Traumatic anterior dislocation of the hip without fracture of the acetabulum or femoral head is rare. They are often secondary to high energy kinetic accidents.

Treatment of the traumatic spine dislocation C6-7 and SCIWORA Th11 in 11-years old girl.

IntroductionTraumatic anterior hip dislocations are rare compared to posterior dislocations. We managed a case of traumatic anterior dislocation caused by high-energy injury. This report describes the treatment strategy, arthroscopic findings, and presumed injury mechanism.Case DescriptionA 17-year-old male sustained an anterior dislocation of the left hip after falling from a motorcycle and being struck by a following vehicle. Closed reduction was performed under general anesthesia. He was treated conservatively with non-weight-bearing for five weeks and achieved full weight-bearing ambulation eight weeks post-injury. Despite this, he remained symptomatic with persistent left hip pain for five months. Clinical evaluation showed a positive impingement sign. Imaging demonstrated a Cam deformity on radiographs and CT, and an anterior-superior labral tear with a Hill-Sachs-like lesion of the femoral head on MRI. He was diagnosed with femoroacetabular impingement (FAI).ResultsHip arthroscopy performed five months post-injury revealed a labral tear with adjacent cartilage delamination and a femoral head depression. No osteochondral fragments were observed. Arthroscopic labral repair and femoral osteoplasty were performed. Postoperatively, the patient experienced significant pain relief and returned to sports, including futsal and bowling, from three months after surgery.DiscussionMRI identified a depression and bone marrow edema at the anterolateral femoral head (1-o’clock position) and at the anterior medial femoral condyle. It is presumed that high-energy force in abduction, external rotation, and extension caused anterior-inferior hip dislocation toward the pubis. Arthroscopic repair and femoral osteoplasty eliminated impingement and improved symptoms.ConclusionThis case highlights the importance of recognizing labral and bony pathology after anterior hip dislocation in adolescents. Hip arthroscopy enabled identification and treatment of intra-articular lesions, facilitating rapid recovery. The surgery may benefit selected young patients with post-traumatic FAI.

Study DesignSystematic review of clinical studies.ObjectiveTo identify neurological, anatomical, and technical predictors of failure in closed cranial traction (CCT) for traumatic cervical facet dislocations (CFD) in adults, and to synthesize evidence to guide early surgical decision-making.MethodsA systematic search was conducted across five databases: PubMed, PubMed Central (PMC), SciELO, Scopus, and Web of Science, for studies published from January 2000 to May 2025. Eligible studies included patients ≥16years with traumatic CFD managed initially with CCT, reporting both success/failure rates and predictive variables. Data extraction focused on demographics, injury patterns, reduction techniques, and outcomes.ResultsEight studies met the inclusion criteria, encompassing 631 patients. Overall, the success rate of closed reduction was 73.3% (463/631), ranging from 56% to 92%. Consistently reported predictors of failure included complete neurological deficit (ASIA A-B; four studies), absence of a contralateral perched facet, involvement of the C7-T1 level, inferior endplate fracture, and attempts without general anesthesia. When open reduction was required after failed CCT, posterior approaches achieved higher success rates than anterior approaches (100% vs 45%).ConclusionsIn adults with traumatic cervical facet dislocations, CCT is more likely to fail with complete neurological deficits (ASIA A-B), C7-T1 involvement, absence of a contralateral perched facet, and awake traction protocols; GA-first strategies showed higher success in available cohorts. Unlike prior technique-focused overviews, this review consolidates predictors of CCT failure and proposes a practical algorithm to triage patients for early open reduction.

