RESUMEN
Grisel's syndrome is a non-traumatic atlantoaxial (C1-C2) subluxation and one of the causes of torticollis in children. The subluxation occurs in the context of an infection in the ENT ("Ear Nose and Throat") region or following surgery. Diagnosis is based on clinical examination and radiological assessment. Treatment is typically medical and conservative, with surgical interventions reserved for recurrences and late presentations. We discuss here two cases of C1-C2 subluxation. The first case involves a 10-year-old child with subluxation following a rhinopharyngitis. This presentation is the classical manifestation of Grisel's syndrome. Prompt management led to correction of the subluxation using medical treatment and a soft Philadelphia collar. The second case involves a 34-year-old adult who developed posterior headaches after sphenoidotomy surgery. Grisel's syndrome is less common in adults, leading to clinical challenges and delayed diagnosis (> 1 month). Reduction combined with a halo vest treatment failed, and the patient required cervical arthrodesis.
Le syndrome de Grisel est une subluxation atlanto-axoïdienne (C1-C2) non traumatique et l'une des causes de torticolis chez l'enfant. La subluxation survient dans le cadre d'une infection de la sphère ORL ou à la suite d'une chirurgie. Le diagnostic est basé sur la clinique et l'examen radiologique. Le traitement est le plus souvent médical et conservateur. Les prises en charge chirurgicales sont limitées aux récidives et aux présentations tardives.Nous discutons ici deux cas de subluxation C1-C2. La première chez un enfant de 10 ans faisait suite à une rhinopharyngite. Cette présentation correspond à la présentation typique du syndrome de Grisel. Une prise en charge rapide a permis une correction de cette subluxation à l'aide d'un traitement médical et d'une minerve souple de type Philadelphia. Le second cas concerne une adulte de 34 ans qui a présenté des céphalées postérieures à la suite d'une chirurgie de sphénoïdotomie. Le syndrome Grisel est moins fréquent chez l'adulte, ce qui a engendré une errance clinique et un diagnostic retardé (> 1 mois). La réduction associée à un traitement par haloveste a échoué et la patiente a nécessité une arthrodèse cervicale.
Asunto(s)
Articulación Atlantoaxoidea , Luxaciones Articulares , Tortícolis , Humanos , Articulación Atlantoaxoidea/lesiones , Adulto , Luxaciones Articulares/terapia , Luxaciones Articulares/diagnóstico , Luxaciones Articulares/etiología , Niño , Masculino , Tortícolis/etiología , Tortícolis/terapia , Tortícolis/diagnóstico , Síndrome , FemeninoRESUMEN
Lisfranc injuries are rare but severe injuries of the foot. They range from ligament sprain to complex fracture dislocations. Etiologically, a distinction is made between indirect and direct force and between high-energy and low-energy trauma. Inadequate diagnostics (injuries overlooked or misinterpreted) can lead to painful posttraumatic osteoarthritis, chronic instability and deformity of the foot. A fracture, malalignment and unclear findings in conventional radiological diagnostics necessitate computed tomography imaging including 3D reconstruction. Lisfranc injuries are often associated with accompanying pathologies of the foot that also need to be addressed. Only stable non-displaced fractures can be treated conservatively. Depending on the injury pattern, surgical treatment is performed percutaneously, minimally invasive or open. The prognosis following Lisfranc injury is determined by the severity of damage and the quality of reconstruction.
