Fracture-Dislocations You Can't Afford to Miss

Abstract

Occult dislocations can accompany extremity fractures and may lead to serious complications if undetected and untreated. Physicians, therefore, need to watch for uncommon trauma like distal radius fractures with radioulnar joint disruption (Galeazzi fractures), proximal ulna fractures with radial head dislocation (Monteggia fractures), and midfoot dislocations with or without fracture (Lisfranc injuries). Injury recognition involves comparing important historical features like a fall onto an outstretched hand, physical exam findings such as the nature of the pain, and sometimes-subtle radiographic clues. Treatment is usually surgical.

Evaluation of common missed fractures and dislocations in orthopedics and traumatology

“…Literatürdeki eski çalışmalara bakıldığında bu iki lezyonun atlanma oranının %50'lerde olduğu görülmektedir. [6,7] Yeni çalışmalarda böyle bir oran bildirilmemekle birlikte %50'nin altında olduğu tahmin edilmektedir. El aşırı ekstansiyonda iken düşme öyküsü ile acil servise gelen hastalarda bu patolojiler dışlanmalıdır.…”

Lisfranc joint injuries

“…He described fracture-dislocation of the tarsometatarsal joint in addition to amputation through the tarsometatarsal joints. There is some controversy as to whether the amputation was done specifically for fracture-dislocation, however the reality is almost certainly that the Lisfranc amputation through the tarsometatarsal joint was perfected as a quick amputation for the sequele of the fracture-dislocation, as well as for frostbite (Vuori and Aro, 1993;Englanoff et al, 1995;Thompson and Cordas, 1996).…”