint could be accurately and easily confirmed. The diagnostic process showing in this paper could be used as a good reference for diagnosing coxofemoral joint luxation in wild swan.

Ankle Arthroscopy for Occult Injuries in the Acute Ankle Fracture (급성 족 관절 골절에서 잠재 손상에 대한 족 관절경)

  • Choi Chong-Hyuk;Yang Kyu-Hyun;Park Seong-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.124-130
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    • 2001
  • Purpose : To identify occult intra-articular pathologies in the acute ankle fracture using arthroscopy and to investigate the factors to predict its possibility of occult injuries that could be occurred. Materials and Methods : This prospective study included fifty patients who got operation for the ankle fractures. Ankle arthroscopy was performed to document the type and anatomical location of occult lesion. We investigated the correlation between incidence of occult injuries and specific fracture type. Results : Of fifty ankles, 37 ankles had occult lesion. Twenty five loose bodies including displaced fragments were found and various cartilage lesions were found in 31 ankles. Tibial avulsion fragment by anterior inferior tibiofibular ligament was occurred in 6 cases. There was no correlation between the incidence of occult lesion and various factors including age, sex, injury mechanism and fracture type(p>0.05). Conclusion : The ankle arthroscopy had an effective role for the detection and treatment of occult injuries and it was difficult to predict the occurrence or associated accurately in all of th ankle fractures.

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Correction of Atlanto-axial Instability by Avulsion Fracture of the Axis in a Dog (중쇠뼈 찢김골절로 인한 고리중쇠 관절 불안정의 교정)

  • Hwang, Yong-Hyun;Kim, Minkyung;Park, Jung-Hyun;Jin, So-Young;Park, Ki-Tae;Lee, Hee-Chun;Lee, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.30 no.6
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    • pp.499-502
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    • 2013
  • An eight-year-old, castrated male, Poodle dog was presented with a bite wound in the neck region. Clinical examination revealed non-ambulatory signs of tetraparesis with deep pain, and upper motor neuron changes in all limbs. Fractures of the transverse process of C1 and the dorsal spinous process of C2 were observed on the radiographs and the computed tomography (CT). Conservative therapy was performed for 1 week. However the neurological problems were not alleviated until 7 days after injury. The owners agreed to perform surgical stabilization. The surgical stabilization was performed 7 days after presentation. Ventral stabilization was performed with screws, K-wires and bone cement. The dog stood up independently after 4 weeks and was able to walk 6 weeks postoperatively. In this report we suggest that using combined stabilization techniques are effective for this type of cervical fracture in which the dorsal and ventral structures of the vertebra are severely disrupted.

Neurotization from Two Medial Pectoral Nerves to Musculocutaneous Nerve in a Pediatric Brachial Plexus Injury

  • Yu, Dong-Woo;Kim, Min-Su;Jung, Young-Jin;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.267-269
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    • 2012
  • Traumatic brachial plexus injuries can be devastating, causing partial to total denervation of the muscles of the upper extremities. Surgical reconstruction can restore motor and/or sensory function following nerve injuries. Direct nerve-to-nerve transfers can provide a closer nerve source to the target muscle, thereby enhancing the quality and rate of recovery. Restoration of elbow flexion is the primary goal for patients with brachial plexus injuries. A 4-year-old right-hand-dominant male sustained a fracture of the left scapula in a car accident. He was treated conservatively. After the accident, he presented with motor weakness of the left upper extremity. Shoulder abduction was grade 3 and elbow flexor was grade 0. Hand function was intact. Nerve conduction studies and an electromyogram were performed, which revealed left lateral and posterior cord brachial plexopathy with axonotmesis. He was admitted to Rehabilitation Medicine and treated. However, marked neurological dysfunction in the left upper extremity was still observed. Six months after trauma, under general anesthesia with the patient in the supine position, the brachial plexus was explored through infraclavicular and supraclavicular incisions. Each terminal branch was confirmed by electrophysiology. Avulsion of the C5 roots and absence of usable stump proximally were confirmed intraoperatively. Under a microscope, neurotization from the musculocutaneous nerve to two medial pectoral nerves was performed with nylon 8-0. Physical treatment and electrostimulation started 2 weeks postoperatively. At a 3-month postoperative visit, evidence of reinnervation of the elbow flexors was observed. At his last follow-up, 2 years following trauma, the patient had recovered Medical Research Council (MRC) grade 4+ elbow flexors. We propose that neurotization from medial pectoral nerves to musculocutaneous nerve can be used successfully to restore elbow flexion in patients with brachial plexus injuries.

