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}
Pub Date : 2025-07-10DOI: 10.1016/j.tcr.2025.101230
Sarah Kim , Jonathan Jou , Thomas Cartolano , Gregory Macaluso , Jane Kayle Lee
Penetrating cardiac injury is a highly lethal injury often resulting in ventricular injury. We present a case of a low-velocity penetrating cardiac injury with pericardial tamponade from a left ventricle myocardial defect managed operatively with a pericardial window that was converted to a median sternotomy with stapled control of the left ventricular injury. Patient was subsequently diagnosed with mitral valve anterior leaflet perforation with left thrombus managed medically with anticoagulation. Our treatment highlights several considerations during operative management of traumatic cardiac injury.
{"title":"Low-velocity penetrating trauma with anterior mitral leaflet perforation and left ventricular injury: Immediate and postoperative management","authors":"Sarah Kim , Jonathan Jou , Thomas Cartolano , Gregory Macaluso , Jane Kayle Lee","doi":"10.1016/j.tcr.2025.101230","DOIUrl":"10.1016/j.tcr.2025.101230","url":null,"abstract":"<div><div>Penetrating cardiac injury is a highly lethal injury often resulting in ventricular injury. We present a case of a low-velocity penetrating cardiac injury with pericardial tamponade from a left ventricle myocardial defect managed operatively with a pericardial window that was converted to a median sternotomy with stapled control of the left ventricular injury. Patient was subsequently diagnosed with mitral valve anterior leaflet perforation with left thrombus managed medically with anticoagulation. Our treatment highlights several considerations during operative management of traumatic cardiac injury.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"58 ","pages":"Article 101230"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596623","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.2025.101226
Kazuki Abe , Toru Iga
Introduction
Surgery for distal femur fractures with metaphyseal comminution remains challenging due to the multiplanar displacement, including the coronal and sagittal alignment, rotation, and length.
Case presentation
A 42-year-old male fell from a height and sustained a distal femur fracture with severe metaphyseal comminution. In surgery, a supplemental one-third tubular plate was placed medially for provisional fixation, enabling a sequential reduction for length, rotation, sagittal alignment, and coronal alignment. The fracture was finally stabilized with a lateral locking plate. The reduction parameters achieved and the functional outcome were satisfactory.
Conclusion
The one-third tubular plate simplified the reduction process by decomposing the multiplanar reduction into three dimensions and enabling a step-by-step approach.
{"title":"Step-by-step reduction utilizing a one-third tubular plate in surgery for distal femur fracture with severe metaphyseal comminution: A case report","authors":"Kazuki Abe , Toru Iga","doi":"10.1016/j.tcr.2025.101226","DOIUrl":"10.1016/j.tcr.2025.101226","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgery for distal femur fractures with metaphyseal comminution remains challenging due to the multiplanar displacement, including the coronal and sagittal alignment, rotation, and length.</div></div><div><h3>Case presentation</h3><div>A 42-year-old male fell from a height and sustained a distal femur fracture with severe metaphyseal comminution. In surgery, a supplemental one-third tubular plate was placed medially for provisional fixation, enabling a sequential reduction for length, rotation, sagittal alignment, and coronal alignment. The fracture was finally stabilized with a lateral locking plate. The reduction parameters achieved and the functional outcome were satisfactory.</div></div><div><h3>Conclusion</h3><div>The one-third tubular plate simplified the reduction process by decomposing the multiplanar reduction into three dimensions and enabling a step-by-step approach.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"58 ","pages":"Article 101226"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655699","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 : 2025-07-09DOI: 10.1016/j.tcr.2025.101225
Elizabeth Roderick , Jonathan Gates , Jane Keating
Upper extremity compartment syndrome is a rare complication of upper extremity trauma and the entity known as Medial Brachial Fascial Compartment Syndrome is even less so. Given the significant morbidity, both entities must remain a consideration in the management of trauma patients. In the present report, we present a case of Medial Brachial Fascial Compartment Syndrome after endovascular repair of a transected mid-brachial artery.
