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Medial subtalar dislocation: Case report  [PDF]
Manojlovi? Radovan,Star?evi? Branislav,Tabakovi? Dejan,Tuli? Goran
Srpski Arhiv za Celokupno Lekarstvo , 2010, DOI: 10.2298/sarh1004252m
Abstract: Introduction. Subtalar dislocation (SI) is a term that refers to an injury in which there is dislocation of the talonavicular and talocalcanear joint, although the tibiotalar joint is intact. Case Outline. A case of medial subtalar dislocation as a result of basketball injury, so-called 'basketball foot', is presented. Closed reposition in i.v. anaesthesia was performed with the patient in supine position and a knee flexed at 90 degrees. Longitudinal manual traction in line of deformity was carried out in plantar flexion. The reposition continued with abduction and eversion simultaneously increasing dorsiflexion. It was made in the first attempt and completed instantly. Rehabilitation was initiated after 5 weeks of immobilization. One year after the injury, the functional outcome was excellent with full range of motion and the patient was symptom-free. For better interpretation of roentgenogram, bone model of subtalar dislocation was made using the cadaver bone. Conclusion. Although the treatment of such injury is usually successful, diagnosis can be difficult because it is a rare injury, and moreover, X-ray of the injury can be confusing due to superposition of bones. Radiograms revealed superposition of the calcaneus, tarsal and metatarsal bones which was radiographically visualized in the anterior-posterior projection as one osseous block inward from the talus, and on the lateral view as in an osteal block below the tibial bone. Prompt recognition of these injuries followed by proper, delicately closed reduction under anaesthesia is crucial for achieving a good functional result in case of medial subtalar dislocation.
Talonavicular joint abnormalities and walking ability of patients with rheumatoid arthritis.
Miyamoto N,Senda M,Hamada M,Katayama Y
Acta Medica Okayama , 2004,
Abstract: Rheumatoid arthritis (RA) is often associated with deformities of the feet, and foot pain often arises in the talonavicular joint of patients with RA. The object of this study was to assess the relationship between magnetic resonance imaging (MRI) findings of the talonavicular joint and walking ability. The subjects were 35 RA patients (10 feet in 5 males and 56 feet in 30 females) aged 34-87 years (mean: 70 years +/- 12.1), with a disease duration from 1-54 years (mean: 14 years +/- 12.1). MRI findings were classified as follows: Grade 1, almost normal; Grade 2, early articular destruction; Grade 3, moderate articular destruction; Grade 4, severe articular destruction; and Grade 5, bony ankylosis dislocation. Walking ability was classified into one of 9 categories ranging from normal gait to bedridden status according to the system of Fujibayashi. As the grade of MRI images became higher the walking ability decreased, and these parameters showed a correlation by Spearman's rank correlation coefficient analysis (P = 0.003). Thus, in the present cohort group of patients with RA, the deterioration of walking ability increased with the severity of destruction of the talonavicular joint.
Medial epiphyseal fracture-detachment of the sternoclavicular joint with posterior displacement in a judo athlete - equivalent of posterior sternoclavicular dislocation  [cached]
Rui Pimenta,Nuno Alegrete,Vítor Vidinha,Sara Lima
Revista Brasileira de Ortopedia , 2013,
Abstract: Posterior sternoclavicular dislocation is a rare traumatic injury that presents a potential risk of injury to mediastinal structures. The diagnosis is fundamentally clinical and treatment is done on an emergency basis. The authors report the clinical case of a young judo athlete with post-traumatic medial epiphyseal fracture-detachment, with posterior displacement (lesion equivalent to posterior sternoclavicular dislocation at pediatric ages). He underwent open reduction and ligament repair by means of a mini-anchor.The radiological and clinical outcome was excellent, and the athlete returned to his sports activity without limitations. We discuss the particular features of this pathological condition, along with the different therapeutic approaches and their complications
