Self-expandable metal stents (SEMS) are widely used for the palliative treatment of unresectable malignant biliary obstruction. However, the long-term durability of SEMSs in biliary strictures is not clear. We describe a case of endoscopic removal of spontaneously fractured uncovered biliary SEMS. A 59-year-old woman presented to our institution with a ...

BACKGROUND: Since 1991, the incidence of injuries associated with pneumatic and explosive powered nail guns has steadily been rising due to increasing use of these devices by the untrained consumer. The vast majority of injuries involve the extremities, but injuries have been reported to occur in virtually every area of ...

SUMMARY:: Patients with hypertrophic and oligotrophic nonunion of the femoral diaphysis associated with plate failure can be treated by Ilizarov external fixation without plate removal. Advantages of this technique include a lack of damage to the blood supply and simultaneous deformity correction.

Background: We present a unique case of a cardiac transplant recipient who received an oversized heart. Methods: To allow the chest to accommodate the organ, extensive resection of the bony chest wall was performed. As both pectoralis major myocutaneous flaps and omental transposition were insufficient to cover the wound, a ...

Case report of 3 thoracic spine fracture-dislocations with complete spinal cord section treated by total vertebrectomy-spine shortening through a posterior approach. To assess the usefulness and safety of this surgical technique in the treatment of acute thoracic spine fracture-dislocation. Total vertebrectomy can be used in different nontraumatic disorders. This surgical ...

The purpose of this study was to investigate the histological changes that occur in rat soft and hard tissues after Er,Cr:YSGG laser surgery. Each of 20 rats was submitted to four procedures which were randomly distributed to the right and left sides of the animal: procedure 1 dorsal incision with ...

A definitive diagonosis of vertical root fracture (VRFs) is often a challenging task for clinicians. Two-dimensional periapical radiographs (PRs) may be not helpful in such a diagnosis when the x-ray beam is not parallel to the plane of the fracture line. This report presents a set of 3 cases in ...

The purpose of our study was to investigate whether shoulder taping affects shoulder kinematics in injured and previously injured overhead athletes during a seated throw. Twenty-six overhead college athletes threw a handball three times with and without tape, while seated on a chair. An 8-camera Vicon Motion Capture system recorded ...

Hamatometacarpal fracture-dislocation is a rare injury that consists of a fourth metacarpal fracture and a fifth carpometacarpal joint injury. We present the case of a 21-year-old man with a divergent hamatometacarpal fracture-dislocation that consisted of a combination of dorsal intra-articular fracture-dislocation of the fourth carpometacarpal joint, palmar dislocation of the ...

Injuries of the sternoclavicular joint are rare. Probably these injuries are frequently missed. Distorsion type lesions mostly heal uneventfully. Their diagnosis and treatment may be demanding. Untreated, a dislocation of the sternoclavicular joint and dislocation fractures may lead to considerable discomfort or even a risk for neurovascular damage. This work ...

The purpose of this study was to evaluate the effect of surgical treatment on displaced and dislocated sagittal fractures of the mandibular condyle (SFMC). Twenty-four patients with 28 displaced and dislocated SFMCs were distinguished into type M, type C, and type L fractures according the location of the fracture line. ...

A percutaneous, intramedullary fracture reduction technique for treatment of unstable dorsal fracture-dislocation of the proximal interphalangeal (PIP) joint is described and the clinical and radiological results are reported. We conducted a retrospective clinical follow-up of 16 patients with 18 dorsal fracture-dislocations of the PIP joint. After closed joint reduction, we ...

Fracture-dislocations of the proximal interphalangeal joint are challenging to treat, since it is difficult to achieve both rigid fixation and early joint motion simultaneously. Palmar fracture-dislocations of the proximal interphalangeal joint are less frequent injuries and a small number of treatment methods have been reported. We describe here a patient ...

Traumatic perilunar and elbow dislocation is rarely seen together. There are only a few reported cases in the literature. Limitation of joint movement, deformity and pain are generally the presenting symptoms. A case of perilunar and elbow dislocation without fracture admitted to the emergency department due to a traffic accident ...

Knee dislocations are rare injuries. Posterolateral knee dislocations are only a small subset of them. There is a paucity of literature regarding the management of such neglected cases. We report here, a case of neglected irreducible posterolateral knee dislocation treated with open reduction and isolated posterior cruciate ligament reconstruction followed ...

Traumatic unilateral facet dislocation of the lumbosacral junction without fracture or with non-displaced fractures of adjacent vertebrae is extremely rare. We describe a case of a young male who sustained a unilateral facet dislocation of the lumbosacral junction in a motor vehicle accident. The unusual features of this case include ...

Pure tibiotalar dislocations without associated fracture are rare. The authors report a case of an unusual closed tibiotalar dislocation without fracture involving proximal ascension of the talus. Immediate closed reduction was performed. Repair of the disrupted medial ligament was performed and one syndesmosis screw inserted, followed by 6 weeks of ...

