Traumatic dislocation of the hip in a child. A case report

A case of traumatic posterior dislocation of the hip in a child in which the diagnosis was initially missed is presented. The fact that the condition may follow extremely mild trauma is demonstrated, and the need for two-plane radiography is stressed. A review of the literature emphasizes that prompt recognition and treatment may markedly reduce the incidence of avascular necrosis of the femoral head, the commonest and most severe complication. Reduction of a traumatically dislocated hip in a child is usually easy and need not be performed only at specialist centres.     

Bilateral anterior hip dislocation in a child with Aarskog syndrome: a case report

Both Aarskog syndrome and atraumatic anterior hip dislocation are rare entities. Aarskog syndrome is an X-linked recessive disorder with facial, digital, and genital anomalies and is associated with varying degrees of ligamentous laxity. This is believed to be the only known reported case of bilateral anterior voluntary dislocating hips in an ambulatory child and the only reported case of hip dislocation in a child with Aarskog syndrome. Staged bilateral varus derotational femoral osteotomies and Dega osteotomies were successfully performed. Hardware was removed 1 year after the second operation. The patient has been asymptomatic at 2 years' follow-up. This article calls attention to the features of Aarskog syndrome and potential orthopaedic concerns.     

Giant cell tumor of the sternum: a case report

We report a rare case of giant cell tumor (GCT) of the sternum in a 55-year-old man. He presented with a bony mass in the body of the sternum that had been slowly growing over 6 months. The patient was treated by surgical curettage and cementation. Histological study showed typical GCT findings with cytogenetic abnormalities of many telomeric associations of chromosomes, predominantly the 19q arm.     

Recurrent dislocation of the elbow in a child: case report and review of the literature

Recurrent dislocation of the elbow is extremely rare in children. Surgical correction must be aimed at the specific pathology present in each case. Transfer of the biceps tendon and a central slip of the triceps were successful in an 8-year-old boy who had sustained six dislocations in 2 years.     

Irreducible dislocation of the radial head with undisplaced olecranon fracture in a child: a case report

Irreducible isolated dislocation of the radial head is a rare injury. In this study, we describe a patient with irreducible dislocation of the radial head associated with an undisplaced fracture of the olecranon. A 6-year-old girl fell down while walking and suffered injury to the posterior aspect of the proximal ulnar shaft with the right elbow in a slightly flexed position. Plain radiographs of the elbow revealed an anterior-medial dislocation of the radial head and an undisplaced fracture of the olecranon. However, the attempted closed reduction was not successful. An open reduction was then performed through a lateral approach. The radial head was found to be protruding through a buttonhole tear of the anterior joint capsule, causing the joint to become interposed between the articular surfaces of the joint, precluding closed reduction. Once the interposed capsule was extricated from the joint, the radial head could be easily reduced. At this point, no tear of the annular ligament was observed. Six months after the surgery, the patient was able to use her elbow fully and without pain. The range of motion was 0-140° for both extension and flexion and 90° for pronation and supination. Plain radiographs revealed a united bone of the olecranon and good reduction of the radial head. The radial head pushed through the tear of the anterior joint capsule. This buttonhole effect on the radial head prevented closed reduction of the radial head.     

Osteochondral flap fracture of the olecranon with dislocation of the elbow in a child: a case report

An osteochondral intraarticular fracture of the ulnotrochlear joint in a child is rare. The author reports on a 12-year-old child with an osteochondral intraarticular flap fracture of the proximal ulna associated with a dislocation of the elbow joint. Three-dimensional reconstruction computerized tomogram imaging revealed the direction of displacement and the origin of the detached flap. This fracture has been previously described by Rang (1974), but no illustration was provided. To date, only one other case in a child was reported by Blasier (1989), but it did not confirm an exact correlation between the osteochondral intraarticular fracture with dislocation of the elbow, which would have suggested the mechanism of injury.     

