In 1984, the Committee on Sports Medicine of the American Academy of Pediatrics published in this journal a statement on the remarkably high incidence of atlantoaxial instability among individuals with Down syndrome. On the assumption that this instability, demonstrable through a specified series of lateral x-ray films of the neck, ...

A case of simultaneous dislocations of the interphalangeal and carpometacarpal joints of the thumb after a fall is described. We believe this is a unique situation not reported before in the literature. The results of operative intervention of the open IP joint and closed CMC joint dislocations resulted in a ...

A case of arthrogryposis multiplex congenita involving the temporomandibular joint is reported. This is only the second reported case in which surgery was used in an attempt to alleviate the limited mandibular opening that may be associated with this uncommon condition. The clinical findings at the time of surgery differed ...

In a review of 1000 consecutive neonates of all races, nasal septal deformity was identified in 29, an incident of 2.9%; significantly fewer cases were found in negroid babies (0.1 greater than P greater than 0.05). Ten cases (35%) underwent manipulation of the deviated septum. Six-monthly review revealed that symptoms ...

The purpose of this paper is to offer the oral and maxillofacial surgeon a collaborative approach to the treatment of complex temporomandibular joint (TMJ) dysfunction. Through a positive relationship with a family therapist, the oral and maxillofacial surgeon in this case reports family therapy intervention as an additive solution to ...

Hemarthrosis of extremity joints in patients with hemophilia has been well documented. However, hemarthrosis of the temporomandibular joint in patients with coagulopathies appears to be rare. Consequently, management of a temporomandibular joint hemarthrosis is difficult because of the lack of treatment guidelines. The purpose of this article is to review ...

The radiographic appearances are reported of chronic stress to the wrist joints of eight adolescent males, seven gymnasts and one roller skater. These consist of bilateral, asymmetrical widening and irregularity of the distal radial growth plates with an ill-defined cystic appearance, sclerosis and flaring of the metaphyses in all eight ...

The author reports on two cases of congenital dislocation of the knees submitted to orthopaedic treatment. The early treatment and the relatively benign nature of the main deformity and of the associated phenomena appear to have contributed to the excellent results obtained after a six year follow-up. A review of ...

A case of total dorsal luxation of the lunate, combined with an avulsion of the radial styloid is recorded. Radiographs did not reveal any other signs of carpal collapse. We suggest that a concurrent hyperflexion, ulnar deviation and pronation of the wrist joint may reasonably be regarded as the etiology ...

Recurrent dislocation of the patella is considered to be a manifestation of generalized joint laxity. An autosomal dominant mode of inheritance was previously suggested in a few instances; however, male-to-male transmission has not yet been reported. We report a recurrent dislocation of the patella occurring in five generations of one ...

An isolated case of prosthetic failure occurred in a total hip arthroplasty. This case involved dislocation of the polyethylene portion of a screw-in acetabular cup. The clinical and radiographic findings were subtle. The radiographic measurements that help to distinguish this complication are discussed. Successful treatment was provided with surgical replacement ...

Simultaneous dislocation of the talus from the tibiotalar, talocalcaneal, and talonavicular joints is uncommon and usually occurs from considerable violence. Total dislocation of the talus is frequently an open injury, or the skin may be tented over the dislocated talus leading to skin slough. Infection and avascular necrosis may follow. ...

Variation in zygapophyseal joint orientation at the thoracolumbar transitional junction was investigated using computed tomography (CT). The study population (N = 214) comprised 176 cases of abdominal scans, 9 thoracolumbar junction referrals and 29 cadaveric vertebral columns. Scans through the superior endplates of T11, T12, L1 and L2 were selected ...

The treatment of acromioclavicular injuries is controversial; few studies document the late results. We have reviewed 53 patients about five years after conservative management, in nine for subluxation and 44 for dislocation. Subjective and objective results were satisfactory in all cases except for one with painful subluxation, who was the ...

The fabella, a sesamoid bone in the lateral head of the gastrocnemius muscle occurring in 10% to 30% of individuals, is rarely considered a possible cause of knee dysfunction. When noted, the fabella is occasionally mistaken radiographically for an intraarticular ossified fragment; however, symptomatic conditions of the fabella have been ...

A case of cricoarytenoid subluxation secondary to endotracheal intubation and documented by computed tomography (CT) and electromyography (EMG) is reported. Successful endoscopic reduction of the displaced arytenoid is confirmed by CT. The normal anatomy and physiology of the cricoarytenoid joint is presented and the literature regarding this rarely reported injury ...

