Background: Elbow dislocations in pediatric patients are rare injuries. This is a therapeutic emergency because a delay in treatment can have disastrous consequences on the functional level of the upper limb. Objectiv...Background: Elbow dislocations in pediatric patients are rare injuries. This is a therapeutic emergency because a delay in treatment can have disastrous consequences on the functional level of the upper limb. Objective: To present the management of elbow dislocation in children in cases of limited resources. Presentation of the Cases: These were 2 older male children aged 7 and 9 years old, admitted to the emergency room for painful functional impotence of the right elbow after a fall and landing on the right hand. Clinical and radiological examinations were in favor of posterior elbow dislocations. The reductions were carried out under sedation and immobilization in Jersey. According to Robert’s criteria, the functional result was excellent in both patients. Conclusion: Emergency reduction and immobilization whatever the means ensure an excellent functional prognosis even in cases of limited resources.展开更多
Introduction: The acromioclavicular joint is a superficial diarthrodial joint that surrounds the medial articular facet of the acromion and the distal portion of the clavicle. Due to its anatomy and biomechanics, it i...Introduction: The acromioclavicular joint is a superficial diarthrodial joint that surrounds the medial articular facet of the acromion and the distal portion of the clavicle. Due to its anatomy and biomechanics, it is highly susceptible to trauma and in young men who play contact sports, acromioclavicular dislocation is common. This article aimed to systematically review the literature and compare the surgical techniques used in the treatment of acromioclavicular dislocation in patients who practice sports. Methods: This systematic review was conducted according to the International Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Eligible studies for this systematic review included articles in English or Spanish published between 2013 and 2023, which mention the occurrence of acromioclavicular dislocation during sports practices. Additionally, only studies that addressed the surgical treatment of acromion-clavicular dislocation and contained original data on the topic were included. Results: We found 144 eligible studies after searching the LILACS and PubMed databases. Based on the inclusion and exclusion criteria and the reviewers’ consensus, we selected four studies for the systematic review. 133 patients with AC joint displacement were evaluated. Mean Age: approximately 31.90 years. 81.92 of these injuries occurred during sports practice. Surgical Procedures Used: titanium plates fixation (49 patients), arthroscopy (24), single tunnel technique (30) and coracoid sling technique (30). The results of the visual analog scale and Constant-Murley scores varied between the techniques used. Twenty-two complications after surgical treatment were identified. Conclusion: A significant variability of operative techniques can be used in the surgical approach of acromioclavicular dislocation, such as arthroscopy, single tunnel, coracoid sling and titanium plates. Although it presented excellent functional results compared to the other three techniques evaluated by this review, using titanium plates is not the gold standard since other techniques not assessed by this work may be more effective.展开更多
Introduction: Acromioclavicular (AC) joint dislocation is a common shoulder injury, comprising 9% - 12% of shoulder girdle injuries. Optimal management remains challenging, with treatment decisions guided by the Rockw...Introduction: Acromioclavicular (AC) joint dislocation is a common shoulder injury, comprising 9% - 12% of shoulder girdle injuries. Optimal management remains challenging, with treatment decisions guided by the Rockwood classification system. Controversies surround grade III injuries, necessitating further classification. Non-operative treatment has shown favorable outcomes, while surgical interventions vary. Anatomical coracoclavicular reconstruction (ACCR) has demonstrated biomechanical advantages over traditional methods. Arthroscopic techniques offer advantages, minimizing deltoid detachment and allowing concurrent pathology identification. This study evaluates the outcomes of arthroscopic-assisted ACCR in chronic AC joint dislocation. Surgical Technique: Arthroscopic-assisted ACCR involves meticulous portal placement, tendon graft harvesting, diagnostic arthroscopy, and coracoid exposure. The clavicle tunnels were made to mimic the conoid and trapezoid ligament positions, using FibreTape#2 loop and Dog Bone Button for correct placement against the coracoid base, and passing the semitendinosus graft through to reconstruct the conoid ligament, reduction done and graft follow through for anatomical reconstruction. Methods: A retrospective cohort study at Hospital Kuala Lumpur analyzed 35 patients undergoing arthroscopic-assisted ACCR for Rockwood grade III - V AC joint dislocations. Inclusion criteria encompassed trauma ≥ 3 weeks prior, no prior shoulder injuries, and ≥12-month follow-up. Functional and radiological assessments utilized ASES scores and coracoclavicular distances, respectively. Statistical analysis employed descriptive statistics and logistic regression. Results: The mean age was 38.9 years (SD 11.26), and 34 of 35 patients were male. Grade IV injuries were predominant (37.1%). Waiting time for surgery averaged 234.9 days. Functional improvement was substantial postoperatively (ASES: 55.5 to 88.9). Radiological outcomes demonstrated reduced coracoclavicular distances and maintained reduction. No significant correlation was observed between injury grade and outcomes. Conclusion: Arthroscopic-assisted ACCR for chronic AC joint dislocation yields significant functional and radiological improvement, irrespective of injury grade. Waiting time for surgery exhibits minor impact on outcomes, emphasizing the procedure’s efficacy. Concomitant injuries do not impede success, highlighting the versatility of this approach in managing shoulder instability. The study contributes valuable insights into the nuanced management of chronic AC joint dislocations and supports the adoption of arthroscopic-assisted ACCR as a viable treatment option.展开更多
BACKGROUND Glenohumeral dislocation is a common injury that may predispose patients to chronic pain and instability.However,there is a paucity of current data available regarding the epidemiological trends of this inj...BACKGROUND Glenohumeral dislocation is a common injury that may predispose patients to chronic pain and instability.However,there is a paucity of current data available regarding the epidemiological trends of this injury.AIM To provide an updated,comparative assessment of the epidemiology of shoulder dislocations presenting to emergency departments in the United States.We also sought to analyze patient demographic risk factors and consumer products associated with dislocation events.METHODS Data were obtained from the national electronic injury surveillance system database for glenohumeral dislocations between 2012 and 2021.Incidence,age,sex,and injury characteristics were analyzed using weighted population statistics as well as incidence rates and 95%confidence intervals(CI).RESULTS In total,an estimated 773039 shoulder dislocations(CI:640598-905481)presented to emergency rooms across the United States during the study period.The annual incidence rate was 23.96 per 100000 persons and the average patient age at the time of injury was 37.1 years.Significantly more male patients sustained dislocations than female patients(537189,69.5%,vs 235834,30.5%,P<0.001).With regard to associated consumer products,sports and recreation equipment were involved in the highest proportion of incidents(44.31%),followed by home structures and construction materials(21.22%),and home furnishings,fixtures,and accessories(21.21%).Regarding product sub-groups,stairs,ramps,landings,floors was cited in the greatest number of cases(131745).CONCLUSION The national annual incidence rate of glenohumeral dislocations throughout the study period was approximately 23.92 per 100000 persons.Male adolescents sustained the highest proportion of dislocations,with a peak incidence in age group 15-20 years,predominantly secondary to participation in sporting and recreational activities.Conversely,women experienced a relatively consistent incidence of dislocation throughout their lifespan.After age 63,the incidence rate of dislocations in females was found to surpass that observed in males.展开更多
