Cases reported "Iatrogenic Disease"

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1/11. Vascular injury from external fixation: case reports.

    The incidence of vascular injury from external fixation of fractures was studied retrospectively in two surgical departments during the period 1985-1990. A total of 1231 fractures of the lower limb were treated. External fixation was used in the initial stabilization of 28 femoral and 93 tibial fractures. In this series of 121 fractures four iatrogenic vascular injuries were seen: two arterial thromboses with distal ischemia and two incidents of the formation of a false aneurysm with bleeding along a pin. The diagnosis was made by angiography. Surgical intervention was necessary in all four cases. In one patient the injury resulted in amputation of the distal portion of the foot.
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ranking = 1
keywords = tibia
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2/11. Exclusion of a crural pseudoaneurysm with a PTFE-covered stent-graft.

    PURPOSE: To describe the successful endovascular treatment of an iatrogenic anterior tibial artery pseudoaneurysm with a polytetrafluoroethylene-covered stent-graft. CASE REPORT: A 58-year-old man was admitted to our hospital with pseudoarthrosis and malunion of the right distal tibia. Fibulotomy and intramedullary fixation were performed, which was complicated by a pseudoaneurysm of the anterior tibial artery. Under local anesthesia, a 4x31-mm Symbiot covered stent was successfully placed over the origin of the pseudoaneurysm. At 12 months, the pseudoaneurysm remained excluded, and the anterior tibial artery was patent. CONCLUSIONS: Endovascular treatment of a crural artery pseudoaneurysm seems to be a feasible treatment option. Further experience with this technique is needed to validate its safety and long-term patency.
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ranking = 4
keywords = tibia
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3/11. tibial nerve mistakenly used as a tendon graft. Reports of three cases.

    We describe three patients in whom the tibial nerve was used, in mistake for the plantaris tendon, to repair a ruptured calcaneal tendon. The tendon repair was successful in all cases, but despite attempted reconstruction of the nerve, no patient had any motor recovery although two regained some protective sensation.
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ranking = 1
keywords = tibia
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4/11. Fractures associated with patellar ligament grafts in cruciate ligament surgery.

    We reviewed retrospectively 490 patellar ligament reconstructions for cruciate ligament injuries performed from 1980 to 1990. There were six cases of patellar splitting and three displaced patellar fractures in donor knees. The fissure fractures all occurred during the removal of the patellar bone block. The displaced fractures were sustained during early rehabilitation, and in two of the three patients, involved the normal contralateral knee. The major reasons for this complication were imprecise saw cuts, spreading osteotomies, and the use of a too large patellar bone block. When a trapezoidal bone block is used to self-lock in the femoral tunnel, this should preferably be taken from the tibia. Special care is needed in rehabilitation when the graft has been taken from the contralateral knee.
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ranking = 1
keywords = tibia
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5/11. Iatrogenic bilateral tibial fractures after intraosseous infusion attempts in a 3-month-old infant.

    A 3-month-old girl presented to the emergency department with a clinical picture compatible with sepsis. When peripheral IV cannulation could not be attained, intraosseous (IO) access was attempted unsuccessfully in both tibias as well as in the right femur. The child was subsequently treated for S pneumoniae meningitis. Three days after discharge and 14 days after initial presentation, the family noticed swelling of the child's right leg. Radiographs revealed healing fractures of both proximal tibias. This case represents a previously unreported complication of intraosseous infusions and underscores the need for the use of proper technique and equipment.
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ranking = 6
keywords = tibia
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6/11. Fractured long bones in a term infant delivered by cesarian section.

    A term infant was delivered uneventfully by repeat Cesarian section. At the age of 1 week there was clinical and radiographic evidence of fractures of the left tibia and right radius. The fractures most likely occurred during the cesarian section. Birth trauma should not be excluded on the basis of Cesarian section delivery.
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ranking = 1
keywords = tibia
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7/11. Iatrogenic posterior tibial neurothlipsis: a tarsal tunnel syndrome.

    Posterior tibial neurothlipsis in the retromalleolar space, secondary to internal fixation of a prior ankle fracture, is presented in the following report. The possibility of a tarsal tunnel syndrome cannot be ruled out. No apparent similar reference is made in the medical literature concerning the above etiology of posterior tibial compression/neurothlipsis/tarsal tunnel syndrome. electrodiagnosis with sensory nerve conduction velocities is reviewed for more accurate diagnosis of tarsal tunnel syndrome.
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ranking = 6
keywords = tibia
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8/11. Iatrogenic entrapment of the femoropopliteal bypass.

    Three cases of infragenicular femoropopliteal bypass grafts are presented in which iatrogenic entrapment of the distal portion of the graft occurred between the medial head of the gastrocnemius muscle and the posterior surface of the tibia. The condition should be suspected if ischemia of the leg develops postoperatively when the knee is hyperextended and is improved when the knee joint is flexed. Measurements of the ankle pressure index or pulse Volume Recorder tracings at the ankle in both flexed and extended positions will confirm the diagnosis. The entrapment of the bypasses in these three patients was easily corrected by transection of the medial head of the gastrocnemius muscle. Relief of the occlusion of the bypass can be easily demonstrated by noninvasive studies.
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ranking = 1
keywords = tibia
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9/11. Iatrogenic transplantation of osteosarcoma.

    We report a case in which a patient having curettage and resection of a presumed benign lesion of the tibia (later recognized as osteosarcoma) had probable iatrogenic transplantation of tumor to the contralateral iliac crest, which had served as a donor site for bone chips used to pack the tibial lesion. The patient later had above-knee amputation for the primary tumor and eventually required contralateral hemipelvectomy when tumor developed in the iliac crest donor site. We discuss the literature of tumor transplantation and seeding in operative settings and stress the clinical importance of avoiding possible tumor contamination of operative fields by meticulous instrument changes and by isolation of multiple surgical fields.
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ranking = 2
keywords = tibia
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10/11. Periarticular fractures after manipulation for knee contractures in children.

    We report two cases, each of which sustained two separate periarticular fractures from overzealous manipulation for knee contracture. The four fractures reported in this study involve one normal child sustaining asynchronous ipsilateral distal femoral and proximal tibial fractures and a child with the diagnosis of amyoplasia sustaining bilateral proximal tibial fractures. The child with knee contracture must be treated carefully and not exposed to overzealous physiotherapy or manipulation. The child who has developed a joint contracture secondary to lengthy immobilization may be at increased risk for periarticular fracture secondary to disuse osteopenia. The knee joint is at particular risk because of the long lever arm of the leg. These concerns should be conveyed to anyone involved in the patient's care, including the parents, therapists, nurses, and physicians. Passive range of motion in the child should never be painful. Normal children often can obtain maximal range of motion if left alone and not restricted.
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ranking = 2
keywords = tibia
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