Combined Radiocarpal Dislocation and Forearm Joint Injuries: A Proposed Modification of the Locker-Based Classification System.

The comprehensive locker-based classification system brought revolutionary insight into the treatment of often misdiagnosed forearm joint injuries. The authors of the classification scheme subsequently described a combination of simple elbow dislocations and forearm joint injuries (two- and three-locker injuries), but to date, no review of the literature on combined radiocarpal dislocation and forearm joint injuries has been undertaken. The combination of radiocarpal dislocation and forearm joint injury is a rare traumatic pattern, usually related to high-energy trauma. The aim of this study was to confirm the possible occurrence of a forearm joint injury and radiocarpal dislocation. We performed a systematic review of the existing literature, including case reports, to find combinations of radiocarpal dislocation and forearm joint injury. Only one case report was found. Based on the results of our search and the literature review, we recommend modifying the comprehensive locker-based classification system by adding injury patterns of combined forearm joint and neighboring joint injuries.

Clinical usage of ischemic tolerance-where are its limits?

Ischemic tolerance is a robust internal defense mechanism of all living organisms. The effectiveness of this mechanism has been repeatedly demonstrated in experiments, but a comprehensive review of the clinical applicability of this phenomenon in practice has not yet been published. The results in clinical practice sound ambiguous and unconvincing in comparison with the results of experimental studies. Also, in many localities, the effect of ischemic tolerance was not clinically proven. For the reasons mentioned, the authors analyze the possible causes of the mentioned discrepancies and provide a comprehensive insight into the possible relevant clinical use of this phenomenon in practice for different groups of patients.