Asunto(s)
Traumatismos de los Pies , Humanos , Traumatismos de los Pies/terapia , Traumatismos de los Pies/diagnóstico por imagen , Traumatismos de los Pies/diagnóstico , Traumatismos de los Pies/cirugía , Tomografía Computarizada por Rayos X , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/terapia , Fracturas Óseas/cirugía , Fracturas Óseas/diagnóstico , Ligamentos Articulares/lesiones , Ligamentos Articulares/diagnóstico por imagen , Luxaciones Articulares/terapia , Luxaciones Articulares/diagnóstico por imagen , Luxaciones Articulares/cirugía , Luxaciones Articulares/diagnósticoRESUMEN
An internal derangement of the temporomandibular joint is described as a deviation in the position or shape of the joint tissues. Such a change is only functionally manifest if it interferes with smooth movements of the jaw joint. There are a number of internal derangements associated with jaw movements in which popping jaw joint sounds can occur. Examples are an anteriorly or posteriorly displaced disc and hypermobility of the condylar head. Although most internal derangements are harmless and only cause minor discomfort to patients, disc displacements can in some cases develop into a clinical problem, for example when there is a limitation of mouth opening (so-called closed lock) or an inability to close the mouth (so-called open lock). Most patients with these conditions do not require any or only conservative treatment.
Asunto(s)
Trastornos de la Articulación Temporomandibular , Humanos , Articulación Temporomandibular/fisiología , Articulación Temporomandibular/fisiopatología , Rango del Movimiento Articular/fisiología , Inestabilidad de la Articulación/diagnóstico , Luxaciones Articulares/etiología , Luxaciones Articulares/terapia , Luxaciones Articulares/diagnósticoRESUMEN
ABSTRACT: Radial head subluxation, or nursemaid's elbow, is a common orthopedic complaint in children and often is the result of a pulling injury to the affected arm. Although this injury largely is a clinical diagnosis, different imaging modalities may be used to identify it and confirm successful reduction. Multiple manipulative techniques can be used to treat this injury and methods are generally specific to clinician preference. This article reviews the causes, evaluation, and management of radial head subluxation.
Asunto(s)
Lesiones de Codo , Luxaciones Articulares , Humanos , Luxaciones Articulares/terapia , Luxaciones Articulares/diagnóstico , Luxaciones Articulares/diagnóstico por imagen , Niño , Articulación del Codo/diagnóstico por imagen , Radio (Anatomía)/lesiones , Radio (Anatomía)/diagnóstico por imagen , Manipulación Ortopédica/métodos , PreescolarRESUMEN
The neuropathic compression of the tibial nerve and/or its branches on the medial side of the ankle is called tarsal tunnel syndrome (TTS). Patients with TTS presents pain, paresthesia, hypoesthesia, hyperesthesia, muscle cramps or numbness which affects the sole of the foot, the heel, or both. The clinical diagnosis is challenging because of the fairly non-specific and several symptomatology. We demonstrate a case of TTS caused by medial dislocation of the talar bone on the calcaneus bone impacting the tibial nerve diagnosed only by ultrasound with the patient in the standing position.
Asunto(s)
Astrágalo , Síndrome del Túnel Tarsiano , Ultrasonografía , Humanos , Luxaciones Articulares/diagnóstico por imagen , Luxaciones Articulares/diagnóstico , Luxaciones Articulares/etiología , Astrágalo/diagnóstico por imagen , Astrágalo/anomalías , Síndrome del Túnel Tarsiano/etiología , Síndrome del Túnel Tarsiano/diagnóstico , Síndrome del Túnel Tarsiano/diagnóstico por imagen , Ultrasonografía/métodos , Soporte de PesoRESUMEN
Background: Isolated subtalar joint dislocations without associated fractures are rare in the medical literature. They occur when the talus bone remains in place while the calcaneus and navicular bones shift out of place. These dislocations account for about 15% of talus bone injuries and 1 to 2% of all joint dislocations. They are more common in young men following inversion trauma. Objective: This study aims to improve the understanding of diagnosis, treatment, and management of these rare injuries for better patient care. Case presentation: 17-year-old male patient with type 1 diabetes mellitus presented to the emergency department with severe ankle pain and swelling following an inversion injury, which rendered him unable to walk or stand. Despite his chronic condition, he was hemodynamically stable, with no neurovascular deficits but an apparent deformity in the left ankle. Treatment involved pain management with morphine, successful closed reduction under ketamine sedation, and immobilization. Follow-up radiographs and a CT scan revealed no fractures but indicated soft tissue edema, joint effusion, and subsequent osteopenia. At a three-month follow-up, the patient experienced ongoing pain and weight-bearing difficulties, diagnosed as complicated pain syndrome requiring further physiotherapy and rehabilitation. Conclusion: This case highlights the clinical challenges and complications in managing isolated subtalar joint dislocations, particularly in patients with systemic health issues, and contributes valuable insights to the sparse literature on this topic.
