• Title/Summary/Keyword: Posterior dislocation

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Post-traumatic Atlantoaxial Rotatory Dislocation in an Adult Treated by Open Reduction and C1-C2 Transpedicular Screw Fixation

  • Kim, Yeon-Seong;Lee, Jung-Kil;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.41 no.4
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    • pp.248-251
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    • 2007
  • Atlantoaxial rotatory dislocation [AARD] is an uncommon disorder of childhood in which clinical diagnosis is generally difficult and often made late. It is very rare in adults because of the unique biomechanical features of the atlantoaxial articulation. We report a case of post-traumatic AARD in an adult. Reduction was difficult to obtain by skull traction and gentle manipulation. Therefore, the patient was treated surgically by an open reduction, transpedicular screw fixation, and posterior C1-2 wiring with graft. The normal atlantoaxial relation was restored with disappearance of torticollis. Postoperatively, the patient remains neurologically intact and has radiographic documentation of fusion. Atlantoaxial transpedicular screw fixation can be one of the treatment options for the AARD.

Spontaneous Healing of Acromial Stress Fracture Caused by Clavicle Hook Plate in Acromioclavicular Joint Dislocation - A Case Report

  • Kim, Gang-Un;Kim, Seong-Hwan;Lee, Jae-Sung;Kim, Jae Yoon
    • Clinics in Shoulder and Elbow
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    • v.17 no.1
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    • pp.36-39
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    • 2014
  • Clavicular hook plate is known to be an effective treatment on acromioclavicular (AC) joint injury, but there have been some reports of complications, like osteolysis and bony erosion of the undersurface of acromion. Fifty-five year old male underwent open reduction and hook plate insertion on Rockwood type 5 acromioclavicular joint dislocation. He complained of protrusion of posterior acromion at 1 month after the surgery, and acromial fracture was noted in simple radiographs. The hook plate was removed and any other treatment for osteosynthesis was refused by the patient. At the 18 months after the surgery, the patient had no pain and a full range of motion with no tenderness around the shoulder joint. After two years, plain radiographs revealed complete bony union of the acromion fracture.

Relevance of the Watson-Jones anterolateral approach in the management of Pipkin type II fracture-dislocation: a case report and literature review

  • Nazim Sifi;Ryad Bouguenna
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.161-165
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    • 2024
  • Femoral head fractures with associated hip dislocations substantially impact the functional prognosis of the hip joint and present a surgical challenge. The surgeon must select a safe approach that enables osteosynthesis of the fracture while also preserving the vascularization of the femoral head. The optimal surgical approach for these injuries remains a topic of debate. A 44-year-old woman was involved in a road traffic accident, which resulted in a posterior iliac dislocation of the hip associated with a Pipkin type II fracture of the femoral head. Given the size of the detached fragment and the risk of incarceration preventing reduction, we opted against attempting external orthopedic reduction maneuvers. Instead, we chose to perform open reduction and internal fixation using the Watson-Jones anterolateral approach. This involved navigating between the retracted tensor fascia lata muscle, positioned medially, and the gluteus medius and minimus muscles, situated laterally. During radiological and clinical follow-up visits extending to postoperative month 15, the patient showed no signs of avascular necrosis of the femoral head, progression toward coxarthrosis, or heterotopic ossification. The Watson-Jones anterolateral approach is a straightforward intermuscular and internervous surgical procedure. This method provides excellent exposure of the femoral head, preserves its primary vascularization, allows for anterior dislocation, and facilitates the anatomical reduction and fixation of the fracture.

Medial Malleolar Fracture Combined with Deltoid Ligament Rupture - one case report - (삼각 인대 파열을 동반한 족근 관절 내과 골절 - 1예 보고 -)

  • Chu, In-Tak;Park, Seong-Jin;Kim, Yang-Soo;Kim, Young-Hoon;Lee, Jun-Seok
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.2
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    • pp.178-180
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    • 2002
  • Authors report one patient of concurrent fracture of medial malleolus and rupture of deltoid ligament. To the author's knowledge, combined failure of both structures has not been previously reported in Korea. Injury mechanism was classified into pronation -abduction type according to Lauge-Hansen classification. Plain radiograph revealed trimalleolar fracture and posterior ankle dislocation. MRI showed complete rupture of both deep and superficial layer of the deltoid ligament. In conclusion, therefore, concurrent rupture of deltoid ligament should be considered for the surgical treatment in trimalleolar ankle fracture with posterior ankle dislocation resulted from pronation-adduction injury.

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Clinical and Radiological Outcomes of Modified Phemister Operation with Coracoclavicular Ligament Augmentation Using Suture Anchor for Acute Acromioclavicular Joint Dislocation

  • Cho, Nam Su;Bae, Sung Ju;Lee, Joong Won;Seo, Jeung Hwan;Rhee, Yong Girl
    • Clinics in Shoulder and Elbow
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    • v.22 no.2
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    • pp.93-99
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    • 2019
  • Background: Modified Phemister operation has been widely used for the treatment of acute acromioclavicular (AC) joint dislocation. Additionally, the use of suture anchor for coracoclavicular (CC) fixation has been reported to provide CC stability. This study was conducted to evaluate the clinical and radiological results of a modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation. Methods: Seventy-four patients underwent the modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation and were followed-up for an average of 12.3 months. The visual analogue scale (VAS), range of motion, Constant score, and Korean shoulder scoring system (KSS) were used for clinical assessment. Acromioclavicular interval (ACI), coracoclavicular distance (CCD), and acromioclavicular distance (ACD) were obtained to evaluate the radiological assessments. Results: At the last follow-up, the mean VAS Score was 1.7 points, the mean joint range of the forward flexion was $164.6^{\circ}$, external rotation at the side was $61.2^{\circ}$ and internal rotation to the posterior was a level of T12. The mean Constant score and the mean KSS was 82.7 points and 84.2 points, respectively. At the mean ACI, CCD, and ACD, significant differences were found preoperatively and at the last follow-up. When the ACI, CCD, and ACD were compared with the contralateral unaffected shoulder at the last follow-up, the affected shoulders had significantly higher values. Conclusions: The modified Phemister operation with CC ligament augmentation using suture anchor is clinically and radiologically effective at acute AC joint dislocation.

