Trauma Case Reports最新文献

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Proximal tibiofibular dislocation with multiligament-knee injury: a case report 胫腓骨近端脱位伴多韧带膝关节损伤1例

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-06-04 DOI: 10.1016/j.tcr.2025.101210

Daniel Gaitan Vargas, Cristian Camilo Fajardo Cantillo, Oriana Pérez Gibson

Proximal tibiofibular dislocations are extremely rare, accounting for less than 1 % of knee injuries. They can present in isolation as a result of athletic participation or in combination with bony or ligamentous injuries, frequently associated with tibial shaft or proximal tibial fractures caused by high-energy trauma, such as motor vehicle accidents. A cohort study with a sample of 129 knees reports a 9 % incidence of proximal tibiofibular instability in patients with multiligament-knee injurie. Multiligament-knee injuries are also uncommon, primarily resulting from high-energy trauma, posing a challenge for the surgeon, and requires a meticulous clinical evaluation and surgical planning to achieve satisfactory outcomes. This is a retrospective descriptive study based on the collection of clinical data from a patient who was a victim of a motor vehicle accident with proximal tibiofibular dislocation involving the posterior cruciate ligament and posterolateral corner, who underwent a single-stage surgical intervention to ensure early functional rehabilitation. The significance of this case lies in the fact that it represents the second reported case of a proximal tibiofibular dislocation with multiligament-knee injury without other associated injuries, in addition to being a recent case reported ten years after the last similar publication.

近端胫腓骨脱位极为罕见，占膝关节损伤的不到1%。它们可以单独出现，作为参加运动的结果，也可以合并骨或韧带损伤，通常与高能创伤（如机动车事故）引起的胫骨干或胫骨近端骨折有关。一项以129个膝关节为样本的队列研究报告称，多韧带膝关节损伤患者近端胫腓骨不稳定发生率为9%。膝关节多韧带损伤也不常见，主要由高能创伤引起，对外科医生提出了挑战，需要细致的临床评估和手术计划才能获得满意的结果。这是一项回顾性描述性研究，基于机动车事故中胫腓骨近端脱位累及后十字韧带和后外侧角的患者的临床资料收集，该患者接受了单阶段手术干预以确保早期功能康复。该病例的重要意义在于，它是第二例报道的胫腓骨近端脱位合并多韧带膝关节损伤而无其他相关损伤的病例，此外，它是上一篇类似文章发表十年后报道的最新病例。

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引用次数: 0

Anaesthesia for proximal femoral nailing in a patient with “Rosai Dorfman disease” with prior laryngotracheal reconstruction - Not all rosy as it seems 曾进行喉气管重建的“Rosai Dorfman病”患者股骨近端髓内钉麻醉-并非所有的麻醉都像看起来那样美好

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-05-30 DOI: 10.1016/j.tcr.2025.101197

Ashna Shetty, Megha Thaleppady, Priyanka Mahanta, Shilpa A Naik, Akanksha Chouhan

Rosai Dorfman disease is a rare disease with massive lymphadenopathy. It presents significant challenges to the anaesthesiologists involving multiple organs especially the airway. Here we present a patient who is a known case of Rosai Dorfman disease with severe hypothyroidism and Alzheimer's disease with previous history of laryngotracheal reconstruction, now presenting with femur inter trochanteric fracture for proximal femur nailing. A tailored approach with detailed preoperative evaluation and planning, emphasis on airway, with backup plan added to the successful management of this case.

rossai Dorfman病是一种罕见的伴有大量淋巴结病变的疾病。它提出了重大的挑战麻醉师涉及多个器官，特别是气道。在此，我们报告一位已知的Rosai Dorfman病合并严重甲状腺功能减退和阿尔茨海默病的患者，既往有喉气管重建病史，现因股骨转子间骨折行股骨近端钉钉手术。量身定制的方法，详细的术前评估和计划，强调气道，并增加备用计划，成功管理该病例。

引用次数: 0

An Indian Gaur (Bos gaurus) Gores in the Western Ghats-A case report 一只印度野牛在西高止山脉栖息——一例报告

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-05-28 DOI: 10.1016/j.tcr.2025.101201

Freston Marc Sirur , Priya Dugani , Neeraja A. Nair , Sudiksha , Vrinda Lath

The forests of the Western Ghats are home to the tallest bovine in the world, the Indian Bison. While attacks are few, they may result in life-threatening injury. We report the case of a 57-year-old agriculturist who got gored by an Indian Gaur resulting in penetrating chest and abdominal trauma resulting in injuries to multiple organs. A prompt Emergency department evaluation and surgical repair of his injuries enabled recovery, with some residual disability.