Intra-articular patellar dislocation due to acute trauma is considered a rare presentation and is less commonly encountered in practice than extra-articular patellar dislocation. This case study presents a rare type 2...Intra-articular patellar dislocation due to acute trauma is considered a rare presentation and is less commonly encountered in practice than extra-articular patellar dislocation. This case study presents a rare type 2 inferior dislocation of the patella in an elderly patient which was successfully reduced and managed non-operatively.展开更多
This study uses the digital image correlation technique to measure the crack tip displacement field at various crack lengths in U71MnG rail steel,and the interpolated continuous displacement field was obtained by fitt...This study uses the digital image correlation technique to measure the crack tip displacement field at various crack lengths in U71MnG rail steel,and the interpolated continuous displacement field was obtained by fitting with a back propagation(BP)neural network.The slip and stacking of dislocations affect crack initiation and growth,leading to changes in the crack tip field and the fatigue characteristics of crack growth.The Christopher-James-Patterson(CJP)model describes the elastic stress field around a growing fatigue crack that experiences plasticity-induced shielding.In the present work,this model is modified by including the effect of the dislocation field on the plastic zone of the crack tip and hence on the elastic field by introducing a plastic flow factorρ,which represents the amount of blunting of the crack tip.The Levenberg-Marquardt(L-M)nonlinear least squares method was used to solve for the stress intensity factors.To verify the accuracy of this modified CJP model,the theoretical and experimental plastic zone errors before and after modification were compared,and the variation trends of the stress intensity factors and the plastic flow factorρwere analysed.The results show that the CJP model,with the introduction ofρ,exhibits a good blunting trend.In the low plasticity state,the modified model can accurately describe the experimental plastic zone,and the modified stress intensity factors are more accurate,which proves the effectiveness of dislocation correction.This plastic flow correction provides a more accurate crack tip field model and improves the CJP crack growth relationship.展开更多
Thermomechanical treatment T10(extension twinning+aging treatment)can largely enhance the precipitation strengthening effect of magnesium alloys.In this study,dislocation structure evolution and precipitation behavior...Thermomechanical treatment T10(extension twinning+aging treatment)can largely enhance the precipitation strengthening effect of magnesium alloys.In this study,dislocation structure evolution and precipitation behavior during T10 treatment of an AZ80 extruded bar were analyzed mainly by two-beam diffraction in TEM.At a compressive strain of 1%in the extrusion direction(ED),a typical dislocation configuration,including basal I1 stacking faults(SFs)and<c+a>dislocations,has been established in extension twins.As the strain reaches 7%,the volume fraction of extension twins increases to more than 90%at which point high dense I1 SFs and<c+a>dislocations occur.After aging for 2 h at 150℃for the 7%strained sample,masses of basal I1 SFs and<c+a>dislocations remain in the extension twins and can act as effective nucleation sites and solute fast-diffusion channels for continuous precipitates.Consequently,the precipitates in extension twins become highly dense.展开更多
Irradiation-induced defects frequently impede the slip of dislocations, resulting in a sharp decline in the performance of nuclear reactor structural materials, particularly core structural materials. In the present w...Irradiation-induced defects frequently impede the slip of dislocations, resulting in a sharp decline in the performance of nuclear reactor structural materials, particularly core structural materials. In the present work, molecular dynamics method is used to investigate the interactions between edge dislocations and three typical irradiation-induced defects(void,Frank loop, and stacking fault tetrahedron) with the sizes of 3 nm, 5 nm, and 7 nm at different temperatures in Fe–10Ni–20Cr alloy. The critical resolved shear stresses(CRSSs) are compared among different defect types after interacting with edge dislocations. The results show that the CRSS decreases with temperature increasing and defect size decreasing for each defect type during the interaction with edge dislocations, except for the case of 3-nm Frank loops at 900 K. According to a comparison, the CRSS in Frank loop is significantly higher than that of others of the same size, which is due to the occurrence of unfaulting and formation of superjog or stacking-fault complex during the interaction. The atomic evolution of irradiation-induced defects after interacting with dislocations can provide a novel insight into the design of new structural materials.展开更多
Dislocations and other atomic-level defects play a crucial role in determining the macroscopic properties of crystalline materials,but it is extremely difficult to observe the evolution of dislocations due to the limi...Dislocations and other atomic-level defects play a crucial role in determining the macroscopic properties of crystalline materials,but it is extremely difficult to observe the evolution of dislocations due to the limitations of the most advanced experimental techniques.Therefore,in this work,the rapid solidification processes of Ni_(47)Co_(53) alloy at five cooling rates are studied by molecular dynamics simulation,and the evolutions of their microstructures and dislocations are investigated as well.The results show that face-centered cubic(FCC) structures are formed at the low cooling rate,and the crystalline and amorphous mixture appear at the critical cooling rate,and the amorphous are generated at the high cooling rate.The crystallization temperature and crystallinity decrease with cooling rate increasing.Dislocations are few at the cooling rates of 1×10^(11) K/s,5×10^(12) K/s,and 1×10^(13) K/s,and they are most abundant at the cooling rates of 5×10^(11) K/s and1 × 10^(12) K/s,in which their dislocation line lengths are both almost identical.There appear a large number of dislocation reactions at both cooling rates,in which the interconversion between perfect and partial dislocations is primary.The dislocation reactions are more intense at the cooling rate of 5×10^(11) K/s,and the slip of some dislocations leads to the interconversion between FCC structure and hexagonal close packed(HCP) structure,which causes the twin boundaries(TBs) to disappear.The FCC and HCP are in the same atomic layer,and dislocations are formed at the junction due to the existence of TBs at the cooling rate of 1 ×10^(12) K/s.The present research is important in understanding the dislocation mechanism and its influence on crystal structure at atomic scales.展开更多
In this work,W/β-Ga_(2)O_(3)Schottky barrier diodes,prepared using a confined magnetic field-based sputtering method,were analyzed at different operation temperatures.Firstly,Schottky barrier height increased with in...In this work,W/β-Ga_(2)O_(3)Schottky barrier diodes,prepared using a confined magnetic field-based sputtering method,were analyzed at different operation temperatures.Firstly,Schottky barrier height increased with increasing temperature from 100 to 300 K and reached 1.03 eV at room temperature.The ideality factor decreased with increasing temperature and it was higher than 2 at 100 K.This apparent high value was related to the tunneling effect.Secondly,the series and on-resistances decreased with increasing operation temperature.Finally,the interfacial dislocation was extracted from the tunneling current.A high dislocation density was found,which indicates the domination of tunneling through dislocation in the transport mecha-nism.These findings are evidently helpful in designing better performance devices.展开更多
