• Title/Summary/Keyword: Fracture dislocation

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Anterior Approach Following Intraoperative Reduction for Cervical Facet Fracture and Dislocation

  • Kim, Seul Gi;Park, Seon Joo;Wang, Hui Sun;Ju, Chang Il;Lee, Sung Myung;Kim, Seok Won
    • Journal of Korean Neurosurgical Society
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    • v.63 no.2
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    • pp.202-209
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    • 2020
  • Objective : The purpose of this study was to evaluate the efficacy of the anterior approach following intraoperative reduction under general anesthesia in patients with cervical facet fracture and dislocation. Methods : Twenty-three patients with single level cervical facet fracture and dislocation who were subjected to the anterior approach alone following immediate intraoperative reduction under general anesthesia from March 2013 to December 2017 were enrolled in this study. Neurological status, clinical outcome, and radiological studies were evaluated preoperatively, postoperatively, and during the follow-up period. Results : The cohort comprised 15 men and eight women with a mean age of 57 years (from 24 to 81). All patients were operated on within the first 8 hours following the injury. After gentle manual reduction or closed reduction with Gardner-Wells traction, under general anesthesia monitored by somatosensory-evoked potentials, all operations were successfully completed using the anterior approach alone except in two patients, who had a risk of over-distraction. In them, a satisfactory gentle manual reduction or closed reduction was not possible, and required open posterior reduction of the locked facets followed by anterior cervical discectomy and fusion. In one patient, screw retropulsion was observed in 1 month after surgery. There were no reduction-related complications or neurological aggravations after surgery. All patients showed evidence of stability at the instrumented level at the final follow-up (mean follow-up, 12 months). Conclusion : Anterior approach following intraoperative reduction monitored by somatosensory-evoked potentials under general anesthesia for cervical dislocation and locked facets is a relatively safe and effective alternative when cervical alignment is achieved by intraoperative reduction.

Posterior Shoulder Dislocation with a Greater Tuberosity Fracture and Total Rupture of Rotator Cuff - A Case Report - (상완골 대결절 골절 및 회전근 개 전 파열이 동반된 견관절 후방 탈구 - 증례 보고 -)

  • Shin, Sung-Ryong;Kim, Do-Young;Lee, Sang-Soo;Ryu, Yun-Sik;Jung, Un-Seob;Choi, Hyun-Seok
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.227-231
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    • 2007
  • A posterior shoulder dislocation with a fracture is rare. Most fractures are impression fractures of the humeral head or lesser tuberosity fractures. However, there are no reports of a complete rupture of the rotator cuff with a combined posterior glenohumeral dislocation. We report a unique case of a posterior shoulder dislocation with an avulsion fracture of the greater tuberosity and a complete rupture of infraspinatus, teres minor and subscapularis tendons, which were treated surgically.

Peroneus Longus Dislocation associated with Trimalleolar Fracture (A Case Report) (족관절 삼과 골절과 동반된 장 비골건 탈구(1예 보고))

  • Hwang, In-Hwan;Kim, Kwang-Yul;Kim, Hyung-Chun;Lim, Moon-Sup;Lee, Ji-Hoon;Cho, Sung-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.227-229
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    • 2009
  • Traumatic dislocation of the peroneus longus tendon is an often unrecognized injury which has been reported to occur most commonly during sports activity. Most acute cases with early detection can be treated by simple repair of the tendon or retinaculum using one of several procedures available. Accurate treatment through a comprehensive evaluation of the ankle injury prevents suboptimal and sometimes unrecorrectable outcomes. The authors experienced concomitantly the peroneus longus tendon dislocation associated with a trimalleolar fracture of the ankle. We report this case a brief review of the literature.

