fracture-dislocation of lumbosacral junction is rare. It usually affects the patients with multiple trauma. In all reported cases, anterior or posterior displacement of L5 on S1 have been reported, but anterolateral displacement has not been reported yet. Herein, we report delayed diagnosis of fracture-dislocation of L5-S1 with anterolateral displacement of L5 on S1, which was treated successfully with surgery (open reduction, posterior fusion, and instrumentation).      

Carpal fracture-dislocation is regarded as an unusual orthopedic injury and, thus, orthopedic surgeons are less experienced in dealing with and treating these fractures and dislocations. We report a 20-year-old worker man suffering from an unusual carpal fracture-dislocation. There was trans-scaphoid fracture and lunate dislocation with other carpal proximal bones toward volar of the wrist. Two volar and dorsal approaches were used to treat and stabilize the fracture. It was Completely stabilized after open reduction and fixation using several pins. After two days, neural symptoms were Completely recovered and the patient was discharged. Postoperative radiographies revealed Complete restitution of lesser and greater arcs and normalization of Gilula’s line. Scapholunate and lunatocapitate angles reached to less than 60° and 10°, respectively. The combined approach had favorable results for treatment of this unusual type of carpus fracture dislocation. However longer follow up is need to evaluate the arthritis and degenerative changes in wrist.

Background: The Monteggia fracture-dislocation is a rare condition among children, and its treatment is still controversial. The treatment can become quite complicated when the diagnosis is delayed. There is a broad range of surgical treatments with various complications like subluxations, degenerative changes, and radial head deformity. The present case was reported as a novel surgical treatment choice for neglected Monteggia fracture-dislocation. Case Report: A 16 year-old boy presented with left elbow severe range of motion (ROM) limitation and pain who was diagnosed with neglected Monteggia fracture-dislocation. The patient went through open reduction beside internal fixation of the ulnar shaft via Limited Contact Dynamic Compression Plate (LC-DCP) and radio-capitellar joint reduction and provisional fixation by a pin. The patient recovered after three months with a significant increase in elbow ROM without any complications. Conclusion: This method could be an appropriate treatment of choice for neglected Monteggia fractures which indeed had excellent outcomes without complication.

Background: Distal radius radiographic indices may play a role as risk factors in pathogenesis of Kienbock’s disease, scaphoid fracture and nonunion. Perilunate fracture dislocations are devastating wrist injuries, and their relationship and distal radius indices have not been addressed in the literature.Objectives: The aim of this study was to evaluate the possible role of distal radius radiographic indices including radial height, radial inclination, ulnar variance and volar tilt as risk factors in the perilunate fracture dislocation injury of the wrist.Patients and Methods: We studied distal radius radiographic indices including radial height, radial inclination, ulnar variance and volar tilt in 43 patients with perilunate fracture dislocations and compared them with 44 wrists in the control group.Results: The mean values of the radial height, radial inclination, ulnar variance and volar tilt were 12.74 (5 - 18), 24.20 (7 - 35), -0.73 (-5- 4) and 12.28 (2 - 20) in the patient group. These values were 12.68 (9 - 22), 23.22 (17 - 30), -0.11 (-4 - 3) and 11.05 (-3 - 20), respectively in the control group. There was no statistically significant difference between the two groups.Conclusions: This study did not show that distal radius anatomical indices including the radial height, radial inclination, ulnar variance and volar tilt influence perilunate fracture dislocation as risk factors.

Proximal humerus fracture-dislocation is a rare condition that occurs mostly in young adults due to high energy trauma and about 60-79 percent of misdiagnosis is occurred in the first diagnosis. In this article, we present two patients with proximal humerus fracture-posterior dislocation the fractures of whom were diagnosed, but after the radiographic studies including x-ray and computer tomography (CT) scan, the posterior dislocation was misdiagnosed. In addition, complications, management, and avoidance of this misdiagnosis were discussed.

Proximal interphalangeal (PIP) fracture-dislocation is a relatively common injury that results from “ jamming” a finger. Treatment hinges on the degree of articular surface involvement, which determines stability of the joint. For unstable injuries, a variety of surgical interventions have been described including extension block pinning, open reduction internal fixation, volar plate arthroplasty, static or dynamic external fixation, and hemi-hamate reconstruction. We present the case of an unstable, subacute ring finger PIP dorsal fracture dislocation for which the above options were not possible or desirable to the patient. We performed temporary bridge plate fixation of the joint, based on the success of a similar procedure used to treat comminuted and unstable distal radius fractures. The procedure allowed immediate return to work, which was the patients’ primary goal, and resulted in a reasonable shortterm outcome, similar to other mentioned procedures. Temporary bridge plate fixation can be considered among treatment choices for PIP fracture dislocation when other, more established options are not possible or desirable.

Femoral head fracture is a rare concomitant injury with traumatic posterior dislocation of hip joint, but isolated traumatic femoral head fracture without dislocation has not been reported so often.The fracture pattern is similar to Pepkins type 2 but its unique features which are being located Completely above cotyloid fossa and being without dislocation have left it apart from classic Pepkins classification.Hereby is a report of a 20 yeas old man following motorcycle to car accident.