Trauma Case Reports最新文献

英文中文

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

Traumatic anterior tibiofemoral dislocation of mobile-bearing total knee arthroplasty: Two cases

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-17 DOI: 10.1016/j.tcr.2025.101144

Carlijn Schoutens , Peter A. Nolte , Arthur van Noort

Background

Anterior tibiofemoral dislocation is a severe complication of a total knee arthroplasty. It is rare, and it is distinctly different from bearing spinout. Most tibiofemoral dislocations are posterior. Anterior dislocation has previously been described in various prosthesis designs, but not in mobile-bearing prostheses. We present two cases and provide recommendations for the management of this rare and severe injury.

Case description

Two cases of complete anterior tibiofemoral dislocation were brought on by trauma, fifteen and eight years after initial implantation of mobile-bearing total knee arthroplasties in 71-year-old and 73-year-old female patients. One was managed with closed reduction and made a full recovery. In the other, closed reduction failed, open reduction was performed, and there was a need for revision surgery for instability after her initial recovery. There were no neurovascular complications. Follow-up was 23 and 14 months respectively.

Conclusion

Anterior tibiofemoral dislocation is a severe injury with a risk of concomitant complications. Early management should include prompt reduction, serial neurovascular exams and CT angiography for all cases. Late management should include assessment of joint stability.

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引用次数: 0

A rare entity of carpal dislocation: A case report

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-17 DOI: 10.1016/j.tcr.2025.101141

El Hassani Abdelkrim, Hicham Douma, Ramzi Zakaria, Belloughe Yacoub, Habbab Mohamed, El Kasseh Mostapha, Nassiri Mohamed, Abdessalam Achkoun, Hanane El Haoury, Mohamed Madhar, Rachid Chafik

Isolated dislocations of the carpal scaphoid are extremely rare injuries, often associated with significant ligamentous disruptions. Consequently, treatment strategies can be conflicting and varied, ranging from closed reduction and percutaneous fixation to open reduction with internal fixation and/or ligamentous reconstruction.

Typically caused by high-energy trauma, these injuries frequently present alongside associated carpal fractures. As a result, only a few cases of isolated scaphoid dislocations have been reported in the literature.

We present the case of a 30-year-old male with an isolated scaphoid dislocation managed with open reduction, internal Kirschner wire fixation, and ligamentous repair. At the two-year follow-up, the patient had successfully returned to work and resumed all desired activities.

Early diagnosis and appropriate management are critical to improving the prognosis of isolated scaphoid dislocations.

Level of evidence

Level VI.

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引用次数: 0

Bilateral Kienböck disease; a literature review and case presentation

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-13 DOI: 10.1016/j.tcr.2025.101138

Ahmadreza Afshar, Mohammad Javad Shariyate, Ali Tabrizi

In this case report and comprehensive literature review, we present the prevalence and clinical variability of bilateral Kienböck disease, focusing on its frequency, gender and age distribution, ulnar variance, and the synchronicity and stage congruence of symptoms bilaterally. A systematic review of the literature and a detailed case presentation revealed that bilateral Kienböck disease, accounting for 3 to 7.3% of cases, may be underdiagnosed due to its variable and often asynchronous presentations between the left and right wrists. Our findings highlight the need for thorough bilateral evaluations in patients with Kienböck disease to ensure a comprehensive diagnosis and to guide optimal management. This study advocates for heightened clinical vigilance and advances a nuanced understanding of this complex condition.

引用次数: 0

Serious lower limb injuries following car gearbox explosion: A rare case report

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.tcr.2025.101130

Hassan Al-Thani , Ayman El-Menyar

Car Gearbox explosion-related injuries are very rare but could be serious. We reported a 43-year-old female patient who sustained severe bilateral lower limb injuries following an explosion of the gearbox in her private car while waiting at a traffic signal. The patient suffered from a left open tibia shaft fracture and severely macerated soft tissues, along with an open wound on the right leg. This case report highlights the unpredictable and serious nature of an incident due to a rare car gearbox explosion and the challenges associated with its management and outcomes.

