Trauma Case Reports最新文献

{"title":"Delayed hemorrhagic shock due to reverse chance thoracic vertebrae fracture complicated with hypoxemia caused by diaphragmatic eventration","authors":"Kentaro Taniguchi ,&nbsp;Tadashi Kaneko ,&nbsp;Takanori Yamaguchi","doi":"10.1016/j.tcr.2025.101177","DOIUrl":"10.1016/j.tcr.2025.101177","url":null,"abstract":"<div><div>Deceleration injuries sometimes cause thoracolumbar spine burst fractures. These injuries can also occur in people with kyphosis, which is common in elderly societies. The type of fracture and initial treatment require greater consideration in elderly than in non-elderly cases.</div><div>An 82-year-old woman with kyphosis was involved in a traffic accident and was admitted to our hospital with severe back pain, to treat reverse chance thoracic vertebrae burst fracture. The initial treatment involving rest in the spine position was unsuccessful. Continuous hemorrhage resulted in shock. She also developed respiratory insufficiency due to diaphragm elevation and diaphragmatic eventration. She required respiratory management with tracheal intubation and massive transfusion to treat her shock.</div><div>Spine burst fractures in elderly patients with kyphosis could cause retroperitoneal hemorrhage and hemothorax. Initial treatment of the spine burst fracture, by placing the patient in a supine position, resulted in massive hemorrhage and shock.</div><div>Learning objectives:<ul><li><span>•</span><span><div>Practitioners should acknowledge the difficulty of treating spine burst fracture in elderly patients with kyphosis, particularly reverse chance fracture. Repositioning of the patient for treatment, unlike in non-elderly patients, may be required to prevent retroperitoneal hemorrhage and hemothorax.</div></span></li><li><span>•</span><span><div>Practitioners should recognize that placing the patient in the supine position, which is conventional initial treatment for spine burst fracture, may not be optimal in elderly patients with kyphosis, given the difficulty of stabilizing the fracture, which can cause hemorrhage. Lying in a supine position can cause diaphragm elevation in patients with diaphragmatic eventration, a common complication in elderly patients with kyphosis that could lead to respiratory insufficiency.</div></span></li></ul></div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"57 ","pages":"Article 101177"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed chest wall abscess after blunt trauma chest leading to multi-organ failure: A case report","authors":"Binayak Deb ,&nbsp;V.M. Balasubramani ,&nbsp;Ram Varaham ,&nbsp;Ramesh Vaidyanathan","doi":"10.1016/j.tcr.2025.101168","DOIUrl":"10.1016/j.tcr.2025.101168","url":null,"abstract":"<div><div>Blunt Trauma Chest (BTC) is a common cause of morbidity and mortality in trauma patients. Although rib fractures, haemothorax, pneumothorax and lung contusions are often found in tandem in BTC, delayed necrotising soft tissue infection (NSTI) without any penetrating injuries or overt puncture wounds have rarely been reported. We report a 61-year-old patient with uncontrolled diabetes, admitted after a motor vehicle collision with head, chest and lower limb injuries and discharged after 9 days of stay in the hospital. He returned with NSTI of the chest wall around a week later with a fulminant clinical course ultimately leading to septic shock, multi-organ dysfunction and demise of the patient.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"57 ","pages":"Article 101168"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Close to the tip, with little bone to grip”: stabilizing two periprosthetic proximal femur fractures above a distal femur megaprosthesis using a combination of DHS and 3.5 mm screws","authors":"José-Vicente Andrés-Peiró ,&nbsp;Carlos Alberto Piedra-Calle ,&nbsp;Jordi Tomàs-Hernández ,&nbsp;Pablo S. Corona ,&nbsp;Carles Amat ,&nbsp;Jordi Teixidor-Serra","doi":"10.1016/j.tcr.2025.101167","DOIUrl":"10.1016/j.tcr.2025.101167","url":null,"abstract":"<div><div>The incidence of periprosthetic fractures is increasing, presenting significant challenges due to patient longevity and the complexity of repeated surgeries. This report details the successful treatment of a previously unreported periprosthetic fracture pattern using a modified dynamic hip screw (DHS) technique. Two cases involved patients with extracapsular fractures in short proximal femur segments above megaprostheses. The fractures were reduced and stabilized with a DHS device, complemented by 3.5 mm screws from a different manufacturer to achieve effective bicortical fixation around the thick stems. Early weight-bearing was initiated postoperatively, with both patients achieving fracture healing without mechanical complications. This approach highlights the importance of careful preoperative planning and the selection of appropriate fixation methods, particularly in complex cases where traditional solutions may not be viable.