Asunto(s)
Fracturas Óseas , Luxaciones Articulares , Astrágalo , Humanos , Masculino , Adolescente , Luxaciones Articulares/diagnóstico , Luxaciones Articulares/terapia , Luxaciones Articulares/complicaciones , Astrágalo/lesiones , Radiografía , Dolor/complicacionesRESUMEN
This critique evaluates a recent study on adult traumatic atlantoaxial rotatory fixation (AARF), focusing on its strengths, weaknesses, and suggestions for future research. The study provides a comprehensive examination of the anatomical and biomechanical complexities of the C1-C2 articulation, shedding light on the rare nature of adult traumatic AARF and common injury mechanisms. It categorizes AARF based on the atlanto-dental interval (ADI) and dislocation severity, aiding clinicians in assessing injury severity and treatment planning. Furthermore, the study explores conservative and surgical management approaches, offering valuable insights into treatment decision-making and outcomes. However, limitations such as its retrospective nature, reliance on reported cases, lack of standardized protocols, and limited sample size may constrain the generalizability of findings. Future research should prioritize prospective, multicenter studies with standardized protocols, collaborative efforts among institutions, and innovative techniques to advance our understanding and management of adult traumatic AARF.
Asunto(s)
Articulación Atlantoaxoidea , Luxaciones Articulares , Adulto , Humanos , Articulación Atlantoaxoidea/cirugía , Articulación Atlantoaxoidea/lesiones , Luxaciones Articulares/cirugía , Luxaciones Articulares/diagnóstico , Revisiones Sistemáticas como AsuntoRESUMEN
RATIONALE: Radial nerve palsy in the newborn and congenital radial head dislocation (CRHD) are both rare disorders, and early diagnosis is challenging. We reported a case of an infant with concurrent presence of these 2 diseases and provide a comprehensive review of the relevant literature. The purpose of the study is to share diagnostic and treatment experiences and provide potentially valuable insights. PATIENT CONCERNS: A newborn has both radial nerve palsy and CRHD, characterized by limited wrist and fingers extension but normal flexion, normal shoulder and elbow movement on the affected side, characteristic skin lesions around the elbow, and an "audible click" at the radial head. The patient achieved significant improvement solely through physical therapy and observation. DIAGNOSES: The patient was diagnosed with radial nerve palsy in the newborn combined with CRHD. INTERVENTIONS: The patient received regular physical therapy including joint function training, low-frequency pulse electrical therapy, acupuncture, paraffin treatment, as well as overnight splint immobilization. OUTCOMES: The child could actively extend the wrist to a neutral position and extend all fingers. LESSONS: If a neonate exhibits limited extension in the wrist and fingers, but normal flexion, along with normal shoulder and elbow movement, and is accompanied by skin lesions around the elbow, there should be a high suspicion of radial nerve palsy in the newborn.
Asunto(s)
Articulación del Codo , Luxaciones Articulares , Neuropatía Radial , Niño , Recién Nacido , Humanos , Neuropatía Radial/diagnóstico , Neuropatía Radial/etiología , Neuropatía Radial/terapia , Radio (Anatomía)/diagnóstico por imagen , Codo , Luxaciones Articulares/diagnósticoRESUMEN
A small number of case reports have documented a link between atlantoaxial dislocation (AAD) and vertebral artery dissection (VAD), but this association has never been described in patients with hereditary connective tissue disorders. We present a case of an 18-year-old female patient, diagnosed with Marfan syndrome since the age of one, who underwent brain MRA for intracranial aneurysm screening revealing tortuosity of the internal carotid and vertebral arteries as well as atlantoaxial dislocation. Since the patient was asymptomatic, a wait-and-see approach was chosen, but a follow-up MRA after 18 months showed the appearance of a dissecting pseudoaneurysm of the V3 segment of the left vertebral artery. Despite the patient being still asymptomatic, it was decided to proceed with C1-C2 stabilization to prevent further vascular complications. Follow-up imaging showed realignment of the atlantoaxial joint and reduction of the dissecting pseudoaneurysm of the left vertebral artery. In our patient, screening MRA has led to the discovery of asymptomatic arterial and skeletal abnormalities which, if left untreated, might have led to severe cerebrovascular complications. Therefore, AAD correction or close monitoring with MRA should be provided to MFS patients with this craniovertebral junction anomaly, even if asymptomatic.
