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At least 145 records · Page 8Linked to original sources
PubMed1998

[Shoulder joint instability after primary arthroplasty].

Instability is one of the most common complications after shoulder arthroplasty. The literature cites subluxation or luxation to occur between 0% and 38% in various studies. Instabilities may present either as subluxation or frank dislocation, and may be directed in an anterior, posterior, inferior or, depending on the state of the rotator cuff, cranial direction. The stability of any shoulder joint is given by the balance of the muscles directing the forces around the shoulder joint in association with the passive stabilizers of the shoulder joint capsule as well as the bony contours between glenoid and humeral head. Any disturbance of this delicate balance will lead the shoulder into instability, particular so if bony erosion patterns such as posterior glenoid wear in osteoarthritics will develop subluxation early on. Therefore implantation of any prosthesis is required to be done in the appropriate version as to avoid secondary instability through the prosthetic components. In the study undertaken here instability was found to be the most common complication in 44 shoulder revision surgeries. The result with an average Score of 41.9 recorded after Constant demonstrates that the excellent and good results obtained with primary arthroplasties can not be expected in revision surgery. Posterior instability may be present just as well as the more easily observed anterior instability. Separate to frank luxation or instability is the late cranialisation of the rotator cuff deficient shoulder which, although resulting in many cases in superior anterior subluxation, will mostly be seen as a late complication after arthroplasty.

Arthroplasty, Replacement↗
PubMed1997

[Dynamic pedography for assessing functional ankle joint instability].

Chronic functional instability of the lateral ankle may be difficult to distinguish from mechanical instability when radiological stress test reveal only small ligamentous defects. When a decision for or against surgical reconstruction of the ligaments has to be made it can be helpful to use additional information on joint function. Therefore, a prospective study of 65 patients (mean age 24.1 +/- 4.6 years) with long-standing chronic ankle instability was conducted to demonstrate that the dynamic measurement of plantar pressure distribution can identify patients with functional ankle instability. Plantar pressure patterns were measured during gait by means of a capacitive platform, the EMED-SF system. The impulses at eight points of the foot were calculated intraindividually and compared with those in a group of 100 healthy subjects. On the basis of clinical criteria alone, the two groups of patients were distinguished, 35 with functional instability and 30 with mechanical instability. The patients with functional instability showed significantly increased lateral loading of the unstable foot (P = 0.01), whereas the group with mechanical instability tended to walk more on the medial side of the unstable foot. This finding is explained by a deficit or peroneal strength during the stance phase, based on a proprioceptive deficit after trauma. The new technique provides additional information, which is relevant and sufficiently important to help in making decisions about the individual patient with chronic instability.

Adult↗
PubMed2003

Proximal interphalangeal joint instability in the dog.

A prospective study into the use of transarticular external skeletal fixation in the treatment of proximal interphalangeal instability was undertaken. Only dogs with soft tissue injuries were included. All the dogs except one were greyhounds or related breeds. A hypothesis was proposed that if the articular surfaces were held in normal congruency for a period of time then the development of periarticular fibrosis would alone give sufficient joint support. Joint congruency was maintained by the application of a unilateral external skeletal fixator for approximately three weeks. Complications were common and were due to frame impingement on the neighbouring digit, pin tract infection and pin loosening, and all resolved following frame removal and antibiotic therapy. Careful pin placement and prophylactic antibiotic treatment prevented complications in subsequent cases. All dogs returned to normal function with no lameness, with the exception of one racing greyhound which had a recurrence of the instability.

Animals↗
PubMed2005

[Chronic instability talocrural joint after tibiofibular syndesmosis traumatic injures].

The authors present long term results of treatment for traumatic injuries of the tibiofibular syndesmosis being a part of crural fractures considering the chronic talocrural joint instability. It presents different operational methods of treatment evaluating simultaneously the effect this method has on regaining the functional efficiency of the operated joint. The evaluation of the talocrural joint anterior stability is performed according to my own method and lateral and medial stability is based on Zwipp's method. The clinical material of 1997-2004 year are 62 cases, 40 male (64.5%) and 22 female (35.5%) treated operatively because of ankle fractures in which performed stabilization of injured tibio-fibular syndesmosis. Average time of study is 6 month. Obtained outcomes of observation permit to make assertion that traumatic damage of tibio-fibular syndesmosis during ankle fractures demand anatomical alignment and effective stabilization of fragments and reconstruction of ligaments. Inveterate ankle sprain cause rotation talocrural joint instability.

