PubMed · 6024491
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J P Sleeckx, J J Shea, F J Pitzer. 1967. Epitympanic ossicular fixation.. https://doi.org/10.1001/archotol.1967.00760040621008
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STUDY DESIGN: Report of an 11-year-old girl with a left atlantoaxial rotatory subluxation and ankylosis found 20 months after she sustained a cervical injury. OBJECTIVE: To describe the radiographic characteristics of this rare deformity assessed with a combination of spiral CT scan with multiplanar three-dimensional reformations and functional CT scan. SUMMARY OF BACKGROUND DATA: Atlantoaxial rotatory subluxation is a well-known condition, but its association with lateral C1-C2 ankylosis has not been reported to our knowledge. METHODS: For a complete assessment of the dislocation, a combined morphologic volumetric and functional CT study was performed. RESULTS: Spiral CT showed an atlantoaxial rotatory subluxation with lateral C1-C2 ankylosis. CT study also demonstrated a lateral C1-C2 subluxation and an ipsilateral occipitoatlantal subluxation. Cervical MRI showed no spinal cord compression despite the seriousness of the dislocation process. CONCLUSIONS: Whereas "classic" spiral study with multiplanar and three-dimensional reformations allows precise assessment of relationships between the upper cervical vertebrae, as well as bony changes, a functional CT study is essential for cervical biomechanic assessment of rotational instabilities of the craniovertebral junction and upper cervical spine.
A stiff elbow is usually defined as having less than 30 degrees in extension or flexion less than 130 degrees. Most activities of daily living are possible if the elbow has a range of motion of 100 degrees (30-130 degrees of flexion, Morrey's arc of motion). Loss of motion of the elbow is not uncommon after trauma, burns, or coma and severely impairs upper limb function. Loss of motion may be difficult to avoid and is challenging to treat. Detailed analysis of the etiology and diagnostic evaluation is of utmost importance for planning any surgical intervention for elbow stiffness. Current operative techniques, such as arthroscopic or open arthrolysis and closed distraction with external fixation (arthrodiatasis), are presented and evaluated. Elbow arthrolysis is a technically demanding procedure, but if indication and techniques are used correctly and surgeon, physiotherapist, and patient are familiar with the procedure, good long-term results may be achieved.
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