DOCSLIB.ORG

STABILISATION of POSTERIOR STERNOCLAVICULAR Clinical Anatomy.2002.15.139-142 Repaired in Childhood Have Been Reported As Associated 5

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
STABILISATION of POSTERIOR STERNOCLAVICULAR Clinical Anatomy.2002.15.139-142 Repaired in Childhood Have Been Reported As Associated 5 East African Orthopaedic Journal Original article East African Orthopaedic Journal be marvelous. This case displayed associated congenital 4. Boon JM: Potgieter D: Van Jaarsveld Z et al. Congential anomalies. The congenital cleft lip and palate that were Undescended Scapula (Sprengel Deformity): A case study. STABILISATION OF POSTERIOR STERNOCLAVICULAR Clinical Anatomy.2002.15.139-142 repaired in childhood have been reported as associated 5. Dilli A, Ayaz, U. Y., Damar, C., et al. Sprengel Deformity: JOINT DISLOCATION USING PALMARIS LONGUS TENDON before(4).The utilized modalities of investigating this Magnetic Resonance Imaging Findings in two Pediatric AUTOGRAFT: A CASE REPORT case were plain X-rays and a 3D CT scan. The information Cases. Journal of Clinical Imaging Sci. 2011. 1. 1. 17-20 6. Cavendish, M. E. Congenital Elevation of the Scapula. J. obtained from these was deemed adequate for the V.M. Mutiso*, MBChB(UON), MMed(Surg) (UON), Fellow (arthroscopy and arthroplasty) (UK), Fellow AO-International (Ger), Bone joint Surg. Br. 1972. 54B. 3.395-408 V. M. Mutiso*, Department of Orthopaedic Surgery, College of Health Sciences, University of Nairobi, (P.O. Box FCS (ecsa), Department of Orthopaedic Surgery, College of Health Sciences, University of Nairobi, P.O. Box 19681 - 00202, treatment planning of this case. No new information 7. Green, W. T. The surgical correction of congenital elevation Nairobi,19681 – Kenya 00202, and Nairobi, J. Chigumbura, Kenya and MBChB J. Chigumbura (UK), GPST1 (UK), GPST1 - University – University Hospital Hospital of North of Stanffordshire, North Stafford UK shire, UK would have been availed by conducting an MRI of the scapula (Sprengel’s deformity). Journal of Bone and Joint Surgery AM. 1957. 39A. 6.1439. examination. Muscle anomalies have been documented Correspondence to: to: Dr. Dr. V.M. V. Mutiso, M. Mutiso, P.O. Box P.O. 19681 Box 19681- 00202, – Nairobi, 00202, Kenya.Nairobi, Email: Kenya. [email protected] Email: [email protected] 8. Grogan, D. P., Stanley, E. A. and Bobechko, W. P. The as part of the sprengel deformity but no mention of Congenital undescended scapula. Journal of Bone and *At the time of writing Dr. Mutiso was a Clinical Fellow ( Arthroplasty and Arthroscopy) in the Musculoskeletal the supraspinatus and infraspinatus atrophy noted in joint Surgery.Br.1983. 65B. 5. 598-605. Directorate of the University Hospital of North Staffordshire, UK. this case exists so far in the literature. The observed 9. Ross, D. M. and Cruess, R. L. The Surgical Correction of Congenital Elevation of the Scapula. Clinical Orthopaedics atrophy of the supraspinatus and infraspinatus Related Research.1977.125.17-23. would no doubt have a big role in determining the 10. Cho, T. J., Choi, I. H., Chung, C. Y., et al. The Sprengel SUMMARYABSTRACT postoperative outcome and gains of surgery. The choice deformity: Morphometric analysis using 3D-CT and its clinical relevance. Journal of Bone and Joint Surgery.Br. of the Woodwards procedure as treatment for this case Posterior sternoclavicular joint dislocation is a rare injury. It is usually sustained acutely in activities 2000. 82B. 5. 711-718 such as contact sports eg. rugby and motorcycle accidents. Plain radiography of the chest will often was arrived at by guidance from the literature as we 11. Petrie, J. G. Congenital elevation of the scapula. Journal miss the diagnosis and confirmation is by CT scans. However CT scans are often reported to miss of Bone and Joint Surgery-BR. 1973. 