Traumatic dislocations of the proximal interphalangeal joint (PIPJ) of the lesser toes are rare injuries in the pediatric population, with limited literature available to guide management decisions. We report the case of a 5-year-old male who presented with irreducible dorsolateral dislocation of the right fifth toe PIPJ following trauma during play activities. Clinical examination revealed swelling, tenderness, and restricted movement of the affected digit. Plain radiographs confirmed the dislocation without associated fractures. Initial attempts at closed reduction under procedural sedation were unsuccessful, leading to the decision for surgical intervention. The patient underwent open reduction and internal fixation under general anesthesia. A dorsal longitudinal incision was made over the affected joint, revealing soft tissue interposition preventing reduction. The interposed tissue was carefully removed, anatomical reduction achieved, and joint stability maintained with Kirschner wire (K-wire) fixation. Postoperative management included appropriate analgesia, antibiotic prophylaxis, and immobilization. Regular follow-up demonstrated satisfactory healing without complications. This case demonstrates that irreducible pediatric toe PIPJ dislocations can be successfully managed with open reduction and K-wire fixation when closed reduction fails. Early recognition and appropriate surgical intervention are crucial for optimal outcomes. The rarity of these injuries necessitates high clinical suspicion and prompt specialist consultation to prevent potential complications and ensure proper treatment.

Background:The utility of indeterminate magnetic resonance (MR) imaging findings in identifying shoulder pathology in overhead throwing athletes is yet to be determined. The assessment of capsular redundancy on MR arthrography, specifically in the abduction external rotation (ABER) position, could help accurately distinguish between throwing disorders involving internal impingement and those involving anterior instability.Purpose:To compare MR arthrography findings in the ABER position between patients with internal impingement with anterior instability and those with traumatic shoulder dislocation.Study Design:Cross-sectional study; Level of evidence, 3.Methods:This study included patients who had subtle glenohumeral instability, as indicated by a positive anterior apprehension test and relocation test results. Those with voluntary and multidirectional instability and with large glenoid bone loss (>25%) were excluded. In total, 95 shoulders (86 male, 9 female; mean age, 23.9 ± 9.4 years) that had undergone arthroscopic procedures were divided into 2 groups: 35 shoulders in the throwing group with internal impingement with anterior instability and 60 in the traumatic dislocation group. We classified the anterior glenohumeral capsular ligaments on MR arthrography in the ABER position into the following 4 types based on a previous report: taut, avulsion, crescent, and fluctuation sign. Compared with arthroscopy, MR arthrography in the side position was evaluated for its accuracy in detecting rotator cuff and labral injuries.Results:MR arthrography in the ABER position revealed that the fluctuation sign in 71% of shoulders in the throwing group was significantly greater than that in 12% of shoulders in the dislocation group (P < .001). MR arthrography revealed that rotator cuff and posterosuperior labral injuries were present in 83% and 71% of shoulders in the throwing group, which was significantly greater than the 20% and 23% of shoulders in the dislocation group (P < .001).Conclusion:The fluctuation sign on MR arthrography in the ABER position could potentially detect characteristic lesions in throwing athletes with internal impingement with anterior instability.

Traumatic dislocation of the thumb carpometacarpal (CMC) joint is relatively rare. Although there are scattered reports of such dislocations, they are all in the dorsoradial direction. We report a very rare case of an ulnar dislocation of the CMC joint of the thumb. The patient fell while on a motorcycle and was presented with an ulnar dislocation of the CMC joint of the left thumb. Manual reduction failed to provide stability, and surgery was performed. The CMC joint was temporarily wired, and the posterior oblique ligament and dorsoradial ligament were repaired with a suture anchor. One year after surgery, the CMC joint was stable and pain-free.