Scaphotrapezial dislocation: a case report

Traumatic dislocation of either trapezium or trapezoid is rare. We found less than 20 cases of each reported in the literature. We describe a case of traumatic dislocation of the scaphotrapezial joint associated with subluxation of the scaphotrapezoidal joint, which to our knowledge has not been reported.     

Anterior transolecranon dislocation of the elbow in a child: A case report and review of literature

Anterior transolecranon dislocation of the elbow is rarely observed in children, reported in only a small series. The present case involves an anterior transolecranon dislocation of the left elbow joint in a 7-year-old child, which was surgically treated. Two attempts of closed reduction failed because the radial head had buttonholed via the joint capsule. After its release, open reduction was easily performed; osteosynthesis of the olecranon was not performed. Remarkably, good result was obtained, despite a mild flexion deformity at the last follow-up. This case report aims to highlight this treatment method, which may be considered for such an uncommon injury.     

Closed talar body fracture with talonavicular dislocation; a case report

Closed fracture dislocation of the body of the talus is rare. The dislocation of the subtalar and ankle joints (associated with fracture body) has been reported and already described in the current classifications. We report a case of closed fracture of the body of the talus associated with talonavicular dislocation. Open reduction and internal fixation was performed after failed attempt of closed reduction. The fracture has healed and there is no evidence of avascular necrosis after 2 years follow up. We recommend early evaluation of this injury by CT scan or by proper radiographic views under sedation and urgent open reduction if one attempt at closed reduction has failed.     

Purely lateral elbow dislocation in a child, case report and literature review

Elbow dislocation is a rare condition in children usually associated with medial epicondyle fractures. Most dislocations are posterior, lateral dislocations are only anecdotal. We report the case of a 14-year-old boy presenting with incomplete purely lateral elbow dislocation. Good reduction was achieved by closed method. The authors present a review of the literature highlighting the characteristics and treatment options of this condition.     

Fracture dislocation of sacroiliac joint associated with triradiate cartilage injury in a child: a case report

We report a very rare injury of a 8-year-old girl with sacroiliac fracture dislocation and triradiate cartilage separation. After the restoration of the sacroiliac joint by open means, reduction of the separated cartilage was seen. At 20 months follow-up, an osseous bridging at the triradiate cartilage and mild coxa valga deformity developed. We think that every child with serious sacroiliac joint injury should be evaluated for associated triradiate cartilage injury and followed to skeletal maturity for late complications such as acetabular dysplasia, hip subluxation and pelvic asymmetry.     

Traumatic posterior hip dislocation in a 16-month-old child: a case report and review of literature

Traumatic posterior hip dislocation is an uncommon injury in children, constituting less than 5% of paediatric dislocations. In a younger child (<5 years), minor trauma such as a slip or fall from a low height may cause a hip dislocation, whereas in an adolescent a dislocation is usually caused by a major trauma such as motor vehicle accident. In this case report we present a rare case of traumatic hip dislocation in a 16-month-old girl. Early detection and closed reduction ensured good outcome in our case. A high index of suspicion is necessary to achieve satisfactory reduction within six hours of dislocation because reduction after this period will greatly increase the risk of complications.     

胸骨体骨折1例

1　病例资料患者 ,男 ,30岁。因前胸部撞伤并疼痛、呼吸困难 2ｈ ,于 2 0 0 1年 5月 15日入院。患者在乘坐一载重约 10 0 0ｋｇ的农用三轮摩托车时 ,发生车祸 ,前胸部被车厢护栏撞伤 ,当即感前胸部疼痛 ,呼吸困难。入院查体 :前胸部有一横向带状淤血痕 ,压痛明显 ,叩击痛阳性 ,听诊双肺呼吸音明显减弱。胸骨Ｘ线侧位片见胸骨体中上 1/ 3处横形骨折 ,未见移位 (图 1) ,正侧位Ｘ线片无积气、积液表现。诊断 :胸骨体横断骨折。治疗 :平卧床束胸围外固定 2周及镇痛处理 ,于1周后出院休养 ,失访图 1　胸部侧位片胸骨体中上 1/3处横形骨折2　讨论…