Pub Date : 2025-08-18DOI: 10.1016/j.tcr.2025.101239
Shuvro Saha , Kanij Fatema Ishrat Zahan , Kazi Irfan Subhan , Gazi M. Habibullah
When a deadly non-missile object like a teta gets impacted in the maxillofacial region, the management becomes challenging. This region has a complex anatomical structure with high vascularity and contains vital structures like the orbit and airway. To avoid ophthalmic or neurological abnormalities in addition to the risk of infection and bleeding, accurate clinical and radiological diagnosis and optimal surgical techniques with postoperative management are crucial. This paper emphasizes the significance of careful preoperative planning and a concerted effort of the multidisciplinary team in managing penetrating maxillofacial injuries.
A 26-year-old man was admitted under the Department of Neurosurgery at Dhaka Medical College Hospital (DMCH) with a teta impacted in his face just below the right lower eyelid, which travelled through the area of the right maxillary sinus, passing the internal carotid artery (ICA) and rested in the middle part of clivus just before basilar artery. We successfully removed the teta without any vital structure injury or visual problem.
Penetrating injury in the maxillofacial region with teta due to interpersonal violence is uncommon because of the presence of protecting reflexes, and there is a dearth of documentation in the literature. The presentation, diagnosis, risk evaluation, surgical management, and outcome made this case unique.
{"title":"Facing the challenge maxillofacial penetrating teta injury: A case report","authors":"Shuvro Saha , Kanij Fatema Ishrat Zahan , Kazi Irfan Subhan , Gazi M. Habibullah","doi":"10.1016/j.tcr.2025.101239","DOIUrl":"10.1016/j.tcr.2025.101239","url":null,"abstract":"<div><div>When a deadly non-missile object like a teta gets impacted in the maxillofacial region, the management becomes challenging. This region has a complex anatomical structure with high vascularity and contains vital structures like the orbit and airway. To avoid ophthalmic or neurological abnormalities in addition to the risk of infection and bleeding, accurate clinical and radiological diagnosis and optimal surgical techniques with postoperative management are crucial. This paper emphasizes the significance of careful preoperative planning and a concerted effort of the multidisciplinary team in managing penetrating maxillofacial injuries.</div><div>A 26-year-old man was admitted under the Department of Neurosurgery at Dhaka Medical College Hospital (DMCH) with a teta impacted in his face just below the right lower eyelid, which travelled through the area of the right maxillary sinus, passing the internal carotid artery (ICA) and rested in the middle part of clivus just before basilar artery. We successfully removed the teta without any vital structure injury or visual problem.</div><div>Penetrating injury in the maxillofacial region with teta due to interpersonal violence is uncommon because of the presence of protecting reflexes, and there is a dearth of documentation in the literature. The presentation, diagnosis, risk evaluation, surgical management, and outcome made this case unique.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"59 ","pages":"Article 101239"},"PeriodicalIF":0.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-12DOI: 10.1016/j.tcr.2025.101195
Chloe Price, Kyle Kim, Amyn Pardhan
Acute duodenal injuries are notably rare and present significant challenges in clinical detection. The advent of bariatric surgery has introduced further complexity, altering the anatomy of the upper gastrointestinal tract and potentially masking typical presentations of duodenal injuries. We present the case of a 58-year-old woman with a history of omega loop bypass, who presumably suffered a traumatic duodenal perforation following a fall from a height of 2 m. The perforation was initially missed due to the absence of free air in the retroperitoneum, likely influenced by the altered anatomy post-bypass surgery. This case highlights the difficulty in timely diagnosis of duodenal injuries and the importance of heightened vigilance in post-bariatric surgery patients who've sustained blunt force trauma.