Dear Editor We present a case of spontaneous dislocation of a toric implantable collamer lens(TICL)resulting in corneal endothelial decompensation 8y after implantation.Since 2006,by helping people take off their glas...Dear Editor We present a case of spontaneous dislocation of a toric implantable collamer lens(TICL)resulting in corneal endothelial decompensation 8y after implantation.Since 2006,by helping people take off their glasses,the Visian TICL(Staar Surgical Co,Monrovia,CA,USA)have gained popularity in China.Though complications of intraocular pressure(IOP)elevation,cataract formation and endothelial damage exist as relevant problems,implantable collamer lens(ICL)implantation has been generally accepted as a viable option to correct moderate to high ametropia[1-2].展开更多
BACKGROUND Isolated capitate fractures are rare carpal fractures.Following high-energy injuries,capitate fractures are usually associated with other carpal fractures or ligament injuries.The management of capitate fra...BACKGROUND Isolated capitate fractures are rare carpal fractures.Following high-energy injuries,capitate fractures are usually associated with other carpal fractures or ligament injuries.The management of capitate fractures depends on the fracture pattern.Here,we report an unusual capitate fracture with a dorsal shearing pattern and concomitant carpometacarpal dislocation,with a 6-year follow-up.To the best of our knowledge,this fracture pattern and surgical management have not been previously reported.CASE SUMMARY A 28-year-old man presented with left-hand volar tenderness and decreased grip strength that persisted for one month after a traffic accident.Radiography showed a distal capitate fracture with carpometacarpal joint incongruence.Computed tomography(CT)revealed a distal capitate fracture with carpometacarpal joint dislocation.The distal fragment was rotated by 90°in the sagittal plane,and an oblique shearing fracture pattern was noted.Open reduction and internal fixation(ORIF)with a locking plate were performed using the dorsal approach.The imaging studies performed 3 mo and 6 years following surgery revealed a healed fracture,and the Disabilities of the Arm,Shoulder,and Hand and visual analog scale scores were significantly improved.CONCLUSION CT can detect capitate fractures with dorsal shearing pattern and concomitant carpometacarpal dislocation.ORIF using a locking plate are possible.展开更多
Pyramidal dislocations in magnesium (Mg) and other hexagonal close-packed metals play an important role in accommodating plastic strains along the c-axis.Bulk single crystal Mg only presents very limited plasticity in...Pyramidal dislocations in magnesium (Mg) and other hexagonal close-packed metals play an important role in accommodating plastic strains along the c-axis.Bulk single crystal Mg only presents very limited plasticity in c-axis compression,and this behavior was attributed to out-of-plane dissociation of pyramidal dislocations onto the basal plane and resulted in an immobile dislocation configuration.In contrast,other simulations and experiments reported in-plane dissociation of pyramidal dislocations on their slip planes.Thus,the core structure and mode of dissociation of pyramidal dislocations are still not well understood.To better understand the dissociation behavior of pyramidal dislocations in Mg at room temperature,in this work,atomistic simulations were conducted to investigate four types of pyramidal dislocations at 300 K:edge and screw Py-Ⅰ on{1011},edge and screw Py-Ⅱ on{1122}by using a modified embedded atom method (MEAM) potential for Mg and anisotropic elasticity dislocation model.The results show that when energy minimization was performed before relaxation,in-plane dissociation of edge dislocations on respective pyramidal plane could be obtained at room temperature for all four types of dislocation.Without energy minimization,the edge dislocations dissociated out-of-plane onto the basal plane.Calculations of potential energy and hydrostatic stress of individual atoms at the edge dislocation core show that the extraordinarily high energy and atomic stresses in the as-constructed dislocation structures caused the out-of-plane dissociation onto the basal plane.The core structures of all four types of pyramidal dislocation after in-plane dissociation were analyzed by computing the distribution of the Burgers vector.展开更多
A crack-free AlN film with 4.5 μm thickness was grown on a 2-inch hole-type nano-patterned sapphire substrates(NPSSs) by hydride vapor phase epitaxy(HVPE). The coalescence, stress evolution, and dislocation annihilat...A crack-free AlN film with 4.5 μm thickness was grown on a 2-inch hole-type nano-patterned sapphire substrates(NPSSs) by hydride vapor phase epitaxy(HVPE). The coalescence, stress evolution, and dislocation annihilation mechanisms in the AlN layer have been investigated. The large voids located on the pattern region were caused by the undesirable parasitic crystallites grown on the sidewalls of the nano-pattern in the early growth stage. The coalescence of the c-plane AlN was hindered by these three-fold crystallites and the special triangle void appeared. The cross-sectional Raman line scan was used to characterize the change of stress with film thickness, which corresponds to the characteristics of different growth stages of AlN. Threading dislocations(TDs) mainly originate from the boundary between misaligned crystallites and the c-plane AlN and the coalescence of two adjacent c-plane AlN crystals, rather than the interface between sapphire and AlN.展开更多
BACKGROUND Traumatic radial head dislocation(RHD)is a well-described injury in the pediatric population.It is usually associated with an injury to the ulna in Monteggia fracture-dislocation,although it can occur as an...BACKGROUND Traumatic radial head dislocation(RHD)is a well-described injury in the pediatric population.It is usually associated with an injury to the ulna in Monteggia fracture-dislocation,although it can occur as an isolated injury.Traumatic RHD with ipsilateral radial shaft fracture has rarely been reported.Delayed RHD secondary to the malunion of an isolated radial shaft fracture is extremely rare.CASE SUMMARY We report a 9-year-old boy with limited pronation of the right elbow.The patient was diagnosed with delayed RHD associated with the malunion of a distal radial fracture.Since the annular ligament was disrupted with forearm rotation causing subluxation of the radial head,a modified double-strip Bell Tawse procedure was performed to reconstruct the annular ligament without corrective osteotomy for the malunited site.Four years after surgery,the angulation deformity of the distal radius was corrected with the restoration of the normal curvature of the radius.There was no recurrence of RHD.CONCLUSION Annular ligament reconstruction without corrective osteotomy could reduce RHD and restore the normal curve of the radial shaft in children with delayed dislocation of the radial head associated with malunion of the radial shaft.Annular reconstruction using double triceps tendon strips might be useful for maintaining a more stable reduction by augmenting anterolateral parts.展开更多
BACKGROUND Dislocation of the long head of biceps tendon(LHBT)usually involves rotator cuff injury,and isolated dislocation with an intact rotator cuff is rare.Some cases of isolated dislocation have been reported.How...BACKGROUND Dislocation of the long head of biceps tendon(LHBT)usually involves rotator cuff injury,and isolated dislocation with an intact rotator cuff is rare.Some cases of isolated dislocation have been reported.However,to the best of our knowledge,there has been no report of bilateral dislocation of the LHBT without rotator cuff pathology.CASE SUMMARY A 23-year-old male presented to our outpatient clinic with left side dominant pain in both shoulders.The patient had no history of trauma or overuse.The patient underwent intra-articular injection and physical therapy,but his symptoms aggravated.Based on preoperative imaging,the diagnosis was bilateral dislocation of the LHBT.Dysplasia of the bicipital groove was detected in both shoulders.Active dislocation of the biceps tendon over an intact subscapularis tendon was identified by diagnostic arthroscopy.Staged biceps tenodesis was performed and continuous passive motion therapy was administered immediately after surgery.The patient’s pain was resolved,and full functional recovery was achieved,and he was satisfied with the condition of his shoulders.CONCLUSION This study describes a rare case of bilateral dislocations of the LHBT without rotator cuff injury due to dysplasia of the bicipital groove.展开更多
