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
Hoffa＇s fracture is an uncommon fracture of the femoral condyle with coronal orientation of the fracture line. The mechanism of injury in pediatric Hoffa＇s fracture is road traffic accident, sports injury, and trivi...Hoffa＇s fracture is an uncommon fracture of the femoral condyle with coronal orientation of the fracture line. The mechanism of injury in pediatric Hoffa＇s fracture is road traffic accident, sports injury, and trivial injury. Clinical examination and proper imaging is important for diagnosis of pediatric Hoffa＇s fracture because of high chances of missing these injuries which can lead to nonunion and malunion at the fracture site. Open reduction and anatomical reduction of intraarticular fragment is the gold standard treatment of these fractures. We present a rare case of Hoffa＇s fracture in a 16-year-old girl with asso- ciated ipsilateral fibular fracture.展开更多
Descending branch of the lateral circumflex femoral artery （LCFA） is commonly used pedicle for anterolateral thigh （ALT） flap. Oblique branch of LCFA is an alternative pedicle that can be used in microvascular sur...Descending branch of the lateral circumflex femoral artery （LCFA） is commonly used pedicle for anterolateral thigh （ALT） flap. Oblique branch of LCFA is an alternative pedicle that can be used in microvascular surgery. According to review of literature and to the best of our knowledge we could not find the use of oblique branch of LCFA as a pedicle of the ALT flap in regional soft tissue reconstruction. Here we presented a case of a 55-year-old man sustaining soft tissue injury and wound over the left trochanteric and gluteal region following a road traffic accident, who was treated by the use of extended ALT pedicle flap with oblique branch of LCFA as the pedicle for reconstruction of soft tissue defect in trochanteric and gluteal regions with successful outcome.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Hoffa＇s fracture is an uncommon fracture of the femoral condyle with coronal orientation of the fracture line. The mechanism of injury in pediatric Hoffa＇s fracture is road traffic accident, sports injury, and trivial injury. Clinical examination and proper imaging is important for diagnosis of pediatric Hoffa＇s fracture because of high chances of missing these injuries which can lead to nonunion and malunion at the fracture site. Open reduction and anatomical reduction of intraarticular fragment is the gold standard treatment of these fractures. We present a rare case of Hoffa＇s fracture in a 16-year-old girl with asso- ciated ipsilateral fibular fracture.
文摘Descending branch of the lateral circumflex femoral artery （LCFA） is commonly used pedicle for anterolateral thigh （ALT） flap. Oblique branch of LCFA is an alternative pedicle that can be used in microvascular surgery. According to review of literature and to the best of our knowledge we could not find the use of oblique branch of LCFA as a pedicle of the ALT flap in regional soft tissue reconstruction. Here we presented a case of a 55-year-old man sustaining soft tissue injury and wound over the left trochanteric and gluteal region following a road traffic accident, who was treated by the use of extended ALT pedicle flap with oblique branch of LCFA as the pedicle for reconstruction of soft tissue defect in trochanteric and gluteal regions with successful outcome.
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.
