Lisfranc injuries in adolescents: A case report and literature review

Lisfranc injuries result if bones or ligaments that support the midfoot are torn. In children and adolescents these injuries are not only rare, but are also similar to adult Lisfranc injuries, in that they are often mistaken especially if the injury is a result of a straightforward twist and fall. The goal of surgical treatment is to realign the joints.However, few studies related to Lisfranc injuries in pediatric patients exist.A case of 15 years old patient treated using an Arthrex mini tight rope is described.     

Bilateral capitellum humeri fracture: a case report and review of the literature

We report a case of a 37-year-old woman who sustained a bilateral Hahn-Steinthal type fracture of her capitellum humeri. Open reduction and internal fixation, using extra-articular insertion of Herbert screws, were performed. Both elbows were immobilised for 3 weeks postoperatively. Radiographic signs of union were present at week 8. Within the observation period of 18 months, no signs of avascular necrosis were detected. At the end of the recovery period, despite intensive physiotherapy, the patient was left with a 20 degrees loss of flexion in her right elbow and a 15 degrees loss of extension in her left elbow. We found the use of Herbert screws particularly suitable for this type of injury: it allows good inter-fragmentary compression due to the sub-articular positioning that avoids the risk of damaging the articular surface. Mobilisation should start early to prevent joint stiffness and long-term disability.     

Traumatic lumbosacral fracture dislocation: a case report and review of the literature

Lumbosacral dislocation is uncommon. We report a case of traumatic lumbosacral dislocation which occurred in a 33-year-old pedestrian traffic accident victim. The posterior impact produced lumbar injury with diffuse pain exacerbated at the lumbosacral junction. Ecchymotic diffusion involving the entire lumbar region fluctuated due to the presence of a subcutaneous hematoma. The neurological examination revealed incomplete L5 paraplegia. Standard x-rays revealed L5-S1 spondylolisthesis and fracture of the L5 spinous process as well as fractures of the L3, L4, and L5 transverse processes. Computed tomography disclosed biarticular L5-S1 fracture dislocation and a voluminous herniation of the L5-S1 disc. Emergency surgery was performed and revealed subaponeurotic detachment from T4 to S1 and bald iliac pyramids. After L5 laminectomy and extraction of the voluminous herniation of the L5-S1 disc, a short L5-S1 posteriolateral fusion was achieved using pedicular screws and two rods on either side as well as a posterolateral iliac autograft. The clinical course was satisfactory with nearly complete neurological recovery (persistent levator ani paresis). This clinical case and a review of the literature illustrate the pathogenic, clinical, radiological and therapeutic aspects of lumbosacral fracture dislocation.     

Isolated hyoid bone fracture: a case report and review of the literature

Isolated hyoid bone fractures secondary to trauma other than strangulation are rare and have few, if any, complications. We report a case of an isolated hyoid bone fracture that resulted in sudden and severe upper airway compromise. Diagnosis of these fractures is difficult and usually can be made only with a strong degree of suspicion. Patients who suffer neck injuries in whom a hyoid fracture is diagnosed or strongly suspected should be observed for 48 to 72 hours, considered for endoscopy, and treated as warranted.     

Bilateral traumatic patellar fracture: a case report and review of literature

Simultaneous isolated bilateral patellar fractures are very rare injuries and most often associated with systemic disorders such as hyperparathyroidism,osteoporosis,stress fracture and kidney failure.I...     

A case report of the Hoffa fracture and a review of literature

The Hoffa fracture is an uncommon fracture. There is a lot of confusion about its diagnosis and management with several conflicting reports in literature. We reported a 25-year-old patient with non-union of Hoffa fracture, and meanwhile tried to develop an algorithm-based treatment for Hoffa fractures. A systematic review of the available literature was performed. Medline, Embase, the Cochrane Library and PubMed were searched for relevant articles. Fifty-five articles were reviewed, and the clinical knowledge base was summarized. The understanding of the mechanism of trauma has become more nuanced. The literature has also evolved to classify the fracture with the purpose of surgical management in mind. This can be used to plan approach and fixation with preservation of blood supply. Classification can also prognosticate the outcomes in Hoffa fracture.     

Unusual ankle fracture: A case report and literature review

Fractures of the talus are uncommon, and talar body fractures in the sagittal plane are still rarer. The aim of its treatment is urgent anatomic reduction to restore congruency of the ankle and to reduce the risk of avascular necrosis by preserving any remaining blood supply. We report the case of a body talar fracture in sagittal plane associated with fracture of the medial malleolus in a young adult; the mechanism of the fracture was plantar hyperflexion, internal rotation and axial compression. We perform an open reduction and stabilization with two screws for the talus and screw the medial malleolus. At 14 months following the injury patient had good range of movement with little pain. The mechanism is discussed along with a literature review.     

