Orthopedics
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Subtalar dislocations are rare in routine orthopedic practice. While many of these dislocations are a result of high-energy injuries such as fall from a height or traffic accidents, it is not uncommon for patients to present after slipping down a few stairs. Two types of dislocation have been described, medial and lateral. ⋯ The reverse is true of lateral dislocation. Medial dislocation has been referred to as "basketball foot" due to its preponderance in basketball players.4 The deciding factor is the inverted or everted position of the foot when the force is dissipated through the weak talonavicular and talocalcaneal ligaments. This article presents a case of an adult with lateral subtalar dislocation following a fall.
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This study reviewed surgical treatment methods in patients with type II odontoid fracture who were admitted to a level 1 spinal cord injury center during a 20-year period. Of the 186 patients who met inclusion criteria, 75 were treated operatively. The rate of surgical intervention increased during the study period. ⋯ The Brooks technique and anterior odontoid screw fixation declined in frequency, whereas the Magerl technique has been used at a consistent rate since its introduction. The C1 lateral mass and C2 pedicle/isthmus screw technique has increased significantly since its description. Pneumonia, vocal cord, and swallowing problems occurred more often with anterior approaches.
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Lesions of knee's lateral side are less common than medial injuries. The anatomy of the lateral ligaments and the presence of additional structures (eg, fibula head) can cause diagnostic problems. Isolated dislocation of the proximal tibiofibular joint is unusual; therefore, it may be overlooked in the emergency department. ⋯ Treatment usually consists of closed or open reduction. In complicated cases, however, arthrodesis or resection of the fibular head may be required. This article reports a rare case of acute isolated anterolateral dislocation of the proximal tibiofibular joint in a soccer player and discusses the joint anatomy, types of dislocations, mechanisms of injury, and treatment options.
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Hip dislocations are becoming more frequent with increasing numbers of motor vehicle accidents. Bilateral hip dislocations are a rare injury, and simultaneous asymmetric dislocations are even more rare. Of the 20 cases described in the English literature, 16 have been sustained by occupants of motor vehicle accidents. This article presents the first case of a female with traumatic simultaneous asymmetric hip dislocations, as well as the first patient with associated asymmetric acetabular wall fractures.
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Simultaneous avulsions of the tibial tubercle and patellar ligament have been reported, but are rare. We present an 11-year-old boy who was initially diagnosed with a Type IIIA tibial tubercle avulsion fracture after falling off of his bicycle. Intraoperatively, following exposure and fixation of the tibial tubercle fragment, knee range of motion under live fluoroscopy revealed a stationary patella with no tension in the patellar ligament. ⋯ In retrospect, a clue to this diagnosis in our patient was the preoperative radiographic finding of multiple calcified fragments below the patella. The calcified fragments likely represent the avulsed tibial tubercle periosteum attached to the distal patellar ligament. In addition, the large tibial tubercle fragment is separated and rotated superiorly, a finding that was also noted in two other similar case reports.