Clinical orthopaedics and related research
-
Clin. Orthop. Relat. Res. · Jun 1980
Case ReportsAvulsion fracture of the fibular sesamoid in association with dorsal dislocation of the metatarsophalangeal joint of the hallux: report of a case and review of the literature.
A case of avulsion fracture of the lateral sesamoid is reported in association with dislocation of themetatarsophalangeal joint of the hallux. The radiographic criteria to establish the diagnosis of fracture in sesamoid bones are outlined. Review of the literature reveals only one other reported case associated with a hallux dislocation, and in that case, the radiographic diagnosis was not clearly established.
-
Clin. Orthop. Relat. Res. · Jun 1980
Winging of the scapula as a complication of first rib resection: a report of six cases.
Long thoracic nerve injury occurred in 6 patients as a complication of first rib resection by the transaxillary route for relief of thoracic outlet syndrome. In a review of 38 patients following 48 first rib resections, this is the second most frequent complication. ⋯ In 4 patients the long thoracic nerve palsy was transient, and complete recovery of serratus anterior function occurred within 6 months. In one patient, complete recovery followed repair of the long thoracic nerve.
-
Clin. Orthop. Relat. Res. · Mar 1980
Injuries to the posterior cruciate ligament: diagnosis and treatment of early injuries and reconstruction of late instability.
Division of the posterior cruciate ligament in amputation specimens enables one to classify injuries as: (a) isolated posterior cruciate ligament injuries with or without damage of the posterior capsule; or (b) injuries of the posterior cruciate ligament plus lateral and/or medial structures which may be associated with stretching or tearing of the anterior cruciate ligament. The mechanism of injury to the posterior cruciate ligament is by: (a) anteroposterior force on the front of the flexed knee; (b) hyperextension of the joint; (c) posteriorly directed rotatory injuries. Early diagnosis is essential and may require general anesthesia to elicit the posterior drawer sign, and to accurately assess the other ligamentous and bony structures. Chronic injuries can be repaired by using the tendons of gracilis and semitendinosus.
-
Clin. Orthop. Relat. Res. · Nov 1979
Case ReportsIrreducible dislocation of the metatarsophalangeal joints of the foot.
An unusual dislocation of the metatarsophalangeal joints of the third, fourth, and fifth toes with fractures of the neck of the second metatarsal bone occurred in a 23-year-old man. Hyperextension of the metatarsophalangeal joints is the mechanism of injury and is substantiated by the anatomic investigation. The metatarsal head is trapped between the fibrocartilaginous plate on the plantar surface of the foot, the dorsal capsule and deep transverse metatarsal ligament on the dorsal surface, the flexor tendons on the lateral aspect and the lumbrical tendons on the medial aspect. Division of the fibrocartilaginous plate, the deep transverse ligament and the dorsal capsule facilitates reduction of dislocation.
-
Clin. Orthop. Relat. Res. · Oct 1979
Primary skeletal infections in heroin users: a clinical characterization, diagnosis and therapy.
Experience with 24 patients and 101 cases reported in the English literature demonstrate that primary skeletal infections occur in heroin users. In young individuals with no significant underlying disease, predominant involvement in the lumbar vertebrae and sternoclavicular joint, Pseudomonas aeruginosa was the dominant pathogen. ⋯ Diagnosis ultimately depended on isolation of the pathogens from either bone or joint fluid. The treatment, as indicated, was prolonged parenteral antibiotics, generally with an aminoglycoside, incision and drainage, and immobilization.