BACKGROUND Eosinophilic granuloma(EG)is a proliferative condition that affects the cells of bone tissue.There are no specific clinical signs or imaging manifestations in the early stages of the disease,making it simpl...BACKGROUND Eosinophilic granuloma(EG)is a proliferative condition that affects the cells of bone tissue.There are no specific clinical signs or imaging manifestations in the early stages of the disease,making it simple to overlook and misdiagnose.Because of the disease's rarity,there is presently no standardized treatment principle.There are few accounts of such occurrences affecting the axis among children.We discovered a case of a child whose EG resulted in atlantoaxial joint dislocation and destruction of the axial bone.CASE SUMMARY After having pharyngeal discomfort for more than six months without a clear explanation,a 6-year-old boy was brought to our hospital.Following a careful evaluation,the pathology indicated a strong likelihood of an axial EG.Ultimately,we decided to treat the boy with posterior pedicle screw fixation and local steroid injections.CONCLUSION EGs of the upper cervical spine are quite uncommon in children,and they are exceedingly easy to overlook or misdiagnose.Posterior pedicle screw fixation and local steroid injections are effective treatments for patients with axial EGs affecting the atlantoaxial junction.展开更多
BACKGROUND Epidemiological understanding of acute sternoclavicular(SC)dislocations secondary to sports across the United States is poorly defined.AIM To identify and assess epidemiological trends of SC dislocations oc...BACKGROUND Epidemiological understanding of acute sternoclavicular(SC)dislocations secondary to sports across the United States is poorly defined.AIM To identify and assess epidemiological trends of SC dislocations occurring secondary to sports-related mechanisms across United States over the past two decades.METHODS This cross-sectional,descriptive epidemiological study evaluates epidemiological trends of SC dislocations from sports that present to emergency departments(EDs)across the United States.Data were obtained from the National Electronic Injury Surveillance System database spanning two decades.Data on incidence,patient demographics,mechanisms of injury,dislocation types,incident locales,and patient dispositions were collected.RESULTS 1622 SC dislocations occurred nationwide from 2001 to 2020[incidence=0.262/1000000 people,confidence interval(CI)=0.250-0.275],comprising 0.1%of shoulder/upper trunk dislocations.Most patients were male(91%,n=1480)and aged 5-17(61%,n=982).Football,wrestling,and biking were the most frequently implicated sports,with contact sports responsible for 59%of athletic injuries(n=961).Recreational vehicle-related sports injuries,such as all-terrain vehicles,dirt bikes,and mopeds accounted for 7.8%of all injuries(n=126),with dirt bikes specifically comprising 3.7%(n=61).Ultimately,82%were discharged from the ED(n=1337),12%were admitted(n=194),and 6%were transferred(n=90).All recorded posterior dislocations were admitted or transferred from the ED.Patients sustaining SC dislocations from contact sports had a significantly increased risk of hospital admission or transfer rather than discharge from the ED as compared to patients whose injuries were from non-contact sports(incidence rate ratio=1.46,CI:=1.32-1.61,P<0.001).CONCLUSION SC dislocations from sports continue to be rare with a stably low incidence over the past two decades,likely comprising a smaller proportion of shoulder dislocations than previously thought.Contact sports are a frequent source of injury,especially among school-aged and teenage males.Most patients are discharged directly from the ED;however,a substantial number are hospitalized,many of which had documented posterior dislocations.Ultimately,understanding the epidemiology and mechanism-related trends of acute SC dislocations is important given the potential severity of these injuries,concentration in a specific population,and uncertainty linked to rare presentation.展开更多
Subtalar joint is a complex joint in hindfoot formed by the talus superiorly and the calcaneus and navicular inferiorly.Subtalar dislocations are high-mechanism injuries,which are caused by simultaneous dislocation of...Subtalar joint is a complex joint in hindfoot formed by the talus superiorly and the calcaneus and navicular inferiorly.Subtalar dislocations are high-mechanism injuries,which are caused by simultaneous dislocation of both talonavicular and talocalcaneal joints,without major fracture of the talus.They are usually classified as medial(most common),lateral,anterior and posterior dislocations,based on the position of foot in relation to talus and the indirect forces that have been applied to cause this significant injury.They are usually diagnosed by X rays,but computed tomography and magnetic resonance imaging can be used to identify associated intra-articular fractures and peri-talar soft tissue injuries respectively.Majority being closed injuries,can be managed in ED by closed reduction and cast immobilisation,but if they are open,have poor outcomes.Complications that ensue open dislocations are post-traumatic arthritis,instability and avascular necrosis.展开更多
Introduction: Shoulder dislocations represent about 50% of all joint dislocations. The objective was to describe the epidemiological, therapeutic and evolutionary aspects of traumatic shoulder dislocations in Bouak...Introduction: Shoulder dislocations represent about 50% of all joint dislocations. The objective was to describe the epidemiological, therapeutic and evolutionary aspects of traumatic shoulder dislocations in Bouaké. Methods: This retrospective and descriptive study was conducted between January 2017 and December 2019. It concerned patients over 15 years of age with a recent traumatic shoulder dislocation treated and followed in the department. The variables studied were epidemiological, therapeutic and evolutionary. The severity of the trauma was assessed according to the Injury Severity Score (ISS). Functional outcome was assessed according to the Constant score. Results: There were 49 patients (49 dislocations) out of 22,569 patients. The prevalence was 0.2%. The mean age was 32 years (17 - 62). There were 38 men (77.5%). The sex ratio was 3.4. Students predominated (n = 10;20.4%). The etiology was dominated by road traffic accidents (n = 19;38.8%). Anterior dislocation was the most common (n = 45;92%). The ISS score was minor (n = 46;93.8%). The mean time to reduction was 7 hours (4 - 16). Orthopaedic reduction using the Kocher technique predominated (n = 44;89.8%). The mean duration of external rotation immobilisation of the shoulder was 23 days (16 - 45). Recurrence occurred in 8 patients (21.6%). The functional outcome at a mean Constant follow-up of 15 months (8 - 20) was satisfactory (n = 44;89.8%). Conclusion: Traumatic dislocation of the shoulder represented 0.2%. Treatment was mainly orthopaedic. Recurrence was rare.展开更多
文摘Background: Elbow dislocations in pediatric patients are rare injuries. This is a therapeutic emergency because a delay in treatment can have disastrous consequences on the functional level of the upper limb. Objective: To present the management of elbow dislocation in children in cases of limited resources. Presentation of the Cases: These were 2 older male children aged 7 and 9 years old, admitted to the emergency room for painful functional impotence of the right elbow after a fall and landing on the right hand. Clinical and radiological examinations were in favor of posterior elbow dislocations. The reductions were carried out under sedation and immobilization in Jersey. According to Robert’s criteria, the functional result was excellent in both patients. Conclusion: Emergency reduction and immobilization whatever the means ensure an excellent functional prognosis even in cases of limited resources.