引用次数: 0

A paradigm in panfacial fracture treatment to improved dental occlusion

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.tcr.2025.101125

Dini Widiarni Widodo , Mirta Hediyati Reksodiputro , Fateha Putri Hakim , Syahrial Marsintha Hutauruk , Eky Nasuri , Raden Ayu Anatriera , Regina Talitha Rosa , Deta Hamida

Introduction

The prevalence of maxillofacial fractures is rising due to increased road traffic accidents, necessitating prompt and effective management, especially in cases of panfacial fractures. The primary objective in treating such fractures is to restore occlusion and stabilize midface buttresses and pillars.

Case report

This article presents the case of a 56-year-old male who sustained panfacial fractures following a road accident, exhibiting symptoms including facial pain and nosebleeds. The treatment involved the use of arch bars for dental occlusion. Post-operative recovery was complicated by silent aspiration, successfully managed with a tracheostomy. After one month, the patient showed symmetrical facial features with no abnormalities.

Conclusion

It is crucial to weigh the benefits and limitations of Maxillomandibular Fixation in relation to the specific fracture types. This case underscores the potential of arch bars in improving outcomes for patients with complex facial fractures.

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引用次数: 0

Isolated scaphoid dislocation and repair of the scapholunate ligament in acute trauma: A case report

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.tcr.2025.101131

Mehar Dhillon, M. Harshith, Ramesh Kalappagol Basappa, Deepak Kumar Negi

Case

We present a case of 20-year-old male with an isolated scaphoid dislocation and scapholunate ligament injury of the wrist, diagnosed and repaired in an acute setting with k wires and suture anchor augmentation. At 1 year follow up patient complained of no pain and returned to work without any limitations, with no signs of avascular necrosis of the scaphoid on imaging.

Conclusion

In acute trauma injuries involving multiple joints, these subtle injuries are often missed, which ultimately leads to degenerative changes. Early diagnosis along with timely repair of the ligament is imperative to achieve satisfactory results in young patients.

引用次数: 0

Off-label use of teriparatide for the treatment of a vertebral burst fracture in a young patient: A case report and literature review

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.tcr.2025.101127

Tiziano Villa , Vincenzo Zottola , Carlo Mariani , Alberto Borgonovo , Luciano Redenti

We describe a case of L2 vertebral burst fracture in a 40-year-old male patient without any other comorbidities due to a ground-fall from horse. Despite surgical intervention with L1-L3 spine fusion was indicated as the treatment of choice since no fracture healing was visible on CT after 40 days post trauma, a conservative off-label therapy was decided with 5-month administration of teriparatide and vitamin D‑calcium supplementation together with nocturnal pulsed electro-magnetic field. Complete fracture healing was obtained after 5 months.

This is the first report of successful off-label use of teriparatide together with pulsed electro-magnetic field for the treatment of a burst vertebral fracture without surgical intervention in a young patient.

引用次数: 0

Delayed diagnosis of posterior tibialis tendon interposition in the distal tibiofibular and tibiotalar joints after open fracture-dislocation of the ankle joint: A case report with a 10-year follow-up

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.tcr.2025.101134

Shuya Nohmi, Taro Ogawa

Irreducible ankle fracture–dislocations due to posterior tibialis tendon (PTT) interposition in the distal tibiofibular and tibiotalar joints are rarely reported, and their diagnoses are often missed and delayed. In addition, previous reports lacked a longer clinical follow-up period, and objective and subjective evaluations of such cases have not been reported.

A 22-year-old man sustained an open fracture–dislocation of the ankle joint associated with a distal third of the fibular shaft fracture and diastasis of the distal tibiofibular joint. After open reduction and fixation of the fibula and distal tibiofibular syndesmosis, malreduced distal tibiofibular syndesmosis and anterior subluxation of the talus persisted. Magnetic resonance imaging (MRI) revealed PTT interposition in the distal tibiofibular and tibiotalar joints. Open reduction of the PTT was performed, resulting in reduction of the distal tibiofibular syndesmosis and talus. At the 10-year follow-up, the patient showed a normal gait but complained of ankle pain. The clinical outcome using subjective evaluation showed a low score on a subscale related to sports activity compared to the other subscales.

