Trauma Case Reports最新文献

Presentation, management and outcome of thoracic trauma in a resource-limited environment: A case series

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-28 DOI: 10.1016/j.tcr.2025.101155

Danielle Benjamin , Patrick Charlorin , Gérald Jonacé , Jude Milcé

Background

Trauma is a major public health problem, causing the death of >5 million people each year. One-fifth of these deaths are related to thoracic trauma (TT). This study aims to provide data on the presentation, management, and outcome of TT at the State University Hospital of Haiti (HUEH).

Methods

This is a retrospective, single-center, formal case series of 35 cases of TT admitted to the General Surgery Department of HUEH from January 2013 to December 2017. Data analyzed included sociodemographic, preoperative (etiology and clinical presentation), management, and outcomes. The Exact Fischer, Welch and Mann-Whitney U tests were used. A P-value p < 0.05 was considered significant. The case series was reported according to PROCESS criteria.

Results

Of our sample of 35 patients, there was a male predominance (n = 27, 77.1 %), and the median age was 40 years. Most patients (n = 33, 94.3 %) presented with penetrating TT. The principal etiology was assaults (n = 30, 85.7 %), committed mostly by strangers (n = 19) and mainly with firearms (n = 18). Topping the list of common thoracic injuries were hemopneumothorax, diaphragmatic tear and open pneumothorax. There were extrathoracic associated injuries in 16 patients (45.7 %) with abdominal involvement in 10 cases (28.6 %). Principal specific management was tube thoracostomy for 33 patients (94.3 %) with additional laparotomy for 12 patients (34.3 %) for a median hospital stay of 6 days. There were 2 deaths due to massive hemorrhage without the possibility of massive transfusion. Estimated blood loss was significantly related to short-term survival outcome (p = 0.02).

Conclusion

This is a rare study in the Haitian environment that explores TT. Rather than road traffic accidents, assaults caused mainly by firearms were the chief cause of TT and testify to the current climate of violence and insecurity in the country. Although most of the TT cases were manage by tube thoracostomy, one third needed additional laparotomy. Increased blood loss associated with poorer patient outcomes highlights the need for more transfusion services and the establishment of standard of care for TT in Haiti.

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引用次数: 0

An 11-month-old infant with laryngeal and pharyngeal injuries due to aspiration of an L-shaped metal fragment: A case report

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-27 DOI: 10.1016/j.tcr.2025.101153

Kyohei Sakurai , Yoshimatsu Ehama , Naomasa Shimizu , Makoto Kobayashi

Airway foreign bodies require urgent removal owing to their life-threatening risks. Symptoms such as coughing and wheezing typically appear immediately after aspiration, although symptom improvement can delay diagnosis and treatment. This report describes a rare case of aspiration of an L-shaped metal fragment that injured the larynx and pharynx. The patient was an 11-month-old girl who developed a persistent cough while eating baby food. Her primary care physician initial discharged her with mild hoarseness, but persistent hoarseness led to an emergency room visit. Although her vital signs were stable, crying revealed hoarseness and inspiratory wheezing. Suspecting an airway foreign body, a chest X-ray revealed a metal object in the neck. Computed tomography showed that the fragment's edges were in the larynx and pharynx, spanning the arytenoid cartilages. The pharyngeal end of the fragment had punctured the posterior pharyngeal wall, and submucosal free air was observed. The foreign body—a thin and 2-cm-long L-shaped metal fragment—was removed under intravenous anesthesia using video laryngoscopy. Owing to the risks of emphysema, hematoma, and edema from inflammation of the posterior pharyngeal wall, the patient was intubated for 3 days and recovered well. As demonstrated, aspiration of irregularly shaped foreign objects can cause severe injury to surrounding structures. Careful diagnostic attention is crucial, and for suspected emphysematous lesions in the pharynx or mediastinum, endotracheal intubation and ventilatory support should be considered.

