Musculoskeletal injuries following seizures have a high morbidity and mortality. These injuries are often missed and the diagnosis is delayed due to a lack of clinical suspicion and appropriate investigations. We repo...Musculoskeletal injuries following seizures have a high morbidity and mortality. These injuries are often missed and the diagnosis is delayed due to a lack of clinical suspicion and appropriate investigations. We report a case of 72 years old male with simultaneous bilateral central acetabular fracture dislocation and bilateral posterior shoulder fracture dislocation secondary to an epileptic seizure. Present study high- lights the significance of clinical suspicion and clinico-radiological evaluation for diagnosis of a rare injury following episode of seizures. Simultaneous fracture dislocation of all four limbs treated with a holistic approach can lead to a good functional recovery. Surgical management with open reduction and internal fixation is preferred and replacement arthroplasty should be reserved for cases with implant failure and elderly patients.展开更多
Purpose： To evaluate the role of immediate and definitive management of Gustilo type Ⅲ A/B tibia fractures with intramedullary nailing and fasciocutaneous flap. Methods： From August 2010 to July 2012, 22 patients w...Purpose： To evaluate the role of immediate and definitive management of Gustilo type Ⅲ A/B tibia fractures with intramedullary nailing and fasciocutaneous flap. Methods： From August 2010 to July 2012, 22 patients with Gustilo Grade Ⅲ A/B tibia fractures were managed with a single stage treatment of ipsilateral fasciocutaneous flap ＆ reamed intramedullary nailing and were included in the study. The severity of the injury was calculated with Ganga Hospital injury severity score. Results： The mean age of patients was 41 years and the follow-up time ranged from six months to one year. Among the 22 patients, 73% were type Ⅲ B fractures with upper leg involved in 55% of them. The time interval from injury to completion of surgery was 8 14 h. The incidence of bone infection requiring secondary procedure was 9%; the major and minor soft tissue complication rate was 9% and 14% respectively. The limb salvage rate was 100%. Conclusion： Multidisciplinary management of severe lower limb trauma is important and provides good outcomes, lntramedullary nailing and immediate flap fixation can achieve early bone union and good soft tissue coverage, leading to good outcomes in patient with Grade Ⅲ A ＆ B tibia fractures.展开更多
文摘Musculoskeletal injuries following seizures have a high morbidity and mortality. These injuries are often missed and the diagnosis is delayed due to a lack of clinical suspicion and appropriate investigations. We report a case of 72 years old male with simultaneous bilateral central acetabular fracture dislocation and bilateral posterior shoulder fracture dislocation secondary to an epileptic seizure. Present study high- lights the significance of clinical suspicion and clinico-radiological evaluation for diagnosis of a rare injury following episode of seizures. Simultaneous fracture dislocation of all four limbs treated with a holistic approach can lead to a good functional recovery. Surgical management with open reduction and internal fixation is preferred and replacement arthroplasty should be reserved for cases with implant failure and elderly patients.
文摘Purpose： To evaluate the role of immediate and definitive management of Gustilo type Ⅲ A/B tibia fractures with intramedullary nailing and fasciocutaneous flap. Methods： From August 2010 to July 2012, 22 patients with Gustilo Grade Ⅲ A/B tibia fractures were managed with a single stage treatment of ipsilateral fasciocutaneous flap ＆ reamed intramedullary nailing and were included in the study. The severity of the injury was calculated with Ganga Hospital injury severity score. Results： The mean age of patients was 41 years and the follow-up time ranged from six months to one year. Among the 22 patients, 73% were type Ⅲ B fractures with upper leg involved in 55% of them. The time interval from injury to completion of surgery was 8 14 h. The incidence of bone infection requiring secondary procedure was 9%; the major and minor soft tissue complication rate was 9% and 14% respectively. The limb salvage rate was 100%. Conclusion： Multidisciplinary management of severe lower limb trauma is important and provides good outcomes, lntramedullary nailing and immediate flap fixation can achieve early bone union and good soft tissue coverage, leading to good outcomes in patient with Grade Ⅲ A ＆ B tibia fractures.
