Trauma Case Reports最新文献

{"title":"Technical tip - Using peroperative distraction in calcaneal fracture surgery after correction of hindfoot varus.","authors":"E R J Bruns, J A Halm, M Swords, A K Sands, T Schepers","doi":"10.1016/j.tcr.2026.101386","DOIUrl":"10.1016/j.tcr.2026.101386","url":null,"abstract":"<p><strong>Introduction: </strong>Calcaneus fracture surgery requires a well thought-out but pragmatic approach. The general fracture dislocation pattern involves shortening and varus deformation. The sinus tarsi approach (STA), which is performed in the lateral decubitus position, has become a more popular option due to its decreased soft tissue complication rate, while retaining the ability to perform anatomic reduction and fixation of most calcaneus fractures. As the STA technique requires indirect reduction, an assistive devise can be used to facilitate the reduction.</p><p><strong>Technique: </strong>The STA is performed in the lateral decubitus position by performing the following five consecutive steps: first, the medial joint surface (sustentaculum tali) is reduced and temporarily stabilized by inserting a medial plantar 1.6 mm K-wire. Second, the 5.0 mm Schanz pin is inserted perpendicularly into the infero-lateral tuberosity, and the calcaneus tuber length and varus are corrected while restoring medial wall congruency. The previously placed two 1.6 mm k-wires are advanced from the plantar medial tuber into the sustentaculum fragment. Third, the mini distractor is mounted after inserting 3.0 mm Schanz pins into the base of the neck of the talus, making sure the tip engages the far cortex. Fourth, distraction is applied using the mini-distractor to further restore height and length of the tuber and body of the calcaneus and to clear space in the posterior facet which aides in the reduction of the lateral joint fragment. Lastly, internal fixation is applied by means of a posterior facet/tuber extension type of lateral anatomical plate and independent angled axial screws.</p><p><strong>Conclusion: </strong>This current technical tip shows how to correct varus first and then uses the same Schanz pin for the use of a mini-distractor on the lateral side of the hindfoot.The technique described places the patient in a lateral decubitus position without the need for medial access to the hindfoot. Reduction and fixation of intra-articular calcaneal fractures safely can be performed with limited lateral incisions.</p>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"64 ","pages":"101386"},"PeriodicalIF":0.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13235360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199800","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":"Extensive necrotizing fasciitis of the thoracic wall and retroperitoneum following penetrating trauma: A case report of severe septic shock and multistage surgical management.","authors":"Parham Khoshdani Farahani","doi":"10.1016/j.tcr.2026.101379","DOIUrl":"10.1016/j.tcr.2026.101379","url":null,"abstract":"<p><strong>Introduction: </strong>Necrotizing fasciitis (NF) of the thoracic wall with retroperitoneal extension is an exceptionally rare and life-threatening condition. It is associated with high morbidity and mortality due to its rapid progression, diagnostic difficulty, and complex surgical requirements.</p><p><strong>Case presentation: </strong>A previously healthy male developed fulminant NF following minor penetrating thoracic trauma. He presented with septic shock, leukocytosis (WBC 54,000/μL), and lactic acidosis. Imaging revealed gas-forming infection extending from the thoracic fascia into the retroperitoneum. The LRINEC score was 10. Cultures identified <i>Acinetobacter baumannii</i>.Emergency radical debridement was performed, including excision of multiple thoracic muscles and retroperitoneal fascial planes. Over 14 days, five staged surgeries were required. Postoperative management included intensive care, broad-spectrum antibiotics, negative-pressure wound therapy, and delayed reconstruction with a pedicled flap and skin grafts.The patient survived despite a predicted mortality over 80%. At six-month follow-up, he had full functional recovery without recurrence.</p><p><strong>Conclusion: </strong>This case underscores the diagnostic and therapeutic challenges of truncal NF. Early recognition, aggressive surgical intervention, and coordinated critical care are vital to survival in such catastrophic infections.