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High energy trans-cuboid Chopart dislocation: From closed reduction to secondary double arthrodesis 高能量经耻骨联合Chopart脱位:从闭合复位到二次双关节固定术
Q4 Medicine Pub Date : 2024-09-14 DOI: 10.1016/j.tcr.2024.101103
Patrick Wise, Augustine Saiz, Gillian Soles, Ellen Fitzpatrick, Mark Lee, Sean T. Campbell

Case report

Chopart joint fracture-dislocations are rare injuries. The purpose of this report is to present the management of a high energy trans-cuboid Chopart dislocation. This fracture-dislocation dislocation was treated with closed reduction, provisional fixation, and definitively with a combination of open reduction internal fixation (ORIF) and a lateral column external fixator. Due to persistent pain and Chopart joint collapse, the patient ultimately required a double arthrodesis.

Conclusion

While rare, Chopart joint fracture-dislocations are impactful injuries that require prompt diagnosis and specialized management. The description of this high energy trans-cuboid Chopart dislocation and the stepwise approach for its management may be useful for other surgeons who encounter similar injuries.

病例报告Chopart关节骨折脱位是一种罕见的损伤。本报告的目的是介绍一例高能量经立方体 Chopart 关节脱位的治疗方法。该骨折脱位患者接受了闭合复位、临时固定治疗,并最终接受了开放复位内固定术(ORIF)和侧柱外固定器联合治疗。结论Chopart关节骨折脱位虽然罕见,但却是一种需要及时诊断和专业治疗的影响性损伤。对这一高能量经立方体Chopart脱位的描述以及逐步处理的方法可能对其他遇到类似损伤的外科医生有所帮助。
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引用次数: 0
Secondary removal of intramedullary metal debris from a defective Reamer-Irrigator-Aspirator (RIA) reamer head: A case report 髓内金属碎片从有缺陷的铰刀-灌注器-喷气器(RIA)铰刀头上的二次清除:病例报告
Q4 Medicine Pub Date : 2024-09-14 DOI: 10.1016/j.tcr.2024.101112
Philipp Vetter, Christian Hübner, Sandro-Michael Heining, Christian Hierholzer, Hans-Christoph Pape

The Reamer-Irrigator-Aspirator (RIA) device represents a safe and efficient method to harvest autologous bone for grafting. However, hardware failure may occur, for example by breakage of the reamer head with metal debris remaining in the intramedullary canal.

This case report describes the uncomplicated secondary removal of femoral intramedullary metal debris from a broken RIA reamer head; three weeks after the final surgery of a two-stage Masquelet procedure for the treatment of posttraumatic segmental bone loss at the tibia.

铰刀-灌注器-呼吸器(RIA)装置是一种安全有效的获取自体骨进行移植的方法。本病例报告描述了在治疗外伤后胫骨节段性骨缺失的两阶段马斯奎莱手术的最后一次手术后三周,从断裂的 RIA 绞刀头上二次清除股骨髓内金属碎片的过程,过程并不复杂。
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引用次数: 0
A suspensory fixation technique for calcaneal tuberosity avulsion fractures using the TightRope Attachable Button System 使用 TightRope 可固定扣系统治疗小腿骨结节撕脱骨折的悬吊固定技术
Q4 Medicine Pub Date : 2024-09-14 DOI: 10.1016/j.tcr.2024.101096
Gopikrishnan S. Nair, Nima Razii, Ting Y. Tan, Robert L. Carter, Stuart W. Bell
Displaced avulsion fractures of the calcaneal tuberosity generally occur as a result of osteoporotic insufficiency or high-energy injuries. Conventional methods of fixation may be complicated by wound breakdown, metalwork failure, or symptomatic hardware. This is particularly relevant in elderly patients and those with comorbidities, including osteoporosis or diabetes. We describe an innovative technique using the TightRope Attachable Button System (ABS; Arthrex, Naples, FL, USA), adapted from suspensory cortical fixation in anterior cruciate ligament reconstruction, to treat displaced Beavis type II ‘beak’ calcaneal fractures in such patients. We present the case of a 67 year old female with multiple comorbidities, who successfully underwent this procedure, with no complications at 4 years follow-up.
小腿骨结节移位撕脱性骨折通常是由于骨质疏松或高能量损伤造成的。传统的固定方法可能会因伤口破裂、金属制品失效或有症状的硬件而变得复杂。这与老年患者和合并症(包括骨质疏松症或糖尿病)患者尤为相关。我们介绍了一种使用 TightRope Attachable Button System(ABS;Arthrex,美国佛罗里达州那不勒斯市)的创新技术,该技术改编自前交叉韧带重建中的悬吊皮质固定,用于治疗这类患者的移位性比维斯 II 型 "喙突 "小头骨折。我们介绍了一位 67 岁女性患者的病例,她患有多种并发症,成功接受了该手术,随访 4 年未发现并发症。
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引用次数: 0
An isolated mesenteric hematoma following blunt abdominal trauma - case report and literature review 腹部钝挫伤后的孤立性肠系膜血肿--病例报告和文献综述
Q4 Medicine Pub Date : 2024-09-14 DOI: 10.1016/j.tcr.2024.101104
Kimihiro Yonemitsu , Yasuhiko Fujita , Teruyoshi Amagai
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引用次数: 0
Comprehensive management of severe crush injury in a pediatric patient: A case report 儿科严重挤压伤的综合治疗:病例报告
Q4 Medicine Pub Date : 2024-09-14 DOI: 10.1016/j.tcr.2024.101098
Phi Duong Nguyen, Tien Minh Nguyen, Phuoc Thien Mai, Dinh Quang Truong

