Traumatic dislocation of the pisiform bone: a case report and review of the literature

Traumatic dislocation of the pisiform bone is uncommon. The authors report a case treated by primary excision with a good result. The literature is reviewed and treatment choices are discussed.     

Simultaneous dislocation of the hamate and pisiform: a case report

A 27-year-old man fell on his flexed wrist and simultaneously sustained a posteriorly dislocated hamate and a laterally dislocated pisiform. The hamate was openly reduced and fixed, and the pisiform was excised. The result was excellent.     

Traumatic dislocation of the pisiform: a case report

Isolated pisiform dislocation is rare. We present one such case in a 20-year-old man occurring after a direct injury to the wrist. After an initial delay in diagnosis and unsuccessful closed reduction, he underwent resection of the pisiform. At 12-month follow-up, he had full range of movement of the wrist and no residual pain.     

Traumatic lumbosacral fracture dislocation: a case report and review of the literature

Lumbosacral dislocation is uncommon. We report a case of traumatic lumbosacral dislocation which occurred in a 33-year-old pedestrian traffic accident victim. The posterior impact produced lumbar injury with diffuse pain exacerbated at the lumbosacral junction. Ecchymotic diffusion involving the entire lumbar region fluctuated due to the presence of a subcutaneous hematoma. The neurological examination revealed incomplete L5 paraplegia. Standard x-rays revealed L5-S1 spondylolisthesis and fracture of the L5 spinous process as well as fractures of the L3, L4, and L5 transverse processes. Computed tomography disclosed biarticular L5-S1 fracture dislocation and a voluminous herniation of the L5-S1 disc. Emergency surgery was performed and revealed subaponeurotic detachment from T4 to S1 and bald iliac pyramids. After L5 laminectomy and extraction of the voluminous herniation of the L5-S1 disc, a short L5-S1 posteriolateral fusion was achieved using pedicular screws and two rods on either side as well as a posterolateral iliac autograft. The clinical course was satisfactory with nearly complete neurological recovery (persistent levator ani paresis). This clinical case and a review of the literature illustrate the pathogenic, clinical, radiological and therapeutic aspects of lumbosacral fracture dislocation.     

Traumatic dislocation of trapezium: case report and review of the literature

A complete dislocation of the trapezium from its fossa is rare. We present a case of a 36-year-old man with a complete ulnar and volar dislocation of the trapezium. The trapezium was reduced with manual manipulation and was held in anatomic position by using multiple Kirschner wires. The patient's clinical course is reviewed and similar cases from the literature are discussed.     

Traumatic obturator foramen hip dislocation: a case report and review of the literature

We report a case of traumatic anteroinferior (obturator foramen) hip dislocation in an adult. Femoral neck fracture occurred during reduction of the dislocation. Cephalic necrosis required total hip arthroplasty. We call attention to the difficult reduction of traumatic obturator formaen dislocation. We reviewed the literature concerning prognostic factors and propose a therapeutic attitude.     

Traumatic atlantooccipital dislocation with survival: case report and review of the literature

Summary We present the case of a patient with traumatic atlantooccipital dislocation. The initial neurological examination showed no abnormalities. Dislocation was the result of rapid deceleration in a motor vehicle accident. The mechanism of injury was hyperextension/rotation, probably combined with a distraction force. Only a few cases of atlantooccipital dislocation without neurological involvement have been reported. Every report pointed out difficulties of initial diagnosis. Special attention should be directed toward the atlanto-odontoid-basion relationships as seen on lateral radiographs. Prompt recognition and surgical stabilization are essential to avoid further neurological injury.     

Traumatic ulnar nerve dislocation (a case report and literature review)

The authors report a case of post-traumatic ulnar nerve dislocation at the elbow and, having reviewed the literature, they discuss the pathogenesis, diagnosis and management of this injury.     

儿童创伤性半骨盆离断1例报告及文献回顾

目的 讨论创伤性半骨盆离断患者早期临床处理问题。方法 病例报告及文献回顾。结果 4岁男孩被汽车碾压左侧腹股沟部及大腿近段，造成肢体不完全离断，伤后7h来我院就诊。经过2h抗休克治疗患者生命体征稳定后，予以彻底清创、髋关节离断、耻骨联合固定，术后病程平稳。本病例早期成功处理与文献报道经验相符，又有独到之处。结论 创伤性伴骨盆离断救治的成功经验有院前局部加压止血、快速运输、积极早期复苏、尽早认识病情的严重程度、满足截肢标准时当机立断给予手术离断肢体以及早产期功能康复。     

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.     

