While clavicular injuries are fairly common, bipolar clavicular injuries are not. They may involve dislocations at both ends of the clavicle, or a fracture at one end and a dislocation at the other. We present two cases; a patient with a bipolar clavicular dislocation, and another with a fracture in both medial and lateral ends of the clavicle with anterior dislocation of the sternoclavicular joint. Both were treated conservatively, with fairly good range of motion and return to normal activity.
Accidental Falls ; Accidents, Traffic ; Clavicle/*injuries ; Clavicle/radiography ; Dislocations/radiography ; Dislocations/*therapy

Prompt and accurate diagnosis of cervical spine injury is important to prevent the catastrophic results that can be caused by undetected lesions. Delayed or missed diagnosis of cervical spine injury occurs with an incidence of 5 to 20% according to previous studies. In this study, we report four cases of cervical instability without initial radiologic evidence. These cases demonstrate that dynamic flexion and extension radiographies can be a proper choice of modality to diagnose and exclude the possibility of cervical instability in a patient with a suspicious ligament injury on the static radiographies following acute cervical trauma.
Cervical Vertebrae ; Diagnosis* ; Dislocations ; Female ; Humans ; Incidence ; Ligaments ; Radiography ; Spine

Posterior shoulder dislocation is a relatively uncommon event, with an incidence of 1~4% of all shoulder dislocations. Because this condition is rare and because accurately interpreting the radiography is difficult, the diagnosis is often missed. In such a case, significant complications, such as chronic posterior dislocation and degenerative disease of the shoulder, can occur. We experienced the case of a patient in whom bilateral posterior shoulder dislocation occurred following an accidental fall a height of 10m. Fortunately, he had no neurovascular injury of the shoulder and fully recovered after closed reduction, but early diagnosis was missed because other injuries were significant and his vital signs were unstable. A careful history and physical examination, complete radiographic evaluation, and a high level of suspicion are required to identify posterior shoulder dislocation. This case may be helpful for diagnosis of posterior shoulder dislocation.
Accidental Falls* ; Diagnosis ; Dislocations ; Early Diagnosis ; Humans ; Incidence ; Physical Examination ; Radiography ; Shoulder Dislocation* ; Shoulder* ; Vital Signs

Secondary osteoarthritis of hip joints is a common disease and is frequently followed by chronic sublexation and dislocation. Twenty four case of the secondary osteoarthritis associated with chronic subluxation and dislocation of the hip joints were evaluated with plain radiography and computed tomography. We retrospectively analyzed 1) the ossification and calcification of the acetabular labrum, 2) the thickeness of the quadrilateral plate of the ilium, and 3) anteroposterior diameter of the acetabulum. The changes of the hip joints in subluxation (n=14) revealed ossification of the acetabular labrum in 12 cases (86%), thickening of the quadrilateral plate of the ilium in 11 cases (78%) but anteroposterior diameter of the acetabulum was not changed. The changes of the hip joints in dislocation (n=10) revealed no evidence of the ossification of the acetabular labrum, thickening of the quadrilateral plate of the ilium in 10 cases (100%) and decreased anteroposterior diameter of the acetabulum. We conclude that CT findings of subluxation and dislocation of the hip joints can be helpful in the evaluation of the secondary osteoarthritis of the hip joints.
Acetabulum ; Dislocations* ; Hip Joint* ; Hip* ; Ilium ; Joints ; Osteoarthritis ; Osteoarthritis, Hip ; Radiography ; Retrospective Studies

Lunate and perilunate dislocations are uncommon, but they have clinical importance because complications, such as median neuropathy and avascular necrosis of the lunate, can occur. Although early diagnosis enabling early surgical treatment is crucial for preventing long-term sequelae, these dislocations are frequently missed in the initial assessment. Imaging tools, such as plain radiography, magnetic resonance imaging, ultrasonography, and electrodiagnostic studies, have been used for diagnosis. The proper choice of initial evaluation tools is important for making an accurate early diagnosis. Here we present a case of lunate dislocation associated with median neuropathy in which ultrasonography, along with the electrodiagnostic study and plain radiography, played an important diagnostic role in detecting structural abnormalities. This case report reveals the complementary diagnostic role of ultrasonography in initial assessment and provides ultrasonographic images of lunate dislocation as a cause of median neuropathy.
Diagnosis ; Dislocations* ; Early Diagnosis ; Lunate Bone ; Magnetic Resonance Imaging ; Median Neuropathy* ; Necrosis ; Radiography ; Ultrasonography*