55B. 441 had no prior experience with Sprengel’s deformity. In epiphyseal injuries. Management is by closed reduction and if the injury is unstable, by open reduction line with the practice of other surgeons, we are likely 12. Le Saout, J. Congenital elevation of the scapula (Sprengel’s deformity) In Professor Jacques Duparc (Ed) EFORT and stabilisation. A case is reported where palmaris longus tendon was used to stabilise the joint to offer future patients the same basic procedure, with Surgical Techniques In Orthopaedics and Traumatology. following open reduction. modifications as the experience enlightens us. What Elsevier 2003. pg 55-210-C-10 we are left wondering is why the shoulder deformity 13. Leibovic, S. J., Ehrlich, M. E. and Zaleske, D. J. Sprengel INTRODUCTION CASE REPORT deformity. Journal of Bone and Joint Surgery.Am. 1990. was not addressed in childhood at the time of the cleft 72A. 2. 192-197 PosteriorINTRODUCTION Sternoclavicular joint dislocation is a relatively CASEA 19 year oldREPORT female was admitted with a history of injury lip and cleft palate repair. A similar scenario has been 14. Doita, M., Lio, H. and Mizuno, K. Surgical Management whilst playing with her friend. During the course of the rarePosterior injury sternoclavicular and is reported to joint have dislocation been first isdocumented a relatively reported before from Japan (14). Had the Sprengel of Sprengel’s Deformity in Adults. Clinical Orthopaedics A19game year he oldreportedly female waspulled admitted on her with right a forearmhistory ofwith in- byrare Sir injury Astley and Cooper is reported in 1824 to have (1, 2). been It is first a potentially documented life Related Research. 2000. 371. 119-124. jurythe arm whilst at approximatelyplaying with her 90 friend. degrees During of elevation the course and deformity been repaired in childhood it is possible the by Sir Astley Cooper in 1824 (1,2). It is a potentially 15. Carson, W. G., Lovell, W. W. and Whitesides, T. E. Congenital threatening injury due to the anatomical structures of45 thedegrees game of she adduction. reportedly She pulledwas upright on her at rightthe time. the outcome would have been better then. Earlier in the Elevation of the Scapula. Journal of Bone and Joint Surgery. life threatening injury due to the anatomical structures that lie immediately behind the joint in the thoracic armShe weighedat approximately approximately 90 degrees nine stoneof elevation and her and friend 45 postoperative period there were indications that the AM. 1981. 63A. 8. 1199-1207. that lie immediately behind the joint in the thoracic cavity. These include the great retrosternal vascular degreeswas of approximately of adduction. the She same was weight. upright She at feltthe rather time. 16. Siu, K. K., Ko, J. Y., Huang, C. C., et al. Woodward Procedure cavity. These include the great retrosternal vascular range of shoulder movement had improved. As of the Shethan weighed heard a ripping approximately sound closely nine stone followed and by her intense friend Improves Shoulder Function In Sprengel Deformity. Chang structures as well as thethe trachea,trachea, oesophagusoesophagus andand last review, the patient did not have an unsightly scar Gung Medical Journal. 2011. 34. 4. 403-408 waspain ofin approximatelythe region of her the right same sternoclavicular weight. She felt joint rath of- neural structures.structures. ComplicationsComplications includeinclude respiratory but there still persisted a disparity of the levels of the 17. Ahmad, A. A. Surgical Correction of Severe Sprengel erher than chest heard wall. She a ripping went to sound the accident closely andfollowed emergency by in- compromise, haemothorax, haemothorax, pneumothorax, pneumothorax, dysphagia, dyspha- deformity to allow greater postoperative range of tensedepartment pain in of the the region hospital of herwhere right chest sternoclavicular X-rays were scapulae. gia, brachial plexopathy and even death (3-5). Shoulder abduction. Journal of Paediatric Orthopaedics. brachial plexopathy and even death (3-5). jointdone ofand her some chest oral wall. analgesics She went administered. to the accident She wasand The capsule surrounding the joint is weakest 2010. 