Diagnosis and treatment of acute Essex-Lopresti injury: focus on terminology and review of literature

Abstract Background Acute Essex-Lopresti injury is a rare and disabling condition of longitudinal instability of the forearm. When early diagnosed, patients report better outcomes with higher functional recovery. Aim of this study is to focus on the different lesion patterns causing forearm instability, reviewing literature and the cases treated by the Authors and to propose a new terminology for their identification. Methods Five patients affected by acute Essex-Lopresti injury have been enrolled for this study. ELI was caused in two patients by bike fall, two cases by road traffic accident and one patient by fall while walking. A literature search was performed using Ovid Medline, Ovid Embase, Scopus and Cochrane Library and the Medical Subject Headings vocabulary. The search was limited to English language literature. 42 articles were evaluated, and finally four papers were considered for the review. Results All patients were operated in acute setting with radial head replacement and different combinations of interosseous membrane reconstruction and distal radio-ulnar joint stabilization. Patients were followed for a mean of 15 months: a consistent improvement of clinical results were observed, reporting a mean MEPS of 92 and a mean MMWS of 90.8. One case complained persistent wrist pain associated to DRUJ discrepancy of 3 mm and underwent ulnar shortening osteotomy nine months after surgery, with good results. Discussion The clinical studies present in literature reported similar results, highlighting as patients properly diagnosed and treated in acute setting report better results than patients operated after four weeks. In this study, the definitions of “Acute Engaged” and “Undetected at Imminent Evolution” Essex-Lopresti injury are proposed, in order to underline the necessity to carefully investigate the anatomical and radiological features in order to perform an early and proper surgical treatment. Conclusions Following the observations, the definitions of “Acute Engaged” and “Undetected at Imminent Evolution” injuries are proposed to distinguish between evident cases and more insidious settings, with necessity of carefully investigate the anatomical and radiological features in order to address patients to an early and proper surgical treatment

Sterno clavicular joint dislocation: A case report of a surgical stabilization technique

Sterno Clavicular Joint (SCJ) dislocations are rare injuries of the shoulder girdle. Their management is controversial due to a not guaranteed outcome after any kind of treatment (conservative or open). Open reduction is challenging because of the anatomical site, while the conservative treatment does not always improve pain or instability discomfort. We report a case of traumatic and painful anterior SCJ dislocation of a young policewoman treated with open reduction by a new surgical technique. Functional result is extremely good at 2 years of follow-up. \ua9 2010 Springer-Verlag

Mud volcanoes, olistostromes and Argille scagliose in the Mediterranean Region.

Tectonic and sedimentary m\ue9langes, rocks with block-in-matrix fabric often referred to as \u2018chaotic\u2019, are widespread in the circum-Mediterranean collisional orogenic belts as well as in submerged Mediterranean Arcs. These rock types have been defined originally as \u2018Argille scagliose\u2019 (Bianconi, 1840) and \u2018olistostromes\u2019 (Flores, 1955, 1959) in the outcrops of the Apennine chain (Italy). Both terminology and concepts have undergone a rather complex evolution through time owing to the gradual recognition of similar chaotic bodies in all the circum-Mediterranean orogenic belts. Submarine mud volcanoes of the Mediterranean region, also composed by block-in-matrix, more commonly referred to as mud breccias, have a much younger history. These mud breccias were discovered in 1981 and, since then, a growing number of sea-going geophysical and geological expeditions have allowed the recognition of a major mud volcano belt in the Eastern Mediterranean and of a number of mud diapirs and mud volcano fields from the Black Sea to the Gulf of Cadiz. Structural, textural and genetic similarities between the mud breccias of the Mediterranean mud volcanoes and the olistostromes and Argille scagliose of the Apennines were noted from the very beginning, but the matter has not been the focus of any detailed study. In this paper, the use of the terms in the geological literature is analysed, the distribution of these rock units in the Mediterranean region explored and the assumed genetic processes are identified in order to formulate a common genetic model that can be applied to the evolution of the circum-Mediterranean sedimentary basins