{"title":"How disruption of the duodenum dodged detection: A tale of anatomical trickery","authors":"Chloe Price, Kyle Kim, Amyn Pardhan","doi":"10.1016/j.tcr.2025.101195","DOIUrl":"10.1016/j.tcr.2025.101195","url":null,"abstract":"<div><div>Acute duodenal injuries are notably rare and present significant challenges in clinical detection. The advent of bariatric surgery has introduced further complexity, altering the anatomy of the upper gastrointestinal tract and potentially masking typical presentations of duodenal injuries. We present the case of a 58-year-old woman with a history of omega loop bypass, who presumably suffered a traumatic duodenal perforation following a fall from a height of 2 m. The perforation was initially missed due to the absence of free air in the retroperitoneum, likely influenced by the altered anatomy post-bypass surgery. This case highlights the difficulty in timely diagnosis of duodenal injuries and the importance of heightened vigilance in post-bariatric surgery patients who've sustained blunt force trauma.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"58 ","pages":"Article 101195"},"PeriodicalIF":0.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-10DOI: 10.1016/j.tcr.2025.101228
Zeddouk Hassan, Boufettal Moncef, Rida-Allah Bassir, Mekkaoui Jalal, Mohammed Reda Fekhaoui
Isolated tibio-tarsal dislocations are uncommon as they are associated in most of the cases with fractures resulting from high-energy injuries. We report a case of a 28-year-old pregnant woman patient who suffered a closed posterior tibio-tarsal dislocation after a tree fell on her foot due to strong wind that day. The treatment consisted of a closed bloodless reduction, immobilization, a close follow up and rehabilitation. Six months later, our patient reported no sign of pain or instability and a good range of movement. In this case of an injured pregnant woman, we discuss the treatment and the importance of an early and adequate rehabilitation and also the challenge in radiographic study for a pregnant woman.
{"title":"Isolated tibiotarsal dislocation: A case report","authors":"Zeddouk Hassan, Boufettal Moncef, Rida-Allah Bassir, Mekkaoui Jalal, Mohammed Reda Fekhaoui","doi":"10.1016/j.tcr.2025.101228","DOIUrl":"10.1016/j.tcr.2025.101228","url":null,"abstract":"<div><div>Isolated tibio-tarsal dislocations are uncommon as they are associated in most of the cases with fractures resulting from high-energy injuries. We report a case of a 28-year-old pregnant woman patient who suffered a closed posterior tibio-tarsal dislocation after a tree fell on her foot due to strong wind that day. The treatment consisted of a closed bloodless reduction, immobilization, a close follow up and rehabilitation. Six months later, our patient reported no sign of pain or instability and a good range of movement. In this case of an injured pregnant woman, we discuss the treatment and the importance of an early and adequate rehabilitation and also the challenge in radiographic study for a pregnant woman.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"58 ","pages":"Article 101228"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-10DOI: 10.1016/j.tcr.2025.101231
Shuya Nohmi, Taro Ogawa
The literature on the reconstruction of bone and soft tissue defects after chronic osteomyelitis in the foot remains limited. Reconstructing bones in weight-bearing areas of the foot is challenging, and the associated osteomyelitis and poor soft tissue conditions make the surgery even more difficult. The induced membrane technique (IMT) is used to treat segmental bone defects. However, IMT using a non-vascularized fibular graft for chronic osteomyelitis of the foot has rarely been reported. We aimed to present a case of a 70-year-old man who sustained an open fracture of the foot at the age of 18 years, with skin grafting. A scar and fistula were found on the medial side of the forefoot, exposing the first metatarsal bone. The patient was diagnosed with chronic osteomyelitis of the first metatarsal bone based on imaging findings. A modified IMT was used to reconstruct bone defects. The scarred skin, including the fistula and shaft of the first metatarsal bone, was removed, and a cement spacer was placed in the bone defect. The forefoot soft tissue defect was covered with a pedicled flap. After flap engrafting and maturation of the induced membrane, the bone defect was reconstructed using a non-vascularized fibular graft and cancellous bone. At the 2-year follow-up, the patient could walk but complained of mild pain around the forefoot without infection recurrence. Plain radiographs revealed graft union.