30. 6. 575-581 The capsule surrounding the joint is weakest emergencysubsequently department referred to ofthe the fracture hospital clinic where for review chest inferioriy with the other surfaces reinforced by REFERENCES 18. Borges, J. L., Shah, A., Torres, B. C., et al. Modified Woodward inferiorly with the other surfaces reinforced by the X-raysand follow were up. done and some oral analgesics adminis- procedure for Sprengel deformity of the Shoulder: Long the interclavicular, anterior and posterior sternocla- tered. SheOn reviewwas subsequently at the clinic referred there was to theno obviousfracture –term results. J. Paed. Orthopaed. 1996. 16. 508-513 interclavicular,vicular and costoclavicular anterior and posteriorligaments. sternoclavicular The posterior 1. DePalma, Anthony F. Surgery of the shoulder. 3rd Edition. clinicchest forbruising review or and deformity follow up. at the sternoclavicular 19. Gonen, E., Simsek, U., Solak, S., et al. Long-Term Results andsternociavicular costoclavicular joint capsule ligaments.The is the most posteriorimportant J.B.lippincott. Philadelphia. 1983.pg 24-25. joint.On It wasreview however at the tender clinic on there palpation. was Theno armobvious had 2. Tachdjian MO. Congenital High Scapula (Sprengel’s of Modified Green Method in Sprengel’s Deformity. J. sternoclavicularstructure for preventing joint capsule both isanterior the most and important posterior Children Orthopaedics. 2010. 4. 309-314. chestgood circulationbruising or and deformity was neurologically at the sternoclavicular intact. Active Deformity). In Tachdjians Paediatric Orthopaedics. Vol translation of the stenoclavicuiar joint with the ante- structure for preventing both anterior and posterior joint.movement It was of however the limb tenderwas however on palpation. restricted
Load more

Recommended publications
  • Sports Medicine Examination Outline
    Sports Medicine Examination Content I. ROLE OF THE TEAM PHYSICIAN 1% A. Ethics B. Medical-Legal 1. Physician responsibility 2. Physician liability 3. Preparticipation clearance 4. Return to play 5. Waiver of liability C. Administrative Responsibilities II. BASIC SCIENCE OF SPORTS 16% A. Exercise Physiology 1. Training Response/Physical Conditioning a.Aerobic b. Anaerobic c. Resistance d. Flexibility 2. Environmental a. Heat b.Cold c. Altitude d.Recreational diving (scuba) 3. Muscle a. Contraction b. Lactate kinetics c. Delayed onset muscle soreness d. Fiber types 4. Neuroendocrine 5. Respiratory 6. Circulatory 7. Special populations a. Children b. Elderly c. Athletes with chronic disease d. Disabled athletes B. Anatomy 1. Head/Neck a.Bone b. Soft tissue c. Innervation d. Vascular 2. Chest/Abdomen a.Bone b. Soft tissue c. Innervation d. Vascular 3. Back a.Bone b. Soft tissue c. Innervation 1 d. Vascular 4. Shoulder/Upper arm a. Bone b. Soft tissue c. Innervation d. Vascular 5. Elbow/Forearm a. Bone b. Soft tissue c. Innervation d. Vascular 6. Hand/Wrist a. Bone b. Soft tissue c. Innervation d. Vascular 7. Hip/Pelvis/Thigh a. Bone b. Soft tissue c. Innervation d. Vascular 8. Knee a. Bone b. Soft tissue c. Innervation d. Vascular 9. Lower Leg/Foot/Ankle a. Bone b. Soft tissue c. Innervation d. Vascular 10. Immature Skeleton a. Physes b. Apophyses C. Biomechanics 1. Throwing/Overhead activities 2. Swimming 3. Gait/Running 4. Cycling 5. Jumping activities 6. Joint kinematics D. Pharmacology 1. Therapeutic Drugs a. Analgesics b. Antibiotics c. Antidiabetic agents d. Antihypertensives e.
