Trauma Case Reports最新文献

英文中文

Pull-out technique with footprint rivet repair of femoral-sided avulsion fracture of the anterior cruciate ligament: A case report 脚钉牵引修复股骨前交叉韧带撕脱性骨折1例

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-11-16 DOI: 10.1016/j.tcr.2025.101280

Yuquan Li, Wei Liu, Quangui Chen, Feng Hu, Zhen Tan

In children, most of the avulsion fractures of the anterior cruciate ligament occur at the tibial eminence. However, femoral-sided avulsion fracture of the anterior cruciate ligament is a very rare disease. Methods to manage such injuries remain unestablished. We have presented here the case of a 10-year-old boy with a femoral-sided avulsion fracture of the anterior cruciate ligament. X-ray and computed tomography scans revealed a free fragment in the knee cavity. Magnetic resonance imaging revealed the anterior cruciate ligament of the left knee with a dislocated fragment. With the assistance of arthroscopy, we performed a pull-out technique combined with a Footprint rivet to fix the fragment and anterior cruciate ligament in their original position. After 3 weeks of postoperative immobilization, the cast was removed. Then, the brace was fixed in the subsequent 2 months. Meanwhile, the patient was started on rehabilitation exercises under the guidance of a rehabilitation physician. After 14 months of follow-up, no deformity, laxity of the knee, or limitations of motion was recorded in this child. Femoral-side avulsion fracture of the anterior cruciate ligament is a rare injury. Pull-out repair with Footprint rivet under arthroscopy could successfully achieve bone union and a good anterior cruciate ligament function. In addition, this approach reduced the risk of thread cut.

在儿童中，大多数前交叉韧带撕脱性骨折发生在胫骨隆起处。然而，股侧前交叉韧带撕脱性骨折是一种非常罕见的疾病。处理此类损伤的方法尚未确定。我们在这里提出的情况下，一个10岁的男孩与股侧前交叉韧带撕脱性骨折。x光和计算机断层扫描显示膝关节腔内有游离碎片。磁共振成像显示左膝前交叉韧带碎片脱臼。在关节镜的帮助下，我们采用拔出技术结合Footprint铆钉将碎片和前十字韧带固定在原来的位置。术后固定3周后，取出石膏。然后在随后的2个月内固定支具。同时，患者在康复医师的指导下开始进行康复训练。随访14个月后，该患儿无畸形、膝关节松弛或活动受限记录。股侧前交叉韧带撕脱性骨折是一种罕见的损伤。关节镜下足部铆钉拔除修复能成功实现骨愈合和前交叉韧带功能良好。此外，这种方法还降低了切螺纹的风险。

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引用次数: 0

A hidden tear: Survival following blunt right atrial appendage rupture without external chest trauma 隐藏撕裂：钝性右心房附件破裂后存活，无胸部外伤

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-11-16 DOI: 10.1016/j.tcr.2025.101279

Phillip Jenkins , Victor Andujo , Philbert Van , Laszlo Kiraly , Julie Doberne

Background

Blunt cardiac chamber ruptures are rare and often fatal. These injuries are typically associated with overt chest trauma, making their diagnosis difficult when external signs are absent.

Case presentation

We report the case of a 17-year-old male who sustained a right atrial appendage rupture with pericardial tamponade after a high-speed auto-versus-pedestrian collision. There was no evidence of chest injury, including rib fractures, upon presentation. The initial assessment revealed hemodynamic instability and a positive Focused Assessment with Sonography for Trauma (FAST) exam in the right upper quadrant, with equivocal pericardial space findings, prompting emergent exploratory laparotomy and pericardial window. Upon decompression of a significant pericardial effusion, cardiothoracic surgery identified and repaired a 2 cm defect of the right atrial appendage via emergent median sternotomy. The patient recovered well following surgical intervention and was discharged home on hospital day 12.

Conclusion

This case highlights the diagnostic challenge of blunt cardiac injury in the absence of apparent external chest trauma. It emphasizes the importance of maintaining a high index of suspicion for occult cardiac injury in patients with unexplained hypotension following high-energy mechanisms, even when chest imaging and exam findings are discordant. Early surgical intervention remains critical for survival in these rare but potentially survivable injuries.