Osteoarthritis of the talonavicular joint with pseudarthrosis of the navicular bone: a case report
Noriyuki Kanzaki, Takayuki Nishiyama, Takaaki Fujishiro, Shinya Hayashi, Yoshiyuki Takakura, Yoshinori Takakura, Masahiro Kurosaka
Journal of Medical Case Reports , 2011, DOI: 10.1186/1752-1947-5-547
Abstract: The patient was a 39-year-old Japanese man. He had complained of pain in his left middle foot since a fall from his motorcycle six months previously. Radiographs and computed tomography (CT) scans revealed pseudarthrosis of the navicular bone. MRI indicated mild arthritic change in the talonavicular joint and avascular necrosis of the navicular bone. We performed an isolated arthrodesis of the talonavicular joint with two 6.5 mm cancellous screws. One year after the operation, radiographical bone union had been obtained, and the patient reported no pain and complete satisfaction with the result.Isolated talonavicular arthrodesis is one of the effective procedures for the treatment of traumatic talonavicular arthritis with pseudarthrosis of the navicular bone both in providing pain relief and functional improvement.Osteoarthritis of the talonavicular joint caused by inflammatory arthritis such as rheumatoid arthritis and pes valgus deformity has been commonly described [1,2], but osteoarthritis occurring as a result of fracture of the navicular bone is rare [3]. Arthritis accompanied by pseudarthrosis of the navicular bone is an extremely rare case.Isolated arthrodesis for talonavicular joint has usually been performed for pes valgus deformities, congenital deformities, neuromuscular diseases, and arthritic conditions, including inflammatory, degenerative, or post-traumatic arthritis [3-11].We report a case of osteoarthritis of the talonavicular joint accompanied by pseudarthrosis of the navicular bone, which was treated with isolated arthrodesis for the talonavicular joint.A 39-year-old Japanese man sustained an injury to his left foot. He had fallen from his motorcycle and was unable to remember the precise mechanism of injury. He visited his local hospital where he was diagnosed with a navicular fracture and treated with a short-leg cast for six weeks. He was referred to our institution because of nonresolution of his prolonged foot pain six months after the initi
Benign Giant Cell Tumor of the Foot Originating from Talonavicular Joint  [PDF]
Hakan Cift, Korhan Ozkan, Serkan Senol, Esat Uygur, Harzem Ozger
Open Journal of Orthopedics (OJO) , 2012, DOI: 10.4236/ojo.2012.22011
Abstract: Benign Giant Cell Tumor is a relatively common benign lesion which usually appears as an enlarging painless mass and has a synovial origin. Although benign giant cell tumors generally involve tendon sheaths, they are infrequently documented in the foot. A 45 years old female presented with a complaint of a lump on the top of her left foot. Under general anesthesia with a pneumatic tourtniquet the mass excised with great care not to leave any residual tumor tissue that can cause recurrence. Benign giant cell tumor of the foot can be associated with talonavicular joint capsule which can be detected with MRI imaging and total excision of the lesion is mandatory to prevent recurrence.
Medial subtalar dislocation: Approach to prompt care
JB Sié Essoh, M Kodo, A Traoré, Y Lambin
Nigerian Journal of Surgical Research , 2005,
Abstract: A 27- year old female patient suffered from a closed medial subtalar dislocation treated by conservative means. This relatively rare injury is reported to outline the problems encountered in diagnosis and management of such troublesome pattern of dislocation in developing countries.
Irreducible dislocation of the interphalangeal joint of the thumb.  [cached]
Mohan B,Kishan S,Munshi P,Pathak R
Journal of Postgraduate Medicine , 1996,
Abstract: Two cases of posttraumatic irreducible compound dislocation of the interphalangeal joint of the thumb are presented. This rare injury requires surgical intervention with anatomic repositioning of the structures responsible for the irreducibility viz. the long Flexor tendon and the volar plate.
