A rare case of testicular dislocation with inguinal hernia as a delayed presentation after scrotal trauma

Testis can be damaged either by blunt or penetrating trauma. Traumatic dislocation of testis is rare sequelae of scrotal trauma. Patients usually present at the time of injury and diagnosis is usually made on emergent basis. However, delayed or missed diagnosis may occur as scrotal injury may be overlooked in the presence of other associated injuries or due to lack of awareness of its possible occurrence. In this article, we report a case of 60 years old gentleman who presented with inguinal hernia with empty left hemiscrotum with history of blunt injury to scrotum 15 years back. The peculiarity of case lies in the fact that the dislocation of testis was diagnosed 15 years after trauma and the displaced testis was found to be atrophic.

Luxación anterior obturatriz traumática de cadera en la edad pediátrica: reporte de un caso / Anterior dislocation traumatic hip obturator in pediatric age: a case report / Obturador traumático de cadeira com luxação anterior em idade pediátrica: relato de caso

La luxación de cadera de tipo anterior-obturatriz es una patología inusual en la ortopedia pediátrica pero con complicaciones potencialmente graves en la evolución. A propósito, presentamos el caso de una niña de 14 años que sufrió una luxación anterior-obturatriz secundaria a un traumatismo de alta energía. Se le realizo reducción cerrada en block quirúrgico bajo anestesia general, con buena evolución y sin complicaciones, con un seguimiento 24 meses.

Hip dislocation of the anterior-obturator type is an unusual pathology in pediatric orthopedics, but with potentially serious complications in evolution. By the way, we present the case of a 14-year-old girl who suffered a secondary anterior-obturator dislocation and high-energy trauma. A closed reduction was made in the surgical block under general anesthesia, with good evolution and without complications in a follow-up of 24 months.

A luxação anterior-luxação do quadril obturador é uma patologia incomum em ortopedia pediátrica, mas com complicações potencialmente graves na evolução. A propósito, apresentamos o caso de uma menina de 14 anos que sofreu um deslocamento obturador prévio secundário a trauma de alta energia. Uma redução fechada foi realizada no bloco cirúrgico sob anestesia geral, com boa evolução e sem complicações no seguimento de 24 meses.

Isolated Traumatic Radial Head Anterior Dislocation Treated with Open Reduction in Children / 대한정형외과학회잡지

Isolated traumatic radial head anterior dislocation without associated injuries is uncommon in pediatric patients. If diagnosed on time, most cases can be reduced by closed reduction. In some cases, the radial head was found to be trapped between annular ligament, anterior joint capsule and a buttonhole tear of the brachialis muscle, preventing closed reduction. This is a very uncommon injury and the diagnosis can be overlooked. We report a case of a 7-year-old girl who sustained an irreducible isolated dislocation of the radial head which was reduced with open reduction.

Volar Open Reduction of Traumatic Dislocation of the 5th Metacarpophalangeal Joint Without Releasing Volar Plate: A Case Report

Traumatic dislocation of the metacarphophalangeal joint is a rare injury. Complex dislocation often require surgical procedure due to its anatomical characteristics. We report one case of surgically treated traumatic dislocation of the 5th metacarpophalangeal joint that was successfully reduced by volar open reduction without splitting the volar plate.

Luxação coxofemoral traumática em cães e gatos: estudo retrospectivo (1997-2006) / Traumatic coxofemoral luxation in dogs and cats: retrospective study (1997-2006)

As luxações coxofemorais traumáticas são importantes afecções ortopédicas nos cães e gatos devido a grande frequência com que acometem esses animais. A principal causa são traumas ocasionados por atropelamentos, e a apresentação craniodorsal destaca-se dentre as demais. Podem ocorrer em qualquer raça, sexo e idade, porém os animais adultos são os mais frequentemente afetados. O tratamento primário de escolha é a redução fechada. No entanto, em algumas circunstâncias, faz-se necessário o uso do método aberto/cirúrgico. O objetivo deste trabalho foi avaliar os casos de luxações coxofemorais traumáticas no Hospital Veterinário Universitário da Universidade Federal de Santa Maria. Para isso, foi realizado um estudo retrospectivo dos atendimentos cirúrgicos realizados entre 1997 e 2006 nesse hospital. Observou-se alta incidência das luxações traumáticas (75,8 por cento), sendo o traumatismo por automóveis a causa mais frequente (58,6 por cento), seguido pelas quedas (17,3 por cento), pelos agentes desconhecidos (17,2 por cento) e pelas brigas (6,9 por cento). A proporção canina/felina foi de 29:1, sendo os machos os mais acometidos em ambas as espécies: 65,5 por cento dos cães e 100 por cento dos gatos. Os animais mais predispostos eram da raça Poodle (44,8 por cento) e aqueles sem raça definida (20,7 por cento). Os tratamentos utilizados foram capsulorrafia (18,3 por cento), pino transarticular (56,7 por cento) e excisão artroplástica da cabeça e do colo femoral como método primário (25 por cento). A taxa de sucesso foi de 71,1 por cento nas duas primeiras técnicas, mostrando-se eficientes na redução da luxação coxofemoral traumática, recomendando-se a excisão da cabeça e do colo femoral em sua impossibilidade ou em complicações.

