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Total extrusion of the talus is a rare and severe injury of the foot. If the talus is viable and can be repositioned, the outcome is unpredictable and mainly depends on whether infection and/or avascular necrosis ensues. If the talus is actually missing, the surgeon is faced with extensive bone loss and destruction of the ankle. In this report, we present 2 cases of total talus extrusion treated with the sandwich block tibiocalcaneal arthrodesis with structural autografts harvested from iliac crest. The surgical technique is reviewed in detail, and its application in 2 male patients who had a complete talus fracture-dislocation and a dislocation, respectively, is described. Follow-up after 18 years and 1 year, respectively, showed favorable clinical outcomes and only minor restrictions in daily activities. In light of these case reports, we believe that the sandwich block arthrodesis offers a useful alternative for the treatment of these serious lower extremity injuries.

In fractures of the elbow with an associated fracture of the coronoid process, the size of the coronoid fragment determines the stability of the joint. A diminution of the arch of the incisura semilunaris by about 30 degrees causes instability of the elbow. We present an alternative way of treating the special case of a fracture of the coronoid process combined with comminuted fracture of the proximal end of the radius. A suitable fragment of the head of the radius is used to reconstruct the coronoid process. The stability achieved allows early functional postoperative treatment with a good range of movement at the elbow joint.

A classification of lesion of the capsule and ligaments of the knee joint can be related to the possible dislocation of the tibial head due to the injury. Analysing the dislocation the injured structures can be determined. This classification provides a better planning for the reconstruction of fresh and old injuries. A proper knowledge of the anatomy and the biomechanics of the knee joint is essential. Experimental and clinical experience over the last decade show that a simple classification in lateral, medial, anterior and posterior instability is inadequate. Therefore a more specific classification is recommended. Under this aspect history and clinical findings are of utmost importance for the diagnosis of injuries to the capsule and the ligaments of the knee joint.

This paper briefly presents the anatomy of the elbow joint, its pathophysiology, the various types of dislocation of the elbow joint and concomitant injuries, the appropriate diagnostic procedures and the indications for surgery and the operative technique applied for correction of dislocation. The only urgent indications for operative treatment are elbow joint dislocation with concomitant bone injuries, persistent instability or luxation position, open injuries and vessel and/or nerve injuries. For purely ligamentous lesions combined with relative loss of stability an operative procedure does not seem necessary. The operative technique applied for the treatment of habitual or recurrent dislocation is also described.

Dorsal dislocation occurs in 80% of all fracture dislocations of the elbow joint. In 10-15% of these njuries the coronoid process and the radial head are involved. If this injury causes the defect of the radial head - which means the loss of the main supporting part of the joint, - it is only the coronoid process which gives stability to the elbow joint. Therefore, in cases of coronoid fracture it is of utmost importance to reconstruct the coronoid process, if the fracture involves more than 1/6 of the incisura olecrani. Advisable for fixation is the use of a lag screw. In some cases the reconstruction with autogenous bone graft or osteotomy of the olecranon is indicated.