[Combination of a Lisfranc injury and a dislocation of the proximal tibiofibular joint].

Lisfranc injuries and dislocations of the proximal tibiofibular joint are both rare and frequently missed on initial examination. However, delayed treatment can lead to chronic instability. This is a case report of a 26-year-old man, who received both of these injuries on the same extremity from a collision during a basketball game. The dislocation of the proximal tibiofibular joint was treated with closed reduction, however the Lisfranc injury required open reduction and internal fixation. At the follow-up after ten weeks, the patient was doing well and started rehabilitation.

False profile view is independently associated with serum metal levels in patients with metal-on-metal hip arthroplasty.

PURPOSE: Elevated levels of serum metal ions can be found in some patients with metal-on-metal (MoM) hip replacements. This study seeks to identify whether there is a significant association between the contact patch to rim distance (CPRD) and the anterior center edge angle (ACEA), respectively, and serum cobalt (Co) and chromium (Cr) levels in patients treated with unilateral MoM hip replacements by using standing anteroposterior and false profile view radiographs. METHODS: This is a retrospective analysis on 53 patients with either unilateral ReCap or M2a-Magnum MoM hip replacements operated in 2006 or 2007. Univariate linear regression and multivariable linear regression (MLR) analyses were performed using the CPRD and ACEA along with risk factors for elevated serum levels of Co and Cr previously suggested in the literature as explanatory variables. Serum Co and Cr were measured using inductively coupled plasma mass spectrometry. RESULTS: The MLR model showed that the same three variables (gender, CPRD and ACEA) were significantly associated with serum levels of both Co and Cr explaining approximately half of the variation. A univariate analysis showed a polynomial association between both anteversion angle and the ACEA with serum levels of Co and Cr. The vertex of the polynomial function was located at approximately 20° and 40°, respectively. CONCLUSION: Gender, CPRD and ACEA are independently associated with serum levels of Co and Cr. Both ACEA and anteversion angles have optimae associated with low serum metal levels which may be useful for post-surgery evaluation of cup positioning.

Oromandibular dystonia--functional and clinical characteristics: a report on 21 cases.

OBJECTIVES: The objectives of this study were to describe subtypes, characteristics, and orofacial function of patients with oromandibular dystonia and report results of special dental importance. STUDY DESIGN: Symptoms, signs, and function were evaluated by questionnaires, video, and clinical and physiological examinations in 21 patients with primary and secondary dystonia (13 focal, 7 segmental, 1 multifocal). RESULTS: A mixture of 2 or more subtypes of jaw movements was most common (43%), and the dystonic electromyographic activity was frequent in the anterior digastric (62%) and temporal and lateral pterygoid (48%) muscles. The impact from the oromandibular dystonia was marked. The prevalence of problems with mastication and swallowing was high, as well as with hyposalivation, dental attrition, and other dental problems. CONCLUSIONS: Patients with oromandibular dystonia may present to dentists with involuntary jaw movements and other severe functional problems. Care must be adapted to the neurological disorder and may be complicated by the condition itself.