A non-vascularized fibular graft is easy to harvest and provides mechanical stability without the need for microsurgical techniques. Flap coverage and an induced membrane improved the vascularity around the bone defect site and created a soft tissue environment advantageous for bone union, even after chronic osteomyelitis. IMT with a non-vascularized fibular strut graft may be a potential solution for metatarsal bone reconstruction after chronic osteomyelitis.
{"title":"Modified induced membrane technique using a non-vascularized fibular graft for chronic osteomyelitis of the metatarsal bone: A case report","authors":"Shuya Nohmi, Taro Ogawa","doi":"10.1016/j.tcr.2025.101231","DOIUrl":"10.1016/j.tcr.2025.101231","url":null,"abstract":"<div><div>The literature on the reconstruction of bone and soft tissue defects after chronic osteomyelitis in the foot remains limited. Reconstructing bones in weight-bearing areas of the foot is challenging, and the associated osteomyelitis and poor soft tissue conditions make the surgery even more difficult. The induced membrane technique (IMT) is used to treat segmental bone defects. However, IMT using a non-vascularized fibular graft for chronic osteomyelitis of the foot has rarely been reported. We aimed to present a case of a 70-year-old man who sustained an open fracture of the foot at the age of 18 years, with skin grafting. A scar and fistula were found on the medial side of the forefoot, exposing the first metatarsal bone. The patient was diagnosed with chronic osteomyelitis of the first metatarsal bone based on imaging findings. A modified IMT was used to reconstruct bone defects. The scarred skin, including the fistula and shaft of the first metatarsal bone, was removed, and a cement spacer was placed in the bone defect. The forefoot soft tissue defect was covered with a pedicled flap. After flap engrafting and maturation of the induced membrane, the bone defect was reconstructed using a non-vascularized fibular graft and cancellous bone. At the 2-year follow-up, the patient could walk but complained of mild pain around the forefoot without infection recurrence. Plain radiographs revealed graft union.</div><div>A non-vascularized fibular graft is easy to harvest and provides mechanical stability without the need for microsurgical techniques. Flap coverage and an induced membrane improved the vascularity around the bone defect site and created a soft tissue environment advantageous for bone union, even after chronic osteomyelitis. IMT with a non-vascularized fibular strut graft may be a potential solution for metatarsal bone reconstruction after chronic osteomyelitis.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"58 ","pages":"Article 101231"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-10DOI: 10.1016/j.tcr.2025.101222
Johanna Michel , Nermine Habib , Joseph M. Schwab , Angela Seidel
Case
A 66-year-old patient sustained a closed tibial fracture which was treated by minimal invasive plate osteosynthesis. She developed a skin necrosis at the contusion side one month after surgery. A free gracilis flap was performed for soft tissue coverage together with hardware replacement. The intraoperative histopathological examen showed no signs of infection. One out of four positive intraoperative cultures taken from bone samples was positive and was interpreted as contamination. That is why the prophylactic antibiotic therapy with Cefuroxime was stopped after 5 days. The gracilis flap developed a distal necrosis with exposure of hardware. As there were no signs of active nor systematic infection no antibiotics were administrated. Directive wound healing was performed with the skin substitute Nushield® which took 5 months.
After consolidation of the fracture, the plate was removed. Intraoperative cultures of bone samples during hardware removal, as well as sonication fluid culture of the plate, were negative.
Conclusion
This case challenges the paradigm that exposed osteosynthesis hardware is always contaminated by cutaneous bacteria.
