Cases reported "Multiple Trauma"

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1/235. High-energy bilateral talar neck fractures secondary to motocross injury.

    The authors present a case of bilateral Hawkins type II talar neck fractures sustained during a motocross race in a 23 year old man. Due to the complexity of the injuries, open reduction with internal fixation and primary subtalar joint arthrodesis was performed bilaterally. This is one of the few cases of bilateral talar neck fractures reported in the literature in the past 15 years and one of the first utilizing open reduction and internal fixation with concomitant subtalar joint arthrodesis as a primary treatment.
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keywords = fracture
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2/235. Intraarticular heterotopic ossification in the knee following intramedullary nailing of the fractured femur using a retrograde method.

    The cases of a forty-five-year-old woman and a twenty-year-old man who developed severe intraarticular and periarticular heterotopic ossification around the knee following intramedullary nailing of a femur fracture using a retrograde technique. The association of musculoskeletal heterotopic ossification with closed head injuries seems well established and can occur in and around the knee following retrograde intramedullary nailing. This complication may occur more often than has been reported.
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keywords = fracture
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3/235. homicide or accident off the coast of florida: trauma analysis of mutilated human remains.

    In the many years Dr. William R. Maples served as a forensic anthropologist, he saw diverse sources of trauma presented in the victims of violent crime, accident and suicide in the state of florida. In 1996 the District 18 Medical Examiner's Office of florida requested the assistance of Dr. Maples in the analysis of human remains recovered by the U.S. Coast Guard. The deceased was in an advanced state of decomposition characterized by skin slippage and discoloration. The torso bore multiple lacerations, including nearly parallel lacerations in the skin of the back. Specimens were carefully macerated and the fractures reconstructed. The skeletal trauma was caused by a device capable of delivering robust cuts and blunt trauma in linear paths, as is consistent with propeller trauma. Unusual in this case were blows to the ventral and dorsal surfaces of the body. Based on the anthropological analysis and interviews with the family of the deceased, the F.B.I. proceeded with the case as a homicide investigation.
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keywords = fracture
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4/235. Sharp-force trauma analysis and the forensic anthropologist: techniques advocated by William R. Maples, Ph.D.

    Forensic anthropological tenets supported by William R. Maples, Ph.D. provide the bases for a case study from the C.A. Pound Human Identification Laboratory. Using a multidisciplinary team that included police investigators, pathologists, odontologists, entomologists, and anthropologists, a biological profile and trauma analysis was constructed. Our analysis determined that the decedent was a middle-aged Hispanic male, approximately 5'6"-5'7" in stature, who had died a minimum of three months before the discovery of his remains. Gross and microscopic analysis revealed 11 areas of sharp trauma to the skull and cervical vertebrae. To aid with analysis of the trauma, nonhuman trauma exemplars were created using a Tiger rear flail mower of the make known to have been used at the scene where the remains were recovered. This use of nonhuman trauma exemplars proved to be essential in the effort to exclude the rear flail mower as the possible trauma agent.
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ranking = 3.4525847647309E-5
keywords = skull
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5/235. Traumatic fracture of the hyoid bone: three case presentations of cardiorespiratory compromise secondary to missed diagnosis.

    hyoid bone fractures secondary to blunt trauma other than strangulation are rare (ML Bagnoli et al., J Oral Maxillofac Surg 1988; 46: 326-8), accounting for only 0.002 per cent of all fractures. The world literature reports only 21 cases. Surgical intervention involves airway management, treatment of associated pharyngeal perforations, and management of painful symptomatology. The importance of hyoid fracture, however, rests not with the rarity of it, but with the lethal potential of missed diagnosis. We submit three cases with varying presentations and management strategies. All three of our cases incurred injury by blunt trauma to the anterior neck. Two patients required emergent surgical airway after unsuccessful attempts at endotracheal intubation. One patient presented without respiratory distress and was managed conservatively. After fracture, the occult compressive forces of hematoma formation and soft tissue swelling may compromise airway patency. It is our clinical observation that hypoxia develops rapidly and without warning, leading to cardiorespiratory collapse. With endotracheal intubation prohibited by obstruction, a surgical airway must be established and maintained. Recognition of subtle clinical and physical findings are critical to the diagnosis of laryngotracheal complex injuries and may be life-saving in many instances. To ensure a positive outcome, a strong degree of suspicion based on mechanism of injury is mandated.
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keywords = fracture
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6/235. wrist arthroscopy and dislocation of the radiocarpal joint without fracture.

