Midfoot dislocation
Appropriate treatment of the acute injury depicted is:
| (A) | Open reduction, internal fixation | |
| (B) | Traction | |
| (C) | Closed reduction and casting | |
| (D) | Primary midfoot arthro |
Tarsal Bones are the seven bones which form the tarsus – namely, CALCANEUS, TALUS, cuboid, navicular, and the internal, middle, and external cuneiforms (Ankle Bones / Cuboid Bone / Cuneiform Bones / Navicular Bone of Foot).
Radial head fractures are usually classified according to the size and displacement of the fracture fragments, but stability is not considered.
At the Combined Annual Meeting of the American Society for Surgery of the Hand (ASSH) and the American Society of Hand Therapies, researchers propose a radiographic definition of stability: complete loss of cortical contact between the fracture fragment and the rest of the proximal radius.
The investigators used a prospective trauma database and billing records to identify 296 consecutive skeletally mature patients with radial head fractures treated over a 6-year period.
Researchers investigated whether or not there was a complete lack of cortical contact between a fracture fragment and the rest of the proximal radius and used this information to classify 121 consecutive fractures of part of the radial head displaced by more than 2 mm.
Study parameters included predictors of an isolated vs. a complex injury pattern in bivariate and multivariable analyses.
30 of the 121 fractures (25%) were classified as having cortical contact, with the remaining 91 displaying no cortical contact.
Ten of 30 fractures with cortical contact were part of a complex elbow injury, while 83 of 91 fractures (91%) without cortical contact were reported to be part of a complex elbow injury with an odds ratio of 21.
Lack of cortical contact with at least one radial head fracture fragment has fair reliability, but the diagnostic performance characteristics suggest that this concept may be useful and it deserves further study.