{"title":"5- months exposed implant after osteosynthesis is not necessarily a problem: A case report of a distal tibia fracture","authors":"Johanna Michel , Nermine Habib , Joseph M. Schwab , Angela Seidel","doi":"10.1016/j.tcr.2025.101222","DOIUrl":"10.1016/j.tcr.2025.101222","url":null,"abstract":"<div><h3>Case</h3><div>A 66-year-old patient sustained a closed tibial fracture which was treated by minimal invasive plate osteosynthesis. She developed a skin necrosis at the contusion side one month after surgery. A free gracilis flap was performed for soft tissue coverage together with hardware replacement. The intraoperative histopathological examen showed no signs of infection. One out of four positive intraoperative cultures taken from bone samples was positive and was interpreted as contamination. That is why the prophylactic antibiotic therapy with Cefuroxime was stopped after 5 days. The gracilis flap developed a distal necrosis with exposure of hardware. As there were no signs of active nor systematic infection no antibiotics were administrated. Directive wound healing was performed with the skin substitute Nushield® which took 5 months.</div><div>After consolidation of the fracture, the plate was removed. Intraoperative cultures of bone samples during hardware removal, as well as sonication fluid culture of the plate, were negative.</div></div><div><h3>Conclusion</h3><div>This case challenges the paradigm that exposed osteosynthesis hardware is always contaminated by cutaneous bacteria.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"58 ","pages":"Article 101222"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-10DOI: 10.1016/j.tcr.2025.101218
Daniel Marks , Matthew Dulas , Solomon Egbe , James Dahm , Anthony Christiano , Jason Strelzow
Purpose
To report upon a series of patients who underwent a combined minimally invasive plate osteosynthesis and intramedullary nailing surgical approach for AO/OTA 41C2/3 +/− 42, 41B2/3 + 42 fracture types and highlight the surgical methodology for application.
Patients
15 patients were treated with combined plate and intramedullary nail constructs at an academic urban trauma center from 2018 to 2022. All patients had AO/OTA 41C2/3 +/− 42 or 41B2/3 + 42 fractures.
Intervention
The study intervention included retrospective review of patient charts and radiographs.
Main outcome measures
Outcome measures included coronal and sagittal alignment at latest follow-up, intra-operative subsidence of articular fragments, reoperation, and complications such as infection, compartment syndrome, screw migration, or component failure.
Results
The average follow-up for patients included was 6.2 months. At final follow-up, 13 patients had available post-operative assessments for review. At latest follow-up, the average coronal alignment ranged from 3.1 degrees of varus to 2.3 degrees of valgus, average sagittal alignment from 2.6 degrees of recurvatum to 2.0 degrees of procurvatum. There was no evidence of intra-operative or post-operative radiographic subsidence of the plateau. No patients underwent reoperation. There was one case of superficial infection and one case of proximal screw loosening.
Discussion
Plate and nail constructs are a practical option for complex intra-articular fractures of the proximal tibia with metaphyseal or diaphyseal extension (AO/OTA 41C2/3 +/− 42, 41B2/3 + 42). This series demonstrates acceptable radiographic alignment and good clinical results associated with these fracture patterns, with short-to-medium-term follow-up and an overall low complication rate.
{"title":"Plate nail constructs for complex proximal tibia fractures","authors":"Daniel Marks , Matthew Dulas , Solomon Egbe , James Dahm , Anthony Christiano , Jason Strelzow","doi":"10.1016/j.tcr.2025.101218","DOIUrl":"10.1016/j.tcr.2025.101218","url":null,"abstract":"<div><h3>Purpose</h3><div>To report upon a series of patients who underwent a combined minimally invasive plate osteosynthesis and intramedullary nailing surgical approach for AO/OTA 41C2/3 +/− 42, 41B2/3 + 42 fracture types and highlight the surgical methodology for application.</div></div><div><h3>Patients</h3><div>15 patients were treated with combined plate and intramedullary nail constructs at an academic urban trauma center from 2018 to 2022. All patients had AO/OTA 41C2/3 +/− 42 or 41B2/3 + 42 fractures.</div></div><div><h3>Intervention</h3><div>The study intervention included retrospective review of patient charts and radiographs.</div></div><div><h3>Main outcome measures</h3><div>Outcome measures included coronal and sagittal alignment at latest follow-up, intra-operative subsidence of articular fragments, reoperation, and complications such as infection, compartment syndrome, screw migration, or component failure.</div></div><div><h3>Results</h3><div>The average follow-up for patients included was 6.2 months. At final follow-up, 13 patients had available post-operative assessments for review. At latest follow-up, the average coronal alignment ranged from 3.1 degrees of varus to 2.3 degrees of valgus, average sagittal alignment from 2.6 degrees of recurvatum to 2.0 degrees of procurvatum. There was no evidence of intra-operative or post-operative radiographic subsidence of the plateau. No patients underwent reoperation. There was one case of superficial infection and one case of proximal screw loosening.</div></div><div><h3>Discussion</h3><div>Plate and nail constructs are a practical option for complex intra-articular fractures of the proximal tibia with metaphyseal or diaphyseal extension (AO/OTA 41C2/3 +/− 42, 41B2/3 + 42). This series demonstrates acceptable radiographic alignment and good clinical results associated with these fracture patterns, with short-to-medium-term follow-up and an overall low complication rate.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"58 ","pages":"Article 101218"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-10DOI: 10.1016/j.tcr.2025.101215
Jun-Hui Xu, Wei Zhang
Objective
To investigate the therapeutic effect of an ilioinguinal lobed flap in the early repair of facial and neck injuries caused by sulfuric acid burn.