Testicular dislocation after blunt trauma to scrotum or to the abdomino-pelvic region is a rare entity, which happens due to spasm of cremasteric muscles. It can be unilateral or bilateral. It can go unnoticed on the first clinical examination at presentation because of associated injuries to other major organs. In this case report, we present the case of an adult male who presented with road traffic accident injury to the faciomaxillary region at some health institute but was later diagnosed with traumatic dislocation of right testis to groin. Later, he presented in our health facility where he was evaluated and diagnosed with traumatic dislocation of the testis of the right side. After confirming the clinical diagnosis of traumatic testicular dislocation with radiological examination, he underwent emergency surgical exploration of right testis and proceeded to orchiopexy. His post op period was uneventful and he was discharged on post op day second. On follow up, the patient did not have any urologic or sexual dysfunction on clinical examination and follow up radiological examination was also normal. Scrotal examination should be thoroughly done to avoid the delay in making the diagnosis of traumatic testicular dislocation. Although few cases can be managed conservatively with manual reduction, surgical exploration remains the mainstay so as to avoid the further complications later in life.

Traumatic bilateral cervical facet dislocation (BFD) represents a high-energy, highly unstable spinal injury with a significant risk of neurological compromise. BFD poses substantial diagnostic and therapeutic challenges across the acute-to-delayed care continuum. Variability in injury morphology, timing of presentation, and patient factors often leads to wide discrepancies in clinical management. This review synthesizes biomechanical principles, diagnostic protocols, classification systems, and surgical strategies from the available literature, with critical appraisal of anterior, posterior, and circumferential approaches. We identify key clinical inflection points, such as the presence of disc extrusion, endplate fracture, irreducibility, and chronicity, that determine optimal intervention. Imaging modalities including CT, MRI, and CT angiography are reviewed in context, and the role of pre-reduction MRI is highlighted in risk mitigation. A novel treatment algorithm is presented, integrating radiographic findings, neurological status, and timing. In neurologically intact patients with reducible injuries, anterior decompression and fixation offers a safe and efficient pathway. In delayed or fixed dislocations, posterior-first or staged approaches may be necessary, particularly when osteotomies or circumferential correction is warranted. Closed reduction is addressed with caution due to risk of cord injury, especially in the absence of pre-reduction imaging. This article offers a practical framework for spine surgeons navigating the rare but high-stakes scenario of BFD. By consolidating contemporary evidence with expert interpretation, we provide a structured pathway to improve safety, consistency, and neurological outcomes.

ABSTRACT Objectives Traumatic anterior glenohumeral joint dislocations are associated with prolonged time loss and high rates of reinjury in rugby. This is particularly common during contact events. There is a lack of clear guidance to facilitate return to contact decisions following these injuries in rugby. The aim of the study was to identify and reach consensus (≥70% agreement) regarding return to contact criteria and assessment methods following traumatic anterior glenohumeral joint dislocations in rugby union players. Methods A three-round Delphi consensus study was conducted. Results Thirty-three health and sport practitioners participated in Round 1. Round 2 and 3 were completed by 28 and 26 practitioners respectively. Thirty criteria reached consensus for inclusion. These criteria included time frames, subjective ratings (including pain, apprehension, and player readiness) and clinical criteria (including clinical stability). Functional criteria such as range of motion, muscle function and proprioception of the glenohumeral joint, and fitness were also recommended for inclusion. In addition, assessment of rugby specific skills were recommended. Modalities reaching consensus to evaluate subjective criteria such as pain included Visual Analogue Scale ratings, specific questions, and palpation. The anterior apprehension and relocation test was recommended for clinical stability, whereas observation of functional movements was recommended to evaluate shoulder function. Conclusion A comprehensive range of clinical, functional, subjective, and sport specific criteria and assessment methods should be considered alongside time frames to guide return to contact decisions following traumatic anterior glenohumeral joint dislocations in rugby union players.