{"title":"An 11-month-old infant with laryngeal and pharyngeal injuries due to aspiration of an L-shaped metal fragment: A case report","authors":"Kyohei Sakurai , Yoshimatsu Ehama , Naomasa Shimizu , Makoto Kobayashi","doi":"10.1016/j.tcr.2025.101153","DOIUrl":"10.1016/j.tcr.2025.101153","url":null,"abstract":"<div><div>Airway foreign bodies require urgent removal owing to their life-threatening risks. Symptoms such as coughing and wheezing typically appear immediately after aspiration, although symptom improvement can delay diagnosis and treatment. This report describes a rare case of aspiration of an L-shaped metal fragment that injured the larynx and pharynx. The patient was an 11-month-old girl who developed a persistent cough while eating baby food. Her primary care physician initial discharged her with mild hoarseness, but persistent hoarseness led to an emergency room visit. Although her vital signs were stable, crying revealed hoarseness and inspiratory wheezing. Suspecting an airway foreign body, a chest X-ray revealed a metal object in the neck. Computed tomography showed that the fragment's edges were in the larynx and pharynx, spanning the arytenoid cartilages. The pharyngeal end of the fragment had punctured the posterior pharyngeal wall, and submucosal free air was observed. The foreign body—a thin and 2-cm-long L-shaped metal fragment—was removed under intravenous anesthesia using video laryngoscopy. Owing to the risks of emphysema, hematoma, and edema from inflammation of the posterior pharyngeal wall, the patient was intubated for 3 days and recovered well. As demonstrated, aspiration of irregularly shaped foreign objects can cause severe injury to surrounding structures. Careful diagnostic attention is crucial, and for suspected emphysematous lesions in the pharynx or mediastinum, endotracheal intubation and ventilatory support should be considered.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"56 ","pages":"Article 101153"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Knee arthrodesis with modular megaprosthesis as salvage procedure for the limb following in a patient with an infected knee tumor prosthesis: A case report

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-27 DOI: 10.1016/j.tcr.2025.101152

Rodrigo Olivieri , Nicolás Franulic , Felipe Amoedo , José I. Laso , Tania Rojas , Carlos Rojas , Nicolás Gaggero

Introduction

The management of periprosthetic knee infections is a complex event, especially in the context of megaprostheses. An accepted option in these cases is knee arthrodesis, aiming to salvage the limb with acceptable and pain-free functionality. We present a successful case of knee arthrodesis using a hybrid model of modular nail-prosthesis in a patient with massive bone stock loss following the removal of an infected tumor-type prosthesis.

Case presentation

A 65-year-old male patient with a chronic periprosthetic infection related to a resection prosthesis implanted 5 years earlier, experiencing knee stiffness and presenting a massive bone stock deficit after prosthesis removal. Initial management involved an osteo-cement spacer and antibiotics, along with a transarticular external fixator. Subsequently, knee arthrodesis was performed using a hybrid model of modular nail-prosthesis, coupled with targeted antibiotic treatment. The arthrodesis was deemed successful, with a pain-free limb and no signs of infection recurrence at the 52-month follow-up.

Conclusion

In the scenario of infection and massive bone stock deficit, knee arthrodesis using intramedullary devices such as nails, megaprostheses, or hybrids is an alternative that can be successful if accompanied by appropriate medical-surgical management of the infection. This approach allows for earlier functional recovery compared to other techniques.

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引用次数: 0

Atypical presentation of fat embolism syndrome: A case report

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-27 DOI: 10.1016/j.tcr.2025.101150

Seok Woo Shin , Barbara Soares Goncalves , Leonardo Magnani Seabra , Henriquy Aguiar Coelho , Talita Magalhaes Sansoni , Thiago Rodrigues Araujo Calderan , Vania Graner Silva Pinto , Elcio Shiyoiti Hirano , Cesar Vanderlei Carmona

We present a case report of fat embolism syndrome in the Trauma Intensive Care Unit with an atypical presentation. A 21-year-old male patient was admitted with multiple fractures after a motorcycle accident. Shortly after the debridement of the open fracture and external fixation of the bones, the patient presented with hypoxemia, tachypnea, fever, and tachycardia. There were no neurologic abnormalities and no petechial rash. Supportive care, including mechanical ventilation, was required. Initial chest angiotomography did not detect pulmonary thromboembolism. There were discrete bilateral consolidations in the lung bases — no bacterial or viral infection findings, including a negative COVID-19 test. Computed tomography was repeated after 5 days, evidenced by bilateral well-demarcated ground glass opacities.

Our case presented an atypical presentation of fat embolism syndrome, without classical signs and symptoms, such as neurologic abnormalities and petechial rash. In this context, other differential diagnoses were considered, since the clinical manifestations of fat embolism are non-specific, and often are seen in other post-traumatic conditions.