This case report presents the management of a severe crush injury in a 7-year-old male patient. The injury occurred following entrapment in a concrete mixer, resulting in extensive soft tissue trauma and vascular compromise. Prompt surgical intervention, including meticulous debridement and vascular reconstruction, was undertaken to optimize outcomes. Postoperative care involved serial debridement, negative pressure wound therapy, and subsequent skin grafting. Reconstructive procedures aimed to enhance hand function, yielding satisfactory outcomes at the three-month follow-up. This case underscores the importance of a multidisciplinary approach in managing pediatric crush injuries and highlights the role of collaborative care in optimizing outcomes.

本病例报告介绍了一名 7 岁男性患者严重挤压伤的治疗过程。患者是在被困在混凝土搅拌机中后受伤的,造成了广泛的软组织创伤和血管损伤。为了优化治疗效果,医生迅速采取了手术干预措施,包括细致的清创和血管重建。术后护理包括连续清创、负压伤口治疗和后续植皮。重建手术旨在增强手部功能,三个月的随访结果令人满意。该病例强调了多学科方法在处理小儿挤压伤中的重要性,并突出了合作护理在优化疗效中的作用。
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引用次数: 0
Pubic symphysis tethering technique under endoscopic approach for treatment of pelvic open-book injury: A cadaver study 内窥镜下耻骨联合拴系技术治疗骨盆开放性损伤:尸体研究
Q4 Medicine Pub Date : 2024-09-14 DOI: 10.1016/j.tcr.2024.101107
Pierre Emmanuel Moreau, Ali Bokhari, Sarah El Yahiouni, Quentin Manach, Peter Upex, Guillaume Riouallon

Purpose

Pubic symphysis disruption is common in pelvic trauma. Open reduction and internal fixation with a plate is the gold standard technique. Despite increasing interest in an endoscopic approach, the challenges of specific endoscopic instrumentation, reduction and fixation remains. In this feasibility cadaveric study, we aimed to describe a novel endoscopic technique of fixation of pubic symphysis disruption with a spinal vertebral tethering system.

Methods

Endoscopic pubic symphysis fixation with the tethering method was performed on a female cadaver specimen as well as an artificial pelvic model.

Results

We describe a step-by-step technique where three abdominal portals were utilized in order to insert screws in the pubic body and superior pubic ramus under endoscopic visualization. The synthetic tether ligament was introduced through a lateral portal and fixed and tensioned to reduce and compress the pubic symphysis.

Conclusions

While open plate fixation is the current gold standard of pubic symphysis disruption there is increasing interest in the minimally invasive endoscopic approach. In this feasibility cadaveric study, we present a new minimally invasive endoscopic fixation method to treat pubic symphysis disruption with a synthetic ligament.