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Coronoidectomy for reduction of superolateral dislocation of mandible condyle

  • Seok, Hyun;Ko, Seung-O;Baek, Jin-A;Leem, Dae-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.3
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    • pp.182-187
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    • 2022
  • Superolateral dislocation of the condyle is a rare mandibular fracture. The treatment goal is to return the dislocated condyle to its original position to recover normal function. This study reports on superolateral dislocation of the condyle with mandibular body fracture. The mandibular body was completely separated, and the medial pole of the condyle head was fractured. The condyle segment was unstable and easily dislocated after reduction. The temporalis muscle on the condyle segment might have affected the dislocation of the condyle. A coronoidectomy was performed to disrupt the function of the temporalis muscle on the condyle segment in order to successfully reduce the dislocated condyle. Coronoidectomy is a simple procedure with minimal complications. We successfully performed a coronoidectomy to reduce the superolateral displaced condyle to its original position to achieve normal function. Coronoidectomy can be effectively used for reduction of superolaterally displaced condyles combined with severe maxilla-mandibular fractures.

Open Reduction of Proximal Interphalangeal Fracture-Dislocation through a Midlateral Incision Using Absorbable Suture Materials

  • Lee, Jae Jun;Park, Hyoung Joon;Choi, Hyun Gon;Shin, Dong Hyeok;Uhm, Ki Il
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.397-402
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    • 2013
  • Background Fracture-dislocation of the proximal interphalangeal (PIP) joint is a relatively common injury. Various treatments for fracture-dislocation of the PIP joint have been reported. In the present study, we performed open reduction through a midlateral incision using absorbable sutures to reduce the small bone fragments and performed volar plate repair. Methods We treated nine patients with fracture-dislocation of the PIP joint with small fractured bone fragments too small for pinning or screw fixation. Patients with volar plate injury were treated with open reduction and volar plate repair at the periosteum of the middle phalangeal bone base by the modified Kessler method using absorbable sutures. All patients were placed in a dorsal aluminum extension block splint, which maintained the PIP joint in approximately 30 degrees of flexion to avoid excessive tension on the sutured volar plate. Results At a mean final follow-up of postoperative 9 months, all patients were evaluated radiographically and had adequate alignment of the PIP joint and reduction of the displaced bone fragments. Range of motion was improved and there were no complications. Conclusions This technique is an excellent alternative to the current method of treating patients with fracture-dislocations that include small fragments that are too small for pinning or screw fixation. It is a less invasive surgical method and enables stable reduction and early exercise without noticeable complications.

Anterior Compartment Syndrome after Surgery of Bosworth Fracture-Dislocation of the Ankle - A Case Report - (족관절의 Bosworth 골절-탈구 발생한 전방 구획 증후군 -증례 보고-)

  • Chung, Hyung-Jin;Park, Se-Jin;Choi, Yun-Seok
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.221-223
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    • 2004
  • Bosworth fracture-dislocation of ankle is very rare, occurred by eversion and external rotation force. It is known as irreducible fracture by closed method. Also, compartment syndrome after ankle fracture are exceedingly rare. There are only a few reported cases of compartment syndrome after ankle fracture and compartment syndrome are involved commonly deep posterior compartment. We present a case in which a patient had a Bosworth fracturedislocation of the ankle underwent open reduction with internal fixation and subsequently occurred an anterior compartment syndrome of the leg.

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Chorpart's Dislocation: A Case Report (중족근 관절 탈구: 1예 보고)

  • Choi, Jun-Weon;Choi, Joon-Choil;Na, Hwa-Yeop;Shim, Dong-Joon;Kim, Young-Ho;Lee, Sang-Ho;Cho, Hyoung-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.121-124
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    • 2005
  • The midtarsal joint which consists of the talonavicular and calcaneocuboid joints lies transversely across the medial and lateral arches of the foot. Complete dislocation of this joint unassociated with fracture is extremely rare. A 36 year-old male who was injured by motor vehicle accident came to help for his left midfoot pain and deformity. We misdiagnosed as subtalar dislocation. Closed reduction was performed. We reviewed initial and post-reduction X-rays, and then we diagnosed as Chopart's dislocation. CT scan was taken; it showed fracture of the anterior process of the calcaneous.