    [Show full text]
  • Surgical Treatment of Traumatic Cervical Facet Dislocation
    DOI: 10.1590/0004-282X20160078 VIEW AND REVIEW Surgical treatment of traumatic cervical facet dislocation: anterior, posterior or combined approaches? Deslocamentos facetários cervicais traumáticos: abordagem anterior, posterior ou combinada? Catarina C. Lins1, Diego T. Prado2, Andrei F. Joaquim1,3 ABSTRACT Surgical treatment is well accepted for patients with traumatic cervical facet joint dislocations (CFD), but there is uncertainty over which approach is better: anterior, posterior or combined. We performed a systematic literature review to evaluate the indications for anterior and posterior approaches in the management of CFD. Anterior approaches can restore cervical lordosis, and cause less postoperative pain and less wound problems. Posterior approaches are useful for direct reduction of locked facet joints and provide stronger fixation from a biomechanical point of view. Combined approaches can be used in more complex cases. Although both anterior and posterior approaches can be used interchangeably, there are some patients who may benefit from one of them over the other, as discussed in this review. Surgeons who treat cervical spine trauma should be able to perform both procedures as well as combined approaches to adequately manage CFD and improve patients’ final outcomes. Keywords: spine; dislocations; bones fractures; surgery. RESUMO O tratamento dos deslocamentos facetários cervicais traumáticos (DFC) é preferencialmente cirúrgico, conforme a literatura pertinente, mas há dúvidas quanto a melhor forma de abordagem da coluna: anterior, posterior ou combinada. Realizamos revisão sistemática para avaliar as indicações da abordagem anterior e da posterior nos DFC. A abordagem anterior permite restaurar a lordose cervical, com menor dor no pós-operatório e menos problemas relacionados a ferida cirúrgica.
    [Show full text]
  • S41598-020-78754-9.Pdf
    www.nature.com/scientificreports OPEN Acromioclavicular and sternoclavicular joint dislocations indicate severe concomitant thoracic and upper extremity injuries in severely injured patients M. Sinan Bakir1,2*, Rolf Lefering3, Lyubomir Haralambiev1,2, Simon Kim1, Axel Ekkernkamp1,2, Denis Gümbel1,2 & Stefan Schulz‑Drost2,4,5 Preliminary studies show that clavicle fractures (CF) are known as an indicator in the severely injured for overall injury severity that are associated with relevant concomitant injuries in the thorax and upper extremity. In this regard, little data is available for the rarer injuries of the sternoclavicular and acromioclavicular joints (SCJ and ACJ, respectively). Our study will answer whether clavicular joint injuries (CJI), by analogy, have a similar relevance for the severely injured. We performed an analysis from the TraumaRegister DGU (TR‑DGU). The inclusion criterion was an Injury Severity Score (ISS) of at least 16. In the TR‑DGU, the CJI were registered as one entity. The CJI group was compared with the CF and control groups (those without any clavicular injuries). Concomitant injuries were distinguished using the Abbreviated Injury Scale according to their severity. The inclusion criteria were met by n = 114,595 patients. In the case of CJI, n = 1228 patients (1.1%) were found to be less severely injured than the controls in terms of overall injury severity. Compared to the CF group (n = 12,030; 10.5%) with higher ISS than the controls, CJI cannot be assumed as an indicator for a more severe trauma; however, CF can. Concomitant injuries were more common for severe thoracic and moderate upper extremity injuries than other body parts for CJI.