文摘Introduction: The acromioclavicular joint is a superficial diarthrodial joint that surrounds the medial articular facet of the acromion and the distal portion of the clavicle. Due to its anatomy and biomechanics, it is highly susceptible to trauma and in young men who play contact sports, acromioclavicular dislocation is common. This article aimed to systematically review the literature and compare the surgical techniques used in the treatment of acromioclavicular dislocation in patients who practice sports. Methods: This systematic review was conducted according to the International Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Eligible studies for this systematic review included articles in English or Spanish published between 2013 and 2023, which mention the occurrence of acromioclavicular dislocation during sports practices. Additionally, only studies that addressed the surgical treatment of acromion-clavicular dislocation and contained original data on the topic were included. Results: We found 144 eligible studies after searching the LILACS and PubMed databases. Based on the inclusion and exclusion criteria and the reviewers’ consensus, we selected four studies for the systematic review. 133 patients with AC joint displacement were evaluated. Mean Age: approximately 31.90 years. 81.92 of these injuries occurred during sports practice. Surgical Procedures Used: titanium plates fixation (49 patients), arthroscopy (24), single tunnel technique (30) and coracoid sling technique (30). The results of the visual analog scale and Constant-Murley scores varied between the techniques used. Twenty-two complications after surgical treatment were identified. Conclusion: A significant variability of operative techniques can be used in the surgical approach of acromioclavicular dislocation, such as arthroscopy, single tunnel, coracoid sling and titanium plates. Although it presented excellent functional results compared to the other three techniques evaluated by this review, using titanium plates is not the gold standard since other techniques not assessed by this work may be more effective.
文摘Introduction: Acromioclavicular (AC) joint dislocation is a common shoulder injury, comprising 9% - 12% of shoulder girdle injuries. Optimal management remains challenging, with treatment decisions guided by the Rockwood classification system. Controversies surround grade III injuries, necessitating further classification. Non-operative treatment has shown favorable outcomes, while surgical interventions vary. Anatomical coracoclavicular reconstruction (ACCR) has demonstrated biomechanical advantages over traditional methods. Arthroscopic techniques offer advantages, minimizing deltoid detachment and allowing concurrent pathology identification. This study evaluates the outcomes of arthroscopic-assisted ACCR in chronic AC joint dislocation. Surgical Technique: Arthroscopic-assisted ACCR involves meticulous portal placement, tendon graft harvesting, diagnostic arthroscopy, and coracoid exposure. The clavicle tunnels were made to mimic the conoid and trapezoid ligament positions, using FibreTape#2 loop and Dog Bone Button for correct placement against the coracoid base, and passing the semitendinosus graft through to reconstruct the conoid ligament, reduction done and graft follow through for anatomical reconstruction. Methods: A retrospective cohort study at Hospital Kuala Lumpur analyzed 35 patients undergoing arthroscopic-assisted ACCR for Rockwood grade III - V AC joint dislocations. Inclusion criteria encompassed trauma ≥ 3 weeks prior, no prior shoulder injuries, and ≥12-month follow-up. Functional and radiological assessments utilized ASES scores and coracoclavicular distances, respectively. Statistical analysis employed descriptive statistics and logistic regression. Results: The mean age was 38.9 years (SD 11.26), and 34 of 35 patients were male. Grade IV injuries were predominant (37.1%). Waiting time for surgery averaged 234.9 days. Functional improvement was substantial postoperatively (ASES: 55.5 to 88.9). Radiological outcomes demonstrated reduced coracoclavicular distances and maintained reduction. No significant correlation was observed between injury grade and outcomes. Conclusion: Arthroscopic-assisted ACCR for chronic AC joint dislocation yields significant functional and radiological improvement, irrespective of injury grade. Waiting time for surgery exhibits minor impact on outcomes, emphasizing the procedure’s efficacy. Concomitant injuries do not impede success, highlighting the versatility of this approach in managing shoulder instability. The study contributes valuable insights into the nuanced management of chronic AC joint dislocations and supports the adoption of arthroscopic-assisted ACCR as a viable treatment option.
文摘BACKGROUND Glenohumeral dislocation is a common injury that may predispose patients to chronic pain and instability.However,there is a paucity of current data available regarding the epidemiological trends of this injury.AIM To provide an updated,comparative assessment of the epidemiology of shoulder dislocations presenting to emergency departments in the United States.We also sought to analyze patient demographic risk factors and consumer products associated with dislocation events.METHODS Data were obtained from the national electronic injury surveillance system database for glenohumeral dislocations between 2012 and 2021.Incidence,age,sex,and injury characteristics were analyzed using weighted population statistics as well as incidence rates and 95%confidence intervals(CI).RESULTS In total,an estimated 773039 shoulder dislocations(CI:640598-905481)presented to emergency rooms across the United States during the study period.The annual incidence rate was 23.96 per 100000 persons and the average patient age at the time of injury was 37.1 years.Significantly more male patients sustained dislocations than female patients(537189,69.5%,vs 235834,30.5%,P<0.001).With regard to associated consumer products,sports and recreation equipment were involved in the highest proportion of incidents(44.31%),followed by home structures and construction materials(21.22%),and home furnishings,fixtures,and accessories(21.21%).Regarding product sub-groups,stairs,ramps,landings,floors was cited in the greatest number of cases(131745).CONCLUSION The national annual incidence rate of glenohumeral dislocations throughout the study period was approximately 23.92 per 100000 persons.Male adolescents sustained the highest proportion of dislocations,with a peak incidence in age group 15-20 years,predominantly secondary to participation in sporting and recreational activities.Conversely,women experienced a relatively consistent incidence of dislocation throughout their lifespan.After age 63,the incidence rate of dislocations in females was found to surpass that observed in males.