The traumatic coxofemoral luxations are important orthopedics injuries in dogs and cats due to their great frequency. The main causes are the automobilistic accidents and craniodorsal appearance is the most frequent. This injury can affect any breed, sex and age, however, adult animals are most frequently involved. Close reduction is the first choice of treatment, but at some circumstances the use of open/surgical methods are necessary. This study aims to evaluate the incidence, predisposition, etiology and results of treatments of traumatic hip luxation at the Santa Maria Federal University Veterinary Hospital. For this, a retrospective study of surgical service was made between 1997 and 2006 in this hospital. It was observed a high incidence of traumatic luxations (75.8 percent), and the most frequent cause was hit t by a car trauma (58.6 percent), followed by falls (17.3 percent), unknown agents (17.2 percent) and fights (6.9 percent). The canine/feline proportion was 58/2, with the males being the most affected in both species: 65.5 percent at dogs and 100 percent at cats. The most predicts breed involved was the Poodle (44.8 percent) and the mixed breed dogs (20.7 percent). The treatments options used were suture of capsule (18.3 percent), transacetabular pinnig (56.7 percent) and femoral head and neck excision (25 percent). The success rate was 71.1 percent in the first two techniques, proving itself efficient in the traumatic coxofemoral luxation reduction, thus, femoral head and neck excision are recommended in complications and impossibility.

Traumatic Dislocation of the Peroneal Tendons / 中国运动医学杂志

Objective To study the injury mechanism, diagnosis and therapy of traumatic dislocation of the peroneal tendons. Methods 18 cases with traumatic dislocation of the peroneal tendons were operated in our institute from 1986 to 2000. The mechanism of injury and clinical findings were investigated. 2 cases with acute dislocation were operated by suturing the peroneal retinaculum directly. 16 cases with recurrent dislocation were treated with Watson-Jones operation. Results 10 cases with recurrent dislocation were follow-up from 1 year to 15 years with an average of 6.2 years. Only one recurrence due to ankle sprain was found and the other 9 cases had no more dislocation and returned to sports without symptom.Conclusion Traumatic dislocation of the peroneal tendons can be caused by the injury of ankle joint in three positions:dorsiflexsion and eversion, dorsiflexsion and inversion, plantflexsion and inversion. Anti-resistant test of dorsiflexsion and eversion may help diagnosis. Watson-Jones operation has the advantages of simple to apply, minor trauma and sound clinical outcome.

Three Cases of Traumatic Dislocation of Testis / 대한비뇨기과학회지

Traumatic dislocation of the testicle is characterized by an ectopically displaced testis as the result of closed injury. Motorvehicle accident have provided the majority of cases, although a number of alternative causes have been reported ranging from kicks to the perineum to falling accidents. Surgery should be performed immediately in traumatic dislocation when closed reduction fails on initial presentation or when a concomitant injury to the testis exists that requires surgical intervention. We experienced 3 cases of subcutaneous inguinal dislocation of the testis. Of these a patient was successfully treated by immediate closed reduction and 2 others need exploration, reduction and fixation of the testis.

Early MRI Finding of Femoral Head in Traumatic Hip Dislocation / 대한정형외과학회잡지

Traumatic dislocation of the hip presents serious problems that may lead to avascular necrosis, nerve palsy, post-traumatic arthritis even when reduction is promptly and adequately carried out. Among them avascular necrosis is the most important prognostic factor, so the early detection of this complication has critical significance for final result. Bone scan has been considered one of early diagnostic test, but recently MRI replaced its role for imaging in the detection of early AVN, treatment monitoring and prediction of prognosis. Authors prospectively studied the early finding of MRI to detect avascular necrosis of the femoral head and to predict prognosis in traumatic hip dislocation and fracture-dislocation. From December 1990 to November 1994, 12 case of dislocation and fracture-dislocation of the hip were studied . In follow up period ranging from 19 months to 65 months, 10 case had excellent or good result. All cases had abnormal MRI finding such as paraarticular edema, capsular bulging, joint effusion, femoral head fracture, but findings such as femoral head signal changes were dectected in only 3 cases. Among the 3 cases, 1 case had developed AVN and 2 cases were uneventful. Other complications were 3 cases of posttraumatic arthritis, 2 cases of incomplete sciatic nerve palsy, and 1 case of heterotrophic ossification. Although early MRI finding at posttrauma 2weeks gave less specific information, it could give good information for risk group and follow up control with more cases. Although it is expensive, MRI can be one of the most reliable reference in early diagnosis of AVN and prediction of prognosis in traumatic dislocation and fracture- dislocation of the hip with non-invasive method.

