Clinical orthopaedics and related research
-
Clin. Orthop. Relat. Res. · Apr 1982
Scapular manipulation for reduction of anterior shoulder dislocations.
Scapular manipulation is an effective, safe method to reduce an acute anterior shoulder dislocation. The method described by Bosley and Miles in 1979 has been used by the Orthopaedic Staff at Henry Ford Hospital since February 1979. It was the initial reduction method used in 51 patients and was successful in 47. With experience, and a properly executed technique, the method is relatively simple and can be applied to all patients.
-
In 55 wrists with dorsal perilunate dislocations, trans-scaphoid dorsal perilunate fracture dislocations and volar lunate dislocations, an anatomic reduction was achieved by closed manipulation in 67% of the cases. After anatomic reduction, 59% of the wrists lost anatomic position during the first six weeks of treatment despite adequate external immobilization. ⋯ Open treatment was successful in gaining anatomic reduction 75% of the time and was uniformly successful in maintaining the reduction. In view of these results, the authors recommend open reduction and Kirschner wire fixation of displaced lunate and perilunate dislocations.
-
Clin. Orthop. Relat. Res. · Apr 1982
Case ReportsComplex dorsal dislocation of the thumb metacarpophalangeal joint.
Complex dorsal dislocation of the thumb metacarpophalangeal joint is an infrequently reported injury. Distinction from its simple counterpart is facilitated by specific physical and radiographic findings. The presence of skin dimpling without gross joint deformity represents physical evidence of a complex lesion. ⋯ The current treatment of choice is immediate operative reduction followed by a brief period of immobilization. Surgery may be performed through a volar, lateral, or dorsal incision. We favor the dorsal approach, in that it provides excellent exposure while reducing the risk of neurovascular injury.
-
Clin. Orthop. Relat. Res. · Apr 1982
The relationship of thoracic outlet syndrome and carpal tunnel syndrome.
The elusive diagnosis of thoracic outlet syndrome and its controversial relationship with carpal tunnel syndrome is examined by a retrospective study of 1000 cases of carpal tunnel syndrome and 63 cases of thoracic outlet syndrome. Thoracic outlet syndrome is rare and difficult to accurately diagnose. The signs and symptoms of thoracic outlet syndrome lack specificity. ⋯ The relationship of carpal tunnel and thoracic syndromes does not represent an example of the double crush syndrome. In this study, the incidence of combined carpal tunnel and thoracic outlet syndromes approached zero. Surgical treatment of the carpal tunnel syndrome alleviated pain from the upper extremity in the majority of patients.