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Irreducible Elbow Dislocation Associated with Hill-Sachs-like Lesion over the Capitellum

  • Weng, Hung-Kai;Chang, Wei-Lun;Yeh, Ming-Long;Su, Wei-Ren;Hsu, Kai-Lan
    • Clinics in Shoulder and Elbow
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    • v.22 no.1
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    • pp.37-39
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    • 2019
  • Irreducible dislocation of the elbow is an uncommon event. We present the case of a posterolateral elbow dislocation after a fall injury in a 67-year-old woman. A closed reduction performed in the emergency department was unsuccessful since the limited passive range of motion resulted in difficulty to perform longitudinal traction and flexion. Computed tomography images showed that the posterolateral aspect of the capitellum was impacted by the tip of the coronoid process, thus appearing similar to the Hill-Sachs lesion in the humeral head. Subsequent open reduction of the elbow revealed the dislocation to be irreducible since the tip of the coronoid process had wedged into a triangular Hill-Sachs-like lesion in the capitellum. The joint was reduced by providing distal traction on the forearm, and main fragments were disengaged using digital pressure. At the 3-month follow-up, the patient reported no dislocations, and had an acceptable range of motion. Thus, we propose that to avoid iatrogenic injury to the joint or other nearby structures, irreducible dislocations should not be subjected to repeated manipulation.

Intra-articular Lesions and Clinical Outcomes in Traumatic Anterior Shoulder Dislocation Associated with Greater Tuberosity Fracture of the Humerus

  • Lim, Kuk Pil;Lee, In Seung;Kim, In-Bo
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.195-200
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    • 2017
  • Background: This study investigated and evaluated the clinical outcomes of intra-articular lesions of traumatic anterior shoulder dislocation (TASD) associated with greater tuberosity (GT) fracture of the humerus. Methods: Subjects included 20 patients who were surgically or non-surgically treated for GT fracture of the humeurs with TASD, and followed-up for at least 2 years. The mean follow-up period was 54.1 months (range, 24-105 months). Of the 20 patients, 12 were treated surgically. Intra-articular lesions were identified randomly on magnetic resonance imaging scans (repeated thrice) by experienced radiologists and orthopedic surgeons. The accompanying intra-articular lesions were left untreated. Clinical outcomes were evaluated by Simple Shoulder Test (SST) and Western Ontario Shoulder Instability index (WOSI) at the last follow-up. Results: Intra-articular lesions were identified in 19 patients: 7 Bankart lesions, 15 humeral avulsion of the glenohumeral ligament lesions, 3 glenoid avulsion of the glenohumeral ligament lesion, and 6 inferior capsular tears. Two or more intra-articular lesions were identified in 6 patients. The mean SST score was 10.9 and the mean WOSI score was 449.3 at the last follow-up. Conclusions: For GT fracture of the humerus with TASD, a high frequency of diverse intra-articular lesions was identified. There were no incidence of recurrent shoulder dislocations, and good clinical outcomes were obtained without treatment of the intra-articular lesions. We thereby comprehend that although intra-articular lesions may occur in TASD associated with GT fracture of the humeurs, merely treating the GT fracture of the humerus is sufficient.

Bucket Handle Type Fracture of the Glenoid (Bucket Handle양상의 관절와 골절 - 증례보고-)

  • Shin, Sang-Jin;Kim, Sung-Jae;Kang, Ho-Jung
    • Clinics in Shoulder and Elbow
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    • v.6 no.1
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    • pp.80-84
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    • 2003
  • We report a patient with an anterior dislocation of the shoulder with uncommon bucket handle type fracture of the anterior glenoid fossa with intact glenoid labrum. The fracture fragment was displaced into the posterior aspect of the glenohumeral joint resulting in prevention of reduction of the shoulder. Excellent fixation was obtained with suture anchors and bioabsorbable interfragmentary screws. This allowed stable range of motion exercises, optimizing the patient's functional outcome.