Cases reported "Femoral Fractures"

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1/17. sciatic nerve injury associated with fracture of the femoral shaft.

    The sciatic nerve escapes injury in most fractures of the femoral shaft. We report a case of sciatic nerve palsy associated with a fracture at the distal shaft of the femur. The common peroneal division of the sciatic nerve was lacerated by a bone fragment at the fracture site. Despite the delay in treatment, a satisfactory result was obtained.
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2/17. Transient peroneal nerve palsies from injuries placed in traction splints.

    Two patients thought to have distal femur fractures presented to the emergency department (ED) of a level 1 trauma center with traction splints applied to their lower extremities. Both patients had varying degrees of peroneal nerve palsies. Neither patient sustained a fracture, but both had a lateral collateral ligament injury and one an associated anterior cruciate ligament tear. One patient had a sensory and motor block, while the other had loss of sensation on the dorsum of his foot. After removal of the traction splint both regained peroneal nerve function within 6 hours. Although assessment of ligamentous knee injuries are not a priority in the trauma setting, clinicians should be aware of this possible complication in a patient with a lateral soft tissue injury to the knee who is placed in a traction splint that is not indicated for immobilization of this type of injury.
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ranking = 0.95091831043711
keywords = nerve, block
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3/17. Spinal muscular atrophy variant with congenital fractures.

    A single report of brothers born to first-cousin parents with a form of acute spinal muscular atrophy (SMA) and congenital fractures suggested that this combination represented a distinct form of autosomal recessive SMA. We describe a boy with hypotonia and congenital fractures whose sural nerve and muscle biopsies were consistent with a form of spinal muscular atrophy. Molecular studies identified no abnormality of the SMN(T) gene on chromosome 5. This case serves to validate the suggestion of a distinct and rare form of spinal muscular atrophy while not excluding possible X-linked inheritance.
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ranking = 0.14285714285714
keywords = nerve
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4/17. Bilateral peroneal nerve injuries in a patient with bilateral femur fractures: a case report.

    The second reported case in the current literature of peroneal nerve palsy in bilateral femur fractures is described. This is the first case report of bilateral nerve palsies occurring in bilateral femoral fractures and the first report of bilateral peroneal nerve palsy associated with bilateral skeletal traction.
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5/17. Complete sciatic nerve palsy after open femur fracture: successful treatment with neurolysis 6 months after injury.

    Although relatively uncommon, peripheral nerve can be injured secondary to fracture or dislocation. As therapeutic strategies may vary with the status of the nerve involved, accurate diagnosis is critical. The case described in this report involves a complete sciatic nerve palsy occurring after an open femur fracture treated 6 months earlier. The palsy was erroneously attributed to ischemic neuropathy from compartment syndrome, but late surgical exploration showed that the sciatic nerve was in continuity but enveloped by scar. Neurolysis resulted in full motor and sensory recovery below the knee. Accurate interpretation of physical findings and neurophysiologic tests in the management of fractures associated with nerve injury is emphasized.
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ranking = 1.2857142857143
keywords = nerve
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6/17. Unimuscular neuromuscular insult of the leg in partial anterior compartment syndrome in a patient with combined fractures.

    A complicated case of ipsilateral fractures of the left femur and tibia after a road traffic accident is reported. The patient presented with numbness of the first web of his left foot and contracture of the extensor hallucis longus muscle, with fixed length deformity after intramedullary nailing of the femur and tibia. The extensor digitorum longus and tibialis anterior muscles were spared. Tinel's sign could be elicited at the mid-portion of the anterior compartment of the injured leg. This indicated that the distal half of the anterior tibial nerve (deep peroneal nerve), together with the extensor hallucis muscle of the anterior compartment of the leg, had been damaged. The subsequent management of this patient is described.
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ranking = 0.28571428571429
keywords = nerve
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7/17. obturator nerve injury associated with femur fracture fixation detected during gracilis muscle harvesting for functioning free muscle transfer.

    A rare case is reported in which injury of the motor nerve of the gracilis (obturator nerve) was detected during its harvesting for functioning free muscle transfer. The probable cause of this rare injury was considered to be accidental penetration while drilling for a proximal locking screw in intramedullary nailing during previous femur fracture surgery.
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ranking = 0.85714285714286
keywords = nerve
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8/17. Composite vascularised osteocutaneous fibula and sural nerve graft for severe open tibial fracture--functional outcome at one year: a case report.

    Management of severe open tibial fracture with neurovascular injury is difficult and controversial. Primary amputation is an acceptable option as salvaging the injured, insensate, and ischaemic limb may result in chronic osteomyelitis and non-functional limb. We report a case of open tibial fracture associated with segmental bone and soft tissue loss, posterior tibial nerve and artery injuries, which was further complicated by chronic osteo-myelitis treated with composite vascularised osteocutaneous fibula and sural nerve graft. Functional outcome of the injured limb at one-year follow-up was satisfactory: the patient was capable of achieving full weightbearing and was able to appreciate crude touch, pain, proprioception, and temperature at the plantar aspect of the foot. There was no pressure sore or ulceration.
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ranking = 0.85714285714286
keywords = nerve
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9/17. Deep venous thrombosis revealed during ultrasound-guided femoral nerve block.

    Ultrasound imaging used to facilitate performance of a femoral nerve block also affords imaging of adjacent anatomical structures. Following a fracture of the femur, an ultrasound guided femoral nerve block (UGFNB) was performed to provide analgesia; this led to the incidental finding of a previously undiagnosed femoral vein thrombosis (DVT), resulting in a change in patient management before surgery. An inferior vena cava (IVC) filter was placed before intramedullary nailing of the fracture.
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ranking = 1.4197955769084
keywords = nerve, block
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10/17. Minimally invasive femoral nail extraction.

    INTRODUCTION: Case report about a minimally invasive technique for removal of a femoral antegrade nail (FAN). Femoral nails are introduced by minimally invasive techniques, but are often removed with more invasive surgery. MATERIALS AND methods: Four cases of young patients are described in whom the femoral nail was removed after consolidation by a minimally invasive extraction technique at the trochanteric site. By using a threaded wire for locating the proximal entrance of the femoral nail followed by reaming over the wire, the entrance of the nail in the trochanteric region is freed. Then the extraction bolt can be placed over the wire and the nail can be extracted through the same incision as it was inserted in, without enlarging the incision. DISCUSSION: This case report discusses a technique for minimally invasive femoral nail extraction, not the necessity of removing nails. Leaving out the endcap at the initial operation is the only preoperative condition, since the endcap blocks the entrance of the nail. This operation is done with fluoroscopic guidance. The difficult part is the reaming. The reamer must not be damaged when approaching the nail entrance. This minimally invasive femoral nail extraction technique is applicable for various types of femoral nails. CONCLUSION: Minimally invasive extraction of femoral nails is possible and needs more attention. The level of evidence is a level IV case series.
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ranking = 0.093775453294253
keywords = block
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