We have reviewed 21 cases of dorsal dislocation of carpometacarpal joints. In 15 of them the diagnosis was missed when they were first seen in an accident and emergency department. General swelling may obscure the characteristic clinical deformity and routine radiographs may not show the displacement clearly. It is recommended ...

The stability on clinical examination (CE) and examination under anaesthesia (EUA) was evaluated in 350 consecutive acute knee injuries. Valgus instability in knees with a medial collateral tear was observed on CE in 62 and on EUA in 67 cases (p less than 0.05). The anterior drawer sign was positive ...

Three cases of volar perilunar dislocation were seen at North Carolina Baptist Hospital over a 6-year period. An important finding on anteroposterior radiographs was the overriding of proximal and distal carpal rows giving rise to the "crowded carpal" appearance. Review of the literature demonstrates this configuration in all illustrations of ...

Scapulothoracic (ST) dissociation is a closed complete traumatic forequarter amputation manifested by a flail pulseless arm and well-defined roentgenographic findings. These roentgenographic findings were previously reported to be lateral displacement of the scapula and either acromioclavicular separation (17) or displaced clavicular fracture (20). In this paper we present four patients ...

Synovial chondromatosis is a rare disorder of unknown cause characterized by multiple calcific bodies in the vicinity of the affected joint. It is most commonly seen in the knee, hip, elbow, and shoulder. We describe three cases of synovial chondromatosis in two extremely uncommon sites, the inferior radioulnar joint and ...

Traumatic atlanto-occipital dislocation is a serious injury that is usually fatal. The number of patients surviving this injury, however, appears to be increasing, and most of these survivors are children. This may reflect an improvement in emergency transport services. Seventeen previously reported cases of patients surviving atlanto-occipital dislocation for more ...

A review of the literature concerning 37 cases of long-standing dislocation of the temporomandibular joint is presented. 3 new cases are added. A wide variety of methods of treatment has been used in the past. A survey of these methods will be given and a scheme of recommendation for managing ...

Volar dislocations of the distal radioulnar joint are often missed initially. Late closed reduction of this joint is generally unsuccessful. Even acute reductions of the distal radioulnar joint is often incomplete or unsuccessful. This is not the case for dorsal dislocations. Obstruction to reduction may be due to the contracted ...

The technique of arthroscopy is, at the present time, available for the investigation of the subtalar joint. In this preliminary report, the relevant anatomy and technique are reviewed. Illustrative cases are presented to review some of its applications. It is the conclusion of the author that arthroscopy of the subtalar ...

Carpometacarpal dislocations occur in less than 1% of hand injuries. Since 1973, five cases were treated at Henry Ford Hospital. Three of the dislocations were unstable and required internal fixation. Of these dislocations only one needed open reduction. The other two dislocations were successfully treated by closed reduction and cast ...

A review of the literature revealed that voluntary habitual dislocation of the hip in children is a rare entity. We encountered the case of a 6-year-old girl with habitual posterior subluxation of the hip. Parental counseling is all that was needed while spontaneous resolution of the condition was awaited.

Congenital dislocation of the radial head, particularly bilateral, is seen in association with many syndromes affecting the musculoskeletal system. The consensus in the literature suggests that all isolated unilateral dislocations are posttraumatic in origin. Recent reports, therefore, recommend that unilateral dislocation be treated by open reduction, despite the benign natural ...

A patient with a volar dislocation of the metacarpophalangeal joint of the thumb is reported in which closed reduction proved impossible because of the interposition of the dorsal capsule, extensor pollicis longus tendon and extensor pollicis brevis tendon in the metacarpophalangeal joint. The collateral ligament was also ruptured. Therefore open ...

At arthroscopy, a 22-year-old woman with repeated spontaneous hemarthrosis of the knee was found to have a synovial hemangioma, which was removed by arthrotomy. In cases of spontaneous hemarthrosis without abnormal bleeding tendency, arthroscopy is recommended to identify and, if possible, treat the cause of bleeding, as repeated bleedings may ...

The first known report of synovial fluid eosinophilia in a dog is described here. The occurrence of eosinophils in joint fluid is rare. Sporadic cases have been recorded in humans and most can be related to immunemediated reactions, both parasitic and non- parasitic. The dog in this case report had ...

Sternocostoclavicular hyperostosis is a benign ossifying diathesis of unknown etiology characterized by hyperostosis and soft-tissue ossification between the clavicles, anterior portion of the upper ribs, and manubrium, with variable hyperostosis or ankylosis in the spine and sacroiliac joints. Our cumulative experience with 11 cases is reported, with emphasis on radiographic ...

A 25-year-old man demonstrated a complete dislocation of the tibiotalar joint, caused by an axial loading injury in which he had fallen to the ground with his foot and ankle in supination. This was associated with disruption of the lateral ligamentous complex. Management consisted of immediate reduction, intravenous antibiotics, formal ...