Asunto(s)
Aneurisma Falso , Aneurisma Intracraneal , Luxaciones Articulares , Síndrome de Marfan , Disección de la Arteria Vertebral , Femenino , Humanos , Adolescente , Disección de la Arteria Vertebral/diagnóstico , Disección de la Arteria Vertebral/diagnóstico por imagen , Síndrome de Marfan/complicaciones , Síndrome de Marfan/diagnóstico , Aneurisma Falso/diagnóstico , Aneurisma Falso/diagnóstico por imagen , Arteria Vertebral/diagnóstico por imagen , Arteria Vertebral/anomalías , Luxaciones Articulares/complicaciones , Luxaciones Articulares/diagnósticoRESUMEN
CHST3-related chondrodysplasia with congenital joint dislocations (CDCJD, #MIM 143095), is a rare genetic skeletal disorder caused by biallelic loss of function variants in CHST3. CHST3 is critical for the sulfation of chondroitin sulfate. This study delineates the clinical presentation of nine individuals featuring the key symptoms of CDCJD; congenital joint (knee and elbow) dislocations, short trunk short stature progressive vertebral anomalies, and metacarpal shortening. Additional manifestations include irregular distal femoral epiphysis, supernumerary carpal ossification centers, bifid humerus, club foot, and cardiac abnormalities. Sanger sequencing was carried out to investigate molecular etiology in eight patients and exome sequencing in one. Genetic testing revealed five homozygous variants in CHST3 (four were novel and one was previously reported). All these variants are located on sulfotransferase domain of CHST3 protein and were classified as pathogenic/ likely pathogenic. We thus report on nine individuals with CHST3-related chondrodysplasia with congenital joint dislocations from India and suggest monitoring the health of cardiac valves in this condition.
Asunto(s)
Enanismo , Luxaciones Articulares , Anomalías Musculoesqueléticas , Osteocondrodisplasias , Humanos , Luxaciones Articulares/diagnóstico , Luxaciones Articulares/genética , Mutación , Osteocondrodisplasias/diagnóstico , Osteocondrodisplasias/genética , Sulfotransferasas/genéticaRESUMEN
INTRODUCTION: Chopart injuries can be allocated into 4 broad groups, ligamentous injury with or without dislocation and fracture with or without dislocation, which must occur at the talonavicular joint (TNJ) and/or calcaneocuboid joint (CCJ). Chopart dislocations are comprised of pure-dislocations and fracture-dislocations. We aim to review the literature, to enable evidence-based recommendations. METHODS: A literature search was conducted to identify relevant articles from the electronic databases, PubMed, Medline and Scopus. The PRISMA flow chart was used to scrutinise the search results. Articles were screened by title, abstract and full text to confirm relevance. RESULTS: We identified 58 papers for analysis, 36 case reports, 4 cohort studies, 4 case series and 14 other articles related to the epidemiology, diagnosis, treatment and outcomes of Chopart dislocations. Diagnostic recommendations included routine imaging to contain computed tomography (CT) and routine examination for compartment syndrome. Treatment recommendations included early anatomical reduction, with restoration and maintenance of column length and joint congruency. For both pure-dislocations and fracture-dislocations urgent open reduction and internal fixation (ORIF) provided the most favourable long-term outcomes. CONCLUSIONS: Chopart dislocations are a complex heterogenous midfoot injury with historically poor outcomes. There is a relative paucity of research discussing these injuries. We have offered evidence-based recommendations related to the clinical and surgical management of these rare pathologies.