This case highlights the diagnostic challenges of fat embolism syndrome in the Intensive Care Unit. Atypical presentation must be taken into consideration when treating high-risk patients.

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引用次数: 0

Open reduction, internal fixation of Vancouver B1, C & D type periprosthetic femoral fractures with use of an antiglide plate at fracture apex - The “Apex Plate”

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-25 DOI: 10.1016/j.tcr.2025.101140

Roland Bell, Mohammed Remtulla, Bryan Riemer

Background

Periprosthetic femoral fractures are associated with significant morbidity, mortality, social and economic cost. The incidence of these fractures is expected to increase with an ever-growing elderly world-population. The complex nature and varied pattern of these injuries requires a range of specialized surgical techniques and tools. Fixation alone is being increasingly regarded as the preferred method of addressing these fractures, even in cases where the femoral stem is unstable, showing favourable outcomes overall when compared to a fix-and-replace approach. Lateral plate fixation is the primary surgical method for either case, and while there is a growing offer of implants specifically for this subset of orthopaedic injuries, the problem of non-union appears to be the most common of complications encountered postoperatively. We prefer fixation alone, including for Unified Classification System (UCS) B2 and B3 type fractures. A small-fragment plate fixed at the fracture apex acts as both a reduction device, thereby simplifying the operation itself, and as a buttressing device. The lateral tension-banding plate method can exploit the latter function of this smaller plate to improve the stability of the fixed construct, and thereby encourage more reliable bone healing.

Cases

We have treated 6 patients between the ages of 59 and 93 with UCS B1, B2, C and D fractures in this fashion. Fragments around an unstable stem (as with a UCS B2 or B3 fracture) were first reduced anatomically and fixed using cerclages, effectively creating a UCS B1, C or D type fracture, which can then be addressed using this two-plating system. All patients were discharged from hospital, returning home to activities of daily living. All radiographic follow-up demonstrated maintenance of reduction and implant position. For patients with radiographic follow-up beyond two months, fracture consolidation or partial consolidation was noted. No surgical infections were recorded.

Conclusions

We present this method of fixation for these types of fractures as a “mixed principles” approach to osteosynthesis. Here, the buttressing nature of the medial femoral cortex is at least in part reconstituted so that compressive forces are generated across cortices where an oblique or spiral fracture pattern would otherwise generate shear forces. Re-establishing these biomechanics with a lateral tension band plate, we assume, generates a more stable construct that favours bone healing and reduces the chances of non- or mal- union.

{"title":"Open reduction, internal fixation of Vancouver B1, C & D type periprosthetic femoral fractures with use of an antiglide plate at fracture apex - The “Apex Plate”","authors":"Roland Bell, Mohammed Remtulla, Bryan Riemer","doi":"10.1016/j.tcr.2025.101140","DOIUrl":"10.1016/j.tcr.2025.101140","url":null,"abstract":"<div><h3>Background</h3><div>Periprosthetic femoral fractures are associated with significant morbidity, mortality, social and economic cost. The incidence of these fractures is expected to increase with an ever-growing elderly world-population. The complex nature and varied pattern of these injuries requires a range of specialized surgical techniques and tools. Fixation alone is being increasingly regarded as the preferred method of addressing these fractures, even in cases where the femoral stem is unstable, showing favourable outcomes overall when compared to a fix-and-replace approach. Lateral plate fixation is the primary surgical method for either case, and while there is a growing offer of implants specifically for this subset of orthopaedic injuries, the problem of non-union appears to be the most common of complications encountered postoperatively. We prefer fixation alone, including for Unified Classification System (UCS) B2 and B3 type fractures. A small-fragment plate fixed at the fracture apex acts as both a reduction device, thereby simplifying the operation itself, and as a buttressing device. The lateral tension-banding plate method can exploit the latter function of this smaller plate to improve the stability of the fixed construct, and thereby encourage more reliable bone healing.</div></div><div><h3>Cases</h3><div>We have treated 6 patients between the ages of 59 and 93 with UCS B1, B2, C and D fractures in this fashion. Fragments around an unstable stem (as with a UCS B2 or B3 fracture) were first reduced anatomically and fixed using cerclages, effectively creating a UCS B1, C or D type fracture, which can then be addressed using this two-plating system. All patients were discharged from hospital, returning home to activities of daily living. All radiographic follow-up demonstrated maintenance of reduction and implant position. For patients with radiographic follow-up beyond two months, fracture consolidation or partial consolidation was noted. No surgical infections were recorded.</div></div><div><h3>Conclusions</h3><div>We present this method of fixation for these types of fractures as a “mixed principles” approach to osteosynthesis. Here, the buttressing nature of the medial femoral cortex is at least in part reconstituted so that compressive forces are generated across cortices where an oblique or spiral fracture pattern would otherwise generate shear forces. <em>Re</em>-establishing these biomechanics with a lateral tension band plate, we assume, generates a more stable construct that favours bone healing and reduces the chances of non- or mal- union.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"56 ","pages":"Article 101140"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rib fixation in a blunt trauma chest patient post-CPR: Navigating dual pathologies and poor chest physiology: Case report with review of literature

