Trauma Case Reports最新文献

{"title":"Quadruple bilateral fracture-dislocation of the elbow and the wrist: A rare and complex case report","authors":"Zakaria Chabihi ,&nbsp;Brahim Demnati ,&nbsp;Abdelwahed Soleh ,&nbsp;Yassine Fath El Khir ,&nbsp;El Mehdi Boumediane ,&nbsp;Mohamed Amine Benhima ,&nbsp;Imad Abkari","doi":"10.1016/j.tcr.2025.101147","DOIUrl":"10.1016/j.tcr.2025.101147","url":null,"abstract":"<div><div>We report an exceptionally rare and complex case of quadruple bilateral fracture dislocation of the elbow and the wrist in a 39-year-old construction worker, who sustained the injury after falling from a scaffold of 9 m secondary to a 6.9 magnitude earthquake. The patient was treated with a combination of closed and open reduction, internal fixation, and radial head arthroplasty, and had a good functional outcome at 12 months follow-up, with no complications or instability. This case illustrates the challenges and the possibilities of managing such complex injuries, and adds to the scarce literature on this topic.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"57 ","pages":"Article 101147"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presentation, management and outcome of thoracic trauma in a resource-limited environment: A case series","authors":"Danielle Benjamin ,&nbsp;Patrick Charlorin ,&nbsp;Gérald Jonacé ,&nbsp;Jude Milcé","doi":"10.1016/j.tcr.2025.101155","DOIUrl":"10.1016/j.tcr.2025.101155","url":null,"abstract":"<div><h3>Background</h3><div>Trauma is a major public health problem, causing the death of &gt;5 million people each year. One-fifth of these deaths are related to thoracic trauma (TT). This study aims to provide data on the presentation, management, and outcome of TT at the State University Hospital of Haiti (HUEH).</div></div><div><h3>Methods</h3><div>This is a retrospective, single-center, formal case series of 35 cases of TT admitted to the General Surgery Department of HUEH from January 2013 to December 2017. Data analyzed included sociodemographic, preoperative (etiology and clinical presentation), management, and outcomes. The Exact Fischer, Welch and Mann-Whitney <em>U</em> tests were used. A <em>P</em>-value <em>p</em> &lt; 0.05 was considered significant. The case series was reported according to PROCESS criteria.</div></div><div><h3>Results</h3><div>Of our sample of 35 patients, there was a male predominance (<em>n</em> = 27, 77.1 %), and the median age was 40 years. Most patients (<em>n</em> = 33, 94.3 %) presented with penetrating TT. The principal etiology was assaults (<em>n</em> = 30, 85.7 %), committed mostly by strangers (<em>n</em> = 19) and mainly with firearms (<em>n</em> = 18). Topping the list of common thoracic injuries were hemopneumothorax, diaphragmatic tear and open pneumothorax. There were extrathoracic associated injuries in 16 patients (45.7 %) with abdominal involvement in 10 cases (28.6 %). Principal specific management was tube thoracostomy for 33 patients (94.3 %) with additional laparotomy for 12 patients (34.3 %) for a median hospital stay of 6 days. There were 2 deaths due to massive hemorrhage without the possibility of massive transfusion. Estimated blood loss was significantly related to short-term survival outcome (<em>p</em> = 0.02).</div></div><div><h3>Conclusion</h3><div>This is a rare study in the Haitian environment that explores TT. Rather than road traffic accidents, assaults caused mainly by firearms were the chief cause of TT and testify to the current climate of violence and insecurity in the country. Although most of the TT cases were manage by tube thoracostomy, one third needed additional laparotomy. Increased blood loss associated with poorer patient outcomes highlights the need for more transfusion services and the establishment of standard of care for TT in Haiti.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"56 ","pages":"Article 101155"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ipsilateral supracondylar humerus fracture and Monteggia fracture–dislocation with distal radius physeal fracture in a pediatric patient: A case report","authors":"Ryu Igaki ,&nbsp;Tomohiro Yasuda ,&nbsp;Yuki Samejima ,&nbsp;Yuto Murakami ,&nbsp;Shinsuke Takagi ,&nbsp;Keikichi Kawasaki","doi":"10.1016/j.tcr.2025.101151","DOIUrl":"10.1016/j.tcr.2025.101151","url":null,"abstract":"<div><div>In pediatric patients, supracondylar humerus fractures concurrent with Monteggia fracture–dislocation and Monteggia fracture–dislocation concurrent with distal radius fracture are rare and have only been reported in case reports. We present the case of a 10-year-old girl with concurrent ipsilateral arm supracondylar humerus fracture with Monteggia fracture–dislocation and distal radius physeal fracture, which were treated with closed reduction and percutaneous pinning. The Monteggia fracture-dislocation was addressed with open reduction via a posterior approach and fixation using titanium elastic nails. The postoperative recovery was favorable. At 1-year postoperative follow-up, the Mayo Elbow Performance score was 100 points, and no limitations in joint range of motion were noted.