Asunto(s)
Fractura-Luxación , Fracturas Óseas , Luxaciones Articulares , Humanos , Fracturas Óseas/cirugía , Luxaciones Articulares/diagnóstico , Luxaciones Articulares/cirugía , Fractura-Luxación/diagnóstico por imagen , Fractura-Luxación/cirugía , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Fijación Interna de Fracturas/métodosRESUMEN
Multiple fracture patterns can occur around the proximal interphalangeal joint and require surgeons to have a thorough understanding of the anatomy, clinical and radiographic examination, common fracture patterns, surgical and nonsurgical treatment options, and potential complications. Proximal phalangeal condylar fractures are typically managed surgically, because even nondisplaced fractures have a propensity for displacement. Middle phalangeal base fractures most commonly present as a volar lip fracture with or without dorsal subluxation or dislocation. Treatment options include extension block splinting or pinning, transarticular pinning, open reduction and internal fixation, external fixation, volar plate arthroplasty, and hemihamate arthroplasty. Less common fractures include dorsal lip fractures with or without volar subluxation or dislocation (the central slip fracture), lateral plateau impaction or avulsion injuries, and pilon fractures. The main goals in the management of middle phalangeal base fractures are to restore articular congruency and initial early range of motion, which are more important than obtaining an anatomic reduction.
Asunto(s)
Fracturas de Tobillo , Traumatismos de los Dedos , Fracturas Óseas , Luxaciones Articulares , Humanos , Articulaciones de los Dedos/cirugía , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/cirugía , Traumatismos de los Dedos/diagnóstico por imagen , Traumatismos de los Dedos/cirugía , Luxaciones Articulares/diagnóstico , Luxaciones Articulares/cirugía , Fijación Interna de Fracturas , Rango del Movimiento ArticularRESUMEN
BACKGROUND: The correct diagnosis and treatment of the atlanto-occipital dislocation (AOD) remains a major challenge. OBJECTIVE: To evaluate the different radiological diagnostic criteria for AOD and discuss potential treatment strategies based on a case with AOD and additional fracture of the atlas. MATERIAL AND METHODS: A 29-year-old male patient is presented who suffered from AOD with concomitant fracture of the anterior and posterior arches of the atlas with rotational atlantoaxial dislocation following an accident in forestry. The following parameters were evaluated for the diagnosis and assessment of postoperative reduction: Powers ratio, the Xlines-method, Wackenheim line, basion-dens interval (BDI), basion-axial interval (BAI) and occipital condyle-C1 interval (CCI). RESULTS: Stabilization was performed by occipitocervical spondylodesis from C0 to C2/3. For final reduction it was necessary to reduce the malrotation of the atlas. In the presented case, the revised CCI proved to be a sensitive and valid yet practical parameter. Powers' ratio and the BDI were less suited for assessing the diagnosis. The Xlines-method, Wackenheim line and the BAI did not adequately detect the pathological situation. DISCUSSION: The AOD is a severe injury requiring immediate correct diagnosis for later adequate treatment results. Among the published parameters, the revised CCI proved to be a practical and valid parameter to detect AOD. For definitive treatment, the operative occipitocervical stabilization is regarded as the method of choice.