Methods
A retrospective analysis was carried out on the case of a 29-year-old female patient with sulfuric acid burns. Initially, a left ilioinguinal lobed flap measuring 25 × 8 cm2 was selected to reconstruct the neck wound. Subsequently, a right ilioinguinal lobed flap was chosen to repair the facial wound. The flap consisted of three lobes, the longest diameter of which measured 29 cm and the shortest was 3.5 cm. During the surgery, the skin flap was dissected in the superficial fascia layer using ultrasound guidance, and the blood flow and anastomosis quality of the flap was ensured through vascular pressurization and fluorescence imaging.
Results
The facial and neck flap transplantation procedure was successfully completed, with complete postoperative flap survival. Both the left and right ilioinguinal donor sites were closed in a single-stage. Wound healing was satisfactory with minimal and concealed scarring. Postoperative facial and neck contour was satisfactory.
Conclusion
Early-stage repair of sulfuric acid burn wounds using free flaps is effective. Based on the anatomical characteristics of perforating branches in the ilioinguinal region, a superficial fascial flap was harvested with lobulation of the secondary perforating branch, enabling multi-vessel supercharged anastomosis with intraoperative fluorescence imaging to facilitate early and successful reconstruction of acid burn wounds.
{"title":"Early reconstruction of the ilioinguinal lobed flap in the treatment of facial and neck sulfuric acid burn: A case report","authors":"Jun-Hui Xu, Wei Zhang","doi":"10.1016/j.tcr.2025.101215","DOIUrl":"10.1016/j.tcr.2025.101215","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the therapeutic effect of an ilioinguinal lobed flap in the early repair of facial and neck injuries caused by sulfuric acid burn.</div></div><div><h3>Methods</h3><div>A retrospective analysis was carried out on the case of a 29-year-old female patient with sulfuric acid burns. Initially, a left ilioinguinal lobed flap measuring 25 × 8 cm<sup>2</sup> was selected to reconstruct the neck wound. Subsequently, a right ilioinguinal lobed flap was chosen to repair the facial wound. The flap consisted of three lobes, the longest diameter of which measured 29 cm and the shortest was 3.5 cm. During the surgery, the skin flap was dissected in the superficial fascia layer using ultrasound guidance, and the blood flow and anastomosis quality of the flap was ensured through vascular pressurization and fluorescence imaging.</div></div><div><h3>Results</h3><div>The facial and neck flap transplantation procedure was successfully completed, with complete postoperative flap survival. Both the left and right ilioinguinal donor sites were closed in a single-stage. Wound healing was satisfactory with minimal and concealed scarring. Postoperative facial and neck contour was satisfactory.</div></div><div><h3>Conclusion</h3><div>Early-stage repair of sulfuric acid burn wounds using free flaps is effective. Based on the anatomical characteristics of perforating branches in the ilioinguinal region, a superficial fascial flap was harvested with lobulation of the secondary perforating branch, enabling multi-vessel supercharged anastomosis with intraoperative fluorescence imaging to facilitate early and successful reconstruction of acid burn wounds.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"58 ","pages":"Article 101215"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-10DOI: 10.1016/j.tcr.2025.101227
Mathayo Shadrack , Linda Tilisho , Abbas Nurdin , Dennis Machaku , Theresia Edward Mwakyembe , Adnan Sadiq , David Msuya , Kondo Chilonga
Introduction
Popliteal artery injuries are frequently seen with fractures and dislocations. In the setting of trauma is a rare but highly comorbid condition associated with significant long-term disability, limb loss, and even mortality. Literature suggests that vascular damage occurring with injury of the lower extremity is rare and uncommon.