文摘Intra-articular patellar dislocation due to acute trauma is considered a rare presentation and is less commonly encountered in practice than extra-articular patellar dislocation. This case study presents a rare type 2 inferior dislocation of the patella in an elderly patient which was successfully reduced and managed non-operatively.
基金Supported by Sichuan Science and Technology Program of China (Grant No.2022YFH0075)Opening Project of State Key Laboratory of Performance Monitoring and Protecting of Rail Transit Infrastructure of China (Grant No.HJGZ2021113)Independent Research Project of State Key Laboratory of Traction Power of China (Grant No.2022TPL_T13)。
文摘This study uses the digital image correlation technique to measure the crack tip displacement field at various crack lengths in U71MnG rail steel,and the interpolated continuous displacement field was obtained by fitting with a back propagation(BP)neural network.The slip and stacking of dislocations affect crack initiation and growth,leading to changes in the crack tip field and the fatigue characteristics of crack growth.The Christopher-James-Patterson(CJP)model describes the elastic stress field around a growing fatigue crack that experiences plasticity-induced shielding.In the present work,this model is modified by including the effect of the dislocation field on the plastic zone of the crack tip and hence on the elastic field by introducing a plastic flow factorρ,which represents the amount of blunting of the crack tip.The Levenberg-Marquardt(L-M)nonlinear least squares method was used to solve for the stress intensity factors.To verify the accuracy of this modified CJP model,the theoretical and experimental plastic zone errors before and after modification were compared,and the variation trends of the stress intensity factors and the plastic flow factorρwere analysed.The results show that the CJP model,with the introduction ofρ,exhibits a good blunting trend.In the low plasticity state,the modified model can accurately describe the experimental plastic zone,and the modified stress intensity factors are more accurate,which proves the effectiveness of dislocation correction.This plastic flow correction provides a more accurate crack tip field model and improves the CJP crack growth relationship.
基金supported by Beijing Natural Science Foundation(No.2194090).
文摘Thermomechanical treatment T10(extension twinning+aging treatment)can largely enhance the precipitation strengthening effect of magnesium alloys.In this study,dislocation structure evolution and precipitation behavior during T10 treatment of an AZ80 extruded bar were analyzed mainly by two-beam diffraction in TEM.At a compressive strain of 1%in the extrusion direction(ED),a typical dislocation configuration,including basal I1 stacking faults(SFs)and<c+a>dislocations,has been established in extension twins.As the strain reaches 7%,the volume fraction of extension twins increases to more than 90%at which point high dense I1 SFs and<c+a>dislocations occur.After aging for 2 h at 150℃for the 7%strained sample,masses of basal I1 SFs and<c+a>dislocations remain in the extension twins and can act as effective nucleation sites and solute fast-diffusion channels for continuous precipitates.Consequently,the precipitates in extension twins become highly dense.
基金supported by the National MCF Energy Research and Development Program,China (Grant No. 2018YFE0308101)the China National Nuclear Corporation Centralized Research and Development Project (Grant No. FY18000120)。
文摘Irradiation-induced defects frequently impede the slip of dislocations, resulting in a sharp decline in the performance of nuclear reactor structural materials, particularly core structural materials. In the present work, molecular dynamics method is used to investigate the interactions between edge dislocations and three typical irradiation-induced defects(void,Frank loop, and stacking fault tetrahedron) with the sizes of 3 nm, 5 nm, and 7 nm at different temperatures in Fe–10Ni–20Cr alloy. The critical resolved shear stresses(CRSSs) are compared among different defect types after interacting with edge dislocations. The results show that the CRSS decreases with temperature increasing and defect size decreasing for each defect type during the interaction with edge dislocations, except for the case of 3-nm Frank loops at 900 K. According to a comparison, the CRSS in Frank loop is significantly higher than that of others of the same size, which is due to the occurrence of unfaulting and formation of superjog or stacking-fault complex during the interaction. The atomic evolution of irradiation-induced defects after interacting with dislocations can provide a novel insight into the design of new structural materials.
基金Project supported by the National Natural Science Foundation of China (Grant Nos. 11964005, 11963003, and 62163006)the Fostering Project of Guizhou University, China (Grant Nos. [2020]33 and [2020]76)+1 种基金the Basic Research Program of Guizhou Province, China (Grant Nos. ZK[2022] 042 and ZK[2022] 143)the Industry and Education Combination Innovation Platform of Intelligent Manufacturing and Graduate Joint Training Base at Guizhou University, China (Grant No. 2020-520000-83-01-324061)。
文摘Dislocations and other atomic-level defects play a crucial role in determining the macroscopic properties of crystalline materials,but it is extremely difficult to observe the evolution of dislocations due to the limitations of the most advanced experimental techniques.Therefore,in this work,the rapid solidification processes of Ni_(47)Co_(53) alloy at five cooling rates are studied by molecular dynamics simulation,and the evolutions of their microstructures and dislocations are investigated as well.The results show that face-centered cubic(FCC) structures are formed at the low cooling rate,and the crystalline and amorphous mixture appear at the critical cooling rate,and the amorphous are generated at the high cooling rate.The crystallization temperature and crystallinity decrease with cooling rate increasing.Dislocations are few at the cooling rates of 1×10^(11) K/s,5×10^(12) K/s,and 1×10^(13) K/s,and they are most abundant at the cooling rates of 5×10^(11) K/s and1 × 10^(12) K/s,in which their dislocation line lengths are both almost identical.There appear a large number of dislocation reactions at both cooling rates,in which the interconversion between perfect and partial dislocations is primary.The dislocation reactions are more intense at the cooling rate of 5×10^(11) K/s,and the slip of some dislocations leads to the interconversion between FCC structure and hexagonal close packed(HCP) structure,which causes the twin boundaries(TBs) to disappear.The FCC and HCP are in the same atomic layer,and dislocations are formed at the junction due to the existence of TBs at the cooling rate of 1 ×10^(12) K/s.The present research is important in understanding the dislocation mechanism and its influence on crystal structure at atomic scales.
