Shoulder dislocation is the most common feature in emergencies, while the
anterior dislocation of the glenohumeral joint is the most frequent and requires
reduction. Accompanied nerve injury is common with an incidence of 21%, while
radial nerve palsy is very rare. We describe the case of a 56-year-old man who
presented with an anterior dislocation of the left shoulder due to a fall on an
outstretched hand with wrist drop 8 hours after injury. Neurological examination
revealed loss of sensation along the radial border of the forearm. Closed
reduction with Kocher procedure was performed. Magnetic resonance image
demonstrated a rotator cuff tear, and 3 weeks after the injury electromyography
showed complete radial nerve palsy. A physiotherapy program was applied to the
wrist and fingers with the goal of maintaining a full passive range of motion in
all joints affected while shoulder rehabilitation started 6 weeks after his
fall. Isolated radial nerve palsy associated with an anterior dislocation of the
shoulder is very rare but not impossible to occur. Correct diagnosis of the
nerve injury associated with the anterior dislocation is very important because
it has serious implications on the management and activity morbidity.
Perilunate dislocation and fracture dislocations are rare injuries corresponding to 10% of all carpal injuries. They usually come with high-energy trauma, with associated injuries representing 61%. Volar lunate dislocation or fracture-dislocation accounts for 3% of perilunate injuries. We present a case of a 42-year-old polytrauma male, transmitted to our department 48 hours after a car accident with a trans-scaphoid volar lunate dislocation. During operation, the lunate was displaced volarly to the ulnar side of the wrist, forward to the styloid process of the distal ulna, while the scaphoid fracture appeared at the waist with comminution, and the proximal pole of the scaphoid protruded under the dorsal capsule. Carpal injuries are often missed out in polytrauma patients, and these injuries are underestimated because of the severity of the other visceral or extremity lesions. Untreated or improperly treated, those injuries lead to serious morbidity and loss of function. Therefore, good functional prognosis with decreased percentage of complications can be achieved following early recognition and early open surgical ligamentous complex repair.
Anterior glenohumeral dislocation is the most common lesion of dislocations that appears in emergency department. Bilateral anterior shoulder dislocation is a rare injury and in majority of cases originates from trauma. We review two cases (a male, 70 years old and a female, 68 years old) with a simultaneous bilateral anterior dislocation of the shoulder after an epileptic seizure during daily activities. Dislocations were diagnosed after detailed clinical and imaging examination. Under general anesthesia closed reduction with Kocher technique was applied in both patients. A percentage more than 10% of the bilateral anterior dislocation may missed out in the first diagnosis which leads to serious morbidity and loss of function in patients. The aim of this study is to describe two rare cases with simultaneous bilateral anterior glenohumeral dislocation.
Perilunate injuries are the most complex severe injuries occurring in the wrist and there is a lack of suggested therapeutic protocols in literature, concerning rehabilitation programs. Although Deep friction massage is a widely known technique in the field of tendinopathies, ligamentous injuries and chronic pain management, its therapeutic value has not yet been documented in treatment of wrist lesions. The purpose of this study is to suggest that the technique should be considered as a good therapeutic method with good tolerance in patients and good functional outcomes and should be included in management of perilunate injuries.
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