Case presentation
We present a case of 37 years old male patient who had popliteal injury on the left knee joint with undisplaced and non-dislocated tibiofemoral joint 8 h after an injury. He underwent surgery at our facility and intraoperatively was found to have a transected popliteal artery. The mechanism of injury was unclear. Surgical debridement was done, systemic heparinization followed by an end to end popliteal artery anastomosis that resulted into well perfusion of the distal limb.
Discussion
Popliteal artery injuries remain a challenging entity that carries the greatest risk of morbidity. Surgical management of popliteal vascular injury continues to be of great needs. This follows after an early and accurate clinical and radiological diagnosis of vascular injury. The computed tomography angiography with intravascular contrast injection and arterial venous ultrasound are the ideal modalities for diagnosing vascular injuries. Popliteal artery anastomosis and systemic heparinization add more value in managing a transected popliteal artery. Postoperative use of heparin is advocated after a successfully primary anastomosis.
Conclusion
Despite major efforts in establishing protocols and guidelines in the management of vascular trauma, optimal strategies of traumatic popliteal artery injuries are still under investigated. Clinical evaluation of popliteal artery injury can readily overlook other associated injuries. An early repair and restoration of blood perfusion as well as liberal use of heparin play important role to achieve acceptable outcomes.
{"title":"Knee joint penetrating trauma associated with complete popliteal artery transection without fracture or joint dislocation: Diagnostic challenge in the resource-limited facility; a case report","authors":"Mathayo Shadrack , Linda Tilisho , Abbas Nurdin , Dennis Machaku , Theresia Edward Mwakyembe , Adnan Sadiq , David Msuya , Kondo Chilonga","doi":"10.1016/j.tcr.2025.101227","DOIUrl":"10.1016/j.tcr.2025.101227","url":null,"abstract":"<div><h3>Introduction</h3><div>Popliteal artery injuries are frequently seen with fractures and dislocations. In the setting of trauma is a rare but highly comorbid condition associated with significant long-term disability, limb loss, and even mortality. Literature suggests that vascular damage occurring with injury of the lower extremity is rare and uncommon.</div></div><div><h3>Case presentation</h3><div>We present a case of 37 years old male patient who had popliteal injury on the left knee joint with undisplaced and non-dislocated tibiofemoral joint 8 h after an injury. He underwent surgery at our facility and intraoperatively was found to have a transected popliteal artery. The mechanism of injury was unclear. Surgical debridement was done, systemic heparinization followed by an end to end popliteal artery anastomosis that resulted into well perfusion of the distal limb.</div></div><div><h3>Discussion</h3><div>Popliteal artery injuries remain a challenging entity that carries the greatest risk of morbidity. Surgical management of popliteal vascular injury continues to be of great needs. This follows after an early and accurate clinical and radiological diagnosis of vascular injury. The computed tomography angiography with intravascular contrast injection and arterial venous ultrasound are the ideal modalities for diagnosing vascular injuries. Popliteal artery anastomosis and systemic heparinization add more value in managing a transected popliteal artery. Postoperative use of heparin is advocated after a successfully primary anastomosis.</div></div><div><h3>Conclusion</h3><div>Despite major efforts in establishing protocols and guidelines in the management of vascular trauma, optimal strategies of traumatic popliteal artery injuries are still under investigated. Clinical evaluation of popliteal artery injury can readily overlook other associated injuries. An early repair and restoration of blood perfusion as well as liberal use of heparin play important role to achieve acceptable outcomes.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"58 ","pages":"Article 101227"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-10DOI: 10.1016/j.tcr.2025.101221
Ali Hossein Samadi Takaldani , Rona Jannati , Amirpasha Mansour
A traumatic pulmonary pseudocyst (TPP) is an uncommon lung lesion that can occur due to blunt chest trauma. This condition is usually harmless and doesn't require medical treatment, but in rare cases, it is complicated by rupture of the lesion and hemothorax. We present the case of a 43-year-old man who fell from a height and suffered chest trauma. Imaging revealed a mass-like lesion and hemothorax, but after ruling out other diagnoses, he was diagnosed with complicated traumatic pulmonary pseudocyst. Over six months, the mass-like lesion shrank and disappeared entirely without any remaining scars. Proper diagnosis and differentiation from other lung lesions are essential in cases of TPP. With conservative management and regular follow-up, the prognosis is generally reasonable.