</p>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"64 ","pages":"101379"},"PeriodicalIF":0.0,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158413","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":"Bone tunnel repair of traumatic lumbar hernias without mesh: A multidisciplinary case series and literature review.","authors":"Sharmila Raju, Kendall Vignaroli, Aldin Malkoc, Elizabeth Tadevosyan, Anthony Tran, Mehnaaz Mohammed, Bradley Carlson, Lance Lamore, Joseph Elsissy, Brandon Woodward","doi":"10.1016/j.tcr.2026.101372","DOIUrl":"10.1016/j.tcr.2026.101372","url":null,"abstract":"<p><p>Lumbar hernias are rare, comprising less than 1.5% of all hernias, with traumatic lumbar hernias (TLH) representing an even rarer subset. Due to their rarity, there is limited consensus on optimal surgical repair techniques. Traditional TLH repairs typically involve primary closure or mesh reinforcement using open, laparoscopic, or hybrid intra-abdominal approaches. We present three cases of TLH managed with a novel bone tunnel technique, approximating the external oblique musculature to the iliac crest under intra-peritoneal visualization, without the use of mesh. To our knowledge, these are the first reported cases of mesh-free iliac crest fixation in TLH repair.</p>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"64 ","pages":"101372"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158315","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":"Pucker sign in proximal humerus fracture: Case report and review of the literature.","authors":"Lorenzo Lucchetta, David Palmieri, Michele Bisaccia, Giuseppe Rinonapoli","doi":"10.1016/j.tcr.2026.101402","DOIUrl":"10.1016/j.tcr.2026.101402","url":null,"abstract":"<p><strong>Introduction: </strong>Proximal humerus fractures (PHFs) are among the most common upper limb fractures, particularly in elderly patients after low-energy falls. The <i>pucker sign</i> is a rare but clinically important finding caused by penetration of a fracture fragment through the deltoid muscle, leading to entrapment of subcutaneous tissue and visible skin dimpling. This sign indicates soft tissue interposition that may prevent closed reduction and threaten skin vascularity if unrecognized.</p><p><strong>Case report: </strong>A 31-year-old male with a history of multiple sclerosis presented with a proximal humerus fracture (AO/OTA 11A2.2) and an evident pucker sign following a low-energy fall. Closed reduction under mild sedation was successfully achieved, followed by intramedullary nailing without complications. Postoperative recovery was uneventful, and early mobilization was initiated, although long-term follow-up was unavailable due to patient relocation.</p><p><strong>Discussion: </strong>A systematic literature review identified twelve published cases of PHFs associated with a pucker sign. The mean patient age was 46.3 years, with equal sex distribution. Closed reduction succeeded in 41.7% of cases, whereas 58.3% required open reduction and internal fixation. Successful closed reduction was generally limited to minimally displaced extra-articular fractures (AO/OTA 11A2-A3), while fully displaced fractures consistently required open management. Early recognition and sedation-assisted reduction improve outcomes and prevent skin necrosis or neurovascular compromise.</p><p><strong>Conclusion: </strong>The pucker sign in proximal humerus fractures is a rare but significant indicator of soft tissue entrapment. Prompt identification and timely reduction, closed or open, are essential to avoid complications. Increased awareness and additional case reporting are needed to establish standardized management strategies for this uncommon but clinically relevant presentation.</p>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"64 ","pages":"101402"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13325975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377111","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":"Staged management of a Tile C3 pelvic ring injury with bilateral sacroiliac disruption and T-shaped sacral fracture.","authors":"Edgar Barros, Felipe Criollo, Francisco Endara, Alejandro Barros Castro","doi":"10.1016/j.tcr.2026.101382","DOIUrl":"10.1016/j.tcr.2026.101382","url":null,"abstract":"<p><p>We present the case of a 16-year-old female polytrauma patient who sustained a rare and highly unstable pelvic ring injury following a high-energy motor vehicle collision with partial ejection. The injury pattern was classified as Tile C3, combining a right anterior crescent-type fracture with anterior sacroiliac (SI) joint dislocation, a left-sided Denis II sacral fracture, a distal T-shaped sacral fracture, and bilateral pubic rami fractures. Neurological deficits included right L5 and left S1-S2 involvement. Initial management adhered to damage control principles, including pelvic binder application, preperitoneal packing, and temporary external fixation. Due to cranial migration of the right hemipelvis and neurovascular compression, urgent anterior open reduction and SI joint plating were performed via an ilioinguinal approach. Definitive fixation, performed on day five, included percutaneous dual iliosacral screws for the Denis II fracture and bilateral retrograde pubic ramus screws, while the distal T-shaped sacral fracture was treated conservatively. The patient achieved stable fixation without implant failure, enabling early mobilization. At 12 months, radiographs demonstrated consolidation of the pelvic ring injuries with maintained alignment and no implant failure. She walked independently with an ankle-foot orthosis for persistent right foot drop, although residual L5-S1 motor weakness and altered reflexes persisted. Functional scores demonstrated marked recovery (Majeed 70/80; Iowa 85/100). This case highlights the importance of individualized, staged surgical strategies in managing complex pelvic fractures with combined rotational and vertical instability, especially in the presence of neurological injury and visceral trauma.