    [Show full text]
  • Dislocation of the Proximal Tibiofibular Joint, Do Not Miss It
    BMJ Case Reports: first published as 10.1136/bcr-2014-207875 on 1 December 2015. Downloaded from Rare disease CASE REPORT Dislocation of the proximal tibiofibular joint, do not miss it Alexander FY van Wulfften Palthe, Linda Musters, Remko JA Sonnega, Hans A van der Sluijs Department of Orthopaedic SUMMARY TREATMENT Surgery, VU University Medical We present a case of a 45-year-old woman with a right After intra-articular infiltration of anaesthetic in the Center, Amsterdam, fi fi fi The Netherlands proximal tibio bular dislocation she sustained after a fall proximal tibio bular joint, the bular head was during roller skating. Anteroposterior and lateral reduced by direct manipulation in anterior to pos- Correspondence to radiographs confirmed the diagnosis; there were no terior direction with the knee in 90° of flexion. Dr Hans A van der Sluijs, other injuries. The dislocation was reduced by direct A radiograph following reduction showed an [email protected] manipulation after intra-articular infiltration, in our anatomical proximal tibiofibular joint (figure 2). Accepted 4 November 2015 emergency department. The patient was treated with a The patient was discharged with a long leg cast, long, non-weight bearing leg cast for 1 week. After non-weight bearing. 4 weeks, she had no pain and a full range of motion of the knee. OUTCOME AND FOLLOW-UP After 1 week, the cast was removed and the patient started with protected weight bearing. After BACKGROUND 4 weeks, she was able to bear full weight, and had a fi A traumatic dislocation of the proximal tibio bular full range of motion and no pain.
    [Show full text]
  • Download PDF File
    Folia Morphol. Vol. 70, No. 2, pp. 61–67 Copyright © 2011 Via Medica R E V I E W A R T I C L E ISSN 0015–5659 www.fm.viamedica.pl Human ligaments classification: a new proposal G.K. Paraskevas Department of Anatomy, Medical School, Aristotle University of Thessaloniki, Greece [Received 24 January 2011; Accepted 22 March 2011] A high concern exists among physicians about surgically important ligaments such as cruciate and collateral ligaments of the knee, patellar ligament, tibiofibular syndesmosis, collateral ligaments of the ankle, and coracoclavicular ligament. However, the classification of the ligaments is insufficient in the literature, due to their origin from connective tissue. A new classification is proposed, based on various parameters such as the macroscopic and microscopic features, the function and the nature of their attachment areas. (Folia Morphol 2011; 70, 2: 61–67) Key words: ligaments, classification, Nomina Anatomica INTRODUCTION connective tissue surrounding neurovascular bundles There was always some confusion concerning the or ducts as “true ligaments” [4]. classification of ligaments of the human body, presu- The “false ligaments”, could be subdivided in the mably due to their origin from the connective tissue following categories: that is considered a low quality tissue compared to oth- a) Splachnic ligaments, which are further subdivid- ers. Moreover, orthopaedists are focused only on surgi- ed into “peritoneal” (e.g. phrenocolic ligament), cally important ligaments. For these reasons there is an “pericardiac” (e.g. sternopericardial ligaments), absence of a well-designated classification system that “pleural” (e.g. suprapleural membrane), and subdivides the ligaments into subgroups according to “pure splachnic ligaments” (e.g.
    [Show full text]
  • Enostosis of Clavicle Causing Severe Dyspnea by Compressing the Trachea Externally: Case Report
    Case Report DOI: 10.14235/bas.galenos.2018.2211 Bezmialem Science 2019;7(2):167-9 Enostosis of Clavicle Causing Severe Dyspnea by Compressing the Trachea Externally: Case Report Osman Cemil AKDEMİR1, Abdülaziz KÖK1, Sedat ZİYADE1, Nuh Mehmet ELMADAĞ2, Erkan ÇAKIR3, Mehmet BİLGİN4, Ömer SOYSAL1, Nur BÜYÜKPINARBAŞLI5 1Bezmialem Vakıf University Faculty of Medicine, Deparment of Thoracic Surgery, İstanbul, Turkey 2Bezmialem Vakıf University Faculty of Medicine, Department of Orthopedics, İstanbul, Turkey 3Bezmialem Vakıf University Faculty of Medicine, Deparment of Child Chest Diseases, İstanbul, Turkey 4Bezmialem Vakıf University Faculty of Medicine, Deparment of Radiological, İstanbul, Turkey 5Bezmialem Vakıf University Faculty of Medicine, Deparment of Pathology, İstanbul, Turkey ABSTRACT Clavicle is the bone that forms anterior border of shoulder arch. It lies on anterosuperior of thorax with first rib. Clavicle is very near to major vascular structures, brachial plexus, esophagus and trachea at thoracic inlet. Because of this, clavicular lesions fractures and sternoclavicular dislocations -especially posterior dislocations- may cause symptoms due to compressing symptoms due to these structures. In this article we present a case with enostosis of clavicle causing respiratory failure by compressing on trachea. Keywords: Clavicle, enostosis, repiratory failure Introduction she was hospitalized in intensive care unit because of occurrence Clavicle is the bone that forms anterior border of shoulder arch. of respiratory failure after a caughing crisis. Flexible bronchoscopy It lies on anterosuperior of thorax with first rib (1). At the upper revealed a pulsatile externally compressing lesion on anterior wall thoracic inlet, around sternoclavicular joints area, both of clavicle of trachea (Figure 1). are anotamically near with subclavian arteries and veins, both brachial plexuses esophagus and trachea, both carotid arteries and jugulary veins.
