Complete Medial Dislocation of the First Cuneiform: A Case Report

Isolated dislocation of the first cuneiform bone is an extremely rare lesion that can usually be diagnosed on plain radiography. Few cases of this injury have been previously described in the literature. The case presented here resulted from a torsion injury and was treated by means of closed reduction with the aid of pointed reduction forceps. After fixation with Kirschner wires, the foot was immobilized for 6 weeks. The patient recovered uneventfully and remains asymptomatic 3 years later.     

Hemipelvic Dislocation Complicated by Dislocation of the Ipsilateral HIP: A Case Report

The case presented involves a rare combination of severe injuries to the hemipelvis and ipsilateral hip joint. Suggestions are made with regard to treatment.     

Calcaneus Secundarius Presenting as Calcaneonavicular Coalition: A Case Report

Calcaneus secundarius is an accessory ossicle of the anterior calcaneal facet identified in up to 5% of the population. Calcaneus secundarius rarely leads to symptoms, but its presence may generate pain around the ankle. The purpose of this case report is to describe this atypical accessory ossicle, which can mimic a calcaneonavicular coalition, and to explain the clinical approach to reach a diagnosis and determine treatment. The authors report the case of a 13-year-old girl who sustained several lateral sprains of the right ankle and had local chronic pain. Clinical findings were consistent with calcaneonavicular coalition but radiographic examinations revealed a calcaneus secundarius. The location of this ossicle may limit the range of motion of the subtalar joint, mimicking a calcaneonavicular coalition. Surgical excision of this bulky accessory ossicle was performed, and this treatment fully resolved the pain and improved subtalar motion.     

Complete Cuboid Dislocation With Associated Lisfranc Injury: A Case Report and Review of the Literature

Cuboid dislocations are rare midfoot injuries that usually occur in the setting of high-energy trauma. Diagnosis can be challenging and optimal treatment remains unknown. This case report and review aims to summarize the recent literature on this topic.     

Intraosseous Lipoma of the Calcaneus: Report of a Case and a Short Review of the Literature

One case of an intraosseous lipoma of the calcaneus bone is presented together with a short review of the literature. Only 20 cases of tumors in the extremities have so far been published. The typical X-ray picture shows a cystic, sharply demarcated cavity, which macroscopically at operation is filled with yellowish, adipose tissue. in the present case and one previously published a central sclerotic mass was observed. The histological picture is typical, with mature adipose tissue mixed with a few degenerated bone trabeculae.     

Resection of Small Avulsion Fractures of the Anterior Process of the Calcaneus for Refractory Complaints

Minor injuries of the anterior process of the calcaneus occur frequently and most heal uneventfully. The present series reports on 6 patients with persistent complaints after anterior process avulsion fractures. The avulsed fragments of the anterior process at the calcaneocuboid joint were surgically excised in all, which resolved the complaints completely in 4 patients and reduced the complaints significantly in 2. If conservative measures fail and the complaints are refractory, debridement of the anterior process avulsion fractures at the calcaneocuboid joint could be a viable option.     

Dislocation of the First Metatarsophalangeal Joint: A Case Report and Suggested Classification System

Dislocation of the first metatarsophalangeal joint is a relatively rare and still poorly known injury. The current classification includes only the dorsal variety of this lesion; thus, as further cases of other varieties are reported, a larger understanding of this entity is required. We report the case of a young male with dorsal dislocation of the first metatarsophalangeal joint treated by closed reduction. The clinical outcome at the 2-year follow-up point is reported. A review of the published data of the variations of this injury reported to date is included, and a new summarizing classification is suggested.     

Double Dislocation of Interphalangeal Joints Accompanied with Contralateral Shoulder Dislocation: A Case Report

Dislocation of any joint is an orthopaedic emergency and needs immediate attention by the attending physician. A delay in reducing a dislocated joint can lead to disastrous complications both immediately as well as in the long run. Although anterior dislocation of a shoulder joint is by far the commonest dislocation encountered by any emergency care physician, other joints may also get dislocated. In certain cases two joints may get dislocated simultaneously. Such dislocation is known as a double dislocation. Double dislocation of the proximal interphalangeal joint and the distal interphalangeal joint in the same finger is a rare injury. High impact loading at the fingertip is the primary cause in most cases and it is often associated with younger individuals playing contact sports. The right little finger is the digit commonly involved and this injury is evident in football players more often than not. Although closed reduction is a preferred treatment, it may not be always successful. Time of presentation, tendon interposition, associated swelling and co‐existent phalangeal fractures are certain key impediments to a successful closed reduction manoeuvre. In patients with an open injury, a thorough wash out and appropriate antibiotic cover is mandatory. We report a rare case of double dislocation of the interphalangeal joints accompanied with contralateral shoulder dislocation in an elderly man sustained after a fall which was treated successfully with closed reduction and early mobilization.     

Open Talar Neck Fracture With Medial Subtalar Joint Dislocation: A Case Report

We present a unique case of an open talar neck fracture with medial subtalar joint dislocation. This rare and traumatic injury was treated with immediate open reduction of the subtalar joint and open reduction internal fixation of the talar neck fracture. After a follow-up of 2.2 years, highlighted by numerous complications including posttraumatic arthritis, soft tissue abscess, and fibrotic adhesions, the patient recovered sufficiently to return full activity.     