Transscaphoid-transtriquetral perilunate fracture dislocation: report of a case and review of the literature

INTRODUCTION: A transscaphoid and transtriquetral perilunate fracture dislocation is fairly rare among the known cases of perilunate fracture dislocations, and the details of the initial treatment and outcome of this injury have never been reported. MATERIALS AND METHODS: A 21-year-old, right-handed man presented with fractures at the proximal third of the scaphoid and at the mid-body of the triquetrum with an associated dorsal perilunate dislocation after a fall onto his outstretched hand. Under general anesthesia, closed reduction was attempted with 3 kg of traction applied by means of finger traps. After anatomical reduction was achieved, percutaneous fixation was applied to both the triquetrum and scaphoid using cannulated screws. A short arm thumb spica splint was applied for 2 weeks, and part-time splinting was continued for an additional 3 weeks. The patient subsequently underwent 3 months of intensive range-of-motion and muscle-strengthening exercises. RESULTS: At the final follow-up examination 68 months after the initial operation, the arc of motion of the right wrist, 150 degrees (extension plus flexion arc), and grip strength, 41 kg, were 94% and 103% of the values for the unaffected wrist, respectively. Radiographs showed a bony union of the scaphoid and triquetrum, and no sign of avascular necrosis in the proximal scaphoid fragment, as well as other carpi. No midcarpal or radiocarpal degenerative arthritis was observed, and the normal carpal bone relationships were still maintained, with a scapholunate angle of 48 degrees and a scapholunate gap of 2 mm. CONCLUSION: We recommend closed reduction and percutaneous screw fixation of the scaphoid, as well as the triquetrum in this case, to minimize the interruption of the blood supply to the carpus and also to obtain rigid fixation during the procedure.     

The scaphocapitate fracture syndrome: report of a case and a review of the literature

The Fenton??s syndrome or scaphocapitate fracture syndrome has been described since 1950. This severe and uncommon injury occurs after a high-energy trauma of the wrist. This syndrome associated the fractures of the scaphoid and capitate, with a rotation of 90° or 180° of the proximal fragment of the capitate. The diagnosis is determined by careful physical and radiological examinations, including conventional radiographs. Computed tomography can be helpful in detecting such lesions. We report one case of Fenton??s syndrome that occurred after a high-energy trauma in a 22-year-old male. We discuss the mechanisms of the injury and the results of treatment.     

Distal fracture clavicle and acromioclavicular dislocation: a case report and review the literature

Acromioclavicular dislocations and clavicle fractures are extremely common injuries. However, complete acromioclavicular dislocation combined with an adjacent clavicle fracture is very rare. Its recognition depends on a thorough assessment of the patient, including high-quality radiographs of the clavicle and acromioclavicular joint. This report describes an unusual injury: an acromioclavicular dislocation type III with a distal clavicle fracture type I in the same arm. The patient was treated conservatively with an immobilization for 6?weeks. After 9?months of follow-up, the patient had a pain-free shoulder with full range of motion.     

Bilateral Hahn–Steinthal fracture: a case report and review of literature

Capitellar fractures are rare. If anatomy is not reconstructed accurately, elbow function is sub-optimal. Various studies have shown good outcome in Type I Hahn–Steinthal fractures. There is only one report of a bilateral capitellar fracture in the English literature so far. We report another case of the same. A 26-year-old mother slipped and fell on level ground. She sustained closed injury to both her elbows. Radiographs revealed bilateral, displaced Hahn–Steinthal fracture of the capitellum. She underwent open anatomic reduction and stabilisation with two partially threaded 4 mm cancellous screws, inserted from posterior to anterior. At 2 months, both fractures united. At final follow-up, 19 months post-operatively, she had full range of movement of both elbows. Anatomic reduction, stable internal fixation and early mobilisation of Type I Hahn–Steinthal capitellar fracture achieves excellent results.     

Complete urethral injury in the penile fracture: a case report and literature review

Penile fracture is described as a traumatic rupture of the tunica albuginea caused by blunt injury to the erect penis. It usually occurs as a single rupture of the tunica albuginea in one of two corpora cavernosa; a rupture with urethral injury is an extremely rare condition. Although its diagnosis is usually clinical, ultrasound plays an important role in confirming diagnosis and identifying the site of the injury. Here, we presented a case of penile fracture with complete urethral injury. A 43-year-old male was admitted to the hospital because of trauma to the genital and dysuria following sexual intercourse. After admission, the patient was diagnosed with double penile fracture and complete urethral injury after the physical and B-ultrasound examinations. Emergency surgery to remove the hematoma and repair the urethra was performed. The patient recovered smoothly and was discharged on the third day after operation. After two months’ follow-up, the patient urinated smoothly and achieved an adequate erection without other complications. In this case, consistent with previous studies, emergency surgery for penile fracture is necessary and can preserve the urethral function and sexual function. In addition, there are two lesions in tunica albuginea in this case, so careful search for the penile shaft during the surgery is important to avoid the missed injuries. This report provides evidence of an uncommon and underreported clinical case.     

