1/33. Iatrogenic spondylolysis leading to contralateral pedicular stress fracture and unstable spondylolisthesis: a case report.STUDY DESIGN: A case report of iatrogenic spondylolysis as a complication of microdiscectomy leading to contralateral pedicular stress fracture and unstable spondylolisthesis. OBJECTIVE: To improve understanding of this condition by presenting a case history and roentgenographic findings of a patient that differ from those already reported and to propose an effective method of surgical management. methods: A 67-year-old woman with no history of spondylolysis or spondylolisthesis underwent an L4-L5 microdiscectomy for a left herniated nucleus pulposus 1 year before the current consultation. For the preceding 8 months, she had been experiencing low back and bilateral leg pain. Imaging studies revealed a left L4 spondylolytic defect and a right L4 pedicular stress fracture with an unstable Grade I spondylolisthesis. RESULTS: The patient was treated with posterior spinal fusion, which resulted in complete resolution of her clinical and neurologic symptoms. CONCLUSIONS: Iatrogenic spondylolysis after microdiscectomy is an uncommon entity. However, it can lead to contralateral pedicular stress fracture and spondylolisthesis, and thus can be a source of persistent back pain after disc surgery. Surgeons caring for these patients should be aware of this potential complication.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/33. Iatrogenic ulnar nerve injury after percutaneous cross-pinning of supracondylar fracture in a child.Supracondylar fracture of the humerus is the most common fracture of the elbow in children and has been treated by a variety of methods. Recently, stabilization of reduced fractures with percutaneous pin fixation has become the accepted method of treatment. ulnar nerve injury is a complication of percutaneous pinning of supracondylar fractures, although many authors have reported that it resolves spontaneously after removal of the pin.- - - - - - - - - - ranking = 1.1428571428571keywords = fracture (Clic here for more details about this article) |
3/33. Emergency portacaval shunt for control of hemorrhage from a parenchymal fracture after adult-to-adult living donor liver transplantation.As more adults undergo transplantation with partial liver grafts, the unique features of these segments and their clinical significance will become apparent. A patient presented with life-threatening hemorrhage from an iatrogenic laceration to a right lobe graft 11 days after transplantation. The creation of a portacaval shunt effectively controlled the bleeding, allowing more elective replacement of the organ with another right lobe graft. The regeneration process combined with increased portal blood flow and relative outflow limitation may have set the stage for this complication. Any disruption of the liver parenchyma during transplantation should be securely repaired and followed cautiously. Portacaval shunting is an option for controlling hemorrhage from the liver in transplant recipients. The timely availability of a second organ was likely the ultimate determinant of survival for this patient.- - - - - - - - - - ranking = 0.57142857142857keywords = fracture (Clic here for more details about this article) |
4/33. Iatrogenic vertebral body compression fracture in a premature infant caused by extreme flexion during positioning for a lumbar puncture.We present a case of vertebral body compression fracture that resulted from manual flexion of the spine of a premature infant in preparation for a lumbar puncture. Vertebral body fractures due to abnormal flexion in child abuse have been described. However, such fractures due to lumbar puncture-related positioning have not been reported. We present a pre-term infant who developed an L3 vertebral body compression fracture immediately after lumbar puncture.- - - - - - - - - - ranking = 1.1428571428571keywords = fracture (Clic here for more details about this article) |
5/33. Endovascular repair of latrogenic subclavian artery perforations using the Hemobahn stent-graft.PURPOSE: To report the use of a new self-expanding endograft for percutaneous treatment of iatrogenic subclavian artery perforations. case reports: The subclavian artery of 2 patients was inadvertently cannulated during percutaneous attempts to implant a permanent pacemaker in one and catheterize the subclavian vein in the other. Because both patients had serious comorbidities, endovascular repair of the subclavian perforations was performed using the Hemobahn endograft, a nitinol stent covered internally with expanded polytetrafluoroethylene. The endoprostheses were successfully deployed via an ipsilateral brachial artery access. No signs of endograft occlusion, migration, deformation, or fracture have been observed during follow-up at 12 and 10 months, respectively, in these patients. CONCLUSIONS: The Hemobahn stent-graft appears well suited to repairing subclavian artery injuries. Longer follow-up will determine if the design of this endograft will resist compression in this vascular location.- - - - - - - - - - ranking = 0.14285714285714keywords = fracture (Clic here for more details about this article) |
