BACKGROUND: Carpometacarpal joint fracture dislocation of the second to fifth finger is a rare hand injury associated with high energy trauma. Due to severe swelling and overlapping of bones on the radiograph of wrist-hand, dislocations are missed. We reported a series of six patients with rare carpometacarpal joint fracture dislocation treated with open reduction. METHODS: We retrospectively studied six cases of carpometacarpal joint fracture dislocation. All patients were treated with open reduction and internal fixation with Kirschner wire. Functional assessment was done with Quick Disabilities of the Arm, Shoulder and Hand score (Quick DASH score) at regular intervals. RESULTS: Average Quick DASH score was improved from 75.76 to 1.9 from 6 weeks to 18 months of duration. Of the six patients, three patients had a Quick DASH score of 0 at the end of 18 months. CONCLUSIONS: Careful hand examination and radiographic assessment is necessary to avoid missed diagnosis of carpometacarpal joint fracture dislocation. Early open reduction and internal fixation lead to excellent recovery of hand function.
Adult ; Carpometacarpal Joints/*injuries/radiography/*surgery ; Dislocations/radiography/*surgery ; Fracture Fixation, Internal ; Fracture Healing ; Hand Injuries/radiography/*surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Adult ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Male ; Metatarsophalangeal Joint ; injuries ; physiopathology ; Radiography ; Range of Motion, Articular

BACKGROUND: In the present study, we aimed to compare clinical and radiographic outcomes between hook plate fixation and coracoclavicular (CC) ligament reconstruction for the treatment of acute unstable acromioclavicular (AC) joint dislocation. METHODS: Forty-two patients who underwent surgery for an unstable acute dislocation of the AC joint were included. We divided them into two groups according to the treatment modality: internal fixation with a hook plate (group I, 24 cases) or CC ligament reconstruction (group II, 18 cases). We evaluated the clinical outcomes using a visual analog scale (VAS) for pain and Constant-Murley score, and assessed the radiographic outcomes based on the reduction and loss of CC distance on preoperative, postoperative, and final follow-up plain radiographs. RESULTS: The mean VAS scores at the final follow-up were 1.6 +/- 1.5 and 1.3 +/- 1.3 in groups I and II, respectively, which were not significantly different. The mean Constant-Murley scores were 90.2 +/- 9.9 and 89.2 +/- 3.5 in groups I and II, respectively, which were also not significantly different. The AC joints were well reduced in both groups, whereas CC distance improved from a mean of 215.7% +/- 50.9% preoperatively to 106.1% +/- 10.2% at the final follow-up in group I, and from 239.9% +/- 59.2% preoperatively to 133.6% +/- 36.7% at the final follow-up in group II. The improvement in group I was significantly superior to that in group II (p < 0.001). Furthermore, subluxation was not observed in any case in group I, but was noted in six cases (33%) in group II. Erosions of the acromion undersurface were observed in 9 cases in group I. CONCLUSIONS: In cases of acute unstable AC joint dislocation, hook plate fixation and CC ligament reconstruction yield comparable satisfactory clinical outcomes. However, radiographic outcomes based on the maintenance of reduction indicate that hook plate fixation is a better treatment option.
Acromioclavicular Joint/injuries/radiography/*surgery ; Acute Disease ; Adult ; Arthroscopy ; Bone Plates ; Dislocations/radiography/*surgery ; Female ; Humans ; Ligaments, Articular/surgery ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo observe the clinical therapeutic effects of sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation.

METHODSFrom June 2010 to June 2012, 7 patients with sternoclavicular joint dislocation were treated with sternoclavicular hook plate fixation. Among the 7 patients, 5 patients were male and 2 patients were female, and the average age was 42.3 years, ranging from 38 to 54 years. The course of the disease ranged from 1 to 4 weeks. All the patients had trauma history. The clinical manifestations included: obvious swelling and pain of sternoclavicular joint, restricted shoulder joint activity. The sternoclavicular joint dislocation was proved by preoperative X-ray and CT. The postoperative curative effect was evaluated according to Rockwood scoring method.