    [Show full text]
  • Bilateral Carpometacarpal Joint Dislocations of the Thumb Changhoon Jeong, MD, Hyoung-Min Kim, MD, Sang-Uk Lee, MD, Il-Jung Park, MD
    Case Report Clinics in Orthopedic Surgery 2012;4:246-248 • http://dx.doi.org/10.4055/cios.2012.4.3.246 Bilateral Carpometacarpal Joint Dislocations of the Thumb Changhoon Jeong, MD, Hyoung-Min Kim, MD, Sang-Uk Lee, MD, Il-Jung Park, MD Department of Orthopaedic Surgery, Bucheon St. Mary’s Hospital, The Catholic University of Korea School of Medicine, Bucheon, Korea A traumatic carpometacarpal joint dislocation of the thumb accounts for less than 1% of all hand injuries. Optimal treatment strategies for this injury are still a subject of debate. In this article, we report a case of bilateral thumb carpometacarpal joint dis- locations: a unique combination of injuries. We believe our case is the second report of bilateral carpometacarpal joint dislocation regarding the thumb in English literature. It was successfully treated with closed reduction and percutaneous K-wires fixation on one side, and an open reduction and reconstruction of the ligament on the other side. Keywords: Bilateral, Carpometacarpal joint, Dislocation, Thumb A carpometacarpal joint (CMCJ) of the thumb is impor- a result of a motorbike accident. At the time of impact, tant for the function of the thumb and in the performance he was firmly grasping the handlebars with both hands. regarding strong pinch and grasp. The dislocation of the A physical examination revealed severe tenderness and CMCJ in the thumb accounts for less than 1% of all hand dorsal prominence at the CMCJ regarding both thumbs. injuries.1) Mechanical instability for the CMCJ of the There were no neurovascular injuries or skin lesions. The thumb is an important factor, which may lead to articu- radiographs showed dorsal dislocation of the CMCJ for lar degeneration of the joint and thus interfere with the both thumbs with a tiny fracture fragment in the right normal function of the hand.
