Lower limb fractures like floating knees are more common in urban areas of low-income countries. In addition, associated complex lesions are manifestations of polytrauma requiring correct and appropriate management. T...Lower limb fractures like floating knees are more common in urban areas of low-income countries. In addition, associated complex lesions are manifestations of polytrauma requiring correct and appropriate management. The treatment is mostly surgical. We present a 19-year-old patient with a floating knee due to ipsilateral femoral and tibial fractures and vascular compression treated with femoral and calcaneus traction followed by a long limb cast. For our patient, the management of the concomitant vascular compression threatening vital and functional prognosis was in focus aiming at avoiding a radical decision such as limb amputation. The non-operative treatment managed to restore the blood supply and save the limb. At the follow-up after 10 months the fractures were clinically healed and radiologically consolidated and the walking capacity was almost restored. Non-surgical treatment accompanied by daily monitoring can prevent the radical solution of amputation in the context of a floating knee with vascular compression. We want to draw attention to the weakness of the existing classifications because they do not take into account vascular lesions as well as the presence of open fractures to define the severity and evaluate the prognosis.展开更多
Trigeminal neuralgia is a syndrome due to dysfunctional hyperactivity of the trigeminal nerve, and is characterized by a sudden, usually unilateral, recurrent lancinating pain arising from one or more divisions of the...Trigeminal neuralgia is a syndrome due to dysfunctional hyperactivity of the trigeminal nerve, and is characterized by a sudden, usually unilateral, recurrent lancinating pain arising from one or more divisions of the nerve. The most accepted pathogenetic mechanism for trigeminal neuralgia is compression of the nerve at its dorsal root entry zone or in its distal course. In this paper, we report four cases with trigeminal neuralgia due to an unknown mechanism after an intracranial intervention The onset of trigeminal neuralgia after surgical interventions that are unrelated to the trigeminal nerve suggests that in patients with greater individual susceptibility, nerve contact with the vascular structure due to postoperative pressure and changes in cerebrospinal fluid flow may cause the onset of pain.展开更多
文摘Lower limb fractures like floating knees are more common in urban areas of low-income countries. In addition, associated complex lesions are manifestations of polytrauma requiring correct and appropriate management. The treatment is mostly surgical. We present a 19-year-old patient with a floating knee due to ipsilateral femoral and tibial fractures and vascular compression treated with femoral and calcaneus traction followed by a long limb cast. For our patient, the management of the concomitant vascular compression threatening vital and functional prognosis was in focus aiming at avoiding a radical decision such as limb amputation. The non-operative treatment managed to restore the blood supply and save the limb. At the follow-up after 10 months the fractures were clinically healed and radiologically consolidated and the walking capacity was almost restored. Non-surgical treatment accompanied by daily monitoring can prevent the radical solution of amputation in the context of a floating knee with vascular compression. We want to draw attention to the weakness of the existing classifications because they do not take into account vascular lesions as well as the presence of open fractures to define the severity and evaluate the prognosis.
文摘Trigeminal neuralgia is a syndrome due to dysfunctional hyperactivity of the trigeminal nerve, and is characterized by a sudden, usually unilateral, recurrent lancinating pain arising from one or more divisions of the nerve. The most accepted pathogenetic mechanism for trigeminal neuralgia is compression of the nerve at its dorsal root entry zone or in its distal course. In this paper, we report four cases with trigeminal neuralgia due to an unknown mechanism after an intracranial intervention The onset of trigeminal neuralgia after surgical interventions that are unrelated to the trigeminal nerve suggests that in patients with greater individual susceptibility, nerve contact with the vascular structure due to postoperative pressure and changes in cerebrospinal fluid flow may cause the onset of pain.
