Dislocation Of Head Research Articles

Volar Surgical Correction of Madelung's Deformity

Volar Surgical Correction of Madelung's Deformity

A rare case of Monteggia's lesion in children

The authors present a rare case of a Monteggia lesion in a child. The fracture of the proximal ulnar metaphysis is associated with a dislocation of the radial head. The outcome is good after closed reduction and six weeks cast. Two years later, the function is normal.

The 'Upside-Down' Radial Head: A Diagnostic Challenge

The author describes a rare, traumatic dislocation of the radial head in an 8 year old girl. Only four similar cases were found in the literature. The danger of misdiagnosis and the life-long disability can be avoided by careful examination of the post-reduction radiograph.

両側先天性とう骨頭脱臼の１例

両側先天性とう骨頭脱臼の１例

Description of a dislocation of the head of the femur, complicated with its fracture; with remarks by John Birkett (1815-1904). 1869.

Description of a dislocation of the head of the femur, complicated with its fracture; with remarks by John Birkett (1815-1904). 1869.

Greater Trochanteric Blood Flow During Total Hip Arthroplasty Using a Posterior Approach

The authors investigated the effect of a posterior surgical approach on the local femoral blood supply during primary total hip arthroplasty. Greater trochanteric blood flow measurements were made with a laser Doppler flowmeter at intervals during the performance of eight uncemented and nine cemented total hip arthroplasties. Complete detachment of the quadratus femoris was associated with a significant decrease in trochanteric blood flow in the uncemented and cemented groups. The lowest perfusion levels during the procedure were seen transiently with posterior dislocation of the femoral head, after which trochanteric perfusion was decreased by 66% in the uncemented group, and 61% in the cemented group compared with baseline values. Blood flow remained approximately half of baseline values after insertion of the femoral prosthesis in the uncemented and cemented groups. These changes in greater trochanteric blood flow may serve as a marker for reduction in proximal femoral blood flow during total hip arthroplasty, and subsequently relate to the extent of bony ingrowth, periprosthetic bone loss, and ultimately the incidence of implant failure caused by aseptic loosening.

尺骨ｂｏｗｉｎｇに伴うとう骨頭脱臼の治療経験

尺骨ｂｏｗｉｎｇに伴うとう骨頭脱臼の治療経験

Posterior Dislocation of the Humeral Head in Association with Obstetric Paralysis

Posterior Dislocation of the Humeral Head in Association with Obstetric Paralysis

Posterior dislocation of the humeral head in association with obstetric paralysis.

Twelve children with obstetric paralysis were diagnosed as having a posterior dislocation of the humeral head. The diagnosis was suspected on clinical grounds and confirmed by computed tomography (CT) scans in all cases. All 12 patients were treated with open reduction via an anterior approach. The age range at the time of surgery was from 7 months to 7 years (average, 2 years and 3 months). All patients were immobilized in a shoulder spica for 6 weeks and a further 6 weeks in an orthosis. All patients were examined by CT scans in the postoperative period, which confirmed a satisfactory reduction in all cases. With a minimal follow-up of 12 months, there have been no redislocations. This article demonstrates that dislocation of the shoulder in association with obstetric paralysis is not rare, as previously described, and shows that once diagnosed, the dislocation can be satisfactorily treated by a single anterior open reduction of the shoulder.

Use of a Modified Bell Tawse Procedure for Chronic Acquired Dislocation of the Radial Head

We retrospectively reviewed five patients with chronic acquired dislocation of the radial head, treated with open reduction and ligament reconstruction with a slip of the triceps tendon. Three of the cases were posttraumatic, one was a dislocation resulting from a mass-occupying lesion, and one case was caused by recurrent radial head subluxation occurring after an initial traumatic episode. An ulnar osteotomy was used in one case to allow reduction of the radial head. All patients had a good postoperative functional and radiographic outcome, without postoperative complications. In two cases, there was slight loss of motion in relation to the contralateral extremity. Reconstruction of the annular ligament by using a strip of the triceps fascia is a safe and effective treatment in the treatment of chronic acquired radial head dislocation.

Irreducible Isolated Dislocation of the Radial Head

Isolated dislocation of the radial head in adults is a rare injury. A 20-year-old man received a direct blow to his elbow and sustained an isolated anterior dislocation of the radial head. Open reduction was required because soft tissue interposition prevented reduction by closed manipulation. At operation the annular ligament was found to be ruptured and interposed between the articular surfaces, preventing reduction. A satisfactory result was obtained 1 year after surgery.