</p>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"64 ","pages":"101382"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151465","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":"Plate fixation of the symphysis after symphysiotomy: A case report.","authors":"B W Hepkema, L R Werf van der, E Nol, W Wegdam, D Embden van","doi":"10.1016/j.tcr.2026.101387","DOIUrl":"10.1016/j.tcr.2026.101387","url":null,"abstract":"<p><strong>Background: </strong>Symphysiotomy is a rarely performed obstetric procedure with known risks of long-term maternal morbidity.</p><p><strong>Case: </strong>We present the case of a 26-year-old woman who developed pelvic instability following a symphysiotomy performed during a delivery complicated by shoulder dystocia and neonatal death. Diagnostic imaging revealed pathological mobility of the pubic symphysis. Surgical stabilization with plate osteosynthesis via a modified Stoppa approach resulted in early recovery with almost normal functional outcomes in the first weeks after surgery.</p><p><strong>Conclusion: </strong>Persistent pelvic instability following symphysiotomy can significantly impair function and quality of life. This case highlights that surgical fixation of the pubic symphysis, can lead to full functional recovery. Early recognition of patients who are likely to benefit from surgery is important. Early surgical intervention may be essential for quick recovery and restore mobility, especially in cases of marked diastasis.</p>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"64 ","pages":"101387"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253402","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":"Distal biceps tendon rupture following elbow dislocation: A case report.","authors":"Derek R Bass, William F McCormick, Parth A Goenka, Lindsay F Remy","doi":"10.1016/j.tcr.2026.101383","DOIUrl":"10.1016/j.tcr.2026.101383","url":null,"abstract":"<p><p>Elbow dislocations occur following axial and valgus overloading leading to disruption of the stabilizing ligaments of the joint. Distal biceps tendon ruptures occur following eccentric overloading of the flexed elbow. Because of their distinctly different mechanisms of injury, there is no mention in the literature of these two pathologies occurring concurrently. A 41-year-old man presented to the emergency department with an elbow dislocation following an ATV rollover. One week after conservative management with splinting, he was found to have a concurrent distal biceps tendon rupture. The patient was managed with a combination of conservative and operative management and has since regained full range of motion and returned to activity without limitation. This report aims to demonstrate a successful management of a complex combination injury, and to reassure physicians that, even in rare combination injuries, adherence to the core principles of orthopedic management remains effective.</p>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"64 ","pages":"101383"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151481","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 omentum protrusion: a case of traumatic abdominal wall hernia in a child.","authors":"Saida Hidouri, Sabrine Ben Ammar, Arije Zouaoui, Sinda Houidi, Mohamed Ali Chaouch, Riadh Jouini","doi":"10.1016/j.tcr.2026.101370","DOIUrl":"10.1016/j.tcr.2026.101370","url":null,"abstract":"<p><strong>Background: </strong>Traumatic abdominal wall hernia (TAWH) is a rare consequence of blunt abdominal trauma, especially in the pediatric population. It involves herniation through a disrupted abdominal wall without skin penetration. Its incidence is approximately 0.1%, and diagnosis may be delayed due to subtle clinical signs.</p><p><strong>Case presentation: </strong>A 4-year-old boy presented with a minor superficial wound after falling onto a vertical iron bar. Initial physical and ultrasound evaluations were unremarkable. One week later, he developed a reducible right lower quadrant abdominal bulge, later confirmed via ultrasound as an omental herniation through a 20 × 10 mm fascial defect. Elective laparotomy revealed omentum prolapse with adhesions, which was repaired with primary suturing. Postoperative recovery was uneventful, and the patient experienced full resolution.