RESULTSAccording to Rockwood scoring method, the excellent results obtained in 6 cases, good in 1. There were no complications such as internal fixation loosening or broken, second dislocation, pain in the sternoclavicular joint, and deformity. The function of shoulder joint was good, and the limb activity was free and no pain appeared.

CONCLUSIONThe sternoclavicular hook plate for the treatment of sternoclavicular joint dislocation has follow advantages: simple procedure, stable fixation, definite therapeutic effects.

Adult ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Radiography ; Sternoclavicular Joint ; injuries ; surgery

OBJECTIVETo investigate the safety and efficacy of close reduction and percutaneous needle fixation for the treatment of anterior dislocation of sternoclavicular joint.

METHODSA retrospective analysis was performed with 6 cases of anterior sternoclavicular dislocation by close reduction and percutaneous needle fixation with Kirschner wire treated from January 2001 to February 2009, including 5 males and 1 female aged from 19 to 45 with an average of 28.8 years old. Among the 6 cases, 4 were on right lateral and 2 were on left lateral. The time from injured to treatment was from 6 hours to 12 days (averaged 4.5 days). The clinical effects were evaluated according to Rockwood scoring and the complications were observed.

RESULTSAll 6 patients were followed-up for 3 to 13 months (averaged 6 months). According to Rockwood scoring,the preoperative score was (7.00 +/- 0.89) points, postoperative score was (13.17 +/- 1.72) points; the results showed excellent in 5 cases and good in 1 case. No local infection, postoperative pain,recurrent dislocation,broken needle, and other complications were observed in this study.

CONCLUSIONThe treatment of anterior sternoclavicular joint dislocation with Kirschner wire minimally invasive fixation is an easy, reliable fixation with less complications.

Adult ; Bone Wires ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Radiography ; Sternoclavicular Joint ; injuries ; surgery

OBJECTIVETo evaluate the feasibility and therapeutic effect of treating sternoclavicular joint dislocation by K-wire and tension band wire fixation, and to improve the safety and stability of this technique.

METHODSThis study consisted of 9 cases, 6 males and 3 females with the mean age of 25 years (range, 9-62 years). The causes were traffic accident in 7 cases, falling in 1 case and fight in 1 case. The duration from injury to operation was 2 hours to 7 days. There were 5 left dislocations and 4 right dislocations; 8 anterior dislocations and 1 posterior dislocation, including one combined with left scapular fracture and one with left olecranon fracture. Open reduction and internal fixation using K-wires and tension band wires were performed to treat dislocations.

RESULTSAll patients were followed up for 6 to 24 months, 10 months on average. According to Rockwood's rating scale on postoperative sternoclavicular joint, 8 cases achieved excellent outcomes with an average score of 13.88, and the rest case achieved a good outcome with the score of 12. Anatomical reduction was obtained in all cases. There were no such postoperative complications as severe infection, injury to blood vessel and nerve, failure of fixation, etc. Patients were all satisfied with the anatomical reduction and functional recovery.

CONCLUSIONSThe technique of K-wire and tension band wire fixation is safe, simple, effective, less invasive and has been successfully used in orthopedic surgery. It is effective in treating sternoclavicular joint dislocation though it has some disadvantages.

Adolescent ; Adult ; Bone Wires ; Child ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Radiography ; Sternoclavicular Joint ; diagnostic imaging ; injuries ; surgery

A 28-year-old man presented with a palmar divergent dislocation of the scaphoid and lunate. He was treated with an open reduction and an internal fixation with two Kirschner's wires after the 25th day of trauma due to a neurological injury. The results were satisfactory after 18 months follow up without any evidence of avascular necrosis and traumatic arthritis of the scaphoid and lunate. The patient had no limitation in motion or intermittent wrist pain. We reported this case with a brief review of relevant literatures.
Adult ; Arthrography ; Bone Wires ; Dislocations/*etiology/radiography/*surgery ; *Fracture Fixation, Internal ; Human ; Male ; *Scaphoid Bone ; *Semilunar Bone ; Tomography, X-Ray Computed ; Wrist Injuries/*complications

OBJECTIVETo analyze the traumatic pathological characteristics of posterolateral dislocation of knee joints and its treatment.

