Journal of orthopaedic trauma
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The Galeazzi fracture-dislocation of the forearm consists of a transverse or short oblique fracture of the radius at the junction of the middle and distal thirds with an associated subluxation or dislocation of the distal radioulnar joint. Anatomic reduction with rigid internal fixation of the radius typically produces anatomic reduction of the distal radioulnar joint and is the favored treatment. ⋯ In all three cases there was dorsal displacement of the ulna. We report a case of an irreducible volar dislocation of the distal radioulnar joint following open anatomic reduction of the radius.
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A patient in the second trimester of pregnancy sustained a gunshot wound of the upper cervical spine with a partial Brown-Séquard syndrome. The patient's condition was evaluated by conventional roentgenography, computed axial tomography (CT), and magnetic resonance imaging (MRI). ⋯ The bullet was removed from the spinal canal by a posterior approach with the patient in the sitting position and in skeletal cervical traction. The neurological status of the patient improved markedly after the surgery.
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Case Reports
Radiological diagnosis of screw penetration of the hip joint in acetabular fracture reconstruction.
Screw penetration of the hip joint following acetabular fracture reconstruction is a relatively uncommon complication but, if not corrected, may have a catastrophic effect on the postoperative function of the hip joint. Intraoperative radiographs and postoperative standard anteroposterior (AP) radiographs frequently show super-imposition of the screws and acetabulum. Computed tomographic (CT) scanning has been the only diagnostic technique available allowing documentation of screw penetration into the hip joint. ⋯ Intraoperative AP radiographs projected as a Judet obturator view were the least helpful in making this determination. When screw penetration is suspected, we recommend the use of intraoperative fluoroscopy in multiple projections or intraoperative arthrogram in the lateral projection of the pelvis. Also, Judet iliac and cross-table lateral radiographs in the operating room while the patient is still under anesthesia might exclude any screw penetration into the hip joint.
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A case of ipsilateral distal clavicle fracture and sternoclavicular joint dislocation is reported. This combination of injuries results from two separate forces in sequence. Closed reduction of the dislocation was possible only after open reduction and internal fixation of the clavicle fracture was performed, because of the inability to manipulate the free-floating segment. Patients should be carefully examined for associated brachial plexus injuries.
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A 25-year-old multiply traumatized patient developed neuroleptic malignant syndrome (NMS) secondary to the use of Haldol. The diagnosis was delayed due to poor recognition of the syndrome, risking a fatal outcome. The signs and symptoms of the syndrome are presented along with the pathophysiology and the available treatments for NMS.