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"56 ","pages":"Article 101151"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An 11-month-old infant with laryngeal and pharyngeal injuries due to aspiration of an L-shaped metal fragment: A case report","authors":"Kyohei Sakurai ,&nbsp;Yoshimatsu Ehama ,&nbsp;Naomasa Shimizu ,&nbsp;Makoto Kobayashi","doi":"10.1016/j.tcr.2025.101153","DOIUrl":"10.1016/j.tcr.2025.101153","url":null,"abstract":"<div><div>Airway foreign bodies require urgent removal owing to their life-threatening risks. Symptoms such as coughing and wheezing typically appear immediately after aspiration, although symptom improvement can delay diagnosis and treatment. This report describes a rare case of aspiration of an L-shaped metal fragment that injured the larynx and pharynx. The patient was an 11-month-old girl who developed a persistent cough while eating baby food. Her primary care physician initial discharged her with mild hoarseness, but persistent hoarseness led to an emergency room visit. Although her vital signs were stable, crying revealed hoarseness and inspiratory wheezing. Suspecting an airway foreign body, a chest X-ray revealed a metal object in the neck. Computed tomography showed that the fragment's edges were in the larynx and pharynx, spanning the arytenoid cartilages. The pharyngeal end of the fragment had punctured the posterior pharyngeal wall, and submucosal free air was observed. The foreign body—a thin and 2-cm-long L-shaped metal fragment—was removed under intravenous anesthesia using video laryngoscopy. Owing to the risks of emphysema, hematoma, and edema from inflammation of the posterior pharyngeal wall, the patient was intubated for 3 days and recovered well. As demonstrated, aspiration of irregularly shaped foreign objects can cause severe injury to surrounding structures. Careful diagnostic attention is crucial, and for suspected emphysematous lesions in the pharynx or mediastinum, endotracheal intubation and ventilatory support should be considered.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"56 ","pages":"Article 101153"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Veno-venous extracorporeal membrane oxygenation application for patient with acute lung injury due to rhabdomyolysis; a case report","authors":"Dongsub Noh ,&nbsp;Yong Han Cha","doi":"10.1016/j.tcr.2025.101154","DOIUrl":"10.1016/j.tcr.2025.101154","url":null,"abstract":"<div><div>A 47-year-old male patient, who underwent open reduction and internal fixation with plate for a Gustilo-Anderson type II open proximal tibiofibular fracture of the right lower leg, experienced rhabdomyolysis. Rapid progression of acute respiratory distress syndrome and acute renal failure occurred due to rhabdomyolysis. After veno-venous extracorporeal membrane oxygenation, he exhibited a relatively smooth clinical recovery. Our case report suggests that circulating cytotoxic substances from rhabdomyolysis resulted in concomitant acute respiratory distress syndrome and acute renal failure. This case was successfully treated after applying extracorporeal membrane oxygenation.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"57 ","pages":"Article 101154"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knee arthrodesis with modular megaprosthesis as salvage procedure for the limb following in a patient with an infected knee tumor prosthesis: A case report","authors":"Rodrigo Olivieri ,&nbsp;Nicolás Franulic ,&nbsp;Felipe Amoedo ,&nbsp;José I. Laso ,&nbsp;Tania Rojas ,&nbsp;Carlos Rojas ,&nbsp;Nicolás Gaggero","doi":"10.1016/j.tcr.2025.101152","DOIUrl":"10.1016/j.tcr.2025.101152","url":null,"abstract":"<div><h3>Introduction</h3><div>The management of periprosthetic knee infections is a complex event, especially in the context of megaprostheses. An accepted option in these cases is knee arthrodesis, aiming to salvage the limb with acceptable and pain-free functionality. We present a successful case of knee arthrodesis using a hybrid model of modular nail-prosthesis in a patient with massive bone stock loss following the removal of an infected tumor-type prosthesis.</div></div><div><h3>Case presentation</h3><div>A 65-year-old male patient with a chronic periprosthetic infection related to a resection prosthesis implanted 5 years earlier, experiencing knee stiffness and presenting a massive bone stock deficit after prosthesis removal. Initial management involved an osteo-cement spacer and antibiotics, along with a transarticular external fixator. Subsequently, knee arthrodesis was performed using a hybrid model of modular nail-prosthesis, coupled with targeted antibiotic treatment. The arthrodesis was deemed successful, with a pain-free limb and no signs of infection recurrence at the 52-month follow-up.