西高止山脉的森林是世界上最高的牛——印度野牛的家园。虽然袭击很少，但它们可能导致危及生命的伤害。我们报告一名57岁的农学家，他被印度野牛顶伤，导致胸部和腹部穿透性创伤，导致多个器官损伤。急诊部的及时评估和手术修复使他的伤势得以恢复，但有一些残障。

引用次数: 0

Osteotomy for distal tibial varus secondary to physeal arrest: A case report 截骨术治疗继发骨骺停止的胫骨远端内翻1例

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-05-28 DOI: 10.1016/j.tcr.2025.101190

Omar Bensitel, Yousra Nabili, Saad El Adaoui, Abdeljebbar Messoudi, Mohammed Rahmi, Mohammed Rafai

Treatment of ankle deformities caused by the physeal bar after a fracture sequel is complicated. Each patient should be treated individually depending on of the severity of the deformity and bar location. We presented a case report of a successful treatment of an 15-year-old male patient with progressive varus deformity and bar formation due to trauma in the distal tibial physis. Tibia distal open wedge osteotomy, and iliac crest graft interposition were performed. The patient is at 1 year follow-up without any complication.

骨折后遗症后由骨棒引起的踝关节畸形的治疗是复杂的。每位患者应根据畸形的严重程度和棒的位置进行单独治疗。我们提出了一个病例报告，成功治疗了一个15岁的男性患者进行性内翻畸形和酒吧形成由于创伤在胫骨远端物理。胫骨远端开楔截骨，髂骨植骨间置。随访1年，无并发症发生。

引用次数: 0

Immediate deep vein thrombosis after trauma: Case report 外伤后立即深静脉血栓1例

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-05-27 DOI: 10.1016/j.tcr.2025.101199

Majid Zamani, Farhad Heidari, Elahe Nasri Nasrabadi

Considering that the diagnostic time of DVT after trauma and the risk factors associated with its incidence as well as its preventive and therapeutic management are very significant, the present study reported a rare case with acute DVT occurring in the shortest time after trauma. This patient was a 19-year-old man who was taken to the hospital due to a motorcycle and car accident. Despite the normality of the clinical examinations and lack of any fractures in the lower and upper limbs, the patients experienced sudden pain and swelling of the left leg in about 6 h after trauma. The venous color Doppler ultrasound showed that SFV, CFV, popliteal veins, and the saphenofemoral junction had no flow and were non-compressible. Therefore, the patient was treated with anticoagulant following the diagnosis of acute DVT. After 10 days of treatment, he was discharged with anticoagulant drug.

考虑到创伤后DVT的诊断时间、与其发生相关的危险因素以及预防和治疗管理非常重要，本研究报道了一例在创伤后最短时间内发生急性DVT的罕见病例。该患者是一名19岁的男子，因摩托车和汽车事故被送往医院。尽管临床检查正常，下肢和上肢均无骨折，但患者在创伤后约6小时出现左腿突然疼痛和肿胀。静脉彩色多普勒超声显示SFV、CFV、腘静脉及股隐连接处无血流且不可压缩。因此，在诊断为急性DVT后，患者接受了抗凝治疗。治疗10天后，患者予抗凝药物出院。

引用次数: 0

A rare case of Bosworth fracture-dislocation entrapped within a posterior malleolus fracture (Volkmann fragment): A case report 一个罕见的Bosworth骨折脱位夹在后踝骨折（Volkmann碎片）：1例报告

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-05-27 DOI: 10.1016/j.tcr.2025.101189

N. Naim Rodriguez, O. Frétier, J. McManus

Bosworth fracture-dislocation is a rare and complicated type of ankle fracture accounting for 1.5 % of all ankle fractures. Diagnosis and treatment are often complex and attention is required to ensure favorable outcomes. We report here a case of a Bosworth fracture-dislocation with incarceration of the distal fibular fracture in a Volkmann's fragment of the in an 18-year-old male who fell from his motorcycle at low velocity causing a supination and external rotation of the foot. The fracture dislocation was initially reduced with a novel minimally invasive technique immediately followed by application of an external fixator and definitive osteosynthesis a few days later. Postoperatively the patient showed excellent functional recovery and was able to return to activities of daily life and high-level sporting activity.

