Abdoulaye Bousso

Open Anterior Transverse (Divergent) Dislocation of the Elbow Joint

A divergent dislocation of the elbow joint is an unusual injury1. To the best of our knowledge, only sixty-nine cases have been reported in the literature since Warmont first described a case in 18542; these dislocations most commonly occurred in children. The upper ends of the radius and ulna dislocate from each other and from the humerus, and therefore diverge posteriorly and laterally (transverse divergence)1 or anteroposteriorly, with the radius diverging anteriorly and the ulna diverging posteriorly (anteroposterior divergence)3, or they converge with the radius posteromedially and the ulna posterolaterally (crossed divergence, radioulnar translocation)4. We report the case of a nine-year-old boy who sustained an open anterior divergent dislocation of the right elbow after a traffic accident. Open reduction and repair of the soft tissue was performed, and complete functional recovery had occurred at six months postinjury. To our knowledge, no other case of an anterior transverse dislocation of the elbow previously has been reported. The patient and his parents were informed that data concerning the case would be submitted for publication, and they provided consent. A nine-year-old right-hand-dominant boy presented to our Emergency Department with an open elbow injury following a traffic accident. He had been crossing the road when a truck struck his right upper limb. The exact mechanism remained undefined. On admission, the elbow joint was flexed and supinated. There was a large posterior wound with loss of soft tissue from the distal part of the arm to the wrist. The olecranon process and radial head were not palpable in their normal positions, and the distal part of the humerus had herniated through the triceps muscle (Fig. 1-A). Active motion of the elbow was not possible. Distally, the radial and ulnar pulses were palpable; the fingers were sensitive …

The treatment of chronic laxities of the ankle by external ligament tension restoration

Chronic external laxities of ankle have long been treated by plasties with the short peroneal as stabilizer of the hindfoot. The restoration of the tension of the internal external capsule–ligament complex with a subastragalus flap is an interesting solution. Thirty-two sporting patients with an external instability of the ankle were treated surgically by restoration of the tension of the external lateral ligament using the Saragaglia technique and were re-examined with an average 5-year time lag. The instability and the anterior drawer were measured in pre and post-operative periods. If the intervention gives good results in severe external laxities, the result is definitely less good in laxities of low importance. The presence of a functional disorder of the forefoot constituted in the series a pejorative factor. The intervention makes it possible to correct external instability of the tibiotalar and subastragalus. The conservation of the axis of the hindfoot is useful for a good performance because an instability of the subastragalus deteriorates the result of the intervention.