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-24 DOI: 10.1016/j.tcr.2025.101145

Reecha Panghal , Alisha Chachra , Divakar Goyal

Managing blunt trauma to the chest and associated rib fractures presents a complex challenge in poly-trauma patients, with considerable mortality and morbidity risks. While the global trend favours non-operative approaches, select centres advocate for surgical stabilization using Rib-specific plating systems. This becomes especially intricate post-cardiopulmonary resuscitation, yet it emerges as a pivotal intervention with significant implications for patient outcomes. We observed positive outcomes based on our experience in the systematic management of a flail chest case, incorporating critical care and chest wall stabilization. This comprehensive approach proved instrumental in restoring cardiopulmonary dynamics, optimizing oxygenation, reducing analgesic requirements, mitigating pneumonia incidence, facilitating mechanical ventilation, expediting weaning, supporting early recovery, and demonstrating cost-effectiveness. Despite these promising results, ongoing research is imperative to fine-tune patient selection criteria and refine indications for rib fixation. This approach holds the potential to minimise morbidity and mortality in thoracic injury cases, underscoring the need for continued exploration and validation of rib-specific plating systems in the evolving landscape of trauma care.

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引用次数: 0

Traumatic pseudoaneurysm of the peroneal artery following lower extremity fracture – A case report and review of the literature

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-24 DOI: 10.1016/j.tcr.2025.101148

Christian Thomas Hübner, Philipp Vetter, Sandro-Michael Heining, Hans-Christoph Pape, Christian Hierholzer

This report documents a rare case of arterial aneurysm following a closed midshaft tibial and fibular fracture. Briefly, a 17-year-old female suffered a traumatic lower extremity fracture and was treated by intramedullary nailing of the tibia. After an uneventful postoperative course, she noted a painful and pulsating swelling of the lateral aspect of the lower extremity about 2 weeks post op. Diagnostic ultrasound confirmed formation of traumatic pseudoaneurysm of the peroneal artery adjacent to the fibular fracture. Subsequent endovascular treatment using coil-embolization was successful. Bony healing occurred in a timely fashion and the patient returned to pain free semi-professional sports activities.

引用次数: 0

Large bone defects in the tibia secondary to Aeromonas hydrophila infection in open fractures: Report of two cases

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-19 DOI: 10.1016/j.tcr.2025.101143

Juan Francisco Guio Oros , Estefanía Arias Cobos , Juanita Villalba Reyes , Jaime Andrés Leal

This paper reports on two cases of post-traumatic osteomyelitis (OM) caused by Aeromonas hydrophila in immunocompetent patients, a rare but severe condition. A. hydrophila, a gram-negative bacterium typically found in aquatic environments, is seldom reported as a cause of OM. The first case involved a 42-year-old male with a Gustilo-Anderson grade II open tibial fracture exposed to sewer water, leading to persistent infection despite initial treatment. The second case described a 38-year-old male inmate with a gunshot-induced tibial fracture managed externally, later presenting with purulent discharge and bone exposure. Both cases required extensive surgical interventions, including multiple debridements, antibiotic therapy, and bone reconstruction using distraction osteogenesis techniques. This report emphasizes the importance of early suspicion of A. hydrophila infection in patients with open fractures and water exposure, noting that standard laboratory procedures may not routinely identify this pathogen. Effective management involves a combination of surgical and medical approaches, including targeted antibiotics and aggressive surgical debridement, with some cases necessitating amputation. The rarity of this infection and its challenging treatment underscore the need for further research to develop standardized protocols and improve clinical outcomes.