Posterior sternoclavicular joint (SCJ) dislocation is a rare injury, usually caused by a direct blow to the medial chest wall. The SCJ is inherently unstable due to its bony components and most of its stability is derived from surrounding soft tissue. Among skeletally immature patients it is important to differentiate between true SCJ dislocation and fractures through the medial clavicle growth plate. There is a high anatomical proximity between the SCJ and mediastinal retrosternal structures, as the thoracic blood vessels, and traumatic posterior SCJ dislocation has the potential of harming these anatomical structures and creating significant symptoms and even life-threatening symptoms during injury or during treatment. Diagnosis of posterior SCJ dislocation can be challenging and necessitates focused physical examination and radiological work-up including X-rays and a CT scan. Treatment posterior SCJ dislocations includes prompt reduction of the joint, mostly open reduction of the joint and stabilization with internal fixation. Due to the risk of damage to the blood vessels in the chest, a thoracic surgeon should be involved in the surgical procedure. Open reduction and internal fixation of this injury is a safe and efficient treatment, with a low complication rate, that allows fast and full recovery of the injured limb and avoids long term symptoms and complications.

Background:Posterior labral injuries can cause shoulder pain and instability. Posterior labral tears account for up to 47% of all tears treated arthroscopically. Injuries can result from repetitive microtrauma, recurrent posterior subluxations, or traumatic posterior dislocations. Posterior labral injuries can be reliably repaired with arthroscopic surgery. A systematic review by Delong et al found improved return to play along with lower recurrence rates when repairing these injuries using an arthroscopic approach compared to an open approach.Indications:The main indication includes a symptomatic labral tear that has been confirmed by magnetic resonance imaging. Patients commonly report deep posterior shoulder pain and can experience instability symptoms. Positive tests (Kim test, Jerk test, posterior load and shift) and findings of posterior laxity may be seen upon physical examination. Arthroscopic treatment remains the gold standard for labral repairs.Technique Description:The surgery is performed using 2 portals, an anterior (viewing) portal and a posterior (working) portal. These portals are used to place the sutures for the repair with knotless anchors. Especially in the case of shoulder instability, the capsulotomy is closed by tying a “blind” arthroscopic knot.Results:Through the use of 2 portals, the capsule labral repair is done in a clear, efficient manner. This technique aims to maximize ideal patient outcomes, including quicker return to sport, a lower rate of recurrence, and improved pain and function.Discussion/Conclusion:The main advantages of this technique are speed and efficiency. This leads to less postoperative swelling and minimal patient discomfort. Benefits also include its stepwise approach, easy reproducibility, and quality and strength of the labral repair.Patient Consent Disclosure Statement:The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Epidemiology, complications and patient-reported outcomes for surgically treated traumatic foot injuries.

Background and purposeLimited population-based data is available concerning traumatic joint dislocations in children and adolescents. We aimed to determine the incidence, typical locations, and demographic patterns of joint dislocations in a pediatric population.MethodsThis retrospective, population-based study analyzed pediatric joint dislocations in the Helsinki University Hospital catchment area from 2009 to 2021. Data was retrieved from electronic health records using ICD-10 codes and radiological keywords. Primary radiographs were reviewed to confirm diagnoses. Incidences were calculated using population data, and trends were analyzed by age, sex, and dislocation site. 2,741 traumatic dislocations were included.ResultsThe overall annual incidence of joint dislocations was 69 per 100,000 children, with a higher incidence in boys than in girls (72 vs 66 per 100,000, odds ratio 1.1, 95% confidence interval 1.02–1.2). The peak incidence occurred at 16 years of age for boys and 15 years of age for girls. Patellar (49%), elbow (19%), finger (12%), and glenohumeral (10%) dislocations accounted for 90% of cases with respective mean incidence; 35, 13, 8.4 and 7.1 per 100,000.ConclusionThe annual incidence averaged 69 per 100,000 children. Joint dislocations in children predominantly affect the patellar, elbow, finger, and glenohumeral joints, with adolescence being the most vulnerable period.