Review of Acute Traumatic Closed Mallet Finger Injuries in Adults

  • Botero, Santiago Salazar;Diaz, Juan Jose Hidalgo;Benaida, Anissa;Collon, Sylvie;Facca, Sybille;Liverneaux, Philippe Andre
    • Archives of Plastic Surgery
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    • v.43 no.2
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    • pp.134-144
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    • 2016
  • In adults, mallet finger is a traumatic zone I lesion of the extensor tendon with either tendon rupture or bony avulsion at the base of the distal phalanx. High-energy mechanisms of injury generally occur in young men, whereas lower energy mechanisms are observed in elderly women. The mechanism of injury is an axial load applied to a straight digit tip, which is then followed by passive extreme distal interphalangeal joint (DIPJ) hyperextension or hyperflexion. Mallet finger is diagnosed clinically, but an X-ray should always be performed. Tubiana's classification takes into account the size of the bony articular fragment and DIPJ subluxation. We propose to stage subluxated fractures as stage III if the subluxation is reducible with a splint and as stage IV if not. Left untreated, mallet finger becomes chronic and leads to a swan-neck deformity and DIPJ osteoarthritis. The goal of treatment is to restore active DIPJ extension. The results of a six- to eight-week conservative course of treatment with a DIPJ splint in slight hyperextension for tendon lesions or straight for bony avulsions depends on patient compliance. Surgical treatments vary in terms of the approach, the reduction technique, and the means of fixation. The risks involved are stiffness, septic arthritis, and osteoarthritis. Given the lack of consensus regarding indications for treatment, we propose to treat all cases of mallet finger with a dorsal glued splint except for stage IV mallet finger, which we treat with extra-articular pinning.

DEVELOPMENTAL AND ERUPTIONAL DISTURBANCES OF PERMANENT SUCCESSORS ASSOCIATED WITH TRAUMATIC INJURY TO PRIMARY TEETH (유치열기의 외상으로 인한 계승 영구치의 발육 및 맹출장애)

  • Lim, Hyoung-Soo;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.2
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    • pp.255-260
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    • 2001
  • Trauma to the primary incisors may cause developmental or eruptional disturbance of the permanent successors. Two cases illustrate developmental disturbances of arrested root formation, dilaceration, and eruptional disturbances of impaction, ectopic eruption of permanent successors caused by traumatic injury to deciduous incisors. The patient of the first case suffered trauma at the age of 4 years 7 months, causing alveolar bone fracture including the maxillary right primary central and lateral incisors that were immedi-ately extracted. The second patient had trauma episodes at the age of 3 years. Avulsion of the maxillary primary right central and lateral incisors were occurred due to trauma. After such trauma, regular follow-up including radiographs is necessary to detect early any possible interference with normal eruption of permanent successors.

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A clinical study on the dental emergency patients visiting an University Hospital emergency room (대학병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구)

  • Jang, Chang-Su;Lee, Chang-Yeon;Kim, Ju-Won;Yim, Jin-Hyuk;Kim, Jwa-Young;Kim, Young-Hee;Yang, Byoung-Eun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.6
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    • pp.439-447
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    • 2011
  • Introduction: In today's society, the rapid and appropriate care of the dental emergency patients is much more important. So, a retrospective study on the characteristics of emergency dental injuries and diseases will be very meaningful. Materials and Methods: This retrospective clinical study was carried by reviewing the radiographic films and emergency chart of 11,493 patients who had visited the emergency room of Hallym Sacred heart Hospital and were treated in the Department of Oral and Maxillofacial Surgery from January 2006 to December 2010. Results: The male to female ratio was 1.9:1. The highest monthly incidence was observed in May (10.4%) and June (8.9%) and the peak age distribution was the first decade (56.0%), followed by the second decade (16.0%). Trauma was the most common cause in dental emergency patients, followed in order by toothache, odontogenic infection, temporomandibular joint (TMJ) disorder and oral hemorrhage. Soft tissue injury was most prevalent in the trauma group, followed by tooth injury and facial bone fractures. In the tooth injury group, tooth fracture (56.7%) showed the highest incidence followed in order by tooth subluxation (18.2%), tooth concussion (16.9%), tooth avulsion (11.5%) and alveolar bone fractures (3.7%). In the facial bone fracture group, mandibular fractures (81.8%) showed the highest incidence followed in order by maxilla fractures (15.7%), nasal bone fractures (9.0%), zygomaticomaxillary complex fractures (5.4%), orbital bone fractures (2.5%). In mandibular bone fractures, the most common location was the symphysis (70.1%), followed in order by the mandibular angle (33.0%), mandibular condyle (22.8%) and mandibular body (13.6%). In the infection group, a submandibular space abscess (46.2%) was most common followed in order by a buccal space abscess (17.4%), canine space abscess (16.9%) and submental space abscess (12.3%). TMJ dislocation (89.3%) showed the highest incidence in the TMJ disorder group, followed by TMJ derangement (10.7%). In the other group, a range of specific symptoms due to post operation complications, trigeminal neuralgia, chemical burns and foreign body aspiration were reported. Conclusion: For the rapid and appropriate care of the dental emergency patients, well-organized system should be presented in oral and maxillofacial surgery. And it is possible under analysis of pattern and the variation of the dental emergency patients.

