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https://www.readbyqxmd.com/read/29245098/the-pit-bull-attack-causing-limb-threatening-vascular-trauma-a-case-series
#1
Patrick Harnarayan, Shariful Islam, Christi Ramsingh, Vijay Naraynsingh
INTRODUCTION: Non-fatal human dog bites are commonplace amongst animal attacks on human beings and these present with mainly skin and soft tissue injuries. However, they can also present with life threatening head and neck injuries, massive soft tissue trauma, as well as combined orthopedic and vascular extremity injuries where a high possibility of limb loss exists. PRESENTATION OF CASES: We present two adult dog bite victims with multiple bites inflicted by large canines identified as Pit-Bull Terriers...
December 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29244969/treatment-of-open-upper-limb-injuries-with-infection-prevention-and-negative-pressure-wound-therapy-a-systematic-review
#2
E Ali, M Raghuvanshi
OBJECTIVE: Open upper limb injuries requiring soft reconstruction can pose a dilemma for trauma surgeons when considering the treatment options. The British Orthopaedic Association and British Association of Plastic, Reconstructive and Aesthetic Surgeons Standard for Trauma (BOAST) have addressed the management of severe open lower limb fractures with the creation of the BOAST 4 guidelines. However, no such gold standard exists for the treatment of open injuries of the upper limb. Furthermore, treatment of these injuries is often more difficult and requires complicated strategies...
December 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/29244704/nonunion-of-a-nondisplaced-radial-neck-fracture-a-case-report
#3
John G Coury, Zachary C Lum, Marc A Trzeciak
CASE: We describe the case of a 66-year-old man who sustained a nondisplaced radial neck fracture and subsequently developed a symptomatic nonunion. After a period of unsuccessful conservative treatment, a radial head resection was performed. CONCLUSION: Radial neck fractures, unlike their radial head counterparts, have a low rate of nonunion. Our patient's only positive risk factor was age, but he developed a nonunion. At the 2-year follow-up after excision of the radial head, there was a lack of proximal migration of the radius during axial loading, demonstrating a positive outcome without the need for replacement of the radial head...
July 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244703/the-risk-of-assuming-abuse-in-an-infant-with-an-isolated-metaphyseal-lesion-a-case-report
#4
Kirsten Norrell, William Hennrikus
CASE: The classic metaphyseal lesion, or corner fracture, is considered a strong indicator of nonaccidental trauma. In the present case, the parents brought their 8-month-old boy to a community hospital after he stopped crawling on the right leg. A knee radiograph demonstrated an isolated metaphyseal lesion, which prompted concern for child abuse. The patient was transferred to the nearest academic medical center; the pediatric radiology expert in child abuse determined that the lesion was a normal variant and not the result of abuse...
July 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244702/challenging-lower-extremity-fractures-in-newborns-and-infants
#5
Ronald W Lindsey, Allan Harper
No abstract text is available yet for this article.
July 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244701/reconstruction-of-a-neglected-tibial-plateau-fracture-malunion-with-an-open-book-osteotomy-a-case-report
#6
Dimitrios S Mastrokalos, Georgios N Panagopoulos, Dimitrios Koulalis, Konstantinos C Soultanis, Vasileios A Kontogeorgakos, Panayiotis J Papagelopoulos
CASE: Surgical management of tibial plateau fractures can be challenging, and complications can be devastating. We report the case of a lateral tibial plateau fracture malunion with an associated intra-articular depression, which we treated with an open-book osteotomy, obviating the need for an early corrective osteotomy or knee arthroplasty. CONCLUSION: A tibial plateau fracture malunion can be reconstructed. The surgical team should give priority to salvage options, which can obviate or delay the need for and the implications of an early total knee arthroplasty, especially in a young and active patient...
January 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244698/restoration-of-humeral-bone-stock-two-years-after-internal-fixation-of-a-periprosthetic-fracture-with-a-loose-stem-a-report-of-two-cases
#7
Christian Fang, Chun-Hoi Yan, Dennis Yee, Tak-Wing Lau, Tak-Man Wong, Frankie Leung
CASE: We describe 2 patients who sustained a periprosthetic humeral fracture with a loosened long-stemmed Coonrad-Morrey total elbow prosthesis. As noted in the literature, the success rate for a major revision with use of strut grafts is around 70%; therefore, both cases were managed without revision of the prosthesis. A submuscular locking plate was placed following typical fracture fixation principles. Screws that interfered with the humeral stem and the distal flange stabilized both the distal fragment and the humeral stem...