    The authors report a rare case of dorsal dislocation of the radiocarpal joint without any bony lesion associated. The traumatic cause was a high energy motorbike accident. Fractures of the other limbs were associated. The authors report the clinical, radiological, and arthroscopic features. wrist arthroscopy showed a complete tear of all the extrinsic ligaments, a radial avulsion of the triangular fibrocartilage complex, and the integrity of the intracarpal ligaments, which guided the treatment. The dislocation was treated by closed reduction and radiocarpal pinning. The authors propose wrist arthroscopy in radiocarpal dislocation for diagnosis of soft tissue and cartilaginous lesions to guide the treatment (close or open).
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keywords = fracture
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7/235. Total dislocations of the navicular: are they ever isolated injuries?

    Isolated dislocations of the navicular are rare injuries; we present our experience of six cases in which the navicular was dislocated without fracture. All patients had complex injuries, with considerable disruption of the midfoot. Five patients had open reduction and stabilisation with Kirschner wires. One developed subluxation and deformity of the midfoot because of inadequate stabilisation of the lateral column, and there was one patient with ischaemic necrosis. We believe that the navicular cannot dislocate in isolation because of the rigid bony supports around it; there has to be significant disruption of both longitudinal columns of the foot. Most commonly, an abduction/pronation injury causes a midtarsal dislocation, and on spontaneous reduction the navicular may dislocate medially. This mechanism is similar to a perilunate dislocation. Stabilisation of both medial and lateral columns of the foot may sometimes be essential for isolated dislocations. In spite of our low incidence of ischaemic necrosis, there is always a likelihood of this complication.
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ranking = 0.16666666666667
keywords = fracture
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8/235. Traumatic cardiac herniation diagnosed by echocardiography and chest CT scanning: report of a case.

    A 62-year-old man who had suffered fractures of the left chest wall and hemothorax 1 year earlier was admitted to our hospital with multiple injuries as a result of a traffic accident. Chest drainage was immediately performed under the diagnosis of left hemothorax followed by immobilization of fractures of the femur and radius. On the second day after admission, he suddenly developed severe chest pain and dyspnea after sitting up in bed. echocardiography and chest computed tomography (CT) showed herniation of the left ventricle into the left thoracic cavity, whereby a diagnosis of cardiac herniation due to rupture of the pericardium was made and an emergency surgical repair was successfully performed. Only eight cases of patients surviving after traumatic cardiac herniation have been reported in japan; however, this is the first in which a preoperative diagnosis was made by echocardiography and chest CT scanning prior to surgical repair.
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keywords = fracture
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9/235. Blunt trauma with flail chest and penetrating aortic injury.

    Blunt chest trauma with flail chest is common. The mortality attributes initially to the associated pulmonary contusion, massive hemothorax and later to the occurrence of adult respiratory distress syndrome. We report a case of flail chest with segmental fractures near the costovertebral junction and delayed hemothorax attacked 14 h later. The final diagnosis of the penetrating aortic injury by detached rib fragment was appreciated by aortogram. Unfortunately, active aortic hemorrhage made prompt thoracotomy in vain for life salvage.
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ranking = 0.16666666666667
keywords = fracture
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10/235. Split free flap and monofixator distraction osteogenesis for leg reconstruction.

    The use of a split muscle flap widens the indications of unilateral external fixation in the treatment of type IIIB open tibial fractures with large bone defects. The same frame can be used for early stabilization and for secondary distraction lengthening procedures. The use of a split flap allows an easy, safe, and painless pin migration. The combination of these techniques represents a very safe solution, especially for patients in poor general and vascular condition.
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ranking = 0.16666666666667
keywords = fracture
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