Post-traumatic Subluxation Research Articles

Focal Neuropathy Mimicking Focal Dystonia in a Child: Diagnostic and Rehabilitative Tools.

Object: Focal neuropathy results from an injury of any etiology that occurs in a peripheral nerve. The lesion may be followed by alteration of the sensory sphere (either dysesthesia or paresthesia with or without neuropathic pain), or by compensatory attitudes that are attributable to the altered contraction in muscles that are innervated by the injured nerve. Methods: We describe the case of a 13-year-old boy who attended our hospital for a focal neuropathy of the radial nerve. Conclusion: This neuropathy was revealed after the removal of a plaster Zimmer splint that was applied following a post-traumatic subluxation of the metacarpal-trapezoid joint.

Delayed diagnosis of post-traumatic C7 vertebra anterior subluxation with an unusual neurological pattern: a case report

IntroductionPost-traumatic subluxations are potentially devastating injuries to the axial skeleton. Of utmost priority are an expedient and timely diagnosis and realignment because of its association with spinal cord and nerve root trauma, which lead to progressive deleterious neurological deficits. A good radiological study of the occipitocervical joint and first thoracic vertebra is key to a successful early diagnosis. However, cases might still fail to be diagnosed, leading to trouble. A case of post-traumatic subluxation at the C7 vertebral level with an unusual neurological pattern is presented here.Case presentationA 35-year-old farmer from the Sindh province of Pakistan presented to our neurology department after a fall 2 months earlier and complained of lower limb pain and difficulty in walking. He had numbness in both of his lower limbs up to his umbilical region, with sparing of bladder function along with intact strength in the upper extremities bilaterally.ConclusionsOur case highlights the unusual sparing of upper limbs and intact urinary continence with severe lower limb deficits in a 70% subluxation. Our case is unusual because highly detrimental effects such as quadriplegia are expected with such extreme subluxation, but our patient presented with only lower limb deficits. This case serves as a reminder to emergency medicine doctors, spine surgeons, and even radiologists (a) to evaluate spine injuries by using computed tomography in trauma patients to identify artifact around a suspected injury and (b) to be mindful of negative conventional radiographs.

Snapping Junctura Tendinum to the Small Finger Simulating Radial Sagittal Band Rupture

Snapping of the extensor tendon over the metacarpophalangeal joint usually involves a longitudinal or oblique tear of the radial sagittal band1, with subsequent displacement of the extensor tendon in an ulnar direction2. Most reports have dealt with pathologic snapping secondary to inflammatory joint disease and posttraumatic subluxation of the extensor tendons, which usually occurs in either the long or ring finger. Because of its rarity, little attention has been given to snapping at the metacarpophalangeal level of the small finger2,3. We report two cases of snapping of junctura tendinum in the fourth intermetacarpal space over the radial side of the fifth metacarpal head, which could be misdiagnosed as extensor tendon subluxation due to sagittal band injury. Surgical treatments together with anatomic variations in this area are also discussed. The patients were informed that data concerning their cases would be submitted for publication, and they consented. Case 1. A twenty-year-old woman was referred because of a three-month history of painful snapping of the left small finger. She had started to play the drums three weeks before the symptoms had developed, and she noted constant and painful snapping with flexion of the metacarpophalangeal joint. On examination, the extensor tendon of the small finger dislocated radially at the level of the metacarpophalangeal joint with flexion of >30°. There was an obvious snapping sound at the time of dislocation (Fig. 1, A ). This finding was not related to wrist or elbow motion. A diagnosis of extensor tendon dislocation of the small finger was made, and surgical reconstruction of the sagittal band was planned. Fig. 1 Case 1. A: The extensor tendon of the small finger dislocated to the radial side of the metacarpophalangeal joint with flexion. B: Surgical exploration revealed a thick cord-like structure (arrows) crossing obliquely …

Posttraumatic subluxation of the glenohumeral joint caused by interposition of the rotator cuff

Irreducibility of a shoulder dislocation is a rare complication of a common injury. Irreducibility can be caused by bony impaction or the interposition of bone or soft tissue. The most common soft tissue block is an interposed biceps tendon; however, the literature contains occasional reports of irreducible shoulder dislocations caused by rotator cuff interposition. We present 5 cases of persistent posttraumatic subluxation of the glenohumeral joint as a result of interposition of the rotator cuff. The literature is reviewed, and the salient clinical points are outlined. CASES

CT-Diagnostik bei der Instabilität des Schultergelenkes

CT is able to demonstrate the predisposing factors for recurrent and posttraumatic subluxation of the shoulder. In addition to demonstrating bony changes in the glenoid (Bankart lesion) and in the humeral head (Hill-Sachs lesion), CT can measure the degree of retroversion of the glenoid and torsion of the humerus. Measurements on 17 shoulders with habitual and 24 shoulders with recurrent posttraumatic subluxation showed low values for glenoid retroversion as compared with a control group. Particularly patients with habitual anterior subluxation frequently showed anteversion of the glenoid. Measurements of humeral torsion showed wide scatter amongst all groups, indicating wide biological variability. The results were compared with those published in the literature and the indications and limitations of CT for the investigation of shoulder instability are discussed.

Posttraumatic recurrent subluxation of the extensor carpi ulnaris tendon

Isolated posttraumatic subluxation of the extensor carpi ulnaris tendon at the wrist has received scant attention in the literature. Five patients with this condition were seen during a 21-month period. All had chronic subluxation resulting from forearm hypersupination injury sustained during an athletic activity. Surgical treatment was indicated for three patients, and each obtained a satisfactory result. The salient pathologic feature appears to be a disruption of the ulnar-restraining septum of the sixth dorsal compartment of the wrist. Surgical treatment by reconstruction of this structure appears to be reliable and beneficial.