Open anterior fracture dislocation of the hip: a case report and review of literature

Open anterior fracture dislocation of the hip is an extremely rare injury and is the result of a violent trauma. Such a case is being reported in a 15-year-old female, who also had other adjacent bony injuries. In spite of early treatment, necrosis and infection could not be controlled, resulting in permanent disability in this young girl.     

Isolated comminuted trapezium fracture: A case report and literature review

Introduction and importanceTrapezium, as a carpal bone positioned at the distal row, is often associated with other wrist injuries such as distal radius fracture. Isolated trapezium fracture, especially in a comminuted form, rarely occurs. There are only six reports of isolated comminuted trapezium fractures in the literature to the best of our knowledge.Case presentationWe present a case with an isolated comminuted trapezium fracture presenting pain in his thenar eminence and thumb motion limitation. He was treated by Open Reduction and Internal Fixation (ORIF) with the K wire pin.Clinical discussionWe searched the published related studies and summarized the signs and symptoms of patients presented with trapezium fracture. The most common presentation of trapezial fracture include pain/tenderness at the base of the first metacarpal bone, pain/tenderness at the snuffbox area and 1st digit motion limitation. The treatment options described in the literature for isolated comminuted trapezium fracture are also presented. Open reduction and fixation with pin is the most common treatment mentioned in the literature. The priority is restoring the scaphotrapezial and trapeziometacarpal joint congruency to save the 1st digit range of motion.ConclusionComminuted trapezial fracture may happen following either low energy (like our patient) or high energy trauma. This paper highlights the fact that even a comminuted trapezium fracture can be easily missed. Regardless of the trauma mechanism (high energy versus low energy trauma), a high index of suspicion and delicate work up would be necessary in order not to miss this type of fracture.     

Intradiploic hematoma after skull fracture: case report and literature review

BACKGROUND: Intradiploic hematoma of the skull was first reported in 1934. The pathogenesis of this lesion is unclear. It is a very rare benign reactive process occurring after minor head trauma, with only seven cases reported in the literature to date. CASE DESCRIPTION: A 3-year-old right hand dominant male presented with a non-tender parietal scalp swelling of a 1-year duration. History included a skull fracture located in the same region 24 months before presentation. Neurological examination was unremarkable. Pathological examination after curettage of the lesion revealed features consistent with organizing hematoma. CONCLUSIONS: The pathology of chronic diploic hematoma mimics aneurysmal bone cyst, giant cell tumor, giant cell reparative granuloma, fibrous dysplasia, eosinophilic granuloma, intradiploic epidermoid and dermoid cyst, cavernous hemangioma, circumscribed osteomyelitis, and tuberculous granuloma. Chronic diploic hematoma is a lesion that must be differentiated from various skull lesions both radiologically and histologically as it is amenable to treatment with a complete cure once excised.     

Bilateral capitulum humeri fracture, a case report and review of the literature

Fracture of the capitellum is an intra-articular fracture of the distal humeral metaphysis and usually occurs in the frontal plane. It is a rare fracture and even more unusual when bilateral. The authors report a case of bilateral isolated fracture of the capitellum (Hahn-Steinthal type I) in a woman aged 28 years, treated surgically. A posterolateral approach was used for both elbows. Internal fixation was performed using two Herbert screws in the right elbow, and AO screws in the left elbow. Both elbows were immobilised for 3 weeks before commencing an intensive mobilization program guided by a physiotherapist. The end result was very satisfactory: both elbows were pain-free, with a complete range of movement on the right and a 10 degrees loss of extension on the left. Radiologically, consolidation was complete and there were no signs of avascular necrosis. Based on a review of the literature, the authors favour the use of Herbert screws in the treatment of capitellar fractures. They give good inter-fragmentary compression and reduce the risk of damaging the articular surface due to their subarticular position.     

Brachial-plexus injury after clavicular fracture: case report and literature review

Brachial plexus injury is a rare complication of the fractured clavicle. The authors describe the second reported case of brachial plexus injury due to secondary fracture displacement. This case emphasizes the following points: the neurologic status of the arm after a fracture of the clavicle must be documented; fractures of the middle one-third of the clavicle are prone to displacement; patients should be advised to report immediately any new symptoms in the arm; when fracture displacement is the cause of brachial-plexus compression then a trial of conservative therapy is indicated; the prognosis for neurologic recovery after this injury is good.