目的 耻骨联合中断是骨盆创伤中常见的一种。切开复位和钢板内固定是金标准技术。尽管人们对内窥镜方法的兴趣与日俱增,但特定的内窥镜器械、复位和固定仍是难题。在这项尸体可行性研究中,我们旨在描述一种使用脊柱椎系系统固定耻骨联合断裂的新型内窥镜技术。结果我们描述了一种分步技术,利用三个腹腔孔在内窥镜可视下将螺钉插入耻骨体和耻骨上横突。结论虽然开腹钢板固定是目前耻骨联合破坏的金标准,但人们对内窥镜微创方法的兴趣与日俱增。在这项尸体可行性研究中,我们提出了一种新的微创内窥镜固定方法,用合成韧带治疗耻骨联合断裂。
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引用次数: 0
Bladder inflation to reduce hemorrhage secondary to a pelvic fracture 充盈膀胱以减少骨盆骨折继发出血
Q4 Medicine Pub Date : 2024-09-14 DOI: 10.1016/j.tcr.2024.101105
Mark Fitzgerald , Tuan Phan , Sarah Fitzgerald , Yuewei Xiao , Madeline Green , Cecil Johnny , Joseph Mathew , Robert Gocentas , Warren Clements
Bladder inflation may be a temporizing measure to tamponade pelvic bleeding in select trauma cases to bridge the patient to definitive interventions. Ultrasonographic confirmation of an intact bladder with an adjacent pelvic haematoma in a shocked adult with pelvic fracture is used for subject selection. An illustrative example of physiologic and interventional radiological control of pelvic bleeding following bladder inflation with sterile saline is presented.
在某些创伤病例中,膀胱充气可能是一种暂时性措施,可用于堵塞盆腔出血,为患者接受明确的干预措施架起桥梁。对于骨盆骨折的休克成人,可通过超声波确认膀胱完好无损,且邻近骨盆有血肿来选择受试者。本文以一个实例说明了使用无菌生理盐水充盈膀胱后盆腔出血的生理学和介入放射学控制。
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引用次数: 0
Bilateral patellar tendon repair with suture bridge augmentation: A case report 双侧髌骨肌腱缝合桥加固修复术:病例报告
Q4 Medicine Pub Date : 2024-09-14 DOI: 10.1016/j.tcr.2024.101097
Brett Biedermann, Will Hill, William J. Karakash, Ioanna K. Bolia, George F. Rick Hatch III

We describe the case of a 37-year-old male who presented with simultaneous bilateral patellar tendon rupture without any associated risk factors. Additionally, this is the first reported use of the suture bridge technique with patellar and tibial suture anchors in repairing bilateral proximal patellar tendon rupture. At 12-month follow-up, the patient had normal alignment, no effusion, and symmetric quadriceps strength.

我们描述了一例 37 岁男性双侧髌腱同时断裂的病例,该病例没有任何相关风险因素。此外,这是首次报道使用髌骨和胫骨缝合锚的缝合桥技术修复双侧髌腱近端断裂。在12个月的随访中,患者对线正常,无渗出,股四头肌力量对称。
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引用次数: 0
Rapid-onset cerebral fat embolism syndrome leading to brain death: A case report 导致脑死亡的急发性脑脂肪栓塞综合征:病例报告
Q4 Medicine Pub Date : 2024-09-13 DOI: 10.1016/j.tcr.2024.101109
Jordyn D. Williams , Jonathan D. Gates , Alfred J. Croteau

Background

Fat Embolism Syndrome (FES) is a rare clinical phenomenon attributed to fat droplet embolization and subsequent multisystem organ failure, typically following traumatic orthopedic injury. It classically presents with hypoxemia, transient neurologic deficits, and skin changes that appear a day or more after the initial insult. Its exact mechanism remains unclear, although the mechanical obstruction of capillaries or production of toxic intermediaries following fat hydrolysis and extravasation of marrow have been described. Here, we present a new case of cerebral FES with symptom onset within 12 h and brain death within 48 h.

Patient

A 22-year-old male with multiple orthopedic fractures developed Fat Embolism Syndrome with neurological and respiratory symptoms within 12 h of presentation.

Results

The patient developed intractable cerebral edema and hypernatremia leading to brain death within 48 h.