    [Show full text]
  • Degloving and Severe Upper Extremity Injuries in Motor Vehicle Crashes Involving Partial Ejection"
    "Degloving and Severe Upper Extremity Injuries in Motor Vehicle Crashes Involving Partial Ejection" Seattle CIREN University of Washington, Harborview Medical Center, Seattle WA Kaufman R., Blanar L., Bulger E. –Seattle CIREN, UW, HMC Lipira A., Friedrickson J. – Harborview Medical Center Mastrioanni S., Nelson M. –Seattle CIREN Upper Extremity (UE) Partial Ejection in Motor Vehicle Crashes (MVC) • Noted as an ‘arm‐ or hand‐out‐ window’ phenomenon • Upper extremity partial ejection in MVCs can result in contact to exterior objects, including the ground in rollovers, which can result in severe degloving type injuries • These severe injuries result in devastating and long‐lasting consequences J Trauma Acute Care Surg. 2013 Feb;74(2):687‐91. Vehicle factors and outcomes associated with hand‐out‐window motor vehicle collisions. Bakker A1, Moseley J, Friedrich J. Partial Ejection Mitigation • Seatbelts are 99.8% effective at preventing complete ejections, but only 38% effective in preventing partial ejections in rollover crashes • Side‐curtain airbags (SABs) can reduced and mitigated risk of partial ejection • BUT, most partial ejection research focuses on head or thoracic injuries • Partial ejection of the upper extremity (UE) remains a highly morbid mechanism of upper extremity injury in motor vehicle collisions References: 1. Bakker, A., Moseley, J. & Friedrich, J. Vehicle factors and outcomes associated with hand‐out‐window motor vehicle collisions. Journal of Trauma and Acute Care Surgery 74, 687–691 (2013). 2. Ball, C. G., Rozycki, G. S. & Feliciano, D. V. Upper Extremity Amputations After Motor Vehicle Rollovers. The Journal of Trauma: Injury, Infection, and Critical Care 67, 410–412 (2009). 3. Nikitins, M.
    [Show full text]
  • Both-Bone Forearm Fracture with Distal Radioulnar Joint Dislocation
    A Case Report & Literature Review Both-Bone Forearm Fracture With Distal Radioulnar Joint Dislocation Michael K. Ryan, MD, Brendan J. MacKay, MD, and Nirmal C. Tejwani, MD and a concomitant ipsilateral DRUJ dislocation, and we review Abstract the literature on this uncommon injury pattern. Both-bone forearm fractures, also known as The patient provided written informed consent for print concomitant diaphyseal radius and ulna frac- and electronic publication of this case report. tures, and distal radioulnar joint (DRUJ) disloca- tions are each uncommon injuries in adult upper Case Report extremity trauma. DRUJ dislocations are more A 38-year-old man with no past medical history presented to often associated with radial shaft (Galeazzi) the emergency department after being thrown from a motor- fractures. In this article, we report the case of cycle. On arrival, he reported bilateral upper extremity pain. a patient who sustained a both-bone forearm Physical examination revealed closed deformities of the left fracture and DRUJ dislocation, and we review forearm and right wrist. Radiographs of the left upper extrem- the literature on this unique injury pattern. ity showed mid-diaphyseal radius and ulna fractures and a DRUJ dislocation (Figure 1). Radiographs of the right upper extremity showed a comminuted radial styloid fracture and widening of the scapholunate interval with dorsal interca- iaphyseal forearm fractures are relatively rare in or- lated segment instability deformity of the carpus. Both upper thopedic trauma, accounting for only 0.9% of all frac- extremity injuries were acceptably reduced and splinted. The 1 AJO Dtures. Both-bone forearm fractures, also known as patient also had a left-side subarachnoid hematoma, which concomitant diaphyseal radius and ulna fractures, are even was stable on serial computed tomography without contrast.
    [Show full text]
  • Cervical Spine Injury Guest Lecture Delivered During the International Conference on Cervical Spine Held at NIMHANS on September 12, 1986
    Article NIMHANS Journal Cervical Spine Injury Guest lecture delivered during the international Conference on Cervical Spine held at NIMHANS on September 12, 1986. Volume: 05 Issue: 01 January 1987 Page: 1-12 Phillip Harris, - Department of Surgical Neurology, Western General Hospital, Edinburgh, Scotland There is no doubt that serious injuries to the cervical spine is one of the major and most devastating health care problems that besets man, affecting so many body systems and necessitating the involvement of many public services and medical and other specialists. The patient's whole life may quite suddenly become disrupted, with permanent personal, family and employment problems. Maximal vertebral column deformity and associated neural and vascular damage usually occurs at the time of the injury. The appreciation, organisation and harnessing of proper resources for traumatic tetraplegic patients is indeed a challenge. The study and management of traumatic tetraplegia is a microcosm of the overall scientific and humanitarian progress of man [1], [2], [3], [4], [5], [6]. As noted by Edwin Smith in the medical writings of the Egyptians some 6,000 years ago, there is a phrase concerning spinal cord injuries: "an ailment not to be treated". This was understandable, because death was the immediate or the early outcome of such injuries - how times have changed! My aim today is to highlight some of the current medical aspects of patients with severe cervical spinal injury. Our interest and responsibility is firstly to try to prevent such injuries from occurring, but having occurred, to ensure that the patient is expertly managed, and this includes maintaining the cervical spinal cord, nerves and vessels in an optimal environment to allow neurological functions to recover maximally, to prevent complications and to permit the best possible future life for the patient.