Radiological Diagnosis of Elbow Luxation and Subluxation of Carpal Joint in the Dog (개에서 발생한 주관절 탈구와 완관절 아탈구의 방사선학적 진단)

  • Kim Sang-Ki;Lee Chung-Gil;Park In-Chul
    • Journal of Veterinary Clinics
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    • v.11 no.1
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    • pp.369-376
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    • 1994
  • The purpose of this report Is to discribe the radiological findings of traumatic elbow luxation and subluxation of carpal joint which were caused by being hit by a wild animal and forced hyperextension of carpus in two hunting dogs. In case 1, carniocaudal and mediolateral radiographic examination of the elbow joint revealed that the radius that the radius and ulna were completely luxated laterally. The lateral projection showed the humeral condyles overlying the radial head with an absent joint space, but displacement is apparent on the craniocaudal projection. Incidence of collateral ligament rupture in conjunction with elbow luxation was not recognized on physical examination of the limb after closed reduction. Radiographic examination of the elbow made 5 months after closed reduction revealed only mild degenerative joint disease. Radiographic examination of the carpus in case 2 demonstrated palmar subluxation of most carpal joints including antebrachiocarpal, mediocarpal carpometacarpal joints, and some intercarpal joints, and avulsion fracture of the palmar surface of the accessory carpal bone. However, the mediocarpal and carpometacarpal joints were most severely affected by tensile forces of hyperextension, and it was concluded that the ligaments of the middle ca,pal joints and carpometacarpal joints as well as the palmar fibrocartilage were ruptured based on clinical and radiographic findings. In elbow luxation and subluxation of carpal Joints of the dog, differentiation of the joint or joints involved, and ligamentous structures damaged is important in determining whether surgery Is necessary and which procedure is most appropriate. And the radiographic findings of these conditions would be of help to practitioners.

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Anterior Dislocation of the Shoulder with Rotator Cuff tear Over the 5th Decades of Age (40대 이후 발생한 견관절 탈구와 회전근 개 파열)

  • Moon, Young-Lae;Lee, Sang-Hong;Kim, Jeoung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.131-135
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    • 2002
  • Object : To evaluate the prognostic factors of the rotator cuff tear after anterior dislocation of the shoulder over the 5th decades of age. Methods : We evaluated twelve patients who had rotator cuff tears combined with primary anterior dislocation of the glenohumeral joint between May 1995 and October 1998. Their age were ranged from 42 to 67-years-old. Two of them were initially presumed to have an injury of the axillary nerve and associated with avulsion fracture of the greater tuberosity. Among twelve patients who had rotator cuff tears, 8 cases had massive, 3 cases had medium and one case had a small sized tear. Results : All the tears of the rotator cuff were repaired and the results were obtained by UCLA shoulder rating scale. Ten cases of them revealed more than good results except for 2 cases who had been unhappy triad of the shoulder injury. Conclusions : In the case of anterior dislocation of shoulder, it is necessary to check the injury of rotator cuff and axillary nerve in the middle age group. If these injuries are combined, proper rotator cuff repair and axillary nerve rehabilitation program would be asked for better results.

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A SURVEY ON THE KNOWLEDGE AND AWARENESS OF TRAUMATIC DENTAL INJURIES IN A GROUP OF JEON-BUK PROVINCE ELEMENTARY SCHOOL TEACHERS (어린이의 치아 외상에 대한 전라북도 초등학교 교사들의 인식도 조사)

  • Lee, Je-Woo;Lee, Kwang-Hee;Ra, Ji-Young;An, So-Youn;Kim, Yun-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.39 no.2
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    • pp.120-128
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    • 2012
  • The purpose of this study was to evaluate the attitude and knowledge level of a group of elementary school teachers in management of traumatic dental injury. The sample consisted of 231 elementary school teachers in Jeon-Buk province, and data was collected by means of a self-administered questionnaire. The questionnaire surveyed the teachers'general information, attitude on the dental trauma education, knowledge of management of tooth fracture, luxation, avulsion and tooth storage media. Only 15.2% of the teachers had received dental first aid treatment education, but 97% were favorable to receiving education. Although there were differences among the questions, insufficient knowledge and awareness of the management of traumatic dental injury were shown in the majority of teachers. It is recommended that education strategies and programs for improving the awareness of immediate management of traumatic dental injuries are necessary for elementary school teachers in Jeon-Buk province.