Orthop Traumatol Sur
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Atlanto-occipital dislocation is a devastating ligamentous injury that most often turns fatal. However, because of on-site resuscitation improvements, the emergency teams are increasingly dealing with this condition. We report a rare case of atlanto-occipital dislocation (AOD) in a surviving patient with more than one-year follow-up. ⋯ Surgical treatment should be combined with cardiorespiratory management. The emergency teams should get familiar with this injury since they will be increasingly confronted to it. Early recognition and standard appropriate management is essential to avoid delayed treatment and complications.
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Orthop Traumatol Sur · May 2011
Case ReportsCranial nerves neuropraxia after shoulder arthroscopy in beach chair position.
We report a case of neuropraxia of the 9th, 10th and 12th cranial nerve pairs after arthroscopic rotator cuff repair in the beach chair position. The elements in the medical file seem to exclude an intracranial cause of the lesions and support a mechanical, extracranial cause due to intubation and/or the beach chair position. This clinical case report shows the neurological risks of the beach chair position during arthroscopic shoulder surgery and presents the essential safety measures to prevent these risks.
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Orthop Traumatol Sur · May 2011
Proximal clavicle physeal fracture-separation mimicking an anterior sterno-clavicular dislocation.
Proximal physeal fracture-separation of the clavicle is a very rare injury occurring in the adolescent and in the young adult which involves a contact loss with fracture between the clavicle and its cartilaginous ossification center similar in appearance to a sternoclavicular dislocation. The authors report an unusual case of a proximal physeal fracture-separation of the clavicle with avulsion of sternoclavicular periosteal and ligamentous structures without vasculonervous injury in a 16-year-old young person. ⋯ Surgical management consisted in costoclavicular ligament and periosteum reattachment associated with reduction of the fracture-separation and pin fixation. This repair demonstrated a successful outcome at 8-month follow-up.
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Orthop Traumatol Sur · May 2011
Comparative StudyStiffness after knee arthrotomy: evaluation of prevalence and results after manipulation under anaesthesia.
The aim of the present study was to determine the prevalence and the effect of manipulation under anaesthesia in patients with Total Knee Arthroplasty (TKA), "revision-knee" and all forms of other intra-articular surgical procedures. We aimed to determine differences in the outcome according to the number of previous surgeries and according to time of manipulation under anaesthesia (MUA). ⋯ MUA is a valuable technique to increase ROM after TKA in patients with stiff knees, for "revision-knees" and all other patients with reduced flexion after different forms of intra-articular knee surgical procedures (excluding trauma cases). The results were similar for early and delayed MUA relative to the last surgery. The patients can therefore undergo conservative treatment (e.g. physiotherapy) before the MUA without the risk of poorer outcome. The results after MUA in patients with many previous operations were significantly worse and so an open/arthroscopic arthrolysis should be discussed earlier for this subgroup.
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Orthop Traumatol Sur · Apr 2011
Acute postoperative pain at rest after hip and knee arthroplasty: severity, sensory qualities and impact on sleep.
The management of acute postoperative pain poses a significant challenge in surgical specialities. Despite the prevalence and impact of acute postoperative pain, there is a paucity of published data regarding its occurrence and sensory qualities after joint replacement. ⋯ Level IV (observational cohort study).