背景：钝性心室破裂很少见，但往往是致命的。这些损伤通常与明显的胸部创伤有关，当没有外部体征时，诊断困难。我们报告一个17岁的男性谁持续的右心房附件破裂心包填塞后，高速汽车与行人碰撞。在就诊时没有胸部损伤的迹象，包括肋骨骨折。初步评估显示血流动力学不稳定，右上象限创伤超声聚焦评估（FAST）检查阳性，心包间隙发现不明确，促使紧急剖腹探查和心包开窗。在对大量心包积液进行减压后，胸外科医生通过紧急胸骨正中切开术发现并修复了右心耳2厘米的缺损。手术干预后患者恢复良好，并于住院第12天出院。结论本病例突出了钝性心脏损伤在无明显胸外外伤的情况下的诊断挑战。它强调了在高能量机制导致不明原因低血压的患者中，即使在胸部影像学和检查结果不一致的情况下，对隐匿性心脏损伤保持高度怀疑的重要性。早期手术干预对于这些罕见但可能存活的损伤的存活仍然至关重要。

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引用次数: 0

Anatomical background of the “Cunéo and Picot” fracture with posterior dislocation and report of a case. Could it be treated conservatively? “cun<s:1> - Picot”骨折合并后路脱位的解剖学背景及1例报告。可以保守治疗吗？

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-11-16 DOI: 10.1016/j.tcr.2025.101281

Vasileios Giovanoulis , Simon Marmor , Christos Koutserimpas , Angelo V. Vasiliadis , Guillaume Auberger , Philippe Leclerc

Background

The “Cuneo and Picot” is a particular lesion of the malleoli. If misdiagnosed, it could be a serious factor of instability, having an impact on the posterior continence of the mortice.

Case description

The present work reports the successful management of a “Cuneo-Picot” isolated fracture with posterior sub-luxation. The patient was treated conservatively with closed reduction under general anesthesia, and a circumferential cast immobilization for six weeks, followed by a functional rehabilitation protocol. The “Cuneo and Picot” osteochondral fragment potentially exhibits instability, even if the posterior fragment malleolar fragment is small, making them difficult to recognize through conventional X-rays, demanding Computer Tomography (CT) scan. In this case, the post-reduction CT scan showed stable syndesmosis and at the final follow-up X-ray showed adequate bone healing. The patient was able to return to physical activities and presented satisfactory functional outcomes.

Conclusion

This report highlights the identification of this distinct fracture-dislocation through X-ray and CT imaging, emphasizing the importance of documenting such cases for better understanding and management, and noting the utility of CT scans for morphological analysis and surgical planning if required.

“丘内奥和皮科特”是一种特殊的malleoli病变。如果误诊，它可能是一个严重的不稳定因素，有影响后失禁的mortice。病例描述：本文报道一例成功治疗的“Cuneo-Picot”孤立骨折伴后侧半脱位。患者在全麻下接受保守治疗，闭式复位，周向石膏固定6周，随后进行功能康复治疗。“Cuneo和Picot”骨软骨碎片可能表现出不稳定性，即使后碎片外踝碎片很小，这使得它们难以通过常规x射线识别，需要计算机断层扫描（CT）。本例复位后CT扫描显示关节联合稳定，最后随访x线显示骨愈合良好。患者能够恢复体力活动，并呈现出令人满意的功能结果。本报告强调了通过x线和CT图像识别这种独特的骨折脱位，强调了记录这类病例的重要性，以便更好地理解和管理，并注意到CT扫描在形态学分析和必要的手术计划中的作用。

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引用次数: 0

Oculocardiac reflex causing bradycardia in a trauma patient following firearm injury 枪伤后创伤患者的心房反射导致心动过缓

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-11-16 DOI: 10.1016/j.tcr.2025.101282

Jennifer E. Geller, Saba Daneshpooy, Sophia Block, Meera Kohli, Megan Lundy

The oculocardiac reflex is a vagal response to pressure on the globe or periorbital structures resulting in a reduction in heart rate greater than 20 %. Here, we describe the case of a patient who sustained extensive craniofacial and orbital trauma from a firearm injury whose otherwise unexplained bradycardia resolved following surgical decompression.

心房反射是对眼球或眶周结构压力的迷走神经反应，导致心率降低20%以上。在这里，我们描述了一例因火器伤害而持续广泛颅面和眶外伤的患者，其其他原因不明的心动过缓在手术减压后消退。

引用次数: 0

Healing of a fracture with a significant bone gap in a supradiacondylar fracture of the distal femur treated with dual plating assisted by the use of Nanostructured Hydroxyapatite (NanoBone®) and Hydroxyapatite and Tricalcium Phosphate Blocks (TRIHA+®): Case report 纳米结构羟基磷灰石（NanoBone®）和羟基磷灰石和磷酸三钙块（TRIHA+®）辅助双重钢板治疗股骨远端髁上骨折伴明显骨间隙骨折的愈合：病例报告

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-11-15 DOI: 10.1016/j.tcr.2025.101273

Francesco Maria Milella , Giovanni Longo , Massimiliano Paolocci , Emanuele Persi , Riccardo Mezzoprete

Distal femur fractures present a surgical challenge due to high rates of varus collapse, nonunion, and delayed healing. In cases of severe bone loss, achieving stable fixation while promoting osteogenesis remains critical. The combination of dual plating with advanced bone substitutes may improve outcomes in complex supracondylar fractures.