{"title":"Large bone defects in the tibia secondary to Aeromonas hydrophila infection in open fractures: Report of two cases","authors":"Juan Francisco Guio Oros , Estefanía Arias Cobos , Juanita Villalba Reyes , Jaime Andrés Leal","doi":"10.1016/j.tcr.2025.101143","DOIUrl":"10.1016/j.tcr.2025.101143","url":null,"abstract":"<div><div>This paper reports on two cases of post-traumatic osteomyelitis (OM) caused by <em>Aeromonas hydrophila</em> in immunocompetent patients, a rare but severe condition. <em>A. hydrophila</em>, a gram-negative bacterium typically found in aquatic environments, is seldom reported as a cause of OM. The first case involved a 42-year-old male with a Gustilo-Anderson grade II open tibial fracture exposed to sewer water, leading to persistent infection despite initial treatment. The second case described a 38-year-old male inmate with a gunshot-induced tibial fracture managed externally, later presenting with purulent discharge and bone exposure. Both cases required extensive surgical interventions, including multiple debridements, antibiotic therapy, and bone reconstruction using distraction osteogenesis techniques. This report emphasizes the importance of early suspicion of <em>A. hydrophila</em> infection in patients with open fractures and water exposure, noting that standard laboratory procedures may not routinely identify this pathogen. Effective management involves a combination of surgical and medical approaches, including targeted antibiotics and aggressive surgical debridement, with some cases necessitating amputation. The rarity of this infection and its challenging treatment underscore the need for further research to develop standardized protocols and improve clinical outcomes.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"56 ","pages":"Article 101143"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analysis of ECMO usage in trauma patients at a major level 1 trauma center

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-17 DOI: 10.1016/j.tcr.2025.101142

April Miller , Megan Post , Crescens Pellecchia , John Bini

Extracorporeal membrane oxygenation (ECMO) has been used for decades in patients where adequate oxygenation could not be achieved using traditional efforts. Data is emerging regarding its use in trauma. Retrospective data was collected from the ECMO database at an urban Level 1 trauma center between 2020 and 2024. Inclusion data was age > 17 years, trauma, and ECMO utilization during admission. Outcomes extracted included patient demographics, mechanism and type of injury, type of ECMO, ECMO days, hospital length of stay (LOS), intensive care LOS, date of injury to ECMO time, P/F ratio, ISS, complications, co-morbidities, anticoagulation, and mortality. Of the included 24 patients, 23 received veno-venous (VV) ECMO and one veno-arterial (VA) ECMO. The overall group demographics were: n = 23 males vs. n = 1 female, age 38.6 (±16.1) years. Duration of ECMO was 8.38 (±7.0) days, inpatient LOS 32.67 (±19.3) days, ICU LOS 26.33 (±18.0) days, DOI to initiation of ECMO 6.25 (±7.8). The ISS average was 29. The most common injury noted was rib fractures, average 4.6 (0−13) per patient. Other injuries included pneumothoraces (50 %), hemothoraces (35 %), blunt cardiac/sternal fracture (33 %). Complications on ECMO included transfusion requirement (54 %), DVT (13 %), and DIC (8 %). Of those studied, 87.5 % survived ECMO, with 70.8 % surviving to discharge. When using Mann-Whitney U and chi-square tests, there was not a statistically significant difference when comparing ISS, age, or P/F ratio between survivors versus non-survivors. Future research with increased sample size will be invaluable for the continued understanding of the role of ECMO in trauma.