</p><p><strong>Discussion: </strong>TAWHs are frequently caused by focused blunt trauma, such as bicycle handlebars, and often accompany intra-abdominal injuries. Diagnosis relies on clinical suspicion, imaging (ultrasound or CT), and exclusion of pre-existing hernias. Early surgical repair is recommended to prevent complications like strangulation or incarceration. The case highlights the importance of monitoring and re-evaluation even after initially normal assessments.</p><p><strong>Conclusion: </strong>TAWH should be suspected in children presenting with abdominal pain after blunt trauma, even when initial findings are minimal. Timely diagnosis and appropriate surgical intervention can prevent morbidity. Due to its rarity, management should be individualized based on patient stability, injury severity, and associated intra-abdominal involvement.</p>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"64 ","pages":"101370"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139088","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":"A case of tracheal injury with cricoid fracture due to blunt laryngeal trauma.","authors":"Eri Uemura, Shimon Murahashi, Shuhei Yamano, Hiroo Izumino, Takamitsu Inokuma, Goro Tajima, Kazunori Yamashita, Sumie Takashima, Yoshihiko Kumai, Osamu Tasaki","doi":"10.1016/j.tcr.2026.101376","DOIUrl":"10.1016/j.tcr.2026.101376","url":null,"abstract":"<p><strong>Background: </strong>Laryngeal injuries, especially cricoid cartilage fractures, are rare but may present with airway emergencies, and appropriate airway management is vital.</p><p><strong>Case presentation: </strong>A 24-year-old man admitted to the emergency room with isolated blunt cervical trauma after a motorcycle accident. The patient presented dysphonia, stridor, hemoptysis, cervical subcutaneous emphysema, and increasing respiratory distress. Oral intubation was initially successful, however, worsening subcutaneous emphysema and loss of effective ventilation suggested airway disruption. Emergency cricothyrotomy was performed, but persistent air leakage from the incision site prompted bronchoscopy, which revealed a 7-mm tracheal laceration on the right side of the larynx. The patient was reintubated under bronchoscopy. Computed tomography showed a cricoid cartilage fracture. Tracheostomy and complete repair were performed 2 days after the injury. The cricoid cartilage was fractured fully circumferentially, with the anterior part deviated toward the caudal side, and its deepest part had perforated the right side of the trachea. The cricoid cartilage was repaired, and the tracheal perforation was dilated to create a laryngo-cutaneous fistula. Persistent hoarseness after fistula closure was associated with scar formation of the left vocal fold and arytenoid cartilage dislocation. Although symptoms gradually improved with voice rehabilitation, increased vocal demand after a job change led to thyroplasty 2 years after injury.</p><p><strong>Conclusion: </strong>Cricoid cartilage fractures associated with blunt laryngeal injuries may cause tracheal injury. This case highlights the challenges of managing concurrent cricoid fracture and tracheal injury, where the surgical airway site coincided with the traumatic defect. Rapid decision-making balancing exploration and stabilization was critical.</p>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"64 ","pages":"101376"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13223509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151448","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":"Penetrating neck trauma with complete tracheal and hypopharyngeal transaction: A case report.","authors":"Parham Khoshdani Farahani","doi":"10.1016/j.tcr.2026.101380","DOIUrl":"10.1016/j.tcr.2026.101380","url":null,"abstract":"<p><strong>Introduction: </strong>This case report describes a rare and severe penetrating neck trauma resulting in complete transection of the trachea and hypopharynx, accompanied by significant vascular injury, caused by a clothesline mechanism.</p><p><strong>Case presentation: </strong>The patient presented with critical hemodynamic instability, necessitating urgent surgical intervention. Management included rapid airway securement via emergent tracheostomy, ligation of bleeding vessels, and repair of the trachea and hypopharynx.</p><p><strong>Conclusion: </strong>This case underscores the importance of swift assessment, resuscitation, and coordinated multidisciplinary surgical efforts to achieve a favorable outcome in such complex, life-threatening neck injuries.</p>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"64 ","pages":"101380"},"PeriodicalIF":0.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13217836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138902","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}