Conclusion

Diffuse fat emboli can lead to rapid development of fatal cerebral edema even in the absence of anatomical shunts. MRI is the superior modality to detect FES and should be pursued early in patients with risk factors or clinical signs of neurologic involvement.
背景脂肪栓塞综合征(FES)是一种罕见的临床现象,由脂肪滴栓塞和随后的多系统器官衰竭引起,通常发生在创伤性骨科损伤之后。它通常表现为低氧血症、一过性神经功能缺损和皮肤改变,在最初损伤后一天或更长时间出现。其确切的发病机制尚不清楚,但有描述称毛细血管机械性阻塞或脂肪水解和骨髓外渗后产生有毒的中间产物。患者22岁,男性,多次骨科骨折,在发病12小时内出现脂肪栓塞综合征,并伴有神经和呼吸系统症状。结果患者在48小时内出现顽固性脑水肿和高钠血症,导致脑死亡。磁共振成像是检测 FES 的最佳方式,对于有危险因素或神经系统受累临床表现的患者,应及早进行磁共振成像检查。
{"title":"Rapid-onset cerebral fat embolism syndrome leading to brain death: A case report","authors":"Jordyn D. Williams ,&nbsp;Jonathan D. Gates ,&nbsp;Alfred J. Croteau","doi":"10.1016/j.tcr.2024.101109","DOIUrl":"10.1016/j.tcr.2024.101109","url":null,"abstract":"<div><h3>Background</h3><div>Fat Embolism Syndrome (FES) is a rare clinical phenomenon attributed to fat droplet embolization and subsequent multisystem organ failure, typically following traumatic orthopedic injury. It classically presents with hypoxemia, transient neurologic deficits, and skin changes that appear a day or more after the initial insult. Its exact mechanism remains unclear, although the mechanical obstruction of capillaries or production of toxic intermediaries following fat hydrolysis and extravasation of marrow have been described. Here, we present a new case of cerebral FES with symptom onset within 12 h and brain death within 48 h.</div></div><div><h3>Patient</h3><div>A 22-year-old male with multiple orthopedic fractures developed Fat Embolism Syndrome with neurological and respiratory symptoms within 12 h of presentation.</div></div><div><h3>Results</h3><div>The patient developed intractable cerebral edema and hypernatremia leading to brain death within 48 h.</div></div><div><h3>Conclusion</h3><div>Diffuse fat emboli can lead to rapid development of fatal cerebral edema even in the absence of anatomical shunts. MRI is the superior modality to detect FES and should be pursued early in patients with risk factors or clinical signs of neurologic involvement.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"54 ","pages":"Article 101109"},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425232","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
Delayed bladder rupture following blunt trauma: A case report and literature review 钝伤后延迟性膀胱破裂:病例报告和文献综述
Q4 Medicine Pub Date : 2024-09-13 DOI: 10.1016/j.tcr.2024.101110
Vo Anh Vinh Trang , Nguyen Hai Dang Le , Dai Thanh Sang Nguyen , Phuc Hai Duong , Thien Tan Tri Tai Truyen , Vu Phuong Do

Delayed bladder rupture, rare condition following trauma, can result from primary laceration or secondary rupture at the lesion site in the bladder wall. Delayed treatment increases mortality. We report the case of a 43-year-old female who presented with an 8-day history of blunt trauma and a 2-day abdominal discomfort. After using point-of-care ultrasound for abdominal paracentesis to confirm the diagnosis, the patient was transferred to the operating room to suture the ruptured bladder. After nine days, she was discharged free of symptoms. This case report and literature review stress the importance of prompt and appropriate intervention for delayed bladder rupture.

延迟性膀胱破裂是外伤后的罕见病症,可由膀胱壁的原发性撕裂或病变部位的继发性破裂引起。延迟治疗会增加死亡率。我们报告了一例 43 岁女性的病例,她有 8 天的钝器外伤史和 2 天的腹部不适。在使用护理点超声进行腹腔穿刺确诊后,患者被转入手术室缝合破裂的膀胱。九天后,她无任何症状出院。本病例报告和文献综述强调了对延迟性膀胱破裂进行及时、适当干预的重要性。
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引用次数: 0
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Trauma Case Reports
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