Ankle Injuries ; complications ; Compartment Syndromes ; etiology ; Female ; Fractures, Bone ; complications ; Humans ; Joint Dislocations ; complications ; Middle Aged

Various musculoskeletal injuries are well known complications of epilepsy either because of direct trauma or because of unbalanced forceful muscle contraction. We report a case of non-traumatic bilateral central acetabular fracture dislocation due to seizure activity induced by neurocysticercosis of the brain, which was managed conservatively and obtained reasonable good outcome. This case highlights the importance of proper evaluation in young non-osteoporotic patients who have experienced an epileptic attack without any previous history. It is also imperative to mention that these patients should be thoroughly examined neurologically to find out the exact etiology and should be treated accordingly to prevent future seizure activity.
Acetabulum ; anatomy & histology ; injuries ; Fractures, Bone ; complications ; etiology ; Joint Dislocations ; complications ; etiology ; Seizures ; complications

Multiple volar dislocations of carpometacarpal (CMC) joints are uncommon and have been reported rarely. A 25 years old male presented with injury to his left hand 6 days following a road traffic accident. Clinical examination revealed gross swelling of the hand and diffuse tenderness over the carpometacarpal area. His radiographs of the hand showed volar dislocation of the second, third and fourth CMC joints in association with an extra-articular fracture of the base of thumb metacarpal. He was treated by open reduction and percutaneous fixation using Kirschner wires. The functional results were excellent at one year follow-up.
Adult ; Carpometacarpal Joints ; injuries ; Fractures, Bone ; complications ; Humans ; Joint Dislocations ; complications ; Male ; Metacarpal Bones ; injuries

Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been described in English language-based medical literature. Primary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted in good clinical outcome in our patient. At 18 months follow-up, no signs of avascular necrosis of the femoral head or infection were observed.
Accidents, Traffic ; Elbow Joint ; injuries ; Hip Dislocation ; complications ; pathology ; Humans ; Joint Dislocations ; complications ; Male ; Soft Tissue Injuries ; complications ; Young Adult

Fracture dislocation of the navicular bone, fracture of the cuboid, cuneiform, and longitudinal split fracture of the lateral malleolus is a rare combination of fractures. This is a high velocity injury fracture and can be caused by forcible plantar flexion and inversion of the foot at the time of impact onto the ground. Here we reported such a case in a 35-year-old male patient who was treated by open reduction and fixation with a partially threaded screw and two K-wires for the navicular bone, and two interfragmentary screws with a one third tubular plate for the lateral malleolus. K-wires were removed 6 weeks after surgery followed by partial weight bearing. After 6 months, the patient can walk normally with minimal pain and swelling of the foot.
Adult ; Ankle Fractures ; complications ; surgery ; Fractures, Bone ; complications ; surgery ; Humans ; Joint Dislocations ; complications ; surgery ; Male ; Tarsal Bones ; injuries

Retropharyngeal calcific tendinitis is defined as inflammation of the longus colli muscle and is caused by the deposition of calcium hydroxyapatite crystals, which usually involves the superior oblique fibers of the longus colli muscle from C1-3. Diagnosis is usually made by detecting amorphous calcification and prevertebral soft tissue swelling on radiograph, CT or MRI. In this report, we introduce a case of this disease which was misdiagnosed as a retropharyngeal tuberculous abscess, or a muscle strain of the ongus colli muscle. No calcifications were visible along the vertical fibers of the longus colli muscle. The lesion was located anterior to the C4-5 disc, in a rheumatoid arthritis patient with atlantoaxial subluxation. Calcific tendinitis of the longus colli muscle at this location in a rheumatoid arthritis patient has not been reported in the English literature.
Adult ; Arthritis, Rheumatoid/*complications ; Atlanto-Axial Joint/*physiopathology ; Calcinosis/*complications/*diagnosis ; Diagnosis, Differential ; Dislocations/*complications ; Female ; Humans ; *Magnetic Resonance Imaging ; Pharyngeal Diseases/*complications/*diagnosis ; Tendinopathy/*complications/*diagnosis

PURPOSE: To evaluate the clinical outcomes of the surgical treatment in patients with dislocation of an intraocular lens (IOL). METHODS: The present study investigated the postoperative naked visual acuity, corrected visual acuity, astigmatism, and postoperative complications in patients with a minimum follow-up of 1 month after the surgical treatment of a dislocated posterior chamber IOL. RESULTS: The study included 48 eyes of 48 patients (32 males and 16 females) with an age ranging from 33 to 76 years with a mean of 56.7 years at initial visit. The mean time interval from cataract extraction and IOL implantation to dislocation of IOL was 4.9 years. The IOL was exchanged in 13 eyes and was repositioned in 35 eyes. The IOL was repositioned without tying in 11 eyes, by scleral fixation with tying inside the eye in 10 eyes, and by scleral fixation with tying outside the eyeball in 14 eyes. The mean naked visual acuity improved from 1.21 +/- 0.70 to 0.70 +/- 0.48 (p = 0.001) and the best corrected visual acuity improved significantly from 0.82 +/- 0.68 to 0.35 +/- 0.30 (p = 0.002). Among the repositioned IOLs managed by IOL repositioning using scleral fixation with tying inside the eye, 4 eyes re-dislocated. These eyes were re-treated for a second time with IOL repositioning and scleral fixation with tying outside the eye. CONCLUSIONS: Surgical management of dislocated IOLs resulted in significant improvement of visual acuity. Scleral fixation with tying inside the eye had a high risk of re-dislocation because of the difficulty in tightly securing the knot.
Astigmatism ; Cataract Extraction ; Dislocations ; Eye ; Follow-Up Studies ; Humans ; Lenses, Intraocular ; Male ; Postoperative Complications ; Visual Acuity

