Biomedical subjects

I Montane

Publications and source records attributed to I Montane.

3 recordsLinked to original sources

PubMed1991

Traumatic occipitoatlantal dislocation.

Four patients with traumatic occipitoatlantal dislocation are presented. The dislocations were the result of rapid deceleration motor vehicle accidents. The mechanism of injury was by hyperextension-rotation combined with a distraction force. Three patients sustained multiple injuries. Neurologic findings were variable. One patient with complete cord transection and closed head trauma died 4 days after the injury. In the three surviving patients, the occipitoatlantal dislocation was not diagnosed by the initial examiner. Prompt recognition and stabilization are essential to avoid further neurologic injury. Care must be taken not to increase the dislocation. A halo applied before operation facilitates reduction and allows posterior occipitoatlantal fusion to be performed under optimum conditions.

Accidents, Traffic↗

PubMed1989

Radicular pain after Harrington instrumentation.

Three patients developed lumbar radicular pain after Harrington instrumentation and posterior spinal fusion for idiopathic scoliosis. They required a second surgical procedure for nerve root decompression. The presenting complaint after the initial procedure was persistent radicular and buttock pain. Subsequent evaluation revealed direct compression by the inferior hook. At surgery the inferior hook was noted to be encased in bone and had imploded into the canal after a stress fracture of the lamina. Removal of the entire Harrington instrumentation resulted in effective relief of nerve root compression and resolution of radicular pain. To avoid this occurrence the addition of a leg extension to a postoperative brace has been instituted for procedures involving instrumentation to L5 and occasionally to L4.

Adult↗

PubMed1986

An unusual fracture of the talus associated with a bimalleolar ankle fracture. A case report and review of the literature.

A 53-year-old man sustained a fall from 1.25 m, injuring his hindfoot and ankle. Roentgenographic examination demonstrated a displaced vertical fracture through the neck of the talus with dislocation at the subtalar and tibiotalar joints (Hawkins Group III) and an ipsilateral bimalleolar fracture. Prompt anatomic reduction of the talus and bimalleolar fracture with rigid internal fixation was performed. Roentgenograms three years postinjury confirmed solid union of all fractures. Avascular necrosis of the talus had not occurred. Minimally disabling post-traumatic arthritis as both the ankle and subtalar joints was the only sequela. Only four similar injuries seem to have been reported previously in the literature. Despite the generally high incidence of avascular necrosis in Hawkins Group III talar neck fractures, none of these four cases developed this complication. A possible explanation is that with the presence of ipsilateral bimalleolar fracture, there is preservation of the extraosseous vascular supply that accompanies the deltoid and talofibular ligamentous complexes.

Ankle Injuries↗