股骨远端骨折由于高内翻塌陷、不愈合和延迟愈合率而成为手术的挑战。在严重骨质流失的情况下，在促进成骨的同时实现稳定的固定仍然至关重要。双钢板联合先进骨替代物可改善复杂髁上骨折的预后。

引用次数: 0

Management of simultaneously bilateral periprosthetic fractures post total hip arthroplasty in a 92 year old: A case report 一例92岁患者全髋关节置换术后双侧假体周围骨折的处理

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-11-15 DOI: 10.1016/j.tcr.2025.101274

Nikolaos A. Stavropoulos, Dimitrios Klapsakis, Spyridon-Rafail Gkartzonis, Anastasia Androutsou, Nefeli Parisi-Kotti, Athanasios Konstas

引用次数: 0

A floating elbow and an associated ipsilateral proximal humerus fracture: A case report 一例漂浮肘关节伴同侧肱骨近端骨折1例报告

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-11-14 DOI: 10.1016/j.tcr.2025.101265

Malick Diop , Mayoro Sow , Mohamed Daffé , Badara Dembele , Badara Diop , Khadim Seck , Andre Daniel Sane

We aim to describe this rare injury and evaluate the surgical treatment.

Floating elbow is a relatively rare traumatic entity. It occurs following a high-velocity trauma and is part of a polytrauma. There is no consensus on its management which remains essentially surgical. They often have a favorable outcome.

We report the case of a 20-year-old patient who presented following a road traffic accident with a floating elbow associated with an ipsilateral proximal humerus fracture. The treatment was surgical. An open reduction and internal fixation with a dual plating of the humerus and pinning of the forearm bones was carried out. At 10 months follow-up, the ASES score was 78. Rehabilitation was started early. The prognosis of this lesion is essentially functional.

我们的目的是描述这种罕见的损伤和评估手术治疗。浮肘是一种相对罕见的创伤性疾病。它发生在高速创伤之后，是多发创伤的一部分。对其管理没有达成共识，基本上仍然是外科手术式的。他们往往有一个有利的结果。我们报告一例20岁的患者，在一次道路交通事故后出现了漂浮肘关节并伴有同侧肱骨近端骨折。手术治疗。行切开复位内固定，肱骨双钢板和前臂骨钉固定。随访10个月时，as评分为78分。康复工作很早就开始了。这种病变的预后主要取决于功能。

引用次数: 0

Bullet embolus to the heart: A case report and systematic review of the literature 子弹栓塞心脏：一例报告及文献系统回顾

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-11-14 DOI: 10.1016/j.tcr.2025.101267

Jacob L. Stubbs , Annika Ackermann , Rachel Livergant , Karan D'Souza , Richard C. Cook , Naisan Garraway

Gun violence is a significant contributor to morbidity and mortality worldwide. Intravascular and intracardiac bullet emboli are a rare but recognized phenomenon; however, the optimal management of intracardiac bullet emboli remains unclear. In this article, we report a unique case of a bullet embolus to the mitral annulus and a systematic review of the literature on intracardiac bullet emboli. Our case involves a patient who sustained multiple gunshot wounds, including an intracardiac bullet embolus to his left ventricle that was identified and managed non-operatively. Blood lead levels increased slightly with the bullet left in situ but did not reach toxic levels. In our systematic review, we identified 56 articles encompassing 61 cases of intracardiac bullet emboli. The majority of previous cases reported emboli to the right ventricle (78.7 %) or right atrium (18.0 %). Management strategies varied, with 54 % of cases managed surgically, 27.9 % managed non-operatively, and 16.4 % managed endovascularly. Serial measurement of blood lead levels was uncommon among previous cases but is important to consider in order to avoid long-term lead toxicity in patients with conservatively managed emboli. This unique case report and review of the literature highlights the diagnostic and management challenges associated with intracardiac bullet emboli.

