[Traumatic dislocation of superior tibiofibular joint].

OBJECTIVE: To explore the characteristics, diagnosis and treatment on traumatic dislocation. METHODS: From April 2000 to August 2010, 12 patients with acute traumatic dislocation of superior tibiofibular joint were treated including 10 males and 2 females with an average age of 30.6 years old ranging from 18 to 60 years. According to Ogden classification, 8 cases were the anterolateral dislocation, 2 were posterior-medial dislocation, and 2 were upward dislocation. All patients had swelling in lateral-inferior of knee, fibular head prominent, fibular head pain, floating feeling in head of fibula. One case was treated by conservative treatment, and the remaining 11 cases by surgical treatment. RESULTS: All patients were followed-up for 10 months to 3 years (means 18 months). Evaluation by Lysholm scoring,the total scores were 95.08 +/- 2.02, involving limbing 4.92 +/- 0.28, support 4.92 +/- 0.28, interlocking 15.00 +/- 0.00, instability 24.58 +/- 0.79, pain 22.50 +/- 1.24, swell 8.50 +/- 0.90, climbing stairs 9.75 +/- 0.62, squatting 4.92 +/- 0.28; 11 cases achieved excellent results and 1 good. Nerve functional recovered. X-ray was no longer dislocation. CONCLUSION: The diagnosis of traumatic dislocation is easy misseddiagnosis, surgery is the main treatment method, the prognosis is good.

[Coracoclavicular ligament reconstruction using autologous double-strand palmaris longus tendon and artificial ligament for the treatment of acromioclavicular joint dislocation].

OBJECTIVE: To investigate clinical effects of coracohumeral ligament reconstruction with autologous double-strand of long palmaris longus tendon and artificial ligament for the treatment of acromioclavicular joint dislocation. METHODS: From April 2006 to June 2009, 31 patients with acromioclavicular joint dislocation were treated with coracohumeral ligament reconstruction using autologous double-strand palmaris longus tendon and artificial ligament. There were 18 males and 13 females, ranging in age from 18 to 60 years, with an average of 35 years. Twenty-six patients were acute trauma and other 5 patients were chronic trauma. Preoperative symptoms included different degrees of pain, restricted movement, and instability of acromioclaviecular joint. The X-ray showed acromioclavicular joint dislocation. RESULTS: The patients had good incision union without vascular and nerve injuries. All the patients were followed up, and the average duration was 23 months. The JOA scores decreased from preoperative (38.8 +/- 1.5) to (73.2 +/- 1.1) at 1 month after operation,and (93.5 +/- 0.8)at the last follow-up. Twenty-eight patients got an excellent result, 2 good and 1 fair. CONCLUSION: The reconstruction of coracohumeral ligament using autologous double-strand palmaris longus tendon and artificial ligament is an effective method for the treatment of acromioclavicular joint dislocation.

[Treatment strategies for the diastasis of the symphysis pubis].

OBJECTIVE: To investigate treatment methods and therapeutic effects of the diastasis of the symphysis pubis. METHODS: Thirteen patients with diastasis of the symphysis pubis, including 7 male and 6 female, ranging in age from 20 to 54 years,were treated according to classification based on the pelvic stability. Five patients of type I were treated with conservative methods, five patients of type II were treated with external fixation, and three patients with type III were treated with posterior internal fixation combined with anterior external fixation. RESULTS: All the patients were followed-up and the duration of the follow-up ranged from 4 to 62 months, with an average of 14 months. According to the reduction, pain,gait, limb length and movement of hip,the therapeutic effects were evaluated. There were 7 patients obtaining excellent results, 5 good, 1 fair, the excellent and good rate was 92.3%. CONCLUSION: Treatment methods should be chosen in view of the differences of the patients with diastasis of the symphysis pubis. The external fixation has advantages of simple operation, decreased wound and stable fixation.