The Evaluation of Usefulness New Assistant Device to Observe Posterior Cruciate Ligament Rupture and Patellofemoral Joint Injury in Emergency Patient (응급환자에서 후방십자인대 손상 및 슬대퇴 관절을 관찰하기 위한 보조기구 제작 및 유용성 평가)

  • Seo, Sun-Youl;Han, Man-Seok;Jeon, Min-Chul;Yu, Se-Jong;Kim, Yong-Kyun
    • Journal of radiological science and technology
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    • v.33 no.2
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    • pp.93-96
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    • 2010
  • This study evaluates usefulness of the developed assistant device by taking projection of patellofemoral joint in emergency patients who were doubt posterior cruciate ligament injury in knee joint. The subjects of experiment were patients who visited Eul-Ji University Hospital due to knee injury from January 2006 to December 2006. Seventeen patients, who took the Knee post stress view, Knee merchant view, Knee Seo's view to use assistant device and Knee MRI. To make assistant device of $170{\times}50{\times}70\;cm$, we evaluated its usefulness by measuring posterior dislocation of tibia. Seo's view is more accurate to make judgment of posterior cruciate ligament injury than original knee post stress view. Interval difference of posterior dislocation of original knee post stress view is $6.17{\pm}3.04$ and Seo's view is $8.74{\pm}4.47$. The results show injury of patellofemoral joint, vertical fracture of patella and posterior cruciate ligament injury by taking a projection using Seo's view. Therefore, it is useful to take projection earlier than talometer and MRI in emergency patients who were doubt posterior cruciate ligament injury in knee joint.

Posterior type II SLAP Lesion Combined with Posterior Bankart Lesion - A Case Report - (후방 Bankart 병변을 동반한 후방 II형 SLAP 병변 - 증례보고 -)

  • Cheon, Sang-Jin;Youn, Myung-Soo;Kim, Hui-Taek;Suh, Jeung-Tak
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.2
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    • pp.134-138
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    • 2008
  • SLAP(Superior labrum anterior to posterior) lesion is found in superior labrum injury alone and also combined with extension of the Bankart lesion(anteroinferior labral tear) in recurrent shoulder dislocation patients and rarely accompanied by the posterior Bankart lesion. There have been reports about SLAP lesions associated with various lesions, however, posterior type II SLAP lesion associated with posterior Bankart lesion has been rarely reported. In such a case, there are important technical tips in inserting anchors and suturing during arthroscopic repair. We experienced a rare case of posterior type II SLAP lesion associated with posterior Bankart lesion, occurred not after repetitive throwing(common mechanism) but after trauma in slipping down with the arm stretched during riding a bicycle. The satisfactory result was obtained after arthroscopic repair in this case.

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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.

An Irreducible Posterolateral Dislocation of Knee by the Detached Femoral Cartilage - A Case Report - (대퇴 연골편에 의해 정복이 불가능한 슬관절 후외방 탈구 - 1예 보고 -)

  • Kim, Seong-Tae;Lee, Bong-Jin;Park, Woo-Sung;Lee, Sang-Hoon;Kim, Tae-Ho;Lee, Sung-Rak
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.2
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    • pp.126-129
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    • 2007
  • An irreducible dislocation of the knee joint is quite rare. Most irreducible knee dislocations are posterolateral dislocations and result from the soft tissue interposition. To the best of our knowledge, there is no report of an irreducible knee dislocation result from interposition of the detached cartilage from the medial femoral condyle. We present a case of 51 years old female with irreducible knee dislocation which was treated with an arthroscopic debridement of the detached cartilage, result in reduction of the joint, which is failed in closed reduction. And then we perform the delayed arthroscopic reconstructions for the ruptured anterior and posterior cruciate ligaments. Debridement of the interposed structure using the arthroscope allows for reduction of the joint and good result without the need for an open procedure.

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Neglected Elbow Dislocation Occurred 3 Years Ago: Open Reduction and Hinged External Fixation - A Case Report - (3년전이 경과된 진구성 주관절 탈구: 개방적 정복술과 경첩 외고정 장치 - 1예 보고 -)

  • Kim, Bo-Kun;Kim, Kyung-Cheon;Park, Jun-Yeong;Shin, Hyun-Dae
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.266-269
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    • 2010
  • Purpose: We report case of neglected elbow dislocation for three years. Material and method: A 45 years old female patient presented with neglected elbow dislocation for three years. Since the patient had contracture in both lateral and medial collateral ligament of elbow, dissection was done. After total separation of posterior articular capsule and incision of anterior articular capsule, by manual manipulation, reduction of radiohumeral and ulnohumeral joints were obtained. We applied modified Morrey type hinged external fixation in the elbow and done early elbow exercise. Result and Conclusion: Since we have experienced a satisfactory result in the case with neglected elbow dislocation for 3 years by using open reduction and hinged external fixation, we report it with the literature.