Dorsal Dislocation of the Intermediate Cuneiform with a Medial Cuneiform Fracture: A Case Report and Review of the Literature  [PDF]
Burak Akan,Tugrul Yildirim
Case Reports in Orthopedics , 2013, DOI: 10.1155/2013/238950
Abstract: Dorsal dislocation of the intermediate cuneiform and isolated medial cuneiform fractures are rare injuries. In this report, we present a patient who sustained a dislocation of the intermediate cuneiform and describe predisposing factors and the treatment procedure. 1. Introduction Dorsal dislocation of the intermediate cuneiform is a rare injury, and only a few cases have been reported [1–3]. The intermediate cuneiform is wedge shaped, lies between the medial and lateral cuneiforms, and is strongly attached to the first metatarsal. It is recessed at the second metatarsal base and forms the “keystone” of the Lisfranc tarsometatarsal joint complex [1]. Because it is wedge shaped and positioned dorsally, it has a tendency to dislocate dorsally, particularly when a plantar flexion force is applied to the midfoot [4]. Isolated cuneiform fractures are rarely observed and represent 1.7% of all tarsal fractures [5]. We present a case of a dorsally dislocated intermediate cuneiform and a fracture at the medial cuneiform. To our knowledge, dorsal dislocation of the intermediate cuneiform with a medial cuneiform fracture has not been previously reported in the literature. 2. Case Report A 30-year-old woman sustained an injury to her right foot when she was walking in high-heeled shoes and fell down the stairs with her foot in an equinus and inversion position. The patient complained of severe pain and was unable to bear weight in her right foot. The initial clinical examination of her foot revealed swelling and tenderness at the dorsum of the midfoot without an open wound. There was no vascular compromise, and sensation was preserved. Plain radiographs showed dorsal dislocation of the intermediate cuneiform bone and a nondisplaced fracture at the medial cuneiform (Figure 1). A computed tomographic scan with three-dimensional reconstruction supported the radiographical findings (Figure 2). The patient was taken to the operation room, and a closed reduction was attempted under general anesthesia, but it did not succeed. The dorsal longitudinal approach was then performed. Open reduction was performed with fluoroscopic control, and two 3.5?mm cortical lag screws were used for stabilization. The postoperative radiographs were satisfactory (Figure 3). A short leg posterior splint in the neutral plantigrade position was applied for three weeks. The active range of ankle motion started 3 weeks after surgery. The patient was advised to avoid weight-bearing activities for 6 weeks. At 3 months after surgery, plain radiographs revealed fusion of the medial cuneiform and no
Spontaneous Relocation of a Posterior Dislocation of Mobile Bearing in a Medial Unicompartmental Knee Replacement  [PDF]
Hussein Noureddine,Jaimes Aird,Paul Latimer
Case Reports in Orthopedics , 2012, DOI: 10.1155/2012/230430
Abstract: We describe a case of spontaneous relocation of a posterior dislocation of the mobile bearing in a medial unicompartmental knee replacement, prior to surgical intervention. We are unaware of any similar cases in the published literature. This paper highlights some clinical issues around this type of dislocation. 1. Case Report A 58-year-old female presented to the Accident and Emergency Department with severe pain in her right knee and unable to weight bear, after sustaining trauma with a valgus force to the knee in a flexed position. An Oxford mobile bearing medial unicompartmental knee arthroplasty had been performed 3 years previously for severe right-knee medial compartment osteoarthritis, with a correctable varus deformity of 10 degrees. She had a 6?mm meniscal bearing inserted at the time of surgery, and no medial collateral ligament release was performed. The knee was felt to be well balanced, and the meniscal bearing was stable. After the surgery she had an uneventful recovery and returned to full pain-free function. On examination she had a painful nonswollen knee, with range of movement limited from thirty to sixty degrees, and tenderness over the medial joint line. There was significant medial-lateral laxity. The knee felt unstable, but medial collateral ligament felt intact. Distal neurovascular status was intact. Radiographs were performed and showed a posterior dislocation of the meniscus (Figure 1), and it was decided to proceed to theatre for a closed/open reduction of the dislocated bearing. Figure 1: Lateral view and AP view radiographs of the knee taken upon presentation at the Accident and Emergency Department. On examination under anaesthetic, the knee was found to have a full range of movement and to be stable prior to any intervention. Spontaneous relocation was considered (Figure 2), but due to concerns regarding recurrent dislocation and possible damage to the bearing, a mini-open approach to the knee was made, and the bearing was observed to have relocated. However, it had significant wear on its superior articular surface in the form of pitting and a small area of delamination of about five squared millimetres, and it was replaced by a 7?mm polyethylene liner (Figure 3). Postoperatively she made a good recovery and 6 months postoperatively has had no further trouble. Figure 2: AP view and lateral view radiographs of the knee prior to replacing the mobile bearing. Figure 3: Lateral view and AP view radiograph of the knee taken following operation. 2. Discussion Unicompartmental knees were first developed in the 1950s by
Lateral Subtalar Joint Dislocation: Things to Consider Regarding Diagnosis and Treatment - A Case Report
Karc? T et al.
Konuralp Tip Dergisi , 2011,
Abstract: Simultaneous dislocation of talocalcaneal and talonavicular joints is called “subtalar dislocation”. Twenty three years old male presented to the emergency department with a lateral subtalar dislocation. A clinical and functional result of conservative treatment was excellent. Important aspects of the diagnosis and treatment of this disorder is discussed according to the relevant literature.
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