Post-cam dislocation in TKA is a rare complication after posterior stabilized TKA. Four cases of posterior dislocation of the tibia relative to the femur are described in one current posterior stabilized design. Specific design features in one contemporary high flexion TKA design contribute to high dislocation rates.

Fracture in metals is controlled by material behavior around the crack tip where size-dependent plasticity, now widely demonstrated at the micron scale, should play a key role. Here, a physical origin of the controlling length scales in fracture is identified using discrete-dislocation plasticity simulations. Results clearly demonstrate that the spacing ...

We report the first case of isolated stapedial dislocation caused by indirect head trauma, and present imaging and surgical findings in the case of a 25-year-old woman who suffered hearing loss and dizziness after head trauma caused by a traffic accident. The pure tone average was 60 dB, with an ...

Elbow dislocations associated with a medial epicondyle fracture and ulnar nerve palsy are uncommon injuries. We present the case of an 11-year-old girl with an elbow dislocation treated by closed manual reduction. The medial epicondyle fracture was missed initially until she developed an ulnar nerve palsy 2 months later. Intraoperatively ...

A 15 years old girl was found to have isolated trochlea fracture 10 weeks after an injury caused by a fall on her left elbow. Movement of the elbow was severely restricted. Radiographs showed a half moon-shaped and anterosuperiorly displaced osteochondral fragment. Medial approach capsulotomy of the elbow and excision ...

To evaluate risk factors for early dislocation after primary total hip arthroplasty (THA). Records of 175 cases with dislocation during hospitalisation after THA and 651 controls without dislocation were reviewed. Cases and controls were matched for age, gender, body mass index classification, primary diagnosis, cup design, hospital, and year of ...

Dislocations and fracture-dislocations of the scaphoid are rare injuries. When they occur in a volar direction, they may be complicated by median nerve compression. While volar dislocations and fracture-dislocations of the scaphoid presenting late with median nerve compression have been reported, such injuries presenting with acute median nerve compression have ...

Trans-scaphoid perilunate fracture dislocation is a complex carpal dislocation causing marked disruption of the carpal structures. Open treatment has been accepted as standard for this injury. We have used arthroscopically assisted percutaneous screw fixation and bone grafting to treat this injury in four patients. The functional outcome was good. All ...

Posterior dislocation of the clavicle in the sternoclavicular joint is rare, but can result in severe complications caused by secondary damage to the adjacent structures on relocation. We present a case of a 12-year-old boy who sustained a dislocated clavicle while playing football. Against the initial request to perform immediate ...

Trauma can render the elbow unstable via a combination of bone and ligament injuries. Some of these injuries feature subluxation rather than dislocation of the elbow. Effective treatment centers on restoring enough of the bony and ligamentous structures to keep the elbow in joint so that recovery can proceed as ...

Posterior sternoclavicular dislocations are a rare injury, representing <5% of all sternoclavicular dislocations and 1 in 1600 shoulder girdle injuries. Proper imaging with computed tomography and prompt diagnosis are essential steps in preventing potentially lethal complications observed in approximately 3% of all posterior sternoclavicular dislocations. Surgical treatment is necessary if ...

First-time patellar dislocation typically occurs with twisting knee motions, during which the medial ligamentous stabilizers rupture, and the patella strikes against the lateral femoral condyle. The typical injury pattern is a tear of the medial patellofemoral ligament (MPFL) and bone bruises of the patella and the lateral femoral condyle. Additionally, ...

Subtalar dislocation is a significant injury characterised by late complications, including subtalar arthritis. We describe a rare case of irreducible posterior subtalar dislocation due to incarceration of a fracture of the anterior process of the calcaneum in the subtalar joint, and discuss appropriate management.

Transstyloid, transscaphoid, transtriquetral perilunate dislocations are extremely rare carpal dislocations. We report a 24-year-old male who presented with this rare injury pattern four weeks after sustaining trauma. The patient underwent open reduction and internal fixation via dorsal approach. Reduction was assisted by the use of Joshi's Distraction System. Scaphoid fracture ...

BACKGROUND: Little epidemiological research on characteristics of upper extremity injuries resulting from snowboarding has been conducted, particularly in relation to snowboarding stance, falling direction, and the side of the body where the injury occurs. HYPOTHESIS: Snowboarding stance and the direction of the fall may influence the frequency of the side ...

Dislocation of the carpometacarpal joint of the thumb is a rare injury. This is the first report in the literature performing ligamentous reconstruction using suture anchors in a case of severe joint instability after manipulative reduction for dislocation of the first carpometacarpal joint. Our surgical procedure successfully resulted in a ...