博斯沃思骨折脱位是一种罕见且复杂的踝关节骨折类型，占所有踝关节骨折的1.5%。诊断和治疗往往是复杂的，需要注意，以确保良好的结果。我们在此报告一例博斯沃思骨折脱位伴Volkmann骨折碎片内嵌的腓骨远端骨折，患者为18岁男性，他从摩托车上低速坠落，导致足部旋后和外旋。骨折脱位最初采用一种新型的微创技术复位，随后使用外固定架，几天后进行固定骨。术后患者表现出良好的功能恢复，能够恢复日常生活活动和高水平的体育活动。

引用次数: 0

Robotic assisted splenectomy after failure of splenic angioembolization in blunt abdominal trauma 钝性腹部创伤脾血管栓塞失败后机器人辅助脾切除术

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-05-27 DOI: 10.1016/j.tcr.2025.101193

Zach Rollins , Deki Tsering , Anthony Mark , Terral Goode

Traumatic blunt splenic injury in the hemodynamically stable patient is initially managed with a nonoperative strategy that may include angioembolization. If patients continue to have ongoing signs of bleeding after angioembolization, definitive management is surgical splenectomy. We report the case of a patient with a grade IV blunt splenic injury who had ongoing bleeding after angioembolization and was taken for diagnostic robotic surgery. An isolated splenic injury was identified and the patient was treated with robotic splenectomy. On one month follow up the patient was noted to be doing well with minimal pain. To our knowledge, this is the first report of robotic splenectomy after failed non-operative manage in the setting of trauma. This case shows the potential value of robotic surgery to apply the benefits of minimally invasive surgery in hemodynamically stable patients who fail non-operative management after traumatic splenic injury.

血流动力学稳定的外伤性钝性脾损伤患者最初采用非手术治疗，可能包括血管栓塞。如果患者在血管栓塞后仍有持续出血的迹象，最终的治疗方法是手术切除脾。我们报告一例IV级钝性脾损伤患者，血管栓塞后持续出血，并采取诊断机器人手术。我们发现了一例孤立性脾损伤，并对患者进行了机器人脾切除术。在一个月的随访中，患者表现良好，疼痛最小。据我们所知，这是第一次报道机器人脾切除术后失败的非手术治疗设置的创伤。该病例显示了机器人手术的潜在价值，将微创手术的优势应用于外伤性脾损伤后血流动力学稳定但非手术治疗失败的患者。

引用次数: 0

Serial irrigation and debridement with the use of Kerecis in the treatment of necrotizing fasciitis: A case report 应用Kerecis连续冲洗清创治疗坏死性筋膜炎1例

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-05-27 DOI: 10.1016/j.tcr.2025.101196

Collin T. Erickson, Robert D. Garner, Katherine A. Manseau, Jacob A. Frisbie, Charles Orth

Introduction

Necrotizing fasciitis is a life-threatening infection that requires emergent irrigation and radical debridement. One of the challenges surgeons often encounter is gaining adequate soft tissue coverage of the defects that remain after debridement. Kerecis SurgiClose (Coloplast, Denmark), a fish skin xenograft, is one option for wound coverage. This has demonstrated potential for fostering an environment beneficial for wound healing in various types of wounds.

Case presentation

A 39-year-old female presented to the emergency department with a one-week history of left knee pain after a fall. She had a wound on the anterior knee, which began to develop erythema. Necrotizing fasciitis was diagnosed with the patient's Laboratory Risk Indication of Necrotizing Fasciitis (LRINEC) score of 10. She was started on antibiotics and was taken to surgery. She underwent debridements until a bed of healthy tissue was appreciated. Kerecis SurgiClose was applied over the defect which helped create a healthy tissue bed prior to placing a skin autograft. After grafting, daily dressing changes started and evident healing in the recipient site was seen.

Conclusion

This case demonstrates the importance of early diagnosis of necrotizing fasciitis, as well as the utility of fish xenografts in wound coverage once a healthy tissue environment is established. These xenografts are used for many types of wounds, however there is a paucity in the literature supporting their use in necrotizing soft tissue infections. The properties of these grafts potentiate various aspects of healing and show promising results in the healing of deep soft tissue voids.

坏死性筋膜炎是一种危及生命的感染，需要紧急冲洗和彻底清创。外科医生经常遇到的挑战之一是在清创后获得足够的软组织覆盖缺损。Kerecis SurgiClose（康乐保，丹麦）是一种鱼皮异种移植，是修复伤口的一种选择。这已经证明了在各种类型的伤口中培养有利于伤口愈合的环境的潜力。病例介绍一名39岁女性，因跌倒后左膝疼痛一周就诊于急诊科。她膝盖前侧有个伤口，开始出现红斑。坏死性筋膜炎诊断时，患者的实验室危险指征（LRINEC）评分为10分。她开始服用抗生素，并被送往手术。她接受了清创手术，直到发现一床健康组织。Kerecis SurgiClose应用于缺损处，有助于在放置自体皮肤移植物之前创造一个健康的组织床。移植后，开始每日换药，可见受体部位明显愈合。结论本病例表明早期诊断坏死性筋膜炎的重要性，以及一旦建立健康的组织环境，异种鱼移植在伤口覆盖中的应用。这些异种移植物用于许多类型的伤口，但是文献中支持其用于坏死性软组织感染的文献很少。这些移植物的特性增强了愈合的各个方面，并在深层软组织空洞的愈合中显示出有希望的结果。

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引用次数: 0

Right-sided diaphragmatic rupture after trauma—hepatothorax: a diagnostic challenge 外伤性肝胸后右侧膈破裂：一个诊断挑战

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-05-27 DOI: 10.1016/j.tcr.2025.101191

Guruprasad Rai , Rajkamal Vishnu , Vijaya Kumara , Ganesh Sevagur Kamath

Background

Traumatic diaphragmatic rupture is an uncommon condition. Furthermore, due to the shielding effect of the liver, right-sided ruptures occur less frequently than left-sided ones.