METHODSNine cases of posterolateral dislocation of knee joint, 5 cases of fresh injuries (the fresh injury group) and 4 cases of old injuries ( the old injury group) were reviewed and analyzed. In the fresh injury group 4 cases failed in close reduction due to "buttonholing" through the medial joint, among them 3 cases underwent repair of the damaged ligaments. In the old injury group 2 cases underwent ACL and MCL repair only in acute stage, but re-dislocated. Of the rest 2 cases 1 was associated with peroneal nerve injury and the other was not treated in acute stage. One case was associated with comminuted fracture of the tibial condyle and popliteal artery injury. Open reduction was performed in 3 cases. One case was fixed with 2-crossed pin and another was fixed with one pin through the tibial and femoral condyle and second pin with olecranization fixation. Plaster immobilization for 6-8 weeks respectively was required. In the old injury group in 1 case ACL and PCL repair (Augustine method) and posterolateral structure were performed and olecranization fixation and plaster immobilization for 6 weeks was needed. Arthrodesis of the knee was done for the patient with comminuted fracture of the tibial condyle and popliteal artery injury.

RESULTSAll the cases were followed up for 1-23 years (average 6 years). Knee stability in 4 cases with repair of the ligaments was improved, although PDT showed (+) with different degrees. The results of the patients treated with ligamentous reconstruction were much better than those of the patients without any repair.

CONCLUSIONSWell understanding of the traumatic pathological characteristics, repair of the damaged ligaments, augmentation of olecranization fixation and postoperative immobilization for 6 weeks are the key points of successful treatment.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Knee Injuries ; diagnostic imaging ; surgery ; Knee Joint ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Radiography ; Range of Motion, Articular ; Recovery of Function ; Treatment Outcome

No abstract available.
Acute Disease ; Adult ; Arteriovenous Fistula/diagnosis/*etiology/surgery ; Brachiocephalic Trunk/*injuries/radiography/surgery/ultrasonography ; Brachiocephalic Veins/*injuries/radiography/surgery/ultrasonography ; Dislocations/*surgery ; Echocardiography, Doppler, Color ; Female ; Heart Failure/diagnosis/*etiology ; Humans ; *Iatrogenic Disease ; Orthopedic Procedures/*adverse effects ; Reoperation ; Sternoclavicular Joint/*surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Vascular System Injuries/diagnosis/*etiology/surgery

OBJECTIVETo observe the clinical effects of clavicular hook plate combined with suture anchor in treating type Tossy III chronic acromioclavicular dislocation.

METHODSFrom January 2008 to December 2012,18 patients with type Tossy III chronic acromioclavicular dislocation were treated with clavicular hook plate and suture anchor. There were 12 males and 6 females, aged from 20 to 56 years old with an average of 31.5 years. Ten cases were left dislocation and 8 cases were right dislocation. Operation time was 3 weeks to 4 months after injury with a mean of 1.8 months. Functional exercise was adopted 2 weeks after operation. And Karlsson standard was used to evaluate curative effect.

RESULTSAll patients were followed up for 6 to 24 months with an average of 16 months. According to Karlsson standard, 17 cases were excellent and 1 was poor.

CONCLUSIONClavicular hook plate combined with suture anchor can repair conoid ligament and trapezoid ligament in treating type Tossy III chronic acromioclavicular dislocation, and had advantages of simple operation, less trauma, stable fixation, it can obtain satisfactory effects.

Acromioclavicular Joint ; diagnostic imaging ; injuries ; surgery ; Adult ; Bone Plates ; Female ; Follow-Up Studies ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Radiography ; Suture Anchors ; Treatment Outcome ; Young Adult