6/33. Complications with intermaxillary fixation screws in the management of fractured mandibles.A dedicated bicortical bone screw for temporary intraoperative intermaxillary fixation (IMF) during open reduction and fixation of mandibular fractures offers many benefits to surgeons and patients. We have used this system for 2 years and confirm the benefits over traditional methods of intermaxillary fixation. However, complications can arise. One hundred and twenty-two patients with mandibular fractures had IMF screws of which five (4%) developed complications intraoperatively and postoperatively. Complications included fracture of the screws on insertion, iatrogenic damage to teeth causing loss and bony sequestra around the area of screw placement.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
7/33. Management of depressed skull fracture in the newborn.The authors describe 3 cases of neonatal depressed skull fracture subsequent to difficult delivery, treated without surgical elevation. None of the patients developed neurological deficits, cosmetic deformity or electroencephalographic signs of epileptiform activity. Neonatal depressed skull fractures not associated with focal neurological signs may not require surgical therapy; we are not certain what the absolute criteria for operation should be.- - - - - - - - - - ranking = 0.85714285714286keywords = fracture (Clic here for more details about this article) |
8/33. Inadvertent intracranial placement of a Foley catheter. A rare iatrogenic complication of severe frontomaxillary trauma.Severe comminuted fractures of the facial bones involving the cranial base are often accompanied by heavy bleeding into the nasopharynx. This presents considerable problems in primary care both for the anesthesiologist and the surgeon. Such bleeding can be controlled by Bellocq tamponade or using a Foley inflatable catheter. skull base fractures may involve the risk of the catheter inadvertently penetrating into the brain. The authors describe a case in which a misguided Foley catheter, which was blindly inserted through the nose in an attempt to tampon the nasopharynx, resulted in fatal cerebral damage.- - - - - - - - - - ranking = 0.28571428571429keywords = fracture (Clic here for more details about this article) |
9/33. Vascular injury from external fixation: case reports.The incidence of vascular injury from external fixation of fractures was studied retrospectively in two surgical departments during the period 1985-1990. A total of 1231 fractures of the lower limb were treated. External fixation was used in the initial stabilization of 28 femoral and 93 tibial fractures. In this series of 121 fractures four iatrogenic vascular injuries were seen: two arterial thromboses with distal ischemia and two incidents of the formation of a false aneurysm with bleeding along a pin. The diagnosis was made by angiography. Surgical intervention was necessary in all four cases. In one patient the injury resulted in amputation of the distal portion of the foot.- - - - - - - - - - ranking = 0.57142857142857keywords = fracture (Clic here for more details about this article) |
10/33. Limb gangrene following treatment of limb injury by traditional bone setter (Tbs): a report of 15 consecutive cases.This study is done to evaluate cases of limb gangrene resulting from treatment of limb injury by traditional bonesetter. METHOD: This is a prospective study in which patients with limb gangrene are evaluated as each presents. Data extracted for evaluation include history of having been to a traditional bonesetter, the original injury, type of treatment given by the traditional healer, progression of condition while on treatment and reason for not coming to orthodox orthopaedic centre ab initio for treatment. RESULTS: 15 cases were seen during the 5-year of study spanning June 1997 to May 2002. Upper limbs were involved in 4 cases while 11 involved the lower limbs. The original injuries were 3 cases of soft tissue injury to the joints, 7 closed fractures and 5 open fractures of type I and II. There was associated sepsis and toxemia in all except one. All the cases were treated by amputation. There were 4 deaths. CONCLUSION: Limb gangrene was not a justifiable end-result of treatment in all the cases judging by the nature of the original injury. Reasons for this end result were adduced. The need to avert unnecessary limb loss from mismanagement of limb injury by education of public in general and enlightenment of the traditional bonesetters of the harmful procedures in their practice is highlighted.- - - - - - - - - - ranking = 0.28571428571429keywords = fracture (Clic here for more details about this article) |
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