基金supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2020R1A2C1013693)the Technology Innovation Program (20016102, Development of 1.2k V Gallium oxide power semiconductor devices technology and RS2022-00144027, Development of 1.2k V-class low-loss gallium oxide transistor) by the Ministry of Trade, Industry, and Energy (MOTIE, Korea)
文摘In this work,W/β-Ga_(2)O_(3)Schottky barrier diodes,prepared using a confined magnetic field-based sputtering method,were analyzed at different operation temperatures.Firstly,Schottky barrier height increased with increasing temperature from 100 to 300 K and reached 1.03 eV at room temperature.The ideality factor decreased with increasing temperature and it was higher than 2 at 100 K.This apparent high value was related to the tunneling effect.Secondly,the series and on-resistances decreased with increasing operation temperature.Finally,the interfacial dislocation was extracted from the tunneling current.A high dislocation density was found,which indicates the domination of tunneling through dislocation in the transport mecha-nism.These findings are evidently helpful in designing better performance devices.
基金Supported by 1.3.5 project for disciplines of excellence,West China Hospital,Sichuan University(No.ZYJC21025)。
文摘Dear Editor We present a case of spontaneous dislocation of a toric implantable collamer lens(TICL)resulting in corneal endothelial decompensation 8y after implantation.Since 2006,by helping people take off their glasses,the Visian TICL(Staar Surgical Co,Monrovia,CA,USA)have gained popularity in China.Though complications of intraocular pressure(IOP)elevation,cataract formation and endothelial damage exist as relevant problems,implantable collamer lens(ICL)implantation has been generally accepted as a viable option to correct moderate to high ametropia[1-2].
文摘BACKGROUND Isolated capitate fractures are rare carpal fractures.Following high-energy injuries,capitate fractures are usually associated with other carpal fractures or ligament injuries.The management of capitate fractures depends on the fracture pattern.Here,we report an unusual capitate fracture with a dorsal shearing pattern and concomitant carpometacarpal dislocation,with a 6-year follow-up.To the best of our knowledge,this fracture pattern and surgical management have not been previously reported.CASE SUMMARY A 28-year-old man presented with left-hand volar tenderness and decreased grip strength that persisted for one month after a traffic accident.Radiography showed a distal capitate fracture with carpometacarpal joint incongruence.Computed tomography(CT)revealed a distal capitate fracture with carpometacarpal joint dislocation.The distal fragment was rotated by 90°in the sagittal plane,and an oblique shearing fracture pattern was noted.Open reduction and internal fixation(ORIF)with a locking plate were performed using the dorsal approach.The imaging studies performed 3 mo and 6 years following surgery revealed a healed fracture,and the Disabilities of the Arm,Shoulder,and Hand and visual analog scale scores were significantly improved.CONCLUSION CT can detect capitate fractures with dorsal shearing pattern and concomitant carpometacarpal dislocation.ORIF using a locking plate are possible.
基金the support from U.S.National Science Foundation (NSF) (CMMI-2016263,2032483)supported by National Science Foundation grant number ACI-1548562,on Bridges Pylon at Pittsburgh Supercomputing Center through TG-MAT200001the support provided by National Natural Science Foundation of China (51971168 and 52022076)。
文摘Pyramidal dislocations in magnesium (Mg) and other hexagonal close-packed metals play an important role in accommodating plastic strains along the c-axis.Bulk single crystal Mg only presents very limited plasticity in c-axis compression,and this behavior was attributed to out-of-plane dissociation of pyramidal dislocations onto the basal plane and resulted in an immobile dislocation configuration.In contrast,other simulations and experiments reported in-plane dissociation of pyramidal dislocations on their slip planes.Thus,the core structure and mode of dissociation of pyramidal dislocations are still not well understood.To better understand the dissociation behavior of pyramidal dislocations in Mg at room temperature,in this work,atomistic simulations were conducted to investigate four types of pyramidal dislocations at 300 K:edge and screw Py-Ⅰ on{1011},edge and screw Py-Ⅱ on{1122}by using a modified embedded atom method (MEAM) potential for Mg and anisotropic elasticity dislocation model.The results show that when energy minimization was performed before relaxation,in-plane dissociation of edge dislocations on respective pyramidal plane could be obtained at room temperature for all four types of dislocation.Without energy minimization,the edge dislocations dissociated out-of-plane onto the basal plane.Calculations of potential energy and hydrostatic stress of individual atoms at the edge dislocation core show that the extraordinarily high energy and atomic stresses in the as-constructed dislocation structures caused the out-of-plane dissociation onto the basal plane.The core structures of all four types of pyramidal dislocation after in-plane dissociation were analyzed by computing the distribution of the Burgers vector.
基金supported by the National Natural Science Foundation of China (Grant No. 61974158)the Natural Science Fund of Jiangsu Province, China (Grant No. BK20191456)。
文摘A crack-free AlN film with 4.5 μm thickness was grown on a 2-inch hole-type nano-patterned sapphire substrates(NPSSs) by hydride vapor phase epitaxy(HVPE). The coalescence, stress evolution, and dislocation annihilation mechanisms in the AlN layer have been investigated. The large voids located on the pattern region were caused by the undesirable parasitic crystallites grown on the sidewalls of the nano-pattern in the early growth stage. The coalescence of the c-plane AlN was hindered by these three-fold crystallites and the special triangle void appeared. The cross-sectional Raman line scan was used to characterize the change of stress with film thickness, which corresponds to the characteristics of different growth stages of AlN. Threading dislocations(TDs) mainly originate from the boundary between misaligned crystallites and the c-plane AlN and the coalescence of two adjacent c-plane AlN crystals, rather than the interface between sapphire and AlN.
文摘BACKGROUND Traumatic radial head dislocation(RHD)is a well-described injury in the pediatric population.It is usually associated with an injury to the ulna in Monteggia fracture-dislocation,although it can occur as an isolated injury.Traumatic RHD with ipsilateral radial shaft fracture has rarely been reported.Delayed RHD secondary to the malunion of an isolated radial shaft fracture is extremely rare.CASE SUMMARY We report a 9-year-old boy with limited pronation of the right elbow.The patient was diagnosed with delayed RHD associated with the malunion of a distal radial fracture.Since the annular ligament was disrupted with forearm rotation causing subluxation of the radial head,a modified double-strip Bell Tawse procedure was performed to reconstruct the annular ligament without corrective osteotomy for the malunited site.Four years after surgery,the angulation deformity of the distal radius was corrected with the restoration of the normal curvature of the radius.There was no recurrence of RHD.CONCLUSION Annular ligament reconstruction without corrective osteotomy could reduce RHD and restore the normal curve of the radial shaft in children with delayed dislocation of the radial head associated with malunion of the radial shaft.Annular reconstruction using double triceps tendon strips might be useful for maintaining a more stable reduction by augmenting anterolateral parts.