Ankle Injuries↗
PubMed1979

Hip joint instability after the neonatal period. I. Value of measuring the acetabular angle.

The acetabular angle was measured by two independent observers in a consecutive series of 29 infants with idiopathic instability of the hip. The diagnosis was made at the age of 1 1/2 to 21 months, and was confirmed by arthrography. The average difference in the measurement values between the two observers was less than 2 degrees. In infants with unilateral instability the acetabular angle was always greater on the unstable side. This difference decreased after treatment. Criteria for pathologic angles are discussed. Measurement of the acetabular angle is of greatest value for assessing the effect of treatment, but is of limited usefulness in diagnosing instability, especially during the first 6 months of life, as the cartilaginous component of the joint is not included in the measurement. Arthrography is recommended in cases difficult to evaluate.

Acetabulum↗
PubMed1992

Neonatal screening for hip joint instability. Its clinical and economic relevance.

Effort to determine the efficacy of neonatal hip examination began in 1967. During the subsequent 23 years, there have been three analyses of the study's data: (1) a retrospective review reported in 1981, (2) a prospective examination in 1989, and (3) an economic evaluation in 1990. The retrospective review concluded that a neonatal hip screening program effectively screens for acetabular dysplasia, and early treatment seems to alter the outcome of congenital dislocation of the hip. The prospective examination, involving 62 newborns diagnosed as having dislocated or dislocatable hips, established that such cases can be effectively treated from birth with flexion/abduction splints monitored by routine clinical and follow-up examinations. An economic evaluation of the data demonstrated an economic benefit of more than $15,000 Cdn per 1000 infants screened. This study, through these three analyses, presents a compelling argument in favor of a routine, standardized neonatal hip examination.

False Negative Reactions↗
PubMed1998

[Instability of the sternoclavicular joint].

Instability of the sternoclavicular joint is a rare diagnosis and will mostly be found after motor vehicle accidents or sports injuries. Depending on the severity of the trauma open reduction is rarely required, and most cases will be treated successfully with conservative management. Associated injuries to the surrounding anatomic structures are not rare, and can be found in posteriorly directed injuries.

Accidents, Traffic↗
PubMed1989

Instability of the subtalar joint.

Instability of the subtalar joint can follow inversion stress injuries to the lateral ankle and hindfoot. Ligaments involved in the injury include the calcaneofibular, lateral talocalcaneal, cervical, interosseous talocalcaneal, or a combination. Although the problem most often occurs in conjunction with lateral ankle instability, it may be an isolated problem and it is not corrected equally well by the various lateral ankle ligament reconstructions. Techniques available for diagnosis include routine stress radiographs of the ankle, which also include the subtalar joint, specific subtalar stress radiographs, stress tomograms, fluoroscopy, or subtalar arthrograms. Once diagnosed, subtalar instability symptoms can be treated by either nonoperative or operative means.

Fluoroscopy↗
PubMed1998

[Instability of the distal radio-ulnar joint].

Instability of the distal radioulnar joint is caused either by bone deformity, fracture or by ligament deficiency. The logical treatment will consist either in osteotomy, osteosynthesis, or in reconstruction of the ligamentous support. The refixation of the TFCC or the ulnar styloid has been demonstrated to be effective in correcting instability biomechanically and clinically. Near-anatomical TFCC reconstruction should always be striven for, rather than resorting to non-anatomical reconstructive procedures. Nevertheless, great efforts will be necessary in the future in order to better understand biomechanics, epidemiology, diagnosis, and treatment of distal radioulnar joint instability.

Fracture Fixation, Internal↗
PubMed1989

[The "positioned image" of the talo-calcaneus joint in instability of the posterior distal ankle joint].

With regard to the very common disease of sprained ankles the combined tear with ruptures of ligaments of the subtalar joint are possible. Even an isolated instability is known as the reason of long lasting post-traumatic complaints. Using the apparatus of Scheuba, well-known in diagnosing instabilities of the knee and ankle joint, a new standardized method controlling instabilities of the subtalar talo-calcanear joint is introduced. In an experimental investigation this radiological technique has been tested out in cadaveric ankle joints (nine joints) with artificial ligamentous lesions. The results show that in all cases an instability is recognizable radiologically using this technique. For clinical use the bilateral examination is recommended failing standardized values for unilateral use.

Humans↗