We report a case of right lower abdominal wall and groin abscess resulting from acute appendicitis. The patient was an 27-year-old man who had no apparent abdominal signs and was brought to the hospital due to progres...We report a case of right lower abdominal wall and groin abscess resulting from acute appendicitis. The patient was an 27-year-old man who had no apparent abdominal signs and was brought to the hospital due to progressive painful swelling of right lower abdomen and the groin for 10 d. Significant inflammatory changes of soft tissue involving the right lower trunk were noted without any apparent signs of peritonitis. Laboratory results revealed leukocytosis. Abdominal ultrasonography described the presence of abscess at right inguinal site also communicating with the intraabdominal region. Right inguinal exploration and laparotomy were performed and about 250 mL of pus was drained from the subcutaneous tissue and preperitoneal space. No collection of pus was found intraabdominally and subserous acute appendicitis was the cause of the abscess. The patient fully recovered at the end of the second post-operation week. This case reminds us that acute appendicitis may have an atypical clinical presentation and should be treated carefully on an emergency basis to avoid serious complications.展开更多
False aneurysm of the femoral artery is a rare complication of intertrochanteric fracture. Most of these situations are due to iatrogenic trauma or the trauma itself and are rarely caused by dislocated bone fragments....False aneurysm of the femoral artery is a rare complication of intertrochanteric fracture. Most of these situations are due to iatrogenic trauma or the trauma itself and are rarely caused by dislocated bone fragments. Here we report a case of a 72-year-old man who presented acutely with a pseudoaneurysm of the superficial femoral artery from the spike of a lesser trochanter fragment. Percutaneous endovascular treatment of the pseudoaneurysm with a covered stent was undertaken on an urgent basis. Five days later, the patient was operated upon and the lesser trochanter fragment was excised through an anterior incision and the intertrochanteric fracture was fixed using dynamic hip screws. The fracture was united at 10 weeks. At one-year＇s follow-up, there were no graft-related complications. This case illustrates that an intertrochanteric fracture with a dis- placed lesser trochanter fragment can present acutely with bleeding and a pseudoaneurysm of the femoral artery.展开更多
Objective： Talar body fractures are rare and have poor treatment outcome. The purpose of this study is to report the long term surgical treatment outcome of closed talar dome fractures.Methods： Eight closed talar bo...Objective： Talar body fractures are rare and have poor treatment outcome. The purpose of this study is to report the long term surgical treatment outcome of closed talar dome fractures.Methods： Eight closed talar body fractures, treated by open reduction and internal fixation with small fragment cancellous screws and/or Herbert screws in our level Ⅰ trauma centre were retrospectively analyzed. Preoperative and postoperative radiographs of the foot （antero-posterior, lateral and oblique views） and ankle （antero-posterior, lateral and mortise views） were obtained. The patients were followed up both radiologically and functionally （foot function index, FFI） after 3 weeks, 6 weeks, 3 months, 6 months and then annually.Results： There were five crush fractures and three shear fractures （two sagittal shear and one coronal shear）,with average follow-up of 5 years. No early complications were noticed in these patients. Late complications included osteoarthrosis of subtalar/ankle joints in six patients and osteonecrosis oftalar body in four patients. On functional assessment, mean FFI after 5 years was 104.63 points and worse outcome was noticed in crush injury and coronal shear fractures. Sagittal shear fractures had a good functional and radiological outcome.Conclusions： Late complications subsequent to surgically treated talar body fractures are inevitable, even though exact reduction and rigid fixation are achieved, thus patients are supposed to be counseled about the adverse outcome. Although crush and coronal shear fractures have poor outcome, sagittal injuries have good prognosis on long term evaluation.展开更多
Objective: To observe the effect of comprehensive treatment for hip fracture in old people. Methods: Three hundred and seventy two old patients with hip fractures were randomly divided into two groups, Group A and Gro...Objective: To observe the effect of comprehensive treatment for hip fracture in old people. Methods: Three hundred and seventy two old patients with hip fractures were randomly divided into two groups, Group A and Group B. Cases in Group A were treated only by operations. Cases in Group B received comprehensive treatment. The Singh Indexes of both uninjured and injured femoral necks were used to judge the osteoporosis levels before operation and one year after the operation. The function of injured hip joints was evaluated one year postoperatively. Results: Complications occurred in 36.56 % of the cases in Group A and 5.91 % of Group B. One year postoperatively, the Singh Index degree distributions of both uninjured and injured femoral necks in Group A had no significant difference compared with those before the operation (P> 0.05 ). In Group B, there was significant difference between one year postoperatively and before operation, and the Singh Index one year after the operation showed better result than that before operation (P< 0.05 ). One year after operation, there was significant difference in the function of injured hip joints between Group A and Group B (P< 0.05 ). Conclusions: Hip fracture in old people should be treated comprehensively according to its internal characteristics, osteoporosis.展开更多
Fracture of femoral shaft in adults is common and mostly managed with intramedullary interlocking nails. Complications during closed intramedullary femoral nailing are uncommon, and mostly of them are caused by techni...Fracture of femoral shaft in adults is common and mostly managed with intramedullary interlocking nails. Complications during closed intramedullary femoral nailing are uncommon, and mostly of them are caused by technical reasons. We describe a case of closed nailing for a femoral shaft fracture in which a jammed intramedullary guide wire, due to an incarcerated bone fragment at the nail tip, was inadvertently advanced across the knee. Forceful attempt of nail insertion caused this complication, which was probably attributed to nail design.展开更多
文摘We report a case of right lower abdominal wall and groin abscess resulting from acute appendicitis. The patient was an 27-year-old man who had no apparent abdominal signs and was brought to the hospital due to progressive painful swelling of right lower abdomen and the groin for 10 d. Significant inflammatory changes of soft tissue involving the right lower trunk were noted without any apparent signs of peritonitis. Laboratory results revealed leukocytosis. Abdominal ultrasonography described the presence of abscess at right inguinal site also communicating with the intraabdominal region. Right inguinal exploration and laparotomy were performed and about 250 mL of pus was drained from the subcutaneous tissue and preperitoneal space. No collection of pus was found intraabdominally and subserous acute appendicitis was the cause of the abscess. The patient fully recovered at the end of the second post-operation week. This case reminds us that acute appendicitis may have an atypical clinical presentation and should be treated carefully on an emergency basis to avoid serious complications.
