Transverse bayonet dislocation of the proximal interphalangeal joint

Complete dislocation of the proximal interphalangeal joint with complete rupture of both the collateral ligaments and volar plate was seen in 8 patients. We call this, "transverse bayonet dislocation of the proximal interphalangeal joint." When treated early, closed manipulation resulted in stable reduction. After a brief period of immobilization of 3 to 5 days with a dorsal aluminum splint, sustained active range of motion exercises were begun by strapping the injured finger to the adjacent finger obtaining good end results in all cases. An untreated dislocation of 5 weeks duration needed operative reduction. This was achieved with good result by release of all the retaining ligaments around the proximal interphalangeal joint including both the collateral ligaments, the volar plate, the transverse retinacular ligaments, and extensor tenolysis.

"False inhibition" of demand pacemaker due to leakage of fluid into the pacemaker lead socket

"False inhibition" of a demand pacemaker usually occurs with a microfracture of the lead system resulting in a galvanic potential at the site of the fracture or with sensing of myopotential with exercise. An increase in the slope of the leading half edge of the pulse contour is generally considered diagnostic of lead fracture. We report the case of a patient in whom "false inhibition" at rest and an increase in the slope of the leading half edge of the pulse contour were caused by leakage of fluid into the pacemaker lead socket.

Fracture of the capitulum humeri

Fourteen patients with fracture of the capitulum of the humerus were treated, ten by excision of a large fragment or multiple small fragments. Their results were superior to those in patients treated either by closed reduction or by open reduction and fixation. Nine had good to excellent retention of elbow motion, six had no pain, and three had minimum pain. None of the ten had valgus deformity or instability.