Cases reported "Fractures, Closed"

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1/17. Nonunion following subcapital (neck) fractures of the proximal phalanx of the thumb in children.

    Six cases of nonunion of subcapital (neck) fractures of the proximal phalanx of the thumb in children were seen over a period of 5 years. Ages at the time of injury ranged between 2 and 3 years. Entrapment of the thumb in a closing door was the mechanism of injury in all cases. All fractures were closed and were significantly displaced. Immediate management was by closed reduction and splinting in four cases, closed reduction and K-wire fixation in one case and no treatment in one case, which was later treated by delayed open reduction and K-wire fixation. Only two of the six ununited fractures were eventually treated with bone grafts and both fractures united resulting in a stable thumb but with a limited range of flexion of the interphalangeal joint. Factors that may increase the risk of nonunion of these fractures in children are discussed.
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2/17. urinary incontinence after pelvic trauma: a case report.

    Stress and Urge urinary incontinence may develop after a pelvic trauma especially after pelvic bone fractures. Incontinence may persist even though any type of bladder neck suspension is performed if malunion occurs between fracture ends. In stress and urge urinary incontinence developed after pelvic trauma, patients should also be evaluated for malunion of fractures which may lead to bone spurs and during any type of bladder neck suspension these should also be removed.
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3/17. Clinics in diagnostic imaging (94). Undisplaced occult subcapital fracture of the right femoral neck.

    An 84-year-old woman, who sustained a fall in the nursing home, complained of right hip pain and inability to bear weight. Radiographs showed no fracture or cortical break. MR imaging showed an undisplaced subcapital fracture of the right femoral neck for which a hemiarthroplasty was performed. The patient was then discharged 10 days post-operation. Effectiveness of MR imaging for assessing occult hip fracture, a more superior imaging modality as compared to radiographs, is discussed. early diagnosis can also expedite appropriate treatment and promote recovery, which can reduce the cost of prolonged or inpatient care. The role of MR imaging in detection of other causes of pain in the hip region is also discussed, drawing on examples in our local experience.
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4/17. Hangman's fracture resulting from improper seat belt use.

    Diagonal seat belt application without accompanying lap belt closure may produce severe cervical spine injuries, including hangman's fracture and decapitation. seat belts are effective in reducing injury, but they must be worn properly to do so. Passive restraint systems involving a diagonal seat belt may be hazardous if the motorist does not use the accompanying lap belt. We have presented a case in which the driver in a motor vehicle accident sustained a hangman's fracture (bilateral fracture of the pedicles of C-2) caused by use of a diagonal seat belt without accompanying lap belt closure. The mechanism of injury, as classically described in judicial hanging, is hyperextension and distraction, which occurred when the victim "submarined" under the diagonal seat belt and was caught at the neck.
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5/17. Cervical spine fracture following a motor vehicle accident.

    We present the case of a 50-year-old man who visited our emergency department 12 h after an alcohol-related motor vehicle accident complaining of shoulder pain and neck stiffness. Cervical spine radiographs were obtained and interpreted as normal, and the patient was discharged. Subsequent review by a radiologist raised the question of a second cervical vertebra (C-2) abnormality, and the patient was recalled. Cervical computed tomography (CT) scan revealed an unstable oblique fracture of C-2 and a congenital nonfusion of the arch of C-1. The patient was placed in halo traction, and subsequent radiographs revealed a fracture of the transverse process of C-7. The patient made an uneventful recovery. The limitations of routine cervical radiographs are well-documented, but no feasible alternative exists as a screening procedure. Thus, a certain level of uncertainty must be accepted. Both physician and patient must recognize the limitations inherent in all medical practice and that follow-up examination and treatment are essential.
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6/17. Irreducible dislocation of the subtalar joint: a report of two cases.

    Two patients with irreducible lateral dislocation of the subtalar joint are reported. In both patients the injury was closed and associated with a lateral calcaneal fracture. Open reduction confirmed the tendon of tibialis posterior was located around the lateral aspect of the neck of the talus and prevented reduction.
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7/17. Cases from the aerospace medicine residents' teaching file. Case #16. A student pilot with an avulsion fracture of C5.

    A student pilot presented to the emergency room with neck pain after having received a blow to the back of the head during participation in a sports event. The clinical presentation, diagnosis, and aeromedical disposition of this patient are discussed. A review of radiologic findings in cervical fractures is also presented.
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8/17. axillary artery damage following a closed fracture of the neck of the humerus--a case report.

    A case of intimal tearing of the axillary artery in association with a close fracture of the neck of the humerus is described. This is a rare injury and illustrates that vascular damage should never be assumed to be due to spasm. Exploration must be carried out because a mechanical vascular occlusion is most likely.
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9/17. Fracture of the talus in childhood. A case report.

    Fractures of the neck of the talus are rare in children. A grade I injury in a 5-year-old girl, with apparent bony union at 6 weeks after the accident, confirmed after 4 months, is reported.
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10/17. axillary artery injury with minimally displaced fracture of the neck of the humerus.

    A case of axillary artery injury resulting from a minimally displaced fracture of the neck of the humerus is reported. Very few such injuries have been reported previously. The mechanism of injury can be from sharp bony fragments, overstretching of the artery especially when atheromatous, or torn intima. angiography should be performed, followed by exploration where indicated.
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