MONTEGGIA LESION IN A CHILD: VARIANT OF A BADO TYPE-IV LESION. A CASE REPORT

Monteggia described a lesion that consisted of a fracture of the proximal third of the ulna and an anterior dislocation of the proximal end of the radius1. Bado, in a series of forty patients, found that the fracture and dislocation could be displaced in various directions; he modified the original definition of a Monteggia lesion to “a group of traumatic lesions having in common a dislocation of the radio-humero-ulnar joint, associated with a fracture of the ulna at various levels or with lesions at the wrist.”2 This is a case report of a four-year-old boy who sustained a Monteggia fracture-dislocation that was Bado2 type IV. The child had a posterolateral angulation deformity of the fracture of the ulna, posterolateral dislocation of the radial head, and a fracture of the middle third of the radial shaft. A four-year-old boy fell from a height of about ten feet (three meters) and sustained an injury of the right forearm. He had a severe posterolateral angular deformity in the proximal part of the forearm without any neurovascular deficit. Motion of the elbow and wrist was very painful and restricted. Roentgenograms showed a fracture of the proximal third of the ulna, with 55 degrees of lateral angulation on the anteroposterior roentgenogram and 30 degrees of posterior angulation on the lateral roentgenogram. The radial head was displaced posterolaterally, and there was a fracture through the middle third of the radial shaft (Fig. 1). In addition, at the site of the fracture, there was plastic deformation of the ulna in an anteromedial direction. Roentgenograms showing a Bado2 type-IV Monteggia lesion with posterolateral angulation of the ulna and posterolateral dislocation of the radial head. Two attempts at closed reduction with the patient under general anesthesia were unsuccessful. The angular deformity of the ulna …

OPERATIVE FIXATION OF MONTEGGIA FRACTURES IN CHILDREN

We reviewed 36 consecutive patients with Monteggia fracture-dislocations of the forearm; 28 had been treated within 24 hours and 8 had been referred a week or more after the initial injury with persisting or recurrent dislocation of the proximal radio-ulnar joint after treatment elsewhere. We treated 15 of the 16 complete fractures and 3 of the 11 incomplete fractures of the ulna by operative fixation. All the early fractures and six of the eight late referrals had good or excellent results. The two poor results were in patients with malalignment and dislocation of the radial head persisting for at least two weeks before definitive treatment. A good outcome after a Monteggia injury in a child requires early diagnosis and prompt, stable, anatomical reduction of the ulnar fracture. In our experience, selective operative fixation of unstable fractures provides reliable reduction and causes few complications.

Intrapelvic Dislocation of the Femoral Head after Central Acetabular and Femoral Neck Fracture

Central fracture-dislocation of the hip associated with fracture of the femoral neck and intrapelvic intrusion of the femoral head is a very rare condition. The treatment of choice consists of open reduction of the dislocation and internal fixation of both fractures, but this is often not possible in delayed cases. In our patient, a young female, operated on six months after the trauma by partial resection of the femoral head and a cementless total hip arthroplasty, a good clinical result was achieved.

Bilateral Inferior Glenohumeral Dislocations

Inferior dislocation of the humeral head, or luxatio erecta, is much less common than either anterior or posterior dislocations, accounting for approximately 1 in 200 glenohumeral dislocations. Bilateral, simultaneous inferior dislocation is an extremely rare injury. We present a patient who came to our trauma unit with bilateral luxatio erecta after a horseback riding accident.

The posterior Monteggia: a pathological lesion?

Ulnar fracture with posterior dislocation of the radial head is thought to be a relatively rare injury. We have recently treated six patients with this posterior Monteggia fracture dislocation. Five of these patients were on long-term corticosteroid therapy. The pathophysiology, treatment and outcome of this complex injury are discussed.

Open setting method of the chronic palm dislocation of the ulna head in distal radioulnar articulation

The open setting atraumatic method of the chronic palm dislocation of the ulna head in distal radioulnar articulation is proposed. The author provides the nes- cessity of careful clearance of the radius articular notch and ulna head from cicatricial tissue, retaining the anatomic structure of the dorsal radioulnar ligament and articular disk part separating the radiocarpal articulation from radioulnar one.

Ｂｉｐｏｌａｒ型人工骨頭置換後にｉｎｎｅｒ ｈｅａｄが反復性に脱臼した１例

Ｂｉｐｏｌａｒ型人工骨頭置換後にｉｎｎｅｒ ｈｅａｄが反復性に脱臼した１例

Ipsilateral Fracture Dislocation of the Radial Shaft Head Associated with Elbow Dislocation

A severe form of an extremely unusual injury, ipsilateral fracture dislocation of the radial shaft head associated with elbow dislocation, is described. Radial shaft fracture was irreducible even after the radial head and the elbow were reduced. Open reduction and internal fixation are viable options.

Early Diagnosis of Hip Dysplasia – A Stress-Radiographic Study

SummaryPresently, the diagnosis of hip dysplasia is based on a single pelvic radiographic examination of the dog at the age of 12 to 24 months. However, by this method, only a static appearance of the coxofemoral joint is evaluated. The purpose of our study was to diagnose hip dysplasia in young dogs and consequently, we included a radiographic evaluation of the dynamic appearance of the coxofemoral joint.A stress-radiographic examination was applied to 23 German Shepherd Dogs at the age of six and 12 months to obtain maximal reduction and maximal dislocation of the coxofemoral joint. Finally, at the age of 12 months, the hips were examined radiographically using the conventional criteria for hip dysplasia.At the age of six months, dogs with hip dysplasia showed significantly greater joint laxity and lateral dislocation of the femoral head than normal dogs. However, some predysplastic dogs, with lateral dislocation of the femoral head, developed normal hips and would be approved for breeding. Based on these findings, we conclude that stress-radiographic examinations of young dogs provide important, hitherto unrecognized, information of relevance in the future screening programmes to reduce the incidence of hip dysplasia.A stress-radiographic examination of young dogs provides important, hitherto unrecognized, information of relevance in the future screening programmes to reduce the incidence of hip dysplasia.