We report two unusual cases of right-sided diaphragmatic rupture due to trauma and describe our experience to aid medical professionals in their diagnosis and management.

Purpose

This report focuses on two atypical cases of right-sided traumatic diaphragmatic rupture causing herniation of the liver into the right thorax, a rare condition, and this provides insights for healthcare professionals regarding diagnosis and management.

Case

We present two case reports involving male patients aged 64 and 56 who sustained right-sided diaphragmatic ruptures due to blunt trauma mechanisms—a motorcycle accident and a similar road traffic accident, respectively. Clinical examinations and imaging studies revealed hemothorax and elevated right dome of the diaphragm in Case 1 and pneumoperitoneum and multiple fractured ribs with elevated right dome of diaphragm and minimal hemothorax in Case 2. Surgical interventions were conducted for both patients; Case 1 confirmed a right diaphragmatic rupture with liver herniation, which was successfully repaired, and Case 2 surgical intervention revealed a large right-sided diaphragmatic tear, with liver herniating into the thorax. A successful reduction of the liver and closure of the defect were performed.

Conclusion

Diaphragmatic rupture should be considered as a differential in patients involved in any abdominal trauma, specifically on the right side, as the presentation is often subtle. Chest x-ray and computed tomography are essential tools to confirm the diagnosis. Surgical repair of the defect is the standard treatment.

背景外伤性膈破裂是一种罕见的疾病。此外，由于肝脏的屏蔽作用，右侧破裂的发生率低于左侧。我们报告两个不寻常的病例右膈破裂由于创伤和描述我们的经验，以帮助医疗专业人员在他们的诊断和管理。目的：本文报道两例非典型右侧外伤性横膈膜破裂导致肝脏疝入右胸的罕见病例，为医疗保健专业人员提供诊断和治疗方面的见解。我们报告了两例男性患者，年龄分别为64岁和56岁，分别因摩托车事故和类似的道路交通事故造成右侧膈肌破裂。临床检查和影像学检查显示病例1为血胸和右侧膈球升高，病例2为气腹和多发肋骨骨折，右侧膈球升高，少量血胸。两例患者均行手术干预；病例1证实右侧膈破裂伴肝疝，并成功修复，病例2手术发现右侧膈大撕裂，肝疝入胸腔。我们成功地复位了肝脏并闭合了缺损。结论膈破裂应被视为腹部创伤患者的鉴别指标，尤其是右侧腹部创伤，因为其表现通常很微妙。胸部x光和计算机断层扫描是确认诊断的基本工具。手术修复是标准的治疗方法。

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Managing missed compartment syndrome in the upper extremity: A review of strategies and challenges 处理上肢遗漏筋膜室综合征：策略和挑战的回顾

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-05-27 DOI: 10.1016/j.tcr.2025.101192

Brian Kwan , Hillary Rolfs , Esther Kuan , Ashley Lamb , Emily Benson , Damayea Hargett

Compartment syndrome in the upper extremity, particularly when missed or delayed in diagnosis, poses significant clinical challenges and long-term consequences. Diagnostic challenges include varied clinical presentations and the frequent occurrence in patients who are found down with altered mental status due to drug overdose, complicating timely recognition. Emergent fasciotomy remains crucial in acute cases. However, controversies persist regarding the necessity, timing, and extent of fasciotomy in patients with missed compartment syndrome in the upper extremity. We discuss three cases of patients who presented after prolonged compression of the upper extremity and their respective outcomes. Additionally, this review synthesizes current literature and clinical experiences to delineate optimal management strategies for this devastating orthopedic emergency.

上肢筋膜室综合征，特别是当诊断遗漏或延误时，会带来重大的临床挑战和长期后果。诊断挑战包括不同的临床表现和频繁发生的患者由于药物过量而发现精神状态改变，使及时识别复杂化。紧急筋膜切开术在急性病例中仍然至关重要。然而，对于上肢遗漏室综合征患者进行筋膜切开术的必要性、时机和程度，仍存在争议。我们讨论三例患者谁提出后长时间压迫上肢和各自的结果。此外，本综述综合了目前的文献和临床经验，以描述这种破坏性骨科紧急情况的最佳管理策略。

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