Recurrent anterior traumatic shoulder instability is related to progressive bone loss on both the humeral and glenoid side. Recurrence of anterior shoulder instability after stabilization surgery is estimated to be around 35%. The severity of bone loss is known to be one of the principal prognostic factors for treatment success. Identification of risk factors of larger bone deficit may help to identify patients at risk. The purpose of this study is to identify modifiable risk factors that will help us counsel patients on habit modification and thus possibly help decrease recurrence of shoulder instability after stabilization surgery. Since 2010, all patients undergoing surgical treatment for recurrent shoulder instability are included in a vast inclusive prospective study cohort: the LUXE study. Patients were all recruited from Montreal's Sacred-Heart Hospital. All patients with complete demographic data and good quality computed tomography (CT) scans were included. Bone loss was measured using the validated Glenoid Track method, shoulder lesions being identified as “on-track” or “off-track” prior to arthroscopic surgery. Analysis of variance (ANOVA) and Pearson correlation statistical tests were used to correlate the Glenoid Track bone loss measurement method with multiple variables such as patient age, gender, BMI, the mean number of shoulder dislocations reported prior to surgery, alcohol and tobacco consumption, epilepsy, the Beighton score and the shoulder Instability Severity Index Score (ISIS). A total of 204 patients met inclusion criteria (161 male, 43 female) with a mean age of 29 years (range 16–52 years). The mean number of dislocations prior to surgery was 14 (range 2–150). Patient BMI was of 25 on average (range 16–41). A quarter (25%) of patients were smokers and a total of 47% reported alcohol consumption over the recommendations issued by Health Canada. Epilepsy was the cause of instability in 6% of patients. Off-track shoulder lesions were identified in 43% of shoulders and significant glenoid bone deficit, meaning 25% or more of the glenoid diameter, was seen in 19% of cases. Male gender, smoking, drinking alcohol, epilepsy, the number of dislocations and older age were all risk factors for greater bone loss at presentation. This study has shown us mutilple modifiable risk factors of increased bone loss in recurrent shoulder instability patients. Canadian shoulder surgeons should work closely with primary care physicians who are seeing patients with traumatic shoulder dislocations. Furthermore, patients should be educated on how smoking and drinking are related to worse outcomes to their shoulder anatomy. They should also be oriented younger and earlier than a mean of 14 shoulder dislocations for surgical stabilization to prevent progression of damage to their shoulder. Future studies with the LUXE cohort will possibly identify more patient risk factors and different measurement methods of glenoid and humeral bone loss that will help us better predict failure of surgical stabilization.

The aim of this paper is to report “Globe Intussusception” as an extreme form of globe dislocation outside the orbital pyramid, and provide a literature review. A single-center, retrospective, interventional case series of three patients is presented. A review of the English-language literature from the years 1971 to 2024 was performed using the search terms “traumatic globe dislocation”, “maxillary sinus” and “ethmoid sinus”. Three cases of globe intussusception are reported. Computed tomography imaging revealed orbital fracture, and globe prolapse into the maxillary sinus with or without involvement of ethmoid sinus. This was associated with complete intussusception of the globe through the conjunctiva, giving an “empty socket” appearance. In all three cases, fracture repair along with retrieval of the eyeball from the sinus was carried out surgically. Reduction of the intussusception, and bringing the eyeball out of the conjunctival pouch was a special additional challenge in these cases. The review of 35 cases reported in world literature till date is presented. We suggest retrieval of the intussuscepted eyeball via a 360° peritomy and suture tagging of extraocular muscles to ensure safe repositioning of globe with intact extraocular muscles.

Traumatic hip dislocation is an orthopedic emergency that requires rapid evaluation and reduction. It may cause severe morbidities like avascular necrosis and posttraumatic osteoarthritis in the long term. This case report discusses a traumatic hip dislocation treated with open reduction using trochanteric osteotomy. A 50-year-old female driver experienced a posterior superior right hip dislocation following a traffic accident. Under sedation in an emergency room, closed reduction was attempted, but the reduction of the hip was not achieved. Under general anesthesia, closed reduction was reattempted, but then performing an open surgery was decided because of the unsuccessful reduction. It was understood that the femoral head tore the posterior labrum and passed out by penetrating the posterior capsule causing the buttonhole phenomenon; therefore, closed reduction was not accomplished. Irreducible traumatic hip dislocations are rare cases in the literature. The buttonhole phenomenon should be considered unless closed reduction can be achieved, and open surgical methods should be preferred.

