Traumatic Hemipelvectomy: A Case Report and a Review of the Literature

Abstract Traumatic hemipelvectomy is a life threatening, devastating pelvic injury with very low survival rates. Excessive loss of blood, related systemic problems and additional injuries about the gastrointestinal and genitourinary systems increase mortality of this severe sort of injury. A young, male farmer injured violently by an agricultural heavy machine; a survivor of traumatic hemipelvectomy is described in this case report.     

Anterior Thoracic Wall Traumatic Lymphocele: A Case Report

Traumatic lymphoceles are usually the result of surgical injuries or blunt trauma. Although usually described in the pelvis after radical pelvic node dissection or kidney transplantation, traumatic lymphoceles are rare. Diagnosis is based on CT scan and confirmed by fine needle aspiration with biochemical analysis. Treatment modalities are not standardized and different techniques have been described. We report herein a case of anterior thoracic wall lymphocele due to blunt trauma treated in our department.     

Traumatic Epidermal Inclusion Cyst After Minimally Invasive Surgery of a Displaced Intra-Articular Calcaneal Fracture: A Case Report

Epidermal inclusion cysts are common epithelial cysts of the skin. The latter classically originate from progressive cystic ectasia of the infundibular portion of hair follicle. Therefore, these cysts are usually found in hairy regions and rarely in glabrous skin such as the palms and soles. The etiology of glabrous epidermal inclusion cysts appear to be different from that of those located in hairy regions. It has been suggested that implantation of epithelial cells into subcutaneous tissue, such as during trauma, is most likely the pathophysiologic basis. Epidermal inclusion cysts on the palms and soles are often misdiagnosed, leading to improper treatment. Therefore, we report a rare case of an epidermal inclusion cyst of the heel after minimally invasive surgery of a displaced intra-articular calcaneal fracture.     

Rare Isolated Trapezoid Fracture: A Case Report

Isolated fractures of the trapezoid are rare. Of all of the fractures of the carpus, the most common is the scaphoid, which represents 68.2% of all carpal fractures (Papp, Orthop Clin N Am 38:251–60, 2007). In contrast, trapezoid fractures represent 0.4% of all carpal injuries. Because it is an infrequently fractured carpal bone, there is a wide variety of treatment plans, including rest, immobilization, and surgery (Green and Pederson, Green’s Operative Hand Surgery, Elsevier, Philadelphia, 759 pp, 2005). In this report, we describe a patient who presented with an isolated fracture of the trapezoid that was successfully treated with cast immobilization and had a full functional recovery.     

Late Hematoma After Aesthetic Breast Augmentation with Textured Silicone Prosthesis: A Case Report

Late hematoma is an extremely rare complication after augmentation mammaplasty with silicone prostheses. The authors present a case of late hematoma after breast augmentation with textured gel-filled silicone prostheses, which appeared after intense physical effort 1 year after the implantation of the prosthesis. The hematoma was drained in three subsequent ultrasound-guided percutaneous needle aspirations, with no need for removal of the implant. In a 9-month follow-up period, the patient had no other problems with the implants.     

Traumatic Complex Hawkins Type IV Talar Fracture: A Case Report

Fracture-dislocations of the talus are one of the most complex injuries involving the foot and ankle. These injuries are often accompanied by additional traumatic orthopedic injuries, avascular necrosis, and infection. When approaching limb reconstruction and salvage, the overall prognosis and functionality of the limb are key factors to consider. In the present report, we draw attention to the importance of a multidisciplinary team approach for formulating a treatment plan that incorporates the talar injury and associated injuries or pathologic features. We also reviewed the published data related to avascular necrosis of the talus, open talar fracture management, and treatment outcomes.     

Pulmonary Tractotomy for a Patient with Traumatic Penetrating Lung Injury: Report of a Case

We report a case of traumatic hemopneumothorax caused by penetrating lung injury in a 26-year-old man. The patient underwent emergency thoractomy, which revealed hemorrhage in the lingular segment of the left lung. We found the bleeding point and controlled the hemorrhage using pulmonary tractotomy by inserting a linear stapler into the stab wound in the pulmonary parenchyma. The original technique of pulmonary tractotomy was performed for complete through-and-through injury by dividing the bridge of lung tissue between the aortic clamps. We were able to apply this procedure safely to stop bleeding from a stab wound that did not go through the lung. Thus, pulmonary tractotomy is an effective damage-control operation for the lung with obvious advantages over major lung resection.     

Late and Long-Standing Capsular Hematoma After Aesthetic Breast Augmentation with a Saline-Filled Silicone Prosthesis: A Case Report

Late capsular hematoma is an extremely rare complication after the implantation of silicone breast prostheses for aesthetic or reconstructive objectives. We present a unique case of late capsular hematoma in an aesthetic breast augmentation with a saline-filled, textured silicone implant, which remained for a year after formation.     

