Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1998
Review Case ReportsRecurrent dislocation of tibialis posterior tendon. A report of two cases.
We successfully treated two patients with recurrent dislocation of the tibialis posterior tendon by creating a bone block. Sudden resistive contraction of the tibialis posterior muscle is considered to be the mechanical cause of the initial traumatic injury, and a shallow tibialis posterior tendon sulcus may be the predisposing factor. ⋯ When treating patients with a complaint of long-standing pain around the medial malleolus, we must bear in mind the possible diagnosis of recurrent dislocation of the tibialis posterior tendon. If the patient can voluntarily dislocate the tendon by active plantar flexion and inversion of the ankle, the diagnosis is definitive.
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Arch Orthop Trauma Surg · Jan 1998
Review Case ReportsComplete dorsal dislocation of the metacarpophalangeal joint of the thumb.
In the pathology of simple complete dislocation involving the metacarpophalangeal joint of the thumb, whether or not the palmar plate is interposed within the joint is controversial. Nine cases of complete dorsal dislocation of the joint were reviewed, and cadaver dissection was performed to study the pathology of this injury. Eight of the nine patients were seen within 4 days of injury and treated successfully by closed manipulation. ⋯ We were able to reproduce the pathological anatomy of the dislocation, wedging of the palmar plate in the joint of the cadaver. In this cadaver and in all clinical cases, radiographs showed a complete dislocation with an increased distance between the palmar edge of the base of the proximal phalanx and the metacarpal head, indicating an interposition of the palmar plate. Our study suggests that in simple complete dislocations of this joint, the palmar plate is interposed between the displaced bones.
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Arch Orthop Trauma Surg · Jan 1998
Review Case ReportsAspiration of intraspinal synovial cyst: recurrence after temporal improvement.
Intraspinal synovial cyst primarily occurs in the lumbar spine and may cause back pain and compression nerve disturbance. Percutaneous aspiration has been recommended as an alternative to surgery in three cases. We report on two patients who improved after aspiration of gelatinous material and steroid injection but whose cyst recurred within a short period of time. ⋯ These two types are indistinguishable on computed tomography or magnetic resonance imaging. The results of all patients whose aspirated material was gelatinous were unsuccessful, including our cases. Thus, the outcome may depend on the pathology of the cyst.
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Arch Orthop Trauma Surg · Jan 1998
Review Case ReportsAbscess formation as a complication caused by postoperative osteomyelitis of the femur.
We report an unusual case of a giant femoral abscess caused by postoperative osteomyelitis after treating a fracture of the femoral shaft. The patient ignored it until the abscess began to interfere with knee flexion, but no symptoms of inflammation such as fever, pain or abnormal laboratory values were found. Within the marrow cavity, many plasma cells produced immunoglobulins G and M, and the level of these substances in the abscess fluid connected to the bony focus were higher than the serum levels. It was concluded that the inflammation in this case signified a peculiarity in a primarily chronic process.
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Arch Orthop Trauma Surg · Jan 1998
Case ReportsThe fate of missed atlanto-axial rotatory subluxation in children.
Torticollis in children can be due to atlanto-axial rotatory subluxation. If diagnosis, based on plain lateral radiography and on computed tomography, and specific treatment are delayed, reduction becomes difficult to accomplish. ⋯ Thus, a diagnostic delay may prevent restoration of cervical spine function. In acquired torticollis in children, radiographic evaluation is indicated if the symptoms are not relieved within 1 week, but immediate radiography is indicated in traumatic torticollis.