</div></div><div><h3>Conclusion</h3><div>In the scenario of infection and massive bone stock deficit, knee arthrodesis using intramedullary devices such as nails, megaprostheses, or hybrids is an alternative that can be successful if accompanied by appropriate medical-surgical management of the infection. This approach allows for earlier functional recovery compared to other techniques.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"56 ","pages":"Article 101152"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical presentation of fat embolism syndrome: A case report","authors":"Seok Woo Shin ,&nbsp;Barbara Soares Goncalves ,&nbsp;Leonardo Magnani Seabra ,&nbsp;Henriquy Aguiar Coelho ,&nbsp;Talita Magalhaes Sansoni ,&nbsp;Thiago Rodrigues Araujo Calderan ,&nbsp;Vania Graner Silva Pinto ,&nbsp;Elcio Shiyoiti Hirano ,&nbsp;Cesar Vanderlei Carmona","doi":"10.1016/j.tcr.2025.101150","DOIUrl":"10.1016/j.tcr.2025.101150","url":null,"abstract":"<div><div>We present a case report of fat embolism syndrome in the Trauma Intensive Care Unit with an atypical presentation. A 21-year-old male patient was admitted with multiple fractures after a motorcycle accident. Shortly after the debridement of the open fracture and external fixation of the bones, the patient presented with hypoxemia, tachypnea, fever, and tachycardia. There were no neurologic abnormalities and no petechial rash. Supportive care, including mechanical ventilation, was required. Initial chest angiotomography did not detect pulmonary thromboembolism. There were discrete bilateral consolidations in the lung bases — no bacterial or viral infection findings, including a negative COVID-19 test. Computed tomography was repeated after 5 days, evidenced by bilateral well-demarcated ground glass opacities.</div><div>Our case presented an atypical presentation of fat embolism syndrome, without classical signs and symptoms, such as neurologic abnormalities and petechial rash. In this context, other differential diagnoses were considered, since the clinical manifestations of fat embolism are non-specific, and often are seen in other post-traumatic conditions.</div><div>This case highlights the diagnostic challenges of fat embolism syndrome in the Intensive Care Unit. Atypical presentation must be taken into consideration when treating high-risk patients.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"56 ","pages":"Article 101150"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open reduction, internal fixation of Vancouver B1, C & D type periprosthetic femoral fractures with use of an antiglide plate at fracture apex - The “Apex Plate”","authors":"Roland Bell,&nbsp;Mohammed Remtulla,&nbsp;Bryan Riemer","doi":"10.1016/j.tcr.2025.101140","DOIUrl":"10.1016/j.tcr.2025.101140","url":null,"abstract":"<div><h3>Background</h3><div>Periprosthetic femoral fractures are associated with significant morbidity, mortality, social and economic cost. The incidence of these fractures is expected to increase with an ever-growing elderly world-population. The complex nature and varied pattern of these injuries requires a range of specialized surgical techniques and tools. Fixation alone is being increasingly regarded as the preferred method of addressing these fractures, even in cases where the femoral stem is unstable, showing favourable outcomes overall when compared to a fix-and-replace approach. Lateral plate fixation is the primary surgical method for either case, and while there is a growing offer of implants specifically for this subset of orthopaedic injuries, the problem of non-union appears to be the most common of complications encountered postoperatively. We prefer fixation alone, including for Unified Classification System (UCS) B2 and B3 type fractures. A small-fragment plate fixed at the fracture apex acts as both a reduction device, thereby simplifying the operation itself, and as a buttressing device. The lateral tension-banding plate method can exploit the latter function of this smaller plate to improve the stability of the fixed construct, and thereby encourage more reliable bone healing.</div></div><div><h3>Cases</h3><div>We have treated 6 patients between the ages of 59 and 93 with UCS B1, B2, C and D fractures in this fashion. Fragments around an unstable stem (as with a UCS B2 or B3 fracture) were first reduced anatomically and fixed using cerclages, effectively creating a UCS B1, C or D type fracture, which can then be addressed using this two-plating system. All patients were discharged from hospital, returning home to activities of daily living. All radiographic follow-up demonstrated maintenance of reduction and implant position. For patients with radiographic follow-up beyond two months, fracture consolidation or partial consolidation was noted. No surgical infections were recorded.