Asunto(s)
Articulación Atlantooccipital , Luxaciones Articulares , Traumatismos Vertebrales , Masculino , Humanos , Adulto , Articulación Atlantooccipital/diagnóstico por imagen , Luxaciones Articulares/diagnóstico , Traumatismos Vertebrales/diagnóstico por imagen , Radiografía , Hueso Occipital/lesionesRESUMEN
Anterior dislocation of the coccyx is rare, but it can occur due to trauma. Conservative treatment is usually performed. However, dislocation reduction may be required to control severe pain in the acute phase or to prevent chronic complications. If manual reduction fails, open reduction is required. The extent of the incision and the method used to maintain the reduction should be considered during open reduction. A 56-year-old male patient experienced a dislocation of the sacrococcygeal joint after falling backwards. Despite conservative treatment, the patient complained of persistent pain during sitting and when using the bathroom. A manual reduction was attempted but failed. We performed joystick reduction via minimal incision and maintained the reduction using a one-strand trans-osseous suture passing through the skin. The patient was advised to use a soft cushion when sitting or lying down for four weeks after surgery. The supine position was not restricted. The patient's symptoms significantly improved after surgery. At the 6-month follow-up, the sacrococcygeal joint showed good alignment and no surgical complications occurred. During the treatment of sacrococcygeal dislocation, the rapid alleviation of acute pain and minimizing potential complications are key points. If open reduction is needed, the minimally invasive reduction technique with a one-strand trans-osseous suture may offer patient satisfaction and a good surgical outcome.
Asunto(s)
Luxaciones Articulares , Masculino , Humanos , Persona de Mediana Edad , Luxaciones Articulares/cirugía , Luxaciones Articulares/diagnóstico , Cóccix/cirugía , Cóccix/lesiones , DolorRESUMEN
BACKGROUND: We have previously reported on the midterm outcomes after a nonoperative protocol to treat simple dislocations of the elbow that included a short period of splinting followed by early movement. We have now performed extended follow-up of the original patient group from the prior study to determine whether the excellent results that previously had been reported were maintained in the long term and also to determine the rate of and need for any late surgical intervention. METHODS: We attempted to contact all of the patients from the original study group. We requested that they complete the Oxford Elbow Score (OES) survey, the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and a validated patient satisfaction questionnaire. Patients also were requested to attend a face-to-face assessment to have a clinical examination that included neurovascular, range-of-motion, and ligamentous stability assessments. RESULTS: Seventy-one patients from the original patient group agreed to participate in the new study. The mean duration of follow-up was 19.3 years. At the time of the final follow-up, patients reported excellent functional outcome scores and a preserved functional range of movement in the injured elbow. The mean OES was 91.6 points, the mean DASH score was 5.22 points, and the mean satisfaction score was 90.9 points. None of the patients had undergone delayed or secondary surgery for instability during the interval period. CONCLUSIONS: This study demonstrated that the original excellent outcomes following treatment with a protocol of a short period of splinting and early movement remained excellent and were maintained into the very long term. LEVEL OF EVIDENCE: Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.
Asunto(s)
Articulación del Codo , Luxaciones Articulares , Humanos , Estudios de Seguimiento , Codo , Luxaciones Articulares/cirugía , Luxaciones Articulares/diagnóstico , Articulación del Codo/cirugía , Hombro , Rango del Movimiento Articular , Resultado del Tratamiento , Estudios RetrospectivosRESUMEN
BACKGROUND: Injuries to the elbow are frequent in judo combat, but studies on down-time and effect on performance after conservative treatments are rare. This issue is particularly relevant for elbow dislocations in high-performance patients such as elite athletes. The purpose of this study was to evaluate (1) time-loss and (2) the regained level of performance in judoka after conservative treatment of simple elbow dislocation. METHODS: In cooperation with the European Judo Union, judoka were asked to complete a 139-item survey regarding elbow injuries they suffered during their career. Besides demographics, injury data, diagnosis and treatment options, the athletes were asked about down-time and reductions in performance level. This study enrolled 108 judoka with conservative treatment of elbow dislocation out of a population of 5426 volunteers. RESULTS: 69% (n=74) reported a time-loss of less than three months; 6% reported a time-loss of more than six months. The majority (68%, n=73) reported that they had returned to their previous performance level, while 22% (n=24) suffered from a slightly reduced level of performance. In the subgroup of international and national athletes (n=54), 63% returned to judo after less than three months, with 72% achieving the same level and 15% reporting a slightly reduced performance level. Level of performance and time lost after conservative treatment for elbow dislocations were comparable for male and female judoka. CONCLUSION: Approximately two out of three judoka returned to the same level of performance after three months of down-time after undergoing conservative therapy for simple elbow dislocations. Despite the high performance level of the study population, conservative treatment of simple elbow dislocation resulted in satisfactory outcomes. The presented data can guide medical professionals and competitive-level contact-sport athletes with respect to expectations in the process of returning to sport.