Traumatic Dislocation of the Knee / 대한정형외과학회잡지

Traumatic dislocation of the knee is an uncommon but serious injury associated with extensive soft tissue damage and the danger of neurological and vascular involvement. During the periods from September 1983 to September 1992, we had experienced 21 cases of the traumatic dislocation of knee at the Guro and Ansan Hospital, Korea University College of Medicine. The results obtained from this study were as follows ; 1. The age of initial dislocation varied from 11 to 79 years with the average of 32. 8 years and the ratio of male to female was 20: 1. 2. Dislocations were classified into 5 types which were anterior in 9, posterior in 4, medial in 1, lateral in 4 and rotatory in 2 cases and also unclassified in 1 case. 3. Causes of the injury were traffic accident in 9, sports injury in 7, fall down in 4 and industriai injury was 1 case. 4. Complications of traumatic dislocation of the knee included popliteal artery rupture in 3, compartment syndrome in 2 and peroneal nerve palsy in 4 cases. 5. All of ligamentous injuries were repaired and augmented except 2 cases which were treated conservating 10-14 days after trauma and all of the cases of arterial injuries were repaired with an autogenous vein graft. 6. Results were excellent 3, good 12, fair 4, and poor 2 cases by Marvin classification at the average 27 months after operation. 7. Prompt completion of vascular repair is critical to avoid amputation and also operative repair of injured ligaments seems to be good method to yield good results with the improved stability.

Traumatic dislocation of the hip due to ski / 体力科学

If the traumas treated at Ishiuchi Clinic of Showa University during the past 31 years from 1957 to 1988 are classified by topical site and type, the traumas in the knee and ankle joints are seen in many cases, occupying totally 53% of the total traumas. Compared with these, the traumas in the hip joint are relatively rare, and particularly, the cases of traumatic dislocation of the hip joint are extremely rare articular traumas. The subject cases were 6 males and 5 females.<BR>The traumatic mechanisms have been elucidated, and concurrently, super selective angiography was performed on the medial circumflex arteries in 8 cases to determine angiographically the time when loading began.<BR>There are many cases whose posterior dislocations were presumably caused by a mechanism that, while the tibia is fixed by skiing boots in a position including forward in angles slightly wider than 90°, flexion and rotary strengths applied to the hip joint are much strong at the skier's position with extended knee joint because the safety binding does not come loose at the fall of the body forward.<BR>The superior retinacular arteries are said to be very important remification of the medial circumflex femoral artery which supplies 2/3-3/4 of blood stream to the outside of the loaded epiphysial region. What are presumed as the causes for the ineffective and defective angiograms are (1) compression by hematoma, (2) extended SRA and (3) rupture of SRA. The time of loading to begin was found as 2 months in the case with favorable angiograms of SRA and 4 months in the cases with ineffective or defective angiogram.

A Clinical Study of Traumatic Dislocation of the Hip / 대한정형외과학회잡지

In recent years, the incidence of traumatic dislocation of the hip joint appears to be on the increase, year by year, as the rate of traffic and industrial accidents increases. To prevent complications after dislocation of the hip, many authors have pointed out the importance of the early accurate reduction. But many authors have advocated different methods for aftercare treatment. In this paper, the author has reviewed 34 patients of traumatic disolocation of the hip who had been hospitalized and treated at Hanyang University Hospital from May 1972 to Dec. 1980. It was possible to follow 21 of these patients for an average followup period of 54 months. With this study, the following results were obtained. l. Of 34 patients, 31 patients were male and 3 were female. The prevalent age distribution was from 21 to 30 years of age 12 patients (35.3%) showing this distribution. 2. 30 (88.4%) of 34 dislocations of the hip were the result of traffic accidents, 22 of these being auto accidents. 3. The order of incidence according to the Thompson-Epstein classification is; posterior type I (44.1%), III (23.5%) and type II (11.8%). 4. 28 (82.4%) dislocations of the hip were complicated by multiple injuries at other sites. The most common site of associated injury was the ipsilateral lower extremity, which occurred in 15 patients. 5. 27 closed reductions, 5 open reductions and 1 prosthetic replacement of femoral head were performed, and 24 (88.9%) of 27 closed reductions were performed within 24 hours. 6. By Thompson-Epstein method, the author evaluated 21 patients who could be followed for an average of 54 months, and so obtained excellent or good results in 16 patients (71.4%) and fair or poor results in 5 patients (28.6%). Of these 21 patients, 13 patients who were performed closed reduction with 24 hours were results of excellent of good. 7. As complications avascular necrosis, traumatic arthritis and ectopic ossification developed in one, four and three patients respectively. In addition 5 patients developed sciatic nerve injuries, 3 of these recovered completely.