文摘BACKGROUND Dislocation of the long head of biceps tendon(LHBT)usually involves rotator cuff injury,and isolated dislocation with an intact rotator cuff is rare.Some cases of isolated dislocation have been reported.However,to the best of our knowledge,there has been no report of bilateral dislocation of the LHBT without rotator cuff pathology.CASE SUMMARY A 23-year-old male presented to our outpatient clinic with left side dominant pain in both shoulders.The patient had no history of trauma or overuse.The patient underwent intra-articular injection and physical therapy,but his symptoms aggravated.Based on preoperative imaging,the diagnosis was bilateral dislocation of the LHBT.Dysplasia of the bicipital groove was detected in both shoulders.Active dislocation of the biceps tendon over an intact subscapularis tendon was identified by diagnostic arthroscopy.Staged biceps tenodesis was performed and continuous passive motion therapy was administered immediately after surgery.The patient’s pain was resolved,and full functional recovery was achieved,and he was satisfied with the condition of his shoulders.CONCLUSION This study describes a rare case of bilateral dislocations of the LHBT without rotator cuff injury due to dysplasia of the bicipital groove.
基金Supported by the Natural Science Foundation of Fujian Province,No.2021J01546the Innovation and Entrepreneurship Star Fund Project of Zhangzhou,No.ZCZZ[2019]17.
文摘BACKGROUND Eosinophilic granuloma(EG)is a proliferative condition that affects the cells of bone tissue.There are no specific clinical signs or imaging manifestations in the early stages of the disease,making it simple to overlook and misdiagnose.Because of the disease's rarity,there is presently no standardized treatment principle.There are few accounts of such occurrences affecting the axis among children.We discovered a case of a child whose EG resulted in atlantoaxial joint dislocation and destruction of the axial bone.CASE SUMMARY After having pharyngeal discomfort for more than six months without a clear explanation,a 6-year-old boy was brought to our hospital.Following a careful evaluation,the pathology indicated a strong likelihood of an axial EG.Ultimately,we decided to treat the boy with posterior pedicle screw fixation and local steroid injections.CONCLUSION EGs of the upper cervical spine are quite uncommon in children,and they are exceedingly easy to overlook or misdiagnose.Posterior pedicle screw fixation and local steroid injections are effective treatments for patients with axial EGs affecting the atlantoaxial junction.
文摘BACKGROUND Epidemiological understanding of acute sternoclavicular(SC)dislocations secondary to sports across the United States is poorly defined.AIM To identify and assess epidemiological trends of SC dislocations occurring secondary to sports-related mechanisms across United States over the past two decades.METHODS This cross-sectional,descriptive epidemiological study evaluates epidemiological trends of SC dislocations from sports that present to emergency departments(EDs)across the United States.Data were obtained from the National Electronic Injury Surveillance System database spanning two decades.Data on incidence,patient demographics,mechanisms of injury,dislocation types,incident locales,and patient dispositions were collected.RESULTS 1622 SC dislocations occurred nationwide from 2001 to 2020[incidence=0.262/1000000 people,confidence interval(CI)=0.250-0.275],comprising 0.1%of shoulder/upper trunk dislocations.Most patients were male(91%,n=1480)and aged 5-17(61%,n=982).Football,wrestling,and biking were the most frequently implicated sports,with contact sports responsible for 59%of athletic injuries(n=961).Recreational vehicle-related sports injuries,such as all-terrain vehicles,dirt bikes,and mopeds accounted for 7.8%of all injuries(n=126),with dirt bikes specifically comprising 3.7%(n=61).Ultimately,82%were discharged from the ED(n=1337),12%were admitted(n=194),and 6%were transferred(n=90).All recorded posterior dislocations were admitted or transferred from the ED.Patients sustaining SC dislocations from contact sports had a significantly increased risk of hospital admission or transfer rather than discharge from the ED as compared to patients whose injuries were from non-contact sports(incidence rate ratio=1.46,CI:=1.32-1.61,P<0.001).CONCLUSION SC dislocations from sports continue to be rare with a stably low incidence over the past two decades,likely comprising a smaller proportion of shoulder dislocations than previously thought.Contact sports are a frequent source of injury,especially among school-aged and teenage males.Most patients are discharged directly from the ED;however,a substantial number are hospitalized,many of which had documented posterior dislocations.Ultimately,understanding the epidemiology and mechanism-related trends of acute SC dislocations is important given the potential severity of these injuries,concentration in a specific population,and uncertainty linked to rare presentation.
文摘Subtalar joint is a complex joint in hindfoot formed by the talus superiorly and the calcaneus and navicular inferiorly.Subtalar dislocations are high-mechanism injuries,which are caused by simultaneous dislocation of both talonavicular and talocalcaneal joints,without major fracture of the talus.They are usually classified as medial(most common),lateral,anterior and posterior dislocations,based on the position of foot in relation to talus and the indirect forces that have been applied to cause this significant injury.They are usually diagnosed by X rays,but computed tomography and magnetic resonance imaging can be used to identify associated intra-articular fractures and peri-talar soft tissue injuries respectively.Majority being closed injuries,can be managed in ED by closed reduction and cast immobilisation,but if they are open,have poor outcomes.Complications that ensue open dislocations are post-traumatic arthritis,instability and avascular necrosis.
文摘Introduction: Shoulder dislocations represent about 50% of all joint dislocations. The objective was to describe the epidemiological, therapeutic and evolutionary aspects of traumatic shoulder dislocations in Bouaké. Methods: This retrospective and descriptive study was conducted between January 2017 and December 2019. It concerned patients over 15 years of age with a recent traumatic shoulder dislocation treated and followed in the department. The variables studied were epidemiological, therapeutic and evolutionary. The severity of the trauma was assessed according to the Injury Severity Score (ISS). Functional outcome was assessed according to the Constant score. Results: There were 49 patients (49 dislocations) out of 22,569 patients. The prevalence was 0.2%. The mean age was 32 years (17 - 62). There were 38 men (77.5%). The sex ratio was 3.4. Students predominated (n = 10;20.4%). The etiology was dominated by road traffic accidents (n = 19;38.8%). Anterior dislocation was the most common (n = 45;92%). The ISS score was minor (n = 46;93.8%). The mean time to reduction was 7 hours (4 - 16). Orthopaedic reduction using the Kocher technique predominated (n = 44;89.8%). The mean duration of external rotation immobilisation of the shoulder was 23 days (16 - 45). Recurrence occurred in 8 patients (21.6%). The functional outcome at a mean Constant follow-up of 15 months (8 - 20) was satisfactory (n = 44;89.8%). Conclusion: Traumatic dislocation of the shoulder represented 0.2%. Treatment was mainly orthopaedic. Recurrence was rare.