{"title":"Analysis of ECMO usage in trauma patients at a major level 1 trauma center","authors":"April Miller , Megan Post , Crescens Pellecchia , John Bini","doi":"10.1016/j.tcr.2025.101142","DOIUrl":"10.1016/j.tcr.2025.101142","url":null,"abstract":"<div><div>Extracorporeal membrane oxygenation (ECMO) has been used for decades in patients where adequate oxygenation could not be achieved using traditional efforts. Data is emerging regarding its use in trauma. Retrospective data was collected from the ECMO database at an urban Level 1 trauma center between 2020 and 2024. Inclusion data was age > 17 years, trauma, and ECMO utilization during admission. Outcomes extracted included patient demographics, mechanism and type of injury, type of ECMO, ECMO days, hospital length of stay (LOS), intensive care LOS, date of injury to ECMO time, P/F ratio, ISS, complications, co-morbidities, anticoagulation, and mortality. Of the included 24 patients, 23 received veno-venous (VV) ECMO and one veno-arterial (VA) ECMO. The overall group demographics were: <em>n</em> = 23 males vs. <em>n</em> = 1 female, age 38.6 (±16.1) years. Duration of ECMO was 8.38 (±7.0) days, inpatient LOS 32.67 (±19.3) days, ICU LOS 26.33 (±18.0) days, DOI to initiation of ECMO 6.25 (±7.8). The ISS average was 29. The most common injury noted was rib fractures, average 4.6 (0−13) per patient. Other injuries included pneumothoraces (50 %), hemothoraces (35 %), blunt cardiac/sternal fracture (33 %). Complications on ECMO included transfusion requirement (54 %), DVT (13 %), and DIC (8 %). Of those studied, 87.5 % survived ECMO, with 70.8 % surviving to discharge. When using Mann-Whitney U and chi-square tests, there was not a statistically significant difference when comparing ISS, age, or P/F ratio between survivors versus non-survivors. Future research with increased sample size will be invaluable for the continued understanding of the role of ECMO in trauma.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"56 ","pages":"Article 101142"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Full-endoscopic assisted surgery using anterior double odontoid screw fixation in type II odontoid fractures: A clinical study of the surgical technique

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-17 DOI: 10.1016/j.tcr.2025.101139

Suthipas Pongmanee , Peem Sarasombath , Anuchit Chaiamporn , Sitthikorn Kaensuk , Korapuk Lerswanichwattana , Wongthawat Liawrungrueang

The most common complication of an odontoid fracture type II according to the Anderson and D'Alonzo classification is nonunion. The current standard is to offer surgical treatment. Anterior odontoid screws with minimally invasive surgery can achieve an effective outcome. Full endoscopic assisted spine surgery is an option that provides good visualization for determining the correct the screw entry point. This clinical case study describes the treatment of an acute displaced fracture a 79-year-old male suffered in a motor vehicle accident using the double odontoid screw technique with full endoscopic assisted surgery. The patient had severe neck pain with ASIA grade E. Radiographic study showed a type II fracture. The patient received urgent surgical intervention using the endoscopic assisted double anterior odontoid screw fixation technique. Intraoperatively the fracture was reduced and compressed without complication using double anterior odontoid screws. Post operative radiographic analysis showed the screws were in good position and the patient participated in a rehabilitation program. The patient's symptoms were completely resolved and union of the fracture was complete at the 1-year follow up. The anterior odontoid screw technique is a challenging minimally invasive surgical technique. Full endoscopic assisted surgery is an effective and desirable technique for use with an anterior double odontoid screw. This technique could be a new option for spine surgery involving an odontoid type II fracture.

{"title":"Full-endoscopic assisted surgery using anterior double odontoid screw fixation in type II odontoid fractures: A clinical study of the surgical technique","authors":"Suthipas Pongmanee , Peem Sarasombath , Anuchit Chaiamporn , Sitthikorn Kaensuk , Korapuk Lerswanichwattana , Wongthawat Liawrungrueang","doi":"10.1016/j.tcr.2025.101139","DOIUrl":"10.1016/j.tcr.2025.101139","url":null,"abstract":"<div><div>The most common complication of an odontoid fracture type II according to the Anderson and D'Alonzo classification is nonunion. The current standard is to offer surgical treatment. Anterior odontoid screws with minimally invasive surgery can achieve an effective outcome. Full endoscopic assisted spine surgery is an option that provides good visualization for determining the correct the screw entry point. This clinical case study describes the treatment of an acute displaced fracture a 79-year-old male suffered in a motor vehicle accident using the double odontoid screw technique with full endoscopic assisted surgery. The patient had severe neck pain with ASIA grade E. Radiographic study showed a type II fracture. The patient received urgent surgical intervention using the endoscopic assisted double anterior odontoid screw fixation technique. Intraoperatively the fracture was reduced and compressed without complication using double anterior odontoid screws. Post operative radiographic analysis showed the screws were in good position and the patient participated in a rehabilitation program. The patient's symptoms were completely resolved and union of the fracture was complete at the 1-year follow up. The anterior odontoid screw technique is a challenging minimally invasive surgical technique. Full endoscopic assisted surgery is an effective and desirable technique for use with an anterior double odontoid screw. This technique could be a new option for spine surgery involving an odontoid type II fracture.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"56 ","pages":"Article 101139"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0