PURPOSE: In previous study, the frequency of osteoarthritis and discomfort were high in ankle fracture-dislocation but detail results about ankle fracture-dislocation has rarely been investigated. In this study, we retrospectively analyze the outcome of the operative treatment of ankle fracture with dislocation for over-2 years follow up. MATERIALS AND METHODS: There were 47 cases of ankle fracture-dislocation in our hospital from March 2007 to May 2010. We investigated 20 patients who underwent operation and were possible for over-2 years follow up. The result was estimated with the direction of dislocation, fracture type, the time of bone union and post-traumatic osteoarthritis with plain radiologic images. In clinical assessment, we statistically evaluated the function and pain through AOFAS score and Olerud & Molander scoring system. RESULTS: By Lauge-Hansen classification, there were 13 cases(65%) of pronation-external rotation and 6 cases(30%) of supination-external rotation, 1 case(5%) of supination-adduction. AOFAS score was 85.5, and Olerud & Molander score was"excellent" in 8 cases, "good" in 5 cases, "fair" in 3 cases and "poor" in 4 cases. Postoperative complications in 4 cases revealed post-traumatic arthritis. All kinds of lateral dislocation of ankle fracture was 15 cases and the most common. Of these, all 3 cases, anterolateral dislocation showed post-traumatic osteoarthritis. CONCLUSION: In ankle fracture-dislocation, post-traumatic osteoarthritis occurred in 4 of 20 patient(20%). Especially, the possibility of post-traumatic osteoarthritis was more in cases of anterolateral or lateral dislocation. So, it must be needed that deliberate examination, for example, preoperative MRI and sufficient explanation to patient. Also, we have to follow up the patients carefully.
Animals ; Ankle ; Arthritis ; Dislocations ; Follow-Up Studies ; Humans ; Osteoarthritis ; Postoperative Complications ; Retrospective Studies

PURPOSE: The purpose of this study was to evaluate the clinical and radiological results of revision total hip arthroplasty using modular distal fixation stems for proximal femoral deficiency. MATERIALS AND METHODS: Forty-five patients (47 hips) were analyzed more than 24 months after revision total hip arthroplasty that used modular distal fixation stems and was performed between 2006 and 2012. There were proximal femoral defects in all cases. Preoperative femoral defect classification revealed Paprosky type II in 31 cases, type IIIA in 7, and type IIIB in 9. The mean duration of follow-up was 53.4 (25-100) months. We evaluated the Harris hip score (HHS), walking ability according to Koval as clinical parameters, stem stability, and stem position change as radiographic parameters. Kaplan-Meier survival analysis was performed. RESULTS: The average HHS improved form 39.5 points to 91.3 points and walking ability also improved in most cases; all patients had stable fixation of the femoral stem. Postoperative complications included 5 cases of infection and 2 cases of dislocation. The survival rate with the end point of re-revision surgery due to infection or dislocation was 86% after 8-year follow-up. CONCLUSION: Cementless revision total hip arthroplasty using modular femoral stems is useful because the stems can be stably fixed on the diaphyseal portion of the femur, which has relatively good bone quality at mid-term follow-up.
Arthroplasty, Replacement, Hip* ; Classification ; Dislocations ; Femur ; Follow-Up Studies ; Hip ; Humans ; Postoperative Complications ; Survival Rate ; Walking

PURPOSE: To report the results of a new technique for intraocular lens scleral fixation of temporary haptic externalization and four-point fixation for enhanced stability. METHODS: Two 10–0 polypropylene strands were fixed at two points 2 mm apart on each haptic of a conventional three-piece intraocular lens, using our previously reported method of temporary haptic externalization after injector implantation. Postoperative refractive outcome and stability were evaluated. RESULTS: Although the intraocular lens was fixed at a total of four points, no intraoperative difficulties were observed during the process. Patients showed successful fixation of the intraocular lens postoperatively. The fixed intraocular lens showed good centering and minimal tilting. When compared to the two-point fixation technique, postoperative astigmatism was significantly smaller in the four-point fixation group (1.80 ± 0.84 vs. 1.00 ± 0.0.50, p = 0.033). Lens-induced astigmatism calculated from subtraction of corneal astigmatism from total astigmatism was also significantly smaller in the four-point fixation group (2.23 ± 0.98 vs.1.17 ± 0.0.70, p = 0.043). No postoperative complications were identified during a mean follow-up period of 14.8 months (range, 10 to 19 months). CONCLUSIONS: By fixing the intraocular lens at two points on each side of the haptics, this method minimizes the tilting of the intraocular lens and thus decreases postoperative lens-induced astigmatism. Also, the possibility of intraocular lens dislocation in the long term might be decreased by this two-point fixation technique.
Aphakia ; Astigmatism ; Cataract ; Dislocations ; Follow-Up Studies ; Humans ; Lens Subluxation ; Lenses, Intraocular ; Methods ; Polypropylenes ; Postoperative Complications