IntroductionAcute patellar dislocation is a relatively common problem. The most common dislocation is laterally in the coronal plane. Sometimes spontaneous reduction occurs, but if not, closed reduction can easily be done. In this paper, we report a very uncommon type of locked dislocation which required an open reduction.Case presentationA 16-year-old girl of Hispanic origin sustained a sudden dislocation of the patella while she was dancing. Pre-operative computed tomography revealed a patellar dislocation with rotation around the vertical axis with the patella wedged on the side of the lateral condyle. Closed reduction failed. Open reduction was needed and the torn structures were repaired. At 1-year follow-up, she had a good functional outcome and reported no recurrence of dislocation.ConclusionThis case report shows that some patellar dislocations may be irreducible with the closed technique. Computed tomography is valuable in case of doubt. If an open reduction is needed, the medial ligamentous structures should be repaired.
Although airbags are designed to save lives and protect victims from serious injuries, airbag deployment can cause unwanted lesions. In this case report, two cases are presented of young women who sustained an important fracture dislocation of the first carpometacarpal joint (CMC I joint) caused by airbag deployment during a car collision.
There is growing evidence that femoroacetabular impingement (FAI) is a probable risk factor for the development of early osteoarthritis in the nondysplastic hip. As FAI arises with end range of motion activities, measurement errors related to skin movement might be higher than anticipated when using previously reported methods for kinematic evaluation of the hip. We performed an in vitro validation and reliability study of a noninvasive method to define pelvic and femur positions in end range of motion activities of the hip using an electromagnetic tracking device. Motion data, collected from sensors attached to the bone and skin of 11 cadaver hips, were simultaneously obtained and compared in a global reference frame. Motion data were then transposed in the hip joint local coordinate systems. Observer-related variability in locating the anatomical landmarks required to define the local coordinate system and variability of determining the hip joint center was evaluated. Angular root mean square (RMS) differences between the bony and skin sensors averaged 3.2° (SD 3.5°) and 1.8° (SD 2.3°) in the global reference frame for the femur and pelvic sensors, respectively. Angular RMS differences between the bony and skin sensors in the hip joint local coordinate systems ranged at end range of motion and dependent on the motion under investigation from 1.91 to 5.81°. The presented protocol for evaluation of hip motion seems to be suited for the 3-D description of motion relevant to the experimental and clinical evaluation of femoroacetabular impingement.
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