January 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244694/failure-of-patellar-plating-with-mini-fragment-implants-a-case-report
#8
Daniel T Miles, Matthew L Graves, Clay A Spitler, Patrick F Bergin
CASE: A 40-year-old woman presented to the emergency department with a comminuted fracture of the patella with separation of the bone fragments. The patient underwent an open reduction and osteosynthesis using medial and lateral 2.0-mm nonlocking plates, which subsequently led to pain in the anterior and posterior aspects of the knee. CONCLUSION: In this patient, bicolumnar nonlocking plating was unable to adequately resist the tensile forces of the extensor mechanism...
January 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244693/bilateral-simultaneous-femoral-neck-stress-fracture-despite-clinical-recovery-from-anorexia-nervosa-a-case-report
#9
Jacques Hernigou, Simon Koulischer, Renaud Maes
CASE: A 38-year-old woman who had returned to sports activity (running) after having clinically recovered from anorexia nervosa presented with a bilateral femoral neck stress fracture that was treated with bilateral hip osteosynthesis. CONCLUSION: Although exercise is usually considered to be beneficial for health, heavy exercise (such as running) after recovery from anorexia nervosa may be associated with an increased risk of fracture.
January 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244689/trochanteric-femoral-fracture-around-a-birmingham-hip-resurfacing-prosthesis-a-case-report-and-review-of-the-literature
#10
Daud Tai Shan Chou, Ben Davis
CASE: A traumatic nondisplaced periprosthetic trochanteric fracture around a well-fixed and functioning Birmingham Hip Resurfacing prosthesis was managed with a reconstruction intramedullary nail. The surgical procedure provided excellent pain relief, and the patient was able to mobilize with crutches the day after surgery. Follow-up at 1 year confirmed excellent clinical and radiographic results. CONCLUSION: In a patient with a previously well-functioning hip resurfacing prosthesis, internal fixation rather than revision hip arthroplasty can offer good clinical and radiographic outcomes...
January 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244687/pilon-fractures-of-the-base-of-the-proximal-phalanx-direct-intraosseous-joint-reduction-with-bone-grafting-and-mini-screws-a-case-report
#11
Iva Neshkova, Rainer H Meffert
CASE: A 31-year-old woman sustained a closed pilon fracture of the base of the second proximal phalanx. Computed tomography showed comminution, central depression, and splaying of the articular surface. We used a method of direct intraosseous joint reduction in combination with bone-grafting and mini-screws to treat the fracture. For reduction, a golf-club-shaped instrument was inserted into the medullary cavity through a drill-hole in the phalanx. CONCLUSION: The advantage of this technique is that it leaves the joint capsular complex and the extensor hood intact...
January 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244683/insufficiency-fracture-occurring-3-years-after-union-of-an-intertrochanteric-hip-fracture-a-case-report
#12
Byung-Ho Yoon, Sung Bae Park
CASE: We present a rare case of insufficiency fracture at the level of the distal interlocking screw following union of an intertrochanteric hip fracture. A 74-year-old woman reported chronic thigh pain for 1 month. She had a history of an osteoporotic stable intertrochanteric fracture that was successfully treated with a short intramedullary nail 3.5 years prior. However, after union, the neck-shaft angle of the femur changed from 125° to 117°. She had been on alendronic acid therapy to prevent a secondary osteoporotic fracture...
January 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244680/irreducible-ankle-fracture-from-an-interposed-chaput-fragment-a-case-report
#13
Chihua Lee, Thomas J Douglas
CASE: A 23-year-old active-duty military service member sustained an unusual irreducible fracture-dislocation of the ankle joint. Preoperative computed tomography showed an anterolateral tibial (Chaput) fragment entrapped within the distal syndesmosis, preventing adequate reduction. An open reduction of the fragment was performed in the operating room, which allowed near-anatomic reduction and internal fixation of the tibiotalar joint. At the 21-month follow-up visit, the patient remained on active duty in the Navy without limitations...
April 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244676/severe-metal-hypersensitivity-following-internal-fixation-of-an-ankle-fracture-a-case-report
#14
Bradley M Kruckeberg, Taylor J Ridley, Lee M Reichel
CASE: A 67-year-old woman underwent internal fixation of an ankle fracture. Ten days postoperatively, the patient developed systemic hives, difficulty breathing, and oral swelling. At 8 weeks postoperatively, the hardware was removed because of a suspected metal hypersensitivity. Despite experiencing perioral edema and difficulty breathing after the hardware removal, she had complete resolution of the symptoms at the 2-week, 6-week, and 12-month follow-up appointments. CONCLUSION: Hypersensitivities to metal-based implants can develop and cause local and systemic reactions...