Trans-Scaphoid Perilunate Dislocation in a Child: A Case Report

An acute trans-scaphoid perilunate dislocation in a 10-year-old boy is reported. Closed reduction was successful and normal strength and mobility resulted 9 weeks after injury. The mechanism of production and the reason for the rarity of this injury is discussed.     

Postoperative Repeat Dislocation of the Posterior Tibial Tendon: A Case Report

Dislocation of the posterior tibial tendon is an uncommon condition. Although surgery is usually performed in most cases of posterior tibial tendon dislocation, postoperative repeat dislocation of the posterior tibial tendon has not been reported in the published data. We report the case of a 27-year-old male patient who experienced repeat dislocation of the posterior tibial tendon after a gymnastic landing, 44 months after initial retinaculum repair. For revision surgery, we reconstructed the flexor retinaculum in conjunction with deepening of the retromalleolar groove, because the groove was hypoplastic. He returned to competitive gymnastics and had not experienced subluxation or dislocation of the posterior tibial tendon at the 1-year follow-up examination.     

Dorsal Dislocation of the Intermediate Cuneiform with Fracture of the Lisfranc Joint: A Case Report

Tarsal cuneiform dislocation in association with Lisfranc fracture-dislocation is a rare pedal injury. In this report, we describe the case of a patient who sustained a dorsal dislocation of the intermediate cuneiform in association with tarsometatarsal fracture-dislocation following traumatic axial loading and torsion of his foot. A satisfactory outcome was achieved by treating the injury by means of closed reduction and percutaneous Kirschner wire fixation. ACFAS Level of Clinical Evidence: 4.     

Neglected Irreducible Dislocation of the Interphalangeal Joint of the Great Toe: A Case Report

Irreducible dorsal dislocation of the interphalangeal joint of the great toe is rare. We report a case of a 58-year-old man with an irreducible interphalangeal joint of the great toe that had been untreated for 4 years. The mechanism of this injury was thought to be a combination of axial loading with a hyperextension force when the patient hit his great toe against a pipe. Invagination of the sesamoid became a barrier for manual reduction attempted after the initial injury. The patient did not seek treatment because of the minor deformity of the affected great toe and lack of severe symptoms. One year later, symptoms eventually developed on the plantar aspect of the great toe, particularly when the patient was walking upstairs. He decided to seek treatment as pain worsened and he became more active when he changed occupations 4 years later. Manual reduction was impossible. The patient was treated with operative exploration of the joint and arthrodesis of the great toe. The operative course was uneventful. At 4 years after surgery, the patient could walk, run, and walk up and down stairs without discomfort.     

Lateral Fracture–Dislocation of the Calcaneus: Case Reports and a Systematic Review

ObjectiveTo report a case series of calcaneal fracture–dislocations, which have not been described previously in China, and to provide a systematic review to explore the clinic manifestations, methods for diagnoses, and treatments.MethodsBetween January 2018 and December 2019, 4 patients (4 men; average age, 33.0 ± 16.67 years; range, 15–50 years) were diagnosed with fracture–dislocation of the calcaneus and treated by surgery. We also reviewed published cases and studies of calcaneal fracture–dislocations through the databases of PubMed and Web of Science between January 1977 and December 2019.ResultsBetween January 2018 and December 2019, 4 cases were identified as calcaneal fracture–dislocations in our hospital. The main clinical manifestations include hindfoot pain, swelling, and deformity. The diagnoses were confirmed via radiographic examination. Two patients underwent open reduction and internal fixation (ORIF) and two were treated with a minimally invasive approach. Diagnosis had been missed in one patient and, consequently, presented with early signs of post‐traumatic arthritis, which may require extra subtalar arthrodesis in the future. Two patients were diagnosed inaccurately but achieved satisfactory outcomes through open reduction and internal fixation. The average follow‐up period was 9.75 ± 5.19 months. Except for the 1 misdiagnosed patient, the other 3 patients showed functional improvement. Only 23 fracture–dislocations of calcaneus cases were reported in the literature between January 1977 and December 2019. There were 15 Sanders type II fractures (65.22%) and 7 (30.43%) Sanders type III fractures, and there was 1 grade II open calcaneal fracture. Among them, 1 was a medial dislocation and 2 were “joint‐elevation” dislocations; the rest of them (20/23, 86.96%) were lateral dislocations. A total of 11 patients (47.83%) exhibited the double‐density sign, and varus tilt of the talus was revealed on plain radiographs for 9 patients (39.13%). Increased Bohler''s angle was evident in lateral X‐ray films for 2 patients (2/23, 8.70%). A total of 21 cases (86.96%) were treated with surgical intervention and achieved satisfactory outcomes. Only 1 patient was treated with external fixation. Another 2 patients were treated conservatively and had poor clinic outcomes.ConclusionCalcaneal fracture–dislocation is a rare injury that is challenging to treat. Clinical manifestations such as fibular tendon dislocation, the double‐density sign on profile radiography, and abnormal talar tilt in the distal talofibular joint are important signs that may indicate this rare injury pattern. Timely surgical intervention is essential for satisfactory clinic outcomes. Orthopaedic surgeons should be aware of this uncommon injury to avoid misdiagnosis or inappropriate treatment.