枪支暴力是全世界发病率和死亡率的一个重要因素。血管内和心内子弹栓塞是一种罕见但公认的现象；然而，心脏内子弹栓塞的最佳治疗方法仍不清楚。在这篇文章中，我们报告了一个独特的案例子弹栓塞二尖瓣环和系统的文献回顾心脏内子弹栓塞。我们的病例涉及一名持续多处枪伤的患者，包括左心室心脏内子弹栓塞，经确认并非手术治疗。子弹留在原位时，血铅水平略有上升，但没有达到中毒水平。在我们的系统综述中，我们确定了56篇文章，包括61例心内子弹栓塞。大多数病例报告栓塞发生在右心室（78.7%）或右心房（18.0%）。治疗策略各不相同，54%的病例采用手术治疗，27.9%的病例采用非手术治疗，16.4%的病例采用血管内治疗。在以前的病例中，连续测量血铅水平并不常见，但为了避免保守治疗栓塞患者的长期铅毒性，考虑这一点很重要。这一独特的病例报告和文献综述强调了与心内子弹栓塞相关的诊断和管理挑战。

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引用次数: 0

Post-traumatic pseudoaneurysm of the common carotid artery associated with arteriovenous fistula to the internal jugular vein: A case report 颈总动脉外伤性假性动脉瘤伴颈内静脉动静脉瘘1例

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-11-14 DOI: 10.1016/j.tcr.2025.101270

Henriquy Aguiar Coelho , Lucas Cardoso Siqueira Albernaz , Lucas Soares de Aguiar , Andrey Salgado Moraes Filho , Mariana Willes Santana Soares , Helena Barbi , João Felipe Federici de Almeida , Alexandre Foratto , Alex Aparecido Cantador , Simone Reges Perales

Traumatic arteriovenous fistulas (AVFs) occur in up to 30 % of cases involving the cervical region, with the concomitant presence of AVF and pseudoaneurysm being a rare but clinically significant condition. This case report describes a 32-year-old male victim of a stab wound in Zone II of the right cervical region, who presented with a palpable thrill and subcutaneous emphysema. Cervical computed tomography angiography (CTA) revealed a pseudoaneurysm of the right common carotid artery and an AVF with the right internal jugular vein. The patient underwent successful endovascular repair using a covered stent, achieving complete resolution of the condition without any neurological or functional deficits. This case underscores the rarity of traumatic AVFs associated with pseudoaneurysms and emphasizes the importance of a systematic evaluation in penetrating cervical trauma. Additionally, it shows CTA as a crucial non-invasive diagnostic tool and demonstrates the effectiveness of endovascular treatment as a safe, minimally invasive, and highly efficient alternative to conventional surgical approaches.

外伤性动静脉瘘（AVF）发生在高达30%的病例中，涉及宫颈区域，伴随AVF和假性动脉瘤是一种罕见但临床上重要的疾病。本病例报告描述了一名32岁男性受害者，在右颈部II区被刺伤，他表现为可触及的震颤和皮下肺气肿。颈计算机断层血管造影（CTA）显示右侧颈总动脉假性动脉瘤和右侧颈内静脉AVF。患者成功接受了覆盖支架的血管内修复，完全解决了病情，没有任何神经或功能缺陷。本病例强调了外伤性动静脉瘘合并假性动脉瘤的罕见性，并强调了在穿透性颈椎创伤中系统评估的重要性。此外，该研究表明CTA是一种重要的非侵入性诊断工具，并证明了血管内治疗作为一种安全、微创和高效的替代传统手术方法的有效性。

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引用次数: 0

Spontaneous superior mesenteric vein tear 自发性肠系膜上静脉撕裂

Q4 Medicine

Trauma Case Reports

Pub Date : 2025-11-14 DOI: 10.1016/j.tcr.2025.101271

Alexandra McMillan , Dustin Williamson , Stefan Iverson , Burt Katubig

Non-traumatic injury of the superior mesenteric vein (SMV) is extremely rare. Hemoperitoneum from blunt abdominal trauma has been well documented in the literature; however, hemorrhage from a ruptured SMV has been rarely reported. A few cases describing non-traumatic rupture of the SMV are secondary to patients with underlying conditions such as portal hypertension, hepatic cirrhosis and acute pancreatitis. However, our patient did not express any of these findings. We present a case of spontaneous SMV tear in a patient who presented with a one-day history of abdominal pain with no underlying comorbidities or history of trauma.

肠系膜上静脉（SMV）的非外伤性损伤极为罕见。钝性腹部创伤引起的腹膜出血在文献中有很好的记载；然而，SMV破裂引起的出血很少有报道。少数病例描述的非创伤性SMV破裂是继发于有门静脉高压、肝硬化和急性胰腺炎等基础疾病的患者。然而，我们的病人没有表现出任何这些发现。我们提出一个自发性SMV撕裂的病例，患者有一天的腹痛史，没有潜在的合并症或创伤史。

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