Non Traumatic Dislocation of Shoulder with Rupture of Axillary Vessel Branch in a Paraplegic Patient: A Case Report

ABSTRACT

Spinal cord injured (SCI) patients utilize the shoulder joints for wheelchair propulsion, for transfers in and out of wheelchairs and for wheelchair “push-ups” for pressure relief, to prevent pressure sores. Accurate incidence of shoulder dislocation in SCI patients is not known. A majority of the dislocations seen are secondary to trauma. A 66-year-old, T10 paraplegic since 1942, developed severe osteoarthritic changes in both shoulders and experienced nontraumatic, recurrent dislocation of his right shoulder with a rupture of the axillary vessel branch. This case is reported here because of its rarity. (J Am Paraplegia Soc 1990; 13: 15–17)     

Postoperative Repeat Dislocation of the Posterior Tibial Tendon: A Case Report

Dislocation of the posterior tibial tendon is an uncommon condition. Although surgery is usually performed in most cases of posterior tibial tendon dislocation, postoperative repeat dislocation of the posterior tibial tendon has not been reported in the published data. We report the case of a 27-year-old male patient who experienced repeat dislocation of the posterior tibial tendon after a gymnastic landing, 44 months after initial retinaculum repair. For revision surgery, we reconstructed the flexor retinaculum in conjunction with deepening of the retromalleolar groove, because the groove was hypoplastic. He returned to competitive gymnastics and had not experienced subluxation or dislocation of the posterior tibial tendon at the 1-year follow-up examination.     

Unusual Traumatic Midthoracic Spondyloptosis and Its Surgical Management: Case Report

Posttraumatic spondyloptosis develops as a result of complete subluxation of the vertebral bodies and causes complete transection of the spinal cord. Severe trauma-related spondyloptosis of the upper-mid thoracic region is a rare form of spinal trauma. Traumatic midthoracic spondyloptosis is quite rare, and radiology plays an important role in the diagnosis and treatment of this condition. Surgical reconstruction and stabilization are required for early mobilization and rehabilitation of patients with this injury. Here, we report the clinical features, radiographic findings, and management of an unusual case of traumatic midthoracic spondyloptosis that showed complete spinal cord transection and was operated.     

Complete Cuboid Dislocation With Associated Lisfranc Injury: A Case Report and Review of the Literature

Cuboid dislocations are rare midfoot injuries that usually occur in the setting of high-energy trauma. Diagnosis can be challenging and optimal treatment remains unknown. This case report and review aims to summarize the recent literature on this topic.     

Function Versus Position: A Randomized Controlled Trial of Interfocal Kirschner Wiring of Unstable Distal Radial Fractures

Abstract Introduction: A randomized, prospective study has been carried out to determine if immobilisation in dorsiflexion following K-wire fixation of unstable distal radial fractures improves functional outcome. Methods: Sixty patients with unstable fractures of the distal radius were entered into the trial. There were 52 female and 11 male with an average age of 60yrs (17-84). Randomisation was undertaken in theatre using a closed envelope system. The fractures were initially reduced by closed manipulation and interfocal percutaneous K-wires inserted. Patients randomised to group I had their wrists placed in 30 degrees of dorsiflexion and group II had their wrists placed in 30 degrees of palmer flexion. Patients were reviewed with an x-ray at 1, 3, 5, and 17 weeks by a single physician. Dorsal angulation, Radial inclination, Radial length and Radial height were measured. The K-wires were removed in the outpatient clinic at 3 weeks and the plaster at 5 weeks. Blinded functional review was carried out by an Occupational therapist at 5, 8 and 17 weeks post operation. The power and pinch grip was measured using a Jamar dynamometer. Flexion and extension were measured with a goniometer. Results: There was no statistical difference in radiological or functional outcomes in either group. At 17 weeks the mean dorsal angulation was -0.5 and -1.9 degrees. The mean radial shortening was 1.5mm in both groups. The power grip was 86% and 82% and pinch grip was 99% and 101%. Patients regained 76% and 79% of flexion and 94% and 88% of extension compared to the opposite side. Conclusions: Immobilisation in dorsi-flexion following K-wiring for unstable distal radial fractures does not improve functional outcome. The overall functional results were excellent and we believe that Kwiring still as a place in the treatment of distal radial fractures in the previously defined population.     

Vacuum-Assisted Closure for Successful Treatment of a Major Contaminated Gunshot Chest-Wound: A Case Report

Vacuum-assisted closure (VAC) is a well-established treatment for complicated wound infections and chronic wounds, including poststernotomy mediastinitis. The use of VAC in treating high-energy trauma has been more limited. We present a case where VAC was successfully used to treat a contaminated self-inflicted gunshot-wound of the chest and abdomen.