</div></div><div><h3>Conclusions</h3><div>We present this method of fixation for these types of fractures as a “mixed principles” approach to osteosynthesis. Here, the buttressing nature of the medial femoral cortex is at least in part reconstituted so that compressive forces are generated across cortices where an oblique or spiral fracture pattern would otherwise generate shear forces. <em>Re</em>-establishing these biomechanics with a lateral tension band plate, we assume, generates a more stable construct that favours bone healing and reduces the chances of non- or mal- union.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"56 ","pages":"Article 101140"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rib fixation in a blunt trauma chest patient post-CPR: Navigating dual pathologies and poor chest physiology: Case report with review of literature","authors":"Reecha Panghal ,&nbsp;Alisha Chachra ,&nbsp;Divakar Goyal","doi":"10.1016/j.tcr.2025.101145","DOIUrl":"10.1016/j.tcr.2025.101145","url":null,"abstract":"<div><div>Managing blunt trauma to the chest and associated rib fractures presents a complex challenge in poly-trauma patients, with considerable mortality and morbidity risks. While the global trend favours non-operative approaches, select centres advocate for surgical stabilization using Rib-specific plating systems. This becomes especially intricate post-cardiopulmonary resuscitation, yet it emerges as a pivotal intervention with significant implications for patient outcomes. We observed positive outcomes based on our experience in the systematic management of a flail chest case, incorporating critical care and chest wall stabilization. This comprehensive approach proved instrumental in restoring cardiopulmonary dynamics, optimizing oxygenation, reducing analgesic requirements, mitigating pneumonia incidence, facilitating mechanical ventilation, expediting weaning, supporting early recovery, and demonstrating cost-effectiveness. Despite these promising results, ongoing research is imperative to fine-tune patient selection criteria and refine indications for rib fixation. This approach holds the potential to minimise morbidity and mortality in thoracic injury cases, underscoring the need for continued exploration and validation of rib-specific plating systems in the evolving landscape of trauma care.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"56 ","pages":"Article 101145"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143480209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elbow terrible triad: Advancing current concepts in the treatment of 13 cases","authors":"Edgar Barros Prieto ,&nbsp;Eduardo Noboa ,&nbsp;Carlos Ballesteros ,&nbsp;Carlos Peñaherrera ,&nbsp;Francisco Endara ,&nbsp;Alejandro Barros Castro","doi":"10.1016/j.tcr.2025.101146","DOIUrl":"10.1016/j.tcr.2025.101146","url":null,"abstract":"<div><h3>Background</h3><div>The “terrible triad” of the elbow is characterized by a combination of elbow dislocation with fractures of the radial head and the coronoid process of the ulna. This injury is notoriously complex due to the rupture of key elements that ensure elbow stability, resulting in poorer outcomes compared to simpler joint injuries. Despite advances in treatment protocols, an optimal surgical approach and fixation technique standard have not yet been established.</div></div><div><h3>Methods</h3><div>This descriptive study focused on reviewing the anatomical and clinical characteristics of the elbow joint, considering the most current biomechanical concepts. Management protocols implemented in our practice were evaluated, including specific surgical techniques and fixation methods based on a deep understanding of elbow anatomy and biomechanics. Retrospective data were collected from patients treated at our centers, analyzing postoperative clinical and radiographic outcomes.</div></div><div><h3>Results</h3><div>The implementation of a treatment based on updated concepts of elbow biomechanics and anatomy showed a significant improvement in postoperative joint stability and functional recovery of patients. There was a reduction in complication rates and an improvement in clinical outcomes compared to traditional approaches. The selection of specific fixation techniques and surgical approaches allowed for more effective management of the “terrible triad,” adapting to the particularities of each case and optimizing results.</div></div><div><h3>Conclusion</h3><div>This study highlights the importance of a detailed understanding of elbow biomechanics and anatomy for the effective management of the “terrible triad.” The implementation of protocols based on these principles can significantly improve clinical outcomes and reduce complications, offering a comprehensive approach to addressing this complex pathology.</div><div>Level of Evidence: IV</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"57 ","pages":"Article 101146"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}