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

Finger Joint ; diagnostic imaging ; pathology ; Humans ; Joint Dislocations ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Radiography

PURPOSE: To establish modality of diagnosis and treatment in pisiform injuries by analysis of its clinical experiences. Materials & Methods : Twelve fractures and one dislocation of the pisiform that were followed up for more than twelve months were reviewed retrospectively. RESULTS: Eight cases had associated injuries on the wrist or hand of ipsilateral side. Eight cases were diagnosed by routine radiography and three cases required additional special radiography such as the supinated oblique view or carpal tunnel view. One case was diagnosed by computed tomography. Cast immobilization was performed in nine cases and three cases underwent internal fixation. Pisiform was excised in one chronic dislocation case. The results were usually satisfactory but two cases showed pisotriquetral arthritis and one of them underwent excision of pisiform. CONCLUSION: The diagnosis of pisiform injury may accompany some difficulties due to associated carpal injuries. Routine radiography is sufficient for the screening of it if attention is paid and specific radiography such as supinated oblique view or carpal tunnel view may be very useful for confirmation. As conservative treatment alone shows good result, operative fixation is recommended for limited cases. The excision of pisiform is required in case of pisotriquetral arthritis or neglected chronic dislocation.
Arthritis ; Diagnosis* ; Dislocations ; Hand ; Immobilization ; Mass Screening ; Radiography ; Retrospective Studies ; Wrist

PURPOSE: The purpose of this study was to evaluate diagnostic criteria using plain lateral radiography, the incidence of traumatic disc herniation and the degree of neurologic deficit in extension injury of the lower cervical spine. MATERIALS AND METHODS: We analyzed 28 patients with extension injury of the lower cervical spine, by measuring the retropharyngeal, retrotracheal space and the intervertebral space at the injured level in plain lateral radiography. We selected 40 patients as a control group for the prevertebral soft tissue space measurement. RESULTS: Widening was found in the retropharyngeal space (6.8 +/-2.9 mm) and in the retrotracheal space (15.2 +/-3.8 mm) compared with the control group (4.2 +/-0.7 mm, 12.6 +/-1.9 mm, p<0.05). No significant increase in the injured intervertebral space was observed with respect to the normal upper and lower disc space. Neurologic deficit occurred in 25 cases (89%); with root injury in 11 cases and cord injury in 14 cases. There were 19 posterior disc herniations (68%), which were associated with neurologic deficits in all cases. CONCLUSION: Extension injuries should be suspected in the presence of soft tissue injury of the anterior column without fracture or dislocation by the radiologic study of the lower cervical spine. Magnetic resonance imaging study is believed to be an essential diagnostic modality for the accurate evaluation and proper management of the lower cervical spine injuries.
Diagnosis* ; Dislocations ; Humans ; Incidence ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Radiography ; Soft Tissue Injuries ; Spine*

PURPOSE: To confirm the effect of the frog leg lateral radiographs for determining the clinical indication of total hip arthroplasty for high riding dislocation and to discuss its theoretical background. MATERIALS AND METHODS: A consequent series of reconstructive THA were studied in 28 recent tuberculous hips. Twenty-three hips (17patients) with developmental dysplastic hip were compared. Preoperatively, frog-leg lateral radiographs were performed in all the patients, which were enhanced using a 2-dimensional computer model to predict the reattachment of the greater trochanter. RESULTS: The modified scores of Merle d'aubigne and Postel improved from a mean of 2.6 points preoperatively to a mean of 5.1 points. Sciatic nerve palsies occurred in three cases. In two cases, they fully recovered, but in one case, it did not. We confirmed that old high dislocation of the hip could be adopted in type 1 and 2 categories of frog leg lateral position. The reconstruction of hip was relatively simple in type 3, however, further study is necessary in type 5 due to unsuitable abduction contracture. CONCLUSION: We confirm that frog leg lateral radiography is effective for determining the operative indication of high riding dislocation. However irreducible frog leg lateral position is absolutely contraindirated for total hip arthroplasty.
Arthroplasty* ; Arthroplasty, Replacement, Hip ; Computer Simulation ; Contracture ; Dislocations* ; Femur ; Hip* ; Humans ; Leg ; Radiography ; Sciatic Neuropathy