Reported cases of dislocation of the mandibular condyle into the middle cranial fossa have been rare, and treatment modalities have varied. The case presented represents an instance of successful closed reduction. Numerous factors should be considered when determining the technique of reduction. Primary goals in selecting the method of treatment ...

In the literature, posterior dislocation of the disc of the temporomandibular joint is seldom mentioned. Although this dislocation occurs rarely, it is important to differentiate this clinical entity from other joint disturbances. After a review of the literature, 3 patients are presented. Repositioning of the disc is succeeded in all ...

The functional role of the scaphoid in stabilising the wrist joint is discussed and the literature on scaphoid dislocations reviewed. A case of isolated dislocation of the scaphoid has been presented with the salient diagnostic features and preferred line of management which includes percutaneous Kirschner-wire fixation to ensure maintenance of ...

Osteochondrosis dissecans is a disease that is known to present in multiple joints. A literature search revealed no reports of this lesion appearing in the knee and ankle of the same patient. Such a clinical presentation is the basis for this report, which is intended to alert clinicians to include ...

Isolated volar dislocation of the distal radioulnar joint may result from a variety of injuries. This injury is incorrectly diagnosed in approximately 50% of presented cases. A case of volar dislocation of the distal radioulnar joint by traumatic hypersupination is presented. The clinical diagnosis may be hindered by marked swelling, ...

The treatment of tabetic arthropathy of the hip by prosthetic replacement has been recorded in the literature in 5 cases, of which only 4 were followed up. The authors present 4 more cases in which follow-up showed that the operation was definitely contraindicated in this condition. All the cases developed ...

Arthrogryposis multiplex congenita is a rare congenital disorder in which the extremities are affected with severe resistant musculoskeletal contractures. In the upper extremity, these deformities typically consist of internal rotational contractures of the shoulder, extension deformity of the elbow, flexion and ulnar deviation of the wrist, thumb-in-palm deformity, and digital ...

An intratendinous tear of the supraspinatus tendon without communication with the joint or with the subacromial bursa occurred in a 31-year-old man. Repair of the cuff relieved the pain and led to functional recovery. Although the true cause of the unusual pattern of limitation of motion caused by this lesion ...

We describe the rare case of a 6-year-old girl with multifocal pigmented villonodular synovitis. The patient is only the sixth child less than or equal to 10 years of age reported in the literature and the youngest to experience multifocal involvement. She had lesions affecting the right knee and the ...

Monarthritis of the manubriosternal joint is a known but uncommon disease. A case is presented with the tissue type HLA-B27 and monarthritis of a persistent transverse articulation of the sternal body. To our knowledge this is a unique case, but with the same etiology as similar changes of the manubrio-sternal ...

Osgood-Schlatter disease is a condition affecting knees of adolescents. Males are affected more frequently than females, and unilateral involvement is more common than bilateral. In the 75 cases seen in our clinic in 4l/3 years, participation in basketball was twice as common among our patients as was any other sport. ...

Two new cases are added to the literature on four previously reported cases of simultaneous dislocation of the five carpometacarpal joints. The priorities of management of other more extensive injuries often delays definitive treatment and in the two cases reported here open reduction and internal fixation was necessary to restore ...

Freiberg's disease of the second metatarsal was found together with the aseptic necrosis of the head of the third metacarpal in a 54-year-old female patient. No similar case was found in the available literature. The deformity of the second metatarsophalangeal joint was corrected with an operation, the alteration of the ...

Tuberculosis of the bones and joints is a rare but treatable disease. This curable condition is frequently overlooked in the differential diagnosis, and often serious cases are not diagnosed until after severe joint destruction has already taken place. The literature on tuberculosis of the bones and joints is reviewed and ...

A 38-year-old woman, a product of consanguineous parents, had been observed to have limited neck flexion and elbow joints contracture since early childhood. In addition, she experienced humeropelvic muscular weakness and atrophy, so that she was unable to walk by age 27. At 34 years of age, she required a ...

Eighty-seven feet have been reviewed after arthrodesis of the first metatarsophalangeal joint stabilised by chromic catgut. Radiological union was present in 90% of patients at the mean review time of six years. Twenty-four patients had significant metatarsalgia before operation and only two failed to improve afterwards. Excellent or good subjective ...

A case of traumatic dorsal dislocation of the triquetrum associated with direct trauma is reported. Diagnosis was delayed, and open reduction and internal fixation with Kirschner wire was performed 7 days after injury. Eight months afterwards, the patient had good alignment of the carpus assessed radiographically, with full range of ...