Complex elbow instability is a challenging injury even for expert elbow surgeons. The preoperative radiographs should be carefully evaluated to recognize all lesions that may occur in complex elbow instabilities. Recognizing all the possible lesions is critical to achieve an optimal outcome. The most common types of injuries are as ...

We describe a unique C1-C2 lateral dislocation complicating a displaced type II odontoid fracture. We report a 63-year-old female pedestrian involved in a motor vehicle accident who required posterior open reduction and segmental C1-C2 instrumentation and fusion. Radiological examination of the cervical spine demonstrated a lateral dislocation of the atlantoaxial ...

A 17-year-old man fell from a height of 10 m onto his right forefoot and sustained ipsilateral calcaneal, comminuted cuboid, and second, third, and fourth metatarsal neck fractures and first metatarsophalangeal joint open dislocation. This report discusses this rare injury. The authors believe that initial debridement with immediate surgical fixation ...

Acromioclavicular (AC) joint injuries are more common than sternoclavicular (SC) joint injuries. There is a spectrum of AC joint traumatic injuries that ranges from a ligament sprain to a complete dislocation. The majority of AC joint injuries are successfully treated non-operatively with a period of sling immobilisation followed by progressive ...

Of eight sternocostoclavicular joint dislocations treated at our institution over an 18-month period, two unstable posterior dislocations were treated with a safe and simple "ledge plating" technique. The ledge of plate left without screws prevents posterior loss of reduction without the use of wires or pins and provides enough stability ...

BACKGROUND: Little attention has been devoted to subtalar dislocations without an associated bone injury in the literature to date. The aim of this study was to assess the functional and subjective results of a cohort of patients with this injury. METHODS: A total of ninety-seven patients with a subtalar dislocation ...

We present a case of simultaneous dorsal perilunate dislocation of both wrists, without a history of fall on outstretched hands. In contrast, it appeared that the mechanism was reverse. His hands were held in radial deviation with wrists in full palmar flexion. The forearms were in neutral position and elbows ...

Dorsal perilunate wrist dislocations are rare. Associated carpal bones or radial styloid process fractures can occur and be included in the current classifications. The authors report an unusual association of dorsal perilunate wrist dislocation with a multifragmentary distal radius fracture. Such traumatic entity has never been previously described. Poor functional ...

The authors report a case of a dorsal dislocation of the fifth metatarsophalangeal joint that could not be reduced by closed manipulation, and instead required open reduction with Kirschner-wire fixation to maintain alignment. Although metatarsophalangeal joint dislocation is not unheard of, it is not common for the deformity to resist ...

We report a patient with complex traumatic translatory atlantoaxial dislocation, who we treated by joint exposure and reduction of the dislocation by facet manipulation and subsequent plate and screw atlantoaxial fixation. A 28-year-old male had fallen 7.6m (25 feet), and following the fall had severe neck pain but no neurological ...

Posterior elbow dislocations are the most common type of elbow dislocation and are usually caused by a fall on an outstretched hand. Although the incidence of elbow dislocation complications is rare, the emergency physician is responsible for evaluation and identification of concomitant neurovascular injuries. Failure to identify neurovascular compromise after ...

This article describes a case of closed reduction of a dislocated total hip arthroplasty (THA) out of a constrained acetabular liner using a novel technique with a peg board secured to the operating table.A 79-year-old woman sustained multiple dislocations after a primary THA. She was converted to a constrained liner ...

Proximal humeral fractures account for 4% to 5% of all fractures, and most of these are minimally displaced and less prone to neurovascular injuries. This article presents a case of a 65-year-old man who injured the posterior circumflex humeral artery following a fracture dislocation of the proximal humerus leading to ...

Posterior sternoclavicular joint dislocations (PSCJDs) are extremely rare, emergent injuries. We present an unprecedented case of a 16-year-old boy without any initial history or signs of trauma who died of a brachiocephalic vein laceration secondary to an occult PSCJD. The pathophysiology, treatment, and diagnosis of PSCJD are discussed.

A 47-year-old man sustained a medial complex dislocation of the right elbow. After initial evaluation, closed reduction was performed. On examination under general anesthesia, the elbow was unstable under varus and valgus stress. Computed tomography scan showed a medial epicondyle and a coronoid fracture. Both medial and lateral approaches were ...

A retrospective study. To study the outcome of repair of cauda equina fibres with fibrin glue after lumbar fracture and/or dislocation. Seven acute cases and one chronic case of L2 or L3 fracture and/or dislocation complicated with complete cauda equina injury were selected. Sural nerve or ventral roots of injured ...

A chronic presentation of closed dorsolateral dislocation of the talus is a rare injury. A 35-year-old woman presented with pain and deformity of the right foot of 6 months' duration. Her medical history was significant for rheumatoid arthritis, for which she was being treated with steroids. Radiographs and computed tomography ...