It is difficult to diagnose PTT interposition in the distal tibiofibular and tibiotalar joints. However, based on the type of fracture and direction and degree of talar dislocation, a diagnosis can be made using computed tomography without MRI. It is important to evaluate clinical outcomes using both objective and subjective assessments because some disorders cannot be fully evaluated using conventional objective assessments.

由于胫腓骨远端关节和胫骨远端关节中的胫骨后肌腱（PTT）间插导致的不可复发的踝关节骨折-脱位很少见报道，其诊断往往被漏诊和延误。此外，以往的报告缺乏较长的临床随访期，对此类病例的主客观评价也未见报道。一名 22 岁的男子因开放性骨折导致踝关节脱位，同时伴有腓骨轴远端三分之一骨折和胫腓骨远端关节松弛。在对腓骨和胫腓骨远端联合进行切开复位和固定后，胫腓骨远端联合缩小不良和距骨前方半脱位的情况依然存在。磁共振成像（MRI）显示，胫腓骨远端和胫骨小关节中存在PTT。对PTT进行了开刀复位，使胫腓骨远端联合关节和距骨得以复位。在10年的随访中，患者步态正常，但主诉踝关节疼痛。通过主观评价得出的临床结果显示，与其他分量表相比，患者在与运动相关的分量表上得分较低。在胫腓骨远端和胫骨远端关节很难诊断出 PTT 内插。不过，根据骨折类型和距骨脱位的方向和程度，可以使用计算机断层扫描而无需核磁共振成像进行诊断。使用客观和主观评估对临床结果进行评估非常重要，因为有些疾病无法使用传统的客观评估方法进行全面评估。

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引用次数: 0

A successful initial management of a penetrating head trauma in a rural district hospital: Case report

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.tcr.2025.101128

S. Kohpe Kapseu , C.H. Esseme Ndjie , V. Tchokonte-Nana

Penetrating head trauma is the most fatal form of head injury. Although many cases of penetrating head trauma have been reported in the literature, its management remains complex, requiring a multidisciplinary team, which makes it a challenge in district hospitals where human resources and technical equipment are limited.

We aim to present a successful initial management of a case of penetrating head trauma in a rural district hospital before a transfer to a first category hospital. A 27-year-old man, smoker with no pathology history was involved in a road accident, falling from a motorbike without a helmet. In admission to our rural district hospital, the Glasgow Coma Scale during physical examination was 6/15 with bilateral mydriasis, haemodynamic distress and good saturation. A penetrating head injury was identified with profuse intracranial haemorrhage. Intracranial packing known in damage control neurosurgery to tamponade severe intracranial haemorrhage and which is a lifesaving neurosurgical manoeuvre was used. The patient was transferred unconscious to a first-category hospital, free of intubation and in a stable haemodynamic state. The post-operative period was marked by convulsive seizures, for which the patient was put on anticonvulsants with a good outcome. At rural district hospital level, when faced with a penetrating head trauma, the principles of neurosurgical damage control must be well-known in order to optimise the use of available resources.

穿透性头部创伤是最致命的头部创伤形式。尽管文献中报道了许多穿透性头部外伤病例，但其处理仍然十分复杂，需要一个多学科团队，这对于人力资源和技术设备有限的地区医院来说是一个挑战。我们旨在介绍一例在农村地区医院成功实施初步治疗的头部穿透性创伤病例，然后再转到一级医院。一名 27 岁的男子，吸烟，无病史，在一次交通事故中，未戴头盔从摩托车上摔下。入院时，他的格拉斯哥昏迷量表（Glasgow Coma Scale）为 6/15，双侧瞳孔散大，血流动力学窘迫，血氧饱和度良好。经鉴定为头部穿透伤，颅内大量出血。在损伤控制神经外科手术中，颅内填塞可用于堵塞严重的颅内出血，是一种挽救生命的神经外科手法。病人在昏迷中被转送到一级医院，没有插管，血流动力学状态稳定。术后出现了抽搐发作，为此患者服用了抗惊厥药物，结果良好。在农村地区医院一级，面对穿透性头部创伤，必须熟知神经外科损害控制原则，以优化可用资源的使用。

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