{"title":"Increased awareness of medial brachial compartment syndrome is mandatory following endovascular arterial repair","authors":"Elizabeth Roderick , Jonathan Gates , Jane Keating","doi":"10.1016/j.tcr.2025.101225","DOIUrl":"10.1016/j.tcr.2025.101225","url":null,"abstract":"<div><div>Upper extremity compartment syndrome is a rare complication of upper extremity trauma and the entity known as Medial Brachial Fascial Compartment Syndrome is even less so. Given the significant morbidity, both entities must remain a consideration in the management of trauma patients. In the present report, we present a case of Medial Brachial Fascial Compartment Syndrome after endovascular repair of a transected mid-brachial artery.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"58 ","pages":"Article 101225"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605567","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 : 2025-07-09DOI: 10.1016/j.tcr.2025.101220
Yukiko Asanuma , Motoo Fujita , Tomomi Sato , Takuma Sato , Shigeki Kushimoto
Back ground
Renal pelvis rupture due to trauma is commonly diagnosed in an excretory phase CT scan, which is not be applied in substantial proportion of trauma patients during initial evaluation. Since renal pelvis rupture has no specific findings, there is no clear indication to perform an excretory phase CT scan in the evaluation of trauma patients. We experienced a case presented with low-density fluid accumulation around kidney on plain CT imaging, subsequently diagnoses as having isolated renal pelvis injury.
Case presentation
68-year-old male fell from the second floor and referred to our institution. He had pain in his left buttock with a subcutaneous hematoma. He presented as blood pressure of 155 mmHg, heart rate of 145 beats/min, and blood test showed no specific abnormalities. Plain CT showed fluid accumulation around the left kidney, and following a contrast-enhanced CT scan at equilibrium phase showed no urinary extravasation. On the 4th hospital day, he complained of worsening back pain, and excretion phase of contrast-enhanced CT revealed left renal pelvic rupture. We placed a double-J ureteral stent for urinary drainage. Thereafter, disappearance of urinary extravasation without ureteral stricture was confirmed.
Conclusion
In patients with blunt trauma, perirenal effusion collection inconsistent with hemorrhage on CT imaging could be considered as a sign of isolated renal pelvic rupture.
{"title":"Isolated renal pelvis rupture due to blunt trauma presenting with low-density fluid accumulation around kidney on initial CT: A case report","authors":"Yukiko Asanuma , Motoo Fujita , Tomomi Sato , Takuma Sato , Shigeki Kushimoto","doi":"10.1016/j.tcr.2025.101220","DOIUrl":"10.1016/j.tcr.2025.101220","url":null,"abstract":"<div><h3>Back ground</h3><div>Renal pelvis rupture due to trauma is commonly diagnosed in an excretory phase CT scan, which is not be applied in substantial proportion of trauma patients during initial evaluation. Since renal pelvis rupture has no specific findings, there is no clear indication to perform an excretory phase CT scan in the evaluation of trauma patients. We experienced a case presented with low-density fluid accumulation around kidney on plain CT imaging, subsequently diagnoses as having isolated renal pelvis injury.</div></div><div><h3>Case presentation</h3><div>68-year-old male fell from the second floor and referred to our institution. He had pain in his left buttock with a subcutaneous hematoma. He presented as blood pressure of 155 mmHg, heart rate of 145 beats/min, and blood test showed no specific abnormalities. Plain CT showed fluid accumulation around the left kidney, and following a contrast-enhanced CT scan at equilibrium phase showed no urinary extravasation. On the 4th hospital day, he complained of worsening back pain, and excretion phase of contrast-enhanced CT revealed left renal pelvic rupture. We placed a double-J ureteral stent for urinary drainage. Thereafter, disappearance of urinary extravasation without ureteral stricture was confirmed.</div></div><div><h3>Conclusion</h3><div>In patients with blunt trauma, perirenal effusion collection inconsistent with hemorrhage on CT imaging could be considered as a sign of isolated renal pelvic rupture.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"58 ","pages":"Article 101220"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605487","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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