Asunto(s)
Luxaciones Articulares , Inestabilidad de la Articulación , Artes Marciales , Humanos , Masculino , Femenino , Tratamiento Conservador , Codo , Volver al Deporte , Luxaciones Articulares/diagnóstico , Luxaciones Articulares/terapiaRESUMEN
BACKGROUND: Noninfectious myositis (NIM) of the masticatory muscles is uncommon local myalgia disorder persisted by a centrally-mediated neurogenic mechanism. Due to the rarity of this condition and the lack of appropriate data regarding it, diagnosing this pathology when it affects the temporal muscle (TM) is challenging. CASE PRESENTATION: Clinical signs and symptoms, diagnostic process, and treatment outcome of 2 rare cases of NIM of the TM were presented. The signs and symptoms of the patients were not pathognomonic. There were restrictions on the mouth opening and lateral excursion of the mandible. The duration of the symptoms may not be chronic. The findings of clinical evaluation may indicate the diagnosis of anterior disc displacement (DD) without reduction of the temporomandibular joint (TMJ) and/or local myalgia. Swelling of the involved muscle could be evident and identified on palpation depending on the involved site of myositis. The axial T2-weighted magnetic resonance (MR) imaging was important for the accurate diagnosis of this rare condition. Application of non-surgical conservative treatment modalities such as administration of non-steroidal anti-inflammatory analgesics for a sufficient period of time, control of oral parafunctional habits, and jaw exercises were effective for the management of NIM of the TM. CONCLUSION: A thorough clinical examination and MR imaging including the axial T2-weighted view are required for accurate diagnosis and effective management of NIM of the TM.
Asunto(s)
Luxaciones Articulares , Miositis , Trastornos de la Articulación Temporomandibular , Humanos , Músculo Temporal/patología , Mialgia/etiología , Articulación Temporomandibular , Miositis/diagnóstico , Miositis/terapia , Imagen por Resonancia Magnética , Luxaciones Articulares/diagnósticoRESUMEN
High-energy injuries, including fractures and dislocations, are occurring with increasing frequency in athletic competitions with the increasing size and speed of players. Common fractures and dislocations will be discussed in this article. We will evaluate emergent versus routine injuries and discuss appropriate treatment at the athletic venue. Fractures that can be seen with athletic activities include cervical spine; knee osteochondral fractures; tibia, ankle, and clavicle. Dislocations that will be considered include knee, patella, hip, shoulder, sternoclavicular joint, and proximal interphalangeal joint of the finger. These injuries vary significantly both in severity and in the emergent nature of the injury.
Asunto(s)
Traumatismos en Atletas , Fracturas Óseas , Luxaciones Articulares , Deportes , Humanos , Traumatismos en Atletas/diagnóstico , Traumatismos en Atletas/terapia , Luxaciones Articulares/diagnóstico , Luxaciones Articulares/terapia , Fracturas Óseas/terapia , Articulación de la RodillaRESUMEN
The complex injury pattern of a posterior elbow dislocation with concomitant radial head and coronoid fractures is usually referred to as a terrible triad injury. Due to the concomitant compromise of several osteoligamentous structures of the elbow joint relevant for stability, these injuries pose a particularly major challenge to the treating trauma surgeons. For this reason, a careful preoperative analysis of all relevant injury components is mandatory in order to make an adequate treatment decision. In most cases, surgical treatment addressing all elements relevant for stability is necessary to achieve a stable and congruent elbow joint. Only this enables early functional follow-up treatment and minimizes the complication rate. Delayed or even insufficient treatment with persistent (sub)dislocation must be avoided at all costs, otherwise there is a high risk of serious posttraumatic functional disorders of the elbow with rapid progression of osteoarthritis.