1/197. erectile dysfunction due to a 'hidden' penis after pelvic trauma.We describe a twenty-six year old patient who presented us with a dorsally retracted 'hidden' penis, which was entrapped in scar tissue and prevesical fat, 20y after a pelvic fracture with symphysiolysis. Penile 'lengthening' was performed by V-Y plasty, removal of fatty tissue, dissection of the entrapped corpora cavernosa followed by ventral fixation.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/197. Ultrasonic assistance in the diagnosis of hand flexor tendon injuries.In contrast to routine flexor tendon injuries, flexor tendon ruptures following blunt injury or re-ruptures following repair can be difficult to diagnose. The authors investigated the efficacy of using ultrasound to assist in the diagnosis. From 1996 to 1997, 8 patients underwent evaluation of the flexor tendons using an ATL HDI-3000 ultrasound machine with a high-resolution, 5 to 9-MHz hockey stick linear probe. Dynamic evaluation was performed in real time, simulating clinical symptoms. Six patients underwent surgical exploration. Sonographic diagnosis and intraoperative findings were correlated. Ultrasound was used to diagnose 3 patients with ruptured flexor digitorum profundus tendons. Mechanisms of injury included forceful extension, penetrating injury, and delayed rupture 3 weeks after tendon repair. Subsequent surgical exploration confirmed the ruptures and location of the stumps. Five patients had intact flexor tendons by ultrasound after forceful extension, penetrating injury, phalangeal fracture, crush injury, and unknown etiology. In 3 patients who underwent surgery for tenolysis, scar release, or arthrodesis, the flexor tendons were found to be intact, as predicted by ultrasound. The authors found ultrasound to be accurate in diagnosing the integrity of flexor tendons and in localizing the ruptured ends. They conclude that ultrasound is helpful in evaluating equivocal flexor tendon injuries.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
3/197. Staged operative treatment in a septic patient with an infected, unstable pelvis, and a missed bladder rupture.This case demonstrates once again the potential and serious complications of pelvic fractures, especially when associated urogenital injuries are missed. Missing the bladder rupture proved almost fatal to our patient. Second, it was confirmed that in very unstable pelvic fractures, external fixation alone does not provide enough stability. Local stability is the cornerstone in the treatment of (bone) infection, and in these cases, maximal stability is only obtainable with internal fixation. The advantages of metal implants in infected areas outweigh the disadvantages by far. For the bladder-rupture, we chose a two-stage approach. First, we performed a urinary diversion, to avoid surgical closure of the infiltrated bladder wall. All cavities, including the open bladder, were packed with omentum to fill the dead space with highly vital tissue to offer stout resistance to infection. Two years later, with the patient in excellent physical condition, urinary undiversion was carried out. Ultimately physical and social recovery was complete.- - - - - - - - - - ranking = 2keywords = fracture (Clic here for more details about this article) |
4/197. Attritional flexor tendon ruptures due to distal radius fracture and associated with volar displacement of the distal ulna: a case report.Flexor tendon rupture following distal radius fractures are rare. In this report, a volarly displaced distal ulna that perforated the volar wrist capsule caused delayed flexor tendon ruptures 25 years after a distal radius fracture. The repair with free tendon graft and the excision of the distal ulna produced a successful result.- - - - - - - - - - ranking = 6keywords = fracture (Clic here for more details about this article) |
5/197. Separation of renal fragments by a urinoma after renal trauma: percutaneous drainage accelerates healing.BACKGROUND: Two boys suffered blunt abdominal trauma resulting in renal injury. In both cases the damaged kidney was fractured through its mid-portion, and the upper and lower fragments of the kidney became widely separated by a urinoma. MATERIALS AND methods: US-guided drainage of the urinoma resulted in immediate apposition of the renal fragments. The drains were left on free drainage by gravity for 1 week before removal. RESULTS: The urinomas did not reaccumulate and follow-up DMSA scans showed good residual function. CONCLUSION: We suggest that drainage of urinomas that separate renal fragments should be considered since this may accelerate healing and help preserve renal function.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
6/197. Checkrein deformity--an unusual complication associated with a closed Salter-Harris Type II ankle fracture: a case report.This article presents a case of tethering of the flexor hallucis longus (FHL) tendon (checkrein deformity) and rupture of the posterior tibialis tendon after a closed Salter-Harris Type II ankle fracture. Delayed repair was affected by tenolysis of the FHL and flexor digitorum longus tendons and tenodesis of the posterior tibialis to the flexor digitorum longus tendon. This case represents the first such report of concomitant entrapment of the FHL tendon and rupture of the posterior tibialis tendon after a closed ankle fracture.- - - - - - - - - - ranking = 6keywords = fracture (Clic here for more details about this article) |
7/197. Medial malleolar fracture associated with deltoid ligament rupture.The author reports a case of a fractured medial malleolus with a completely disrupted deltoid ligament following a pronation injury. To the author's knowledge, concurrent failure of both structures over the medial side of the ankle has not been previously documented in a pronatory injury.- - - - - - - - - - ranking = 5keywords = fracture (Clic here for more details about this article) |
8/197. Peroneus longus tendon rupture as a cause of chronic lateral ankle pain.rupture of the peroneus longus tendon with an associated fracture of the os peroneum is an uncommon injury, which may present as chronic lateral ankle instability. There have been only seven cases documented in the literature since 1966. A case of chronic peroneus longus tendon rupture with os peroneum fracture is presented. The authors review their clinical, radiographic, and operative treatment of this patient and review the literature of this unusual injury.- - - - - - - - - - ranking = 2keywords = fracture (Clic here for more details about this article) |
9/197. Clinics in diagnostic imaging (41). Viable fractured kidney.A 21-year-old man sustained blunt injury leading to major left renal laceration (Organ Injury Scale Grade IV). The upper and lower poles of the left kidney remained perfused and excreted contrast satisfactorily. Extensive contrast extravasation and urinoma formation were noted. The patient was managed nonoperatively and blood transfusion was given. His left kidney function was preserved and he remains well at 55-month follow-up. The role of imaging in the evaluation of renal injuries and the management of patients with blunt renal trauma are discussed.- - - - - - - - - - ranking = 4keywords = fracture (Clic here for more details about this article) |
10/197. Traumatic rupture of the tibialis posterior tendon after ankle fracture: a case report.Degenerative tears of the posterior tibial tendon associated with chronic disease are well documented in the literature. Traumatic ruptures of this tendon, however, are much less common and consequently have received little attention. An association has been shown between pronation-external rotation ankle fractures and tears of the tendons that cross the medial aspect of the ankle, most commonly the posterior tibial tendon. In the present case report, we share our unique experience of an open-ankle fracture associated with the traumatic rupture of the posterior tibial tendon. This injury illustrates that soft-tissue injury must always be suspected concomitantly in the treatment of certain fractures on the basis of both mechanism of injury and fracture pattern.- - - - - - - - - - ranking = 8keywords = fracture (Clic here for more details about this article) |
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