文摘False aneurysm of the femoral artery is a rare complication of intertrochanteric fracture. Most of these situations are due to iatrogenic trauma or the trauma itself and are rarely caused by dislocated bone fragments. Here we report a case of a 72-year-old man who presented acutely with a pseudoaneurysm of the superficial femoral artery from the spike of a lesser trochanter fragment. Percutaneous endovascular treatment of the pseudoaneurysm with a covered stent was undertaken on an urgent basis. Five days later, the patient was operated upon and the lesser trochanter fragment was excised through an anterior incision and the intertrochanteric fracture was fixed using dynamic hip screws. The fracture was united at 10 weeks. At one-year＇s follow-up, there were no graft-related complications. This case illustrates that an intertrochanteric fracture with a dis- placed lesser trochanter fragment can present acutely with bleeding and a pseudoaneurysm of the femoral artery.
文摘Objective： Talar body fractures are rare and have poor treatment outcome. The purpose of this study is to report the long term surgical treatment outcome of closed talar dome fractures.Methods： Eight closed talar body fractures, treated by open reduction and internal fixation with small fragment cancellous screws and/or Herbert screws in our level Ⅰ trauma centre were retrospectively analyzed. Preoperative and postoperative radiographs of the foot （antero-posterior, lateral and oblique views） and ankle （antero-posterior, lateral and mortise views） were obtained. The patients were followed up both radiologically and functionally （foot function index, FFI） after 3 weeks, 6 weeks, 3 months, 6 months and then annually.Results： There were five crush fractures and three shear fractures （two sagittal shear and one coronal shear）,with average follow-up of 5 years. No early complications were noticed in these patients. Late complications included osteoarthrosis of subtalar/ankle joints in six patients and osteonecrosis oftalar body in four patients. On functional assessment, mean FFI after 5 years was 104.63 points and worse outcome was noticed in crush injury and coronal shear fractures. Sagittal shear fractures had a good functional and radiological outcome.Conclusions： Late complications subsequent to surgically treated talar body fractures are inevitable, even though exact reduction and rigid fixation are achieved, thus patients are supposed to be counseled about the adverse outcome. Although crush and coronal shear fractures have poor outcome, sagittal injuries have good prognosis on long term evaluation.
文摘Objective: To observe the effect of comprehensive treatment for hip fracture in old people. Methods: Three hundred and seventy two old patients with hip fractures were randomly divided into two groups, Group A and Group B. Cases in Group A were treated only by operations. Cases in Group B received comprehensive treatment. The Singh Indexes of both uninjured and injured femoral necks were used to judge the osteoporosis levels before operation and one year after the operation. The function of injured hip joints was evaluated one year postoperatively. Results: Complications occurred in 36.56 % of the cases in Group A and 5.91 % of Group B. One year postoperatively, the Singh Index degree distributions of both uninjured and injured femoral necks in Group A had no significant difference compared with those before the operation (P> 0.05 ). In Group B, there was significant difference between one year postoperatively and before operation, and the Singh Index one year after the operation showed better result than that before operation (P< 0.05 ). One year after operation, there was significant difference in the function of injured hip joints between Group A and Group B (P< 0.05 ). Conclusions: Hip fracture in old people should be treated comprehensively according to its internal characteristics, osteoporosis.
文摘Fracture of femoral shaft in adults is common and mostly managed with intramedullary interlocking nails. Complications during closed intramedullary femoral nailing are uncommon, and mostly of them are caused by technical reasons. We describe a case of closed nailing for a femoral shaft fracture in which a jammed intramedullary guide wire, due to an incarcerated bone fragment at the nail tip, was inadvertently advanced across the knee. Forceful attempt of nail insertion caused this complication, which was probably attributed to nail design.
