Cases reported "Fractures, Bone"

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11/138. Traumatic cardiac injury following sternal fracture: a case report and literature review.

    Myocardial injury used to be thought as one of the major complications associated with sternal fracture even though recent studies on injuries associated with fracture of sternum are contrary to this belief. Many authors now believe the presence of sternal fracture is no longer indicative of occult injuries to the underlying structure such as the heart. However, clinicians should still maintain a high index of suspicion for the presence cardiac tamponade in cases presented as blunt chest trauma as early diagnosis and surgical intervention is vital to the patient's survival. Presented is a case of a 38-year-old female patient transferred to our hospital after being injured in a motor vehicle accident. On arrival her blood pressure (BP) was 90/50 mmHg but it then dropped to 60/30 mmHg two hours later. Although her chest roentgenography and electrocardiography (ECG) did not reveal any significant findings, the two-dimensional echocardiography was performed and revealed a moderate amount of pericardial effusion. The chest computerized tomography (CT) scan later revealed sternal fracture and cardiac tamponade. A diagnosis of cardiac rupture resulting from sternal fracture following blunt chest trauma was made. Under midline sternotomy, her right atrial rupture was repaired. The patient was reported to be doing well during a three months, post-operative follow-up.
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keywords = roentgen
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12/138. A new consideration in athletic injuries. The classical ballet dancer.

    The professional ballet dancer presents all of the problems of any vigorous athlete. The problems include osteochondral fractures, fatigue fractures, sprains, chronic ligamentous instability of the knee, meniscal tears, impingement syndrome, degenerative arthritis of multiple joints and low back pain. attention to minor problems with sound conservative therapy can avoid many major developments and lost hours. Observations included the extraordinary external rotation of at the hip without demonstrable alteration in the hip version angle and hypertrophy of the femur, tibia and particularly the second metatarsal (in female dancers). Careful evaluation of the range of motion of the extremities, serial roentgenographic examination, and systematic review of previous injuries, training programs and rehearsal techniques have been evaluated in a series of cases to provide the basis for advice to directors and teachers of the ballet.
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keywords = roentgen
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13/138. Osteochondral fractures of the dome of the talus.

    Fractures of the talor dome are uncommon and may elude diagnosis despite routine roentgenograms of injured ankles. Tomograms are helpful in localizing this lesion. Surgical removal of the osteochondral fragment is often indicated. Medial lesions may be inaccessible except by osteotomy of the medial malleolus which is then fixed with a bone screw. Lateral fragments are approached through anterolateral or posterolateral ankle incisions. Of 9 symptomatic ankles, 6 had satisfactory results following surgery. The other 3 were treated conservatively, one improved; two did not. One additional asymptomatic ankle remained so with no treatment. In one case the talus also contained an unusual cystic lesion; in another there was tarsal coalition.
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keywords = roentgen
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14/138. Unstable hemipelvic fractures with internal rotation displacement.

    Two cases of unstable hemipelvic fractures with internal rotation displacement successfully treated by outward (external lateral) rotation and continuous skeletal traction by wires passed through the crest of the ilium are described. x-rays show both patients before and 2 years after treatment.
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ranking = 0.0021740943271661
keywords = ray
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15/138. Congenital bipartite scaphoid--fact or fiction?

    Whether there is such a condition as congenital bipartite scaphoid has long been debated. Five cases that fulfill the established criteria are presented, supplemented by a review of roentgenograms of 17,439 hands in which no case of bipartite scaphoid was detected. Serial sections of 196 fetal hands also failed to reveal any evidence of bipartite development of the scaphoid. We concluded that bipartite scaphoid is of traumatic origin and should be treated accordingly.
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keywords = roentgen
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16/138. Misleading fractures after profundus tendon avulsions: a report of six cases.

    From 1986 to 1990, twelve patients were treated for avulsions of the flexor digitorum profundus in either the ring or the long finger. Six patients had misleading x-ray films because the tendon had retracted farther than the fracture pattern had suggested. All of these patients had avulsion fractures from the palmar aspect of the distal phalanx. Although the classification of Leddy and Packer is very helpful in determining the prognosis for these injuries, the fracture patterns are not reliable in predicting the location of the retracted tendon end preoperatively. Therefore all flexor digitorum profundus tendon avulsions should be surgically repaired as soon as possible.
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ranking = 0.002387369499863
keywords = ray, x-ray
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17/138. A 22-year-old man with a swollen left hand after a motor vehicle accident.

    The following case is presented to illustrate roentgenographic and clinical findings of a condition of interest to the orthopaedic surgeon and emergency room physician. The initial history, physical examination, and pertinent roentgenographic findings are found on this page. The final clinical diagnosis is presented on the next page.
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ranking = 2
keywords = roentgen
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18/138. Avulsion fracture of peroneus longus at the first metatarsal insertion: a case report.

    Reports of isolated avulsion fracture at the planter lateral base of the first metatarsal without injury of the tarsometatarsal joint are very rare. A 24 year old man sustained an avulsion fracture at the plantar lateral base of the first metatarsal. Normal alignment of metatarsal bones and tarsometatarsal joint was maintained. In this paper, we describe internal fixation of the displaced fragment using x ray and minimally invasive surgery with good results.
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ranking = 0.0021740943271661
keywords = ray
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19/138. Early intrathoracic migration of Kirschner wires used for percutaneous osteosynthesis of a two-part humeral neck fracture: a case report.

    We present an unusual case of early migration of three Kirschner wires used for percutaneous osteosynthesis of a two-part humeral neck fracture, causing hemothorax. An 85-year-old woman was admitted to the emergency room after casual accident. She was found to have suffered a two-part fracture of the surgical neck of the right humerus. The humeral fracture was treated by closed reduction and percutaneous osteosynthesis with three threaded Kirschner wires, which were bent subcutaneously. Ten days after the accident the patient presented with dyspnea and laterocervical pain. Plain x-rays and complementary CT demonstrated intrathoracic migration of the three Kirschner wires with hemothorax. Two of the wires were seen under the right clavicle and adjacent to the C7 vertebra. The third wire reached the lateral chest wall. Immediate surgery was performed, with withdrawal of the wires and placement of a drainage tube. The patient had an uneventful recovery after surgery. The humeral fracture resulted in a nonunion, which was well tolerated by the patient and was left untreated. The use of Kirschner wires for osteosynthesis of proximal humeral fractures may cause significant thoracic morbidity, even if various prophylactic measures, including the use of threaded wires, subcutaneous bending, and close radiographic follow-up, are adopted. The use of Kirschner wires should anyway be restricted to carefully selected cases, in order to avoid major complications.
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ranking = 0.0021740943271661
keywords = ray
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20/138. Fracture of the trapezial ridge.

    The trapezial ridge is a longitudinal projection of bone on the palmar surface of the trapezium and serves as an attachment for a portion of the transverse carpal ligament. It can be fractured from a fall onto the outstretched palm. Presented here is a case report of a young woman who sustained a fracture of the trapezial ridge. Point tenderness was a key initial symptom. Standard anteroposterior, lateral, and oblique roentgenograms did not demonstrate the fracture, and the diagnosis was repeatedly missed. The carpal tunnel view was obtained seven weeks after the original injury and showed a nondisplaced fracture through the trapezial ridge. Cast immobilization initiated at that time was not successful in obtaining fracture union. The delay in diagnosis and subsequent nonunion resulted in chronic discomfort and weakness of pinch and grasp. Careful clinical examination for point tenderness over the palmar surface of the trapezium and proper roentgenographic analysis should minimize delays in diagnosis and treatment of this fracture.
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ranking = 2
keywords = roentgen
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