{"title":"Complicated traumatic pulmonary pseudocyst: a case report","authors":"Ali Hossein Samadi Takaldani , Rona Jannati , Amirpasha Mansour","doi":"10.1016/j.tcr.2025.101221","DOIUrl":"10.1016/j.tcr.2025.101221","url":null,"abstract":"<div><div>A traumatic pulmonary pseudocyst (TPP) is an uncommon lung lesion that can occur due to blunt chest trauma. This condition is usually harmless and doesn't require medical treatment, but in rare cases, it is complicated by rupture of the lesion and hemothorax. We present the case of a 43-year-old man who fell from a height and suffered chest trauma. Imaging revealed a mass-like lesion and hemothorax, but after ruling out other diagnoses, he was diagnosed with complicated traumatic pulmonary pseudocyst. Over six months, the mass-like lesion shrank and disappeared entirely without any remaining scars. Proper diagnosis and differentiation from other lung lesions are essential in cases of TPP. With conservative management and regular follow-up, the prognosis is generally reasonable.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"58 ","pages":"Article 101221"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report two cases of implant removal failure following internal fixation of femoral neck fractures using the Prima Hip Screw Side Plate (PHS-SP) system.
Case 1 involved an 80-year-old woman with stripped screw heads, which prevented standard screw removal. The femoral neck was osteotomized, and the screws were severed to allow removal of the plate.
Case 2 involved a 50-year-old man in whom a screw was firmly lodged in the barrel of the implant, making extraction impossible. The protruding screw was excised, and a second operation was later performed to cut the femoral neck and remove the implant.
Conclusion: In both cases, implant removal required osteotomy of the femoral neck and mechanical destruction of the screws. These cases highlight the potential for implant removal failure in locking plate systems, and the importance of preoperative planning and patient counseling.
{"title":"Two cases of implant removal failure after open reduction and internal fixation using the Prima Hip Screw Side Plate system for femoral neck fracture","authors":"Tetsuya Takeuchi, Ayano Amagami, Tetsuo Hayama, Hideki Fujii, Yasuhiko Kawaguchi, Takuya Otani, Mitsuru Saito","doi":"10.1016/j.tcr.2025.101217","DOIUrl":"10.1016/j.tcr.2025.101217","url":null,"abstract":"<div><div>We report two cases of implant removal failure following internal fixation of femoral neck fractures using the Prima Hip Screw Side Plate (PHS-SP) system.</div><div>Case 1 involved an 80-year-old woman with stripped screw heads, which prevented standard screw removal. The femoral neck was osteotomized, and the screws were severed to allow removal of the plate.</div><div>Case 2 involved a 50-year-old man in whom a screw was firmly lodged in the barrel of the implant, making extraction impossible. The protruding screw was excised, and a second operation was later performed to cut the femoral neck and remove the implant.</div><div>Conclusion: In both cases, implant removal required osteotomy of the femoral neck and mechanical destruction of the screws. These cases highlight the potential for implant removal failure in locking plate systems, and the importance of preoperative planning and patient counseling.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"58 ","pages":"Article 101217"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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