1/7. Traumatic anterior dislocation of the hip associated with ipsilateral femoral shaft fracture in a child: a case report.Traumatic anterior dislocation of the hip joint in children is rare, and only one case with ipsilateral femoral fracture has been reported in japan. We report a case of such dislocation and a review of the literature. The patient was a 31-month-old girl who was injured in a car accident while asleep on a tilted front passenger seat. Radiographic examination showed dislocation of the right obturator foramen and transverse fracture of the ipsilateral femoral shaft. The dislocation of the right hip was easily reduced without anaesthesia during radiography. We applied Bryant traction after reduction for 4 weeks, followed by cast application for 3 weeks. walking with support and full weightbearing were permitted 14 weeks and 16 weeks after the injury, respectively. radiography at 4.5 years after the injury showed a mildly enlarged right femoral head and femur overgrowth of approximately 8 mm. magnetic resonance imaging showed no evidence of suspected avascular necrosis of the femoral head. The patient has no subjective or objective symptoms, and is able to engage in all usual activities. The detailed mechanism of the injury is unknown. We assume that the lower leg was dislocated through abduction during flexion, or abducent, external flexion, considering that the child was sleeping at the time of the accident. Since she was hurled to the back seat, it was assumed that strong external force was vertically added to the femur, which caused the abducent force.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/7. Postpartum sacral fracture presenting as lumbar radiculopathy: a case report.Although rare, sacral stress fractures may occur in pregnant women, and osteoporosis of pregnancy is a poorly understood entity. We present the case of a young, postpartum, recreational runner who developed low back pain (LBP) and radicular symptoms suggestive of L5 radiculopathy found to be secondary to sacral stress fracture. The patient had a good clinical outcome after several months and was able to resume her normal activities. This case illustrates that clinicians should have a high index of suspicion for sacral stress fracture in athletic pregnant or postpartum women presenting with LBP and/or lumbar radiculopathy. Also included are a brief review of osteoporosis in pregnancy and guidelines on the diagnosis and management of sacral stress fractures.- - - - - - - - - - ranking = 1.3333333333333keywords = fracture (Clic here for more details about this article) |
3/7. Avulsion fractures of the lesser tuberosity of the humerus in adolescents: review of the literature and case report.Isolated fracture of the lesser tuberosity is an unusual phenomenon in children and adolescents. These injuries are difficult to diagnose acutely and often present as chronic shoulder pain. In this study, we report on 1 case of a displaced lesser tuberosity apophysis avulsion fracture in an adolescent treated with open reduction and internal fixation, as well as a review of the literature. A 14-year-old adolescent male presented to the senior surgeon complaining of left shoulder pain and weakness 10 days after a wrestling injury. He was diagnosed with a displaced, isolated fracture of the lesser tuberosity apophysis for which he underwent open reduction and internal fixation. A combination of sutures passed through drill holes in the proximal humerus and bioabsorbable suture tacks were used to anatomically fix the lesser tuberosity fragment and subscapularis tendon. Postoperatively, he underwent a progressive physical therapy regimen. At 4 months follow-up, he had full range of motion, complete return of strength, and returned to competitive athletics. We report here on the successful surgical treatment of a fracture of the lesser tuberosity apophysis in an adolescent.- - - - - - - - - - ranking = 1.3333333333333keywords = fracture (Clic here for more details about this article) |
4/7. Broken stent in oesophageal malignancy: a rare complication.Metallic expandable stents are used increasingly for palliative treatment of inoperable malignant tumours of oesophagus to improve dysphagia. We report a rare case of oesophageal stent fracture that was broken and left in situ within the stomach uneventfully until the end of the patient's life after the application of another stent.- - - - - - - - - - ranking = 0.16666666666667keywords = fracture (Clic here for more details about this article) |
5/7. Isolated malleus neck fracture.Isolated fracture of the malleus seems to be an extremely rare ossicular injury. All previously reported cases involved the handle of the malleus. This is the first reported case of fracture of the neck of the malleus. The diagnosis can easily be missed because the tympanic membrane remains intact. Furthermore, the history may not be suggestive. Surgical repair is particularly difficult.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
6/7. Isolated intra-articular fracture of the distal ulna: a rare injury related to airbag deployment.An isolated intra-articular and adjacent shaft fracture of the distal ulna is described. A 38-old-year woman driver sustained an automobile accident with subsequent airbag deployment injuring her left wrist. Imaging studies showed displacement of a radiovolar fragment and deformity of the ulnar articular surface. The fracture was reduced and internally fixed with 3, 3.5-mm, cannulated screws to avoid future difficulties in forearm rotation, ulnocarpal impaction, and late posttraumatic arthritis. The final outcome was excellent. Careful clinical and radiologic examination is strongly recommended for this type of fracture, which seems to be a part of the spectrum of upper limb injuries associated with airbag deployment. Such injuries can be expected to occur more frequently with the increasing use of airbags.- - - - - - - - - - ranking = 1.1666666666667keywords = fracture (Clic here for more details about this article) |
7/7. femoral nerve palsy following mini-open extraperitoneal lumbar approach: report of three cases and cadaveric mechanical study.Anterior extraperitoneal exposures to the lumbar spine are being increasingly used owing to the expanding use of novel technologies to treat degenerative disc disease. Lumbar plexus injuries are potential, albeit uncommon, complications of such exposures and can lead to significant perioperative morbidity. In this report, we present three patients with thoracolumbar fractures who sustained isolated femoral nerve palsies after a mini-open extraperitoneal approach to the midlumbar spine was undertaken to perform a partial corpectomy. To further understand the pathophysiology of this nerve injury, we conducted a cadaveric experiment to evaluate the effect of performing this approach and the effect of hip positioning on linear displacement of the femoral nerve. The displacement of the femoral nerve during the anterolateral extraperitoneal exposure through a 4- to 6-cm incision was equal to 6.6% of the full femoral nerve length. relaxation of the femoral nerve was equal to 25% of the full nerve length when the hip was flexed to 90 degrees in neutral abduction-adduction. We conclude that the anterolateral extraperitoneal exposure of the midlumbar spine can potentially stretch the femoral nerve beyond its physiologic limits, particularly in trauma cases where exposure of the lateral vertebral body necessitates substantial retraction of the psoas muscle. The avoidance of self-retaining retractors for prolonged periods of time and the positioning of the hip in flexion may help to avoid such nerve injuries.- - - - - - - - - - ranking = 0.16666666666667keywords = fracture (Clic here for more details about this article) |