    [Show full text]
  • Spinal Cord Injury and Compression
    Page 1 of 10 View this article online at: patient.info/doctor/spinal-cord-injury-and-compression Spinal Cord Injury and Compression See also the separate article on Whiplash and Cervical Spine Injury. Acute spinal cord compression is a neurosurgical emergency. Rapid diagnosis and management are essential to have the highest chances of preventing permanent loss of function. The spinal cord extends from the base of the skull and terminates near the lower margin of the L1 vertebral body. Below L1, the spinal canal contains the lumbar, sacral and coccygeal spinal nerves that comprise the cauda equina. Therefore, injuries below L1 involve the segmental spinal nerves and/or cauda equina. Injuries above the termination of the spinal cord at L1 often involve both spinal cord lesions and segmental root or spinal nerve injuries. The incidence of traumatic spinal cord injury in Western Europe is about 16 per million.[1] Spinal cord injury in children is relatively rare.[2] A traumatic spinal cord injury is a lesion of neural elements of the spinal cord that can result in any degree of sensory and motor deficit, and autonomic or bowel dysfunction.[3] Spinal cord injuries may be primary or secondary: Primary injuries arise from a variety of mechanisms, including mechanical disruption, transection, penetrating injuries due to bullets or weapons, vertebral fracture/subluxation or displaced bony fragments causing penetrating spinal cord and/or segmental spinal nerve injuries. The primary traumatic impact initiates vascular and chemical processes leading to oedema and ischaemia which can lead to secondary injuries. Further cord insult can occur through subsequent inappropriate manual handling following trauma.
    [Show full text]
  • UL-Shoulder Girdle Movement
    Movements of Shoulder Girdle •Consists of bones that connects upper limb to axial skeleton. •Bones of pectoral girdle are: •Clavicle •Scapula •Joints of pectoral girdle are: •Sternoclavicular Joint. •Acromioclavicular joint. •Only one small joint: Sternoclavicular connects the pectoral girdle to axial skeleton. •Two bones Clavicle and Scapula are joined to one another by even smaller joint: Acromioclavicular •Remaining attachment is purely muscular •Account for greater mobility of shoulder girdle •Function of pectoral girdle is to provide mobility on the thorax to enhance mobility of shoulder joint. •Except during slight movements of shoulder joints, all movements of shoulder joints are accompanied by movement of clavicle and scapula. •Shoulder joint, acromioclavicular and sternoclavicular joint moves together in harmony to provide thoraco-humeral articulation. Brief anatomy of joints of pectoral girdle Sternoclavicular Joint •Saddle type of synovial joint. •Articulation between sternal end of clavicle, clavicular notch of manubrium sterni and upper surface of first costal cartilage. • Clavicular surface is more extensive. • It is covered by fibrocartilage and not by usual hyaline cartilage. • Atypical synovial variety. • Clavicular surface is convex from above downward and concave from before backward. • Articular surface of sternal end is set at an angle of 45 degrees with transverse line. • Notch on manubrium sterni is either plane or convex. • Notch on manubrium sterni and costal cartilage are continuous articular surface covered by fibrocartilage. Ligaments of the joint •Capsular ligament •Anterior and Posterior sternoclavicular ligament. •Articular disc. •Interclavicular ligament. Capsular ligament • Capsular ligament is attached to peripheral margin of the articulating bones. It is thickened in front and behind to form anterior and posterior sternoclavicular ligaments respectively.
    [Show full text]