April 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244674/thrower-s-fracture-of-the-humerus-an-investigation-of-risk-factors-following-an-unlikely-scenario-a-case-report
#15
Kyle D Morgenstern, Gonzalo Barinaga, Paul J Cagle
CASE: A 26-year-old amateur baseball player without prodromal arm pain sustained a thrower's fracture of the humerus on a warm-up throw performed with submaximal effort. The fracture occurred during the first throwing session following a 6-week layoff. The patient was treated nonoperatively and made a full recovery, but he elected to not return to throwing sports. CONCLUSION: Because of the lack of risk factors in this case, we suggest that time off or irregularity in throwing may play a greater role in a thrower's fracture than previously established...
April 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244673/using-double-contrast-ct-arthrography-to-confirm-suspected-dissociation-of-a-cemented-polyethylene-liner-in-the-setting-of-revision-total-hip-arthroplasty-a-case-report
#16
Aakash Chauhan, Sean Fitzpatrick, Robert L Sciulli, Nicholas G Sotereanos, Jeffrey J Sewecke
CASE: A 67-year-old woman who underwent a re-revision of a total hip arthroplasty with a cemented polyethylene liner fell 14 months after surgery. The patient had symptoms of pain and weakness; however, clinical, laboratory, and radiographic evaluation did not disclose fracture, infection, osteolysis, or component migration. Liner dissociation was suspected, and a double-contrast computed tomography (CT) arthrogram confirmed failure at the cement-liner interface. She underwent additional revision surgery and was doing well at the 3-year follow-up...
April 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244672/a-short-femoral-stem-in-revision-total-hip-replacement-an-alternative-solution-for-prosthetic-fracture-a-case-report
#17
Paul Y F Lee, David J Woodnutt, David M Golding
CASE: A 65-year-old farmer re-presented 5 years after sustaining a midshaft prosthetic fracture of a previous long-stem revision hip replacement. He was treated with a proximal-loading short femoral stem, and did not require an extended trochanteric osteotomy for removal of the well-fixed distal implant. He was able to fully bear weight immediately postoperatively, and he remained pain-free without functional loss at the 42-month follow-up. CONCLUSION: This use of a modern short-stem prosthesis is a treatment option for a potentially complex prosthetic fracture in highly active patients, and it reduces intraoperative complexity...
April 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244669/operative-fixation-of-an-anterior-inferior-iliac-spine-apophyseal-avulsion-fracture-nonunion-in-an-adolescent-soccer-player-a-case-report
#18
James B Carr, Evan Conte, Evan A Rajadhyaksha, Kevin A Laroche, F Winston Gwathmey, Eric W Carson
CASE: A 14-year-old male competitive soccer player presented with a history of recurrent right hip pain for 18 months. He was diagnosed with an anterior inferior iliac spine (AIIS) apophyseal avulsion fracture nonunion with subspinal impingement, which was confirmed by radiographs, computed tomography, and magnetic resonance imaging. The patient underwent surgical fixation and subspinal decompression. He returned to competitive soccer 5 months postoperatively. CONCLUSION: AIIS apophyseal avulsion fractures occur in adolescent athletes and generally respond to nonoperative treatment...
April 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244658/a-distally-based-sartorius-muscle-flap-for-a-gustilo-grade-iii-open-fracture-of-the-lateral-femoral-condyle-and-the-head-of-the-fibula-with-a-complex-soft-tissue-defect-a-case-report-and-review-of-the-literature
#19
Victoire Bouveau, Damien Potage, Arnaud Dubory, Romain Chevallier, Jean-Paul Meningaud, Jérémy Niddam, Charles-Henri Flouzat-Lachaniette
CASE: We present a case of lower-limb trauma associated with an extensive soft-tissue defect around the knee joint, which led to the exposure of bone and the metalwork that was used for the management of the associated fractures. Coverage was performed with a distally based sartorius muscle flap in a single-stage procedure, allowing good recovery with a nice aesthetic and functional outcome at the 1-year follow-up. Additionally, we discuss alternative options for the coverage of severe soft-tissue defects based on the clinical context...
December 13, 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29244657/an-unusual-case-of-an-intra-articular-osseous-fragment-associated-with-a-medial-collateral-ligament-femoral-avulsion-fracture-in-an-adult-a-case-report
#20
Meagan M McCarthy, Dana C Covey
CASE: The medial collateral ligament (MCL) is the most commonly injured ligament of the knee; however, to our knowledge, avulsion fractures of the MCL resulting in an intra-articular fragment have not been reported. We present the case of a 55-year-old woman with a posterior cruciate ligament avulsion fracture and an MCL avulsion fracture with an intra-articular bony fragment. CONCLUSION: Patients who sustain trauma to the knee should be carefully evaluated for ligamentous avulsion injuries...
December 13, 2017: JBJS Case Connector
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