Phacoemulsification in modern ophthalmic surgery is the gold standard for the treatment of lens pathology. However, extensive damage to the ligamentous apparatus makes phacoemulsification more difficult, and, according to some surgeons, forces them to abandon this method of surgical treatment. In case of lens dislocation into the posterior vitreous body, there is virtually no alternative to vitreectomy with the introduction of a perfluoroorganic compound and subsequent phacoemulsification from the anterior segment of the eyeball. This requires a certain level of qualification from the surgeon and also entails risks of postoperative complications such as hemophthalmos, secondary glaucoma, partial atrophy of the optic nerve, and others. However, in case of lens dislocations in the anterior parts of the vitreous body, surgical treatment is possible without performing posterior closed subtotal vitreectomy and the introduction of perfluoroorganic compound. We analyzed 2 clinical cases of traumatic dislocation of the lens into the anterior vitreous body, treated at the ophthalmology department of the V. I. Voynov Regional Clinical Hospital. During the surgical treatment, posterior closed subtotal vitreectomy was not used, perfluoroorganic compounds were not administered, and high functional results were achieved on the first day after the operation. In addition, the capsular bag is preserved, which functions as a natural anatomical barrier between the anterior and posterior segments of the eyeball. Based on this, we can conclude that the method of phacoemulsification of the lens dislocated into the anterior parts of the vitreous body has proven its effectiveness and can be an alternative to more radical methods of surgical treatment of this pathology. Keywords: dislocated lens, phacoemulsification, vitrectomy

Comparative efficacy of latissimus dorsi and teres major vs. pectoralis major tendon transfers combined with Exactech Equinoxe reverse total shoulder arthroplasty in improving internal rotation: a preliminary result.

ObjectivesAdjacent-level disc degeneration after anterior cervical discectomy and fusion (ACDF) is established in degenerative cervical disease. Plate-to-disc distance (PDD) <5 mm is a known cause of this complication. Our aim was to assess the likelihood of disc degeneration of adjacent levels in patients with traumatic fracture dislocation within two years of surgery.MethodsWe retrospectively reviewed scans of patients who underwent ACDF surgery using an anterior plate for fracture dislocation of the cervical spine in the Royal London Hospital, London, UK. ACDF for indications other than trauma and fusions without an anterior plate were excluded. The distance between the edges of the plate and the superior and inferior intervertebral discs was measured on scans before and after surgery, with six months to two years of follow-up. Degeneration of the adjacent intervertebral discs was assumed if there was a difference in height equal to or greater than 30% and signs of ossification.ResultsTwenty-five patients with 50 discs were included. We investigated a PDD cutoff of 5 mm. Adjacent discs with PDD >5 mm were in group A (n = 14) while those with PDD <5 mm were in group B (n = 36). The mean age was 38 and 43 years, respectively. There was significantly lower incidence of radiological evidence of disc degeneration in group A compared to group B (43.24% vs. 15.38%; p = 0.03). More patients had PDD <5 mm in cephalad adjacent discs compared to caudal adjacent discs (84.62% vs. 58.33%; p = 0.03). No significant difference was found comparing the proportion of caudal and cephalad adjacent discs that underwent degeneration (37.50% vs. 34.62%; p = 0.41). We further analysed the impact of different PDD cutoffs, varying from 2 mm to 6 mm, and found that a PDD of at least 4 mm significantly decreases the likelihood of adjacent disc degeneration (p = 0.03).ConculsionThere was a significant increase in adjacent disc degeneration in patients undergoing ACDF when PDD was <5 mm. There was no difference in patient outcome between patients with two discs <5 mm away from the plate or patients with only one. A PDD of at least 4 mm decreased the likelihood of adjacent disc degeneration.