Traumatic hemipelvectomy: case report and literature review

Traumatic hemipelvectomy is a rare but devastating injury involving complete disruption of the hemipelvis from the pubic symphysis to the sacroiliac joints and often results in death. We present an interesting case of traumatic hemipelvectomy caused by a previously undescribed mechanism of injury in which judicious angiography and aggressive surgical treatment contributed to patient survival.     

Pisiform and hamate coalition: case report and review of literature.

Pisiform and hamate coalition is a rare anomaly of the carpal bones; a symptomatic case is an especially rare condition. We report a case of symptomatic pisiform and hamate coalition in a 15-year-old Japanese male. The literature of pisiform and hamate coalition is reviewed.     

Traumatic testicular dislocation: a case report and review of published reports

Testicular dislocation after blunt scrotal trauma is a rare event. Its diagnosis depends on the awareness of the physician of its possible occurrence. It is usually a late finding during treatment of a motorcyclist brought to the emergency room because of multitrauma injury and is sometimes demonstrated in an abdominal computed tomography scan. We describe a typical case and discuss the chain of events leading toward the correct diagnosis and treatment based on a review of published reports.     

Traumatic lateral lumbosacral dislocation: one case and review of literature

OBJECTIVE: Lateral traumatic lumbosacral dislocation is a rare and severe lesion of the lumbosacral junction. Only one case has been reported in the literature. We report a new case of pure lateral lumbosacral dislocation. METHODS: A 27-year-old man had an isolated pure lateral traumatic dislocation of the lumbosacral junction after a motorcycle accident. The diagnosis and the therapeutic course are analyzed and discussed. RESULTS: Traumatic lumbosacral dislocation usually occurs in patient with multiple traumas. Generally, in the case of complete fracture-dislocation, on lateral radiographs one can observe the L5 vertebra slippage over the sacrum, resulting from an associated severe disc disruption. This feature was not seen in our patient. Surgical treatment consisted of an open reduction of the dislocation, stabilization with posterior instrumentation, and a lumbosacral arthrodesis by posterolateral grafting. In cases of pure lateral dislocation, short instrumentation can be recommended, extending from L5 to S1. Addition of an interbody fusion should be considered when the L5-S1 disc is disrupted, which is responsible for the anterior slippage of L5 over S1. Disc disruption can be evoked on preoperative magnetic resonance imaging (MRI) and intraoperatively by exploring the spinal canal. CONCLUSIONS: Pure lumbosacral dislocation with a lateral translation seemed to have no disc disruption as observed in complete fracture dislocation. Nevertheless, we recommend looking for an L5-S1 disc disruption either on preoperative MRI or during surgical exploration.     

Traumatic abdominal hernia: a case report and review of the literature

Traumatic abdominal hernia remains a rare clinical entity despite an overall increase in blunt abdominal trauma. What appears to be the most extensive traumatic abdominal hernia so far described is presented. Traumatic abdominal herniae fall into three general categories: small lower quadrant abdominal defects and inguinal hernias, typically the result of blunt trauma with bicycle handlebars, are the most common; larger abdominal wall defects sustained in motor vehicle accidents are the next most common hernias; intra-abdominal herniations through rents in the retroperitoneum are rarely seen. The diagnosis may often be established with physical examination alone. Conventional radiology, computerized tomography, and ultrasound have also proven useful. Because of the high incidence of other associated intra-abdominal injuries, early exploration and repair through a midline incision is advocated. Adequate debridement and solid repair of fascial planes with non-absorbable sutures are required to prevent recurrence.     

Proximal tibiofibular dislocation: a case report and review of literature

An isolated dislocation of the proximal tibiofibular joint is uncommon. The mechanism of this injury is usually sports related. We present a case where initial X-rays did not show the tibiofibular joint dislocation conclusively. It was diagnosed after comparative bilateral AP X-rays of the knees were obtained. A closed reduction was performed and followed by unrestricted mobilization after 1 week of rest. A review of the literature was conducted on PubMed MEDLINE. Thirty cases of isolated acute proximal tibiofibular joint dislocations were identified in a search from 1974. The most common direction of the dislocation was anterolateral, and common causes were sports injury or high velocity accident related. More than 75 % of the cases were successfully treated by closed reduction. Complaints, if any, at the last follow-up (averaging 10 months, range 0–108) were, in the worst cases, pain during sporting activities. We advise comparative knee X-rays if there is a presentation of lateral knee pain after injury and diagnosis is uncertain. Closed reduction is usually successful if a dislocation of the proximal tibiofibular joint is diagnosed. There is no standard for after-care, but early mobilization appears safe if there are no other knee injuries.