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"57 ","pages":"Article 101167"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forefoot amputation and free flap reconstruction for fracture-dislocations of the Lisfranc joint associated with plantar soft tissue defects: A report of two cases","authors":"Shuya Nohmi ,&nbsp;Ryo Wakamoto ,&nbsp;Taro Ogawa","doi":"10.1016/j.tcr.2025.101165","DOIUrl":"10.1016/j.tcr.2025.101165","url":null,"abstract":"<div><div>Fracture-dislocations of the Lisfranc joint associated with plantar soft tissue defects are difficult to reconstruct because both the Lisfranc joint and plantar soft tissue defects must be repaired. Inadequate reduction and fixation of the Lisfranc joint causes persistent weight-bearing foot pain, and an inappropriate choice of soft tissue reconstruction for plantar weight-bearing areas causes ulcers.</div></div><div><h3>Case 1</h3><div>A 48-year-old man sustained a fracture-dislocation of the Lisfranc joint. Soft tissue defects occurred in the dorsal and plantar parts beyond the forefoot, exposing the metatarsal heads. The Lisfranc joint was reduced and fixed using screws, and the dorsal and plantar soft tissue defects were covered with a free latissimus dorsi myocutaneous flap. Three years postoperatively, debulking surgery was performed, and the patient was able to walk without an orthosis and wear regular shoes, and no equinovarus deformity was observed; however, plantar ulcers occasionally occurred. Plain radiographs showed a reduced Lisfranc joint and malunited metatarsal bones.</div></div><div><h3>Case 2</h3><div>A 55-year-old man sustained an open fracture-dislocation of the Lisfranc joint. Soft tissue defects occurred in the dorsal and plantar parts distal to the midfoot. After transmetatarsal amputation, the Lisfranc joint was reduced and fixed using a screw and staples, and the dorsal and plantar soft tissue defects were covered with a free latissimus dorsi myocutaneous flap. Two years postoperatively, the patient was able to walk without an orthosis and wear regular shoes, and no equinovarus deformity was observed. Plain radiographs showed a reduced Lisfranc joint</div><div>For fracture-dislocations of the Lisfranc joint associated with plantar soft tissue defects, anatomical reduction and fixation of the Lisfranc joint, free flap reconstruction of the plantar weight-bearing area, and forefoot amputation help prevent equinovarus foot deformities and preserve gait function.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"57 ","pages":"Article 101165"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abdominal reconstruction after propeller injury with massive loss of domain","authors":"April Miller ,&nbsp;Nicholas Flugstad ,&nbsp;Megan Post","doi":"10.1016/j.tcr.2025.101160","DOIUrl":"10.1016/j.tcr.2025.101160","url":null,"abstract":"","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"57 ","pages":"Article 101160"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic popliteal artery injury required total gastrocnemius muscle resection: A case report","authors":"Yuta Izawa ,&nbsp;Hiroko Murakami ,&nbsp;Kazuo Sato ,&nbsp;Mizuki Minegishi ,&nbsp;Yoshihiko Tsuchida","doi":"10.1016/j.tcr.2025.101166","DOIUrl":"10.1016/j.tcr.2025.101166","url":null,"abstract":"<div><div>Popliteal artery injury (PAI) is one of the challenging trauma because it requires prompt revascularization and appropriate management for the associated injuries. Blood flow to the muscles may be interrupted due to injury to branches from the main trunk of the popliteal artery. Muscles with interrupted blood flow require early debridement to prevent infection; however, extensive resection of the lower leg muscles can lead to functional impairment.</div><div>We have experienced the treatment of a patient who required total gastrocnemius muscle resection because blood flow to the gastrocnemius muscle was interrupted due to traumatic popliteal artery injury. One year after the injury, the patient was able to walk without any problems and returned to his work. Although sprinting is difficult, jogging was possible. In addition, the patient was able to stand on tiptoe on the affected limb. Range of motion of knee and ankle, and functional score of knee joint was good. If the patient is young and intensive training for soleus muscle strength is performed, there may be no persistent major functional impairment.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"57 ","pages":"Article 101166"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143835041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical presentation of forearm compartment syndrome in a child","authors":"P.A. Saxena ,&nbsp;M. Veylamuthen ,&nbsp;L. Kitsi ,&nbsp;A. Crawford ,&nbsp;A.P. Dekker ,&nbsp;N. Ashwood","doi":"10.1016/j.tcr.2025.101170","DOIUrl":"10.1016/j.tcr.2025.101170","url":null,"abstract":"<div><h3>Background</h3><div>Compartment syndrome (CS) in children is rare in the paediatric population and diagnosis is challenging. Atypical or delayed management of CS has been known to have poor outcomes. We report an 8-year-old girl with an atypical presentation of CS and her management.</div></div><div><h3>Case report</h3><div>In this case report, we discuss the case of an 8-year-old girl with an open fracture of the midshaft radius and ulna fracture managed with Titanium elastic nailing system (TENS). She presented 2 weeks post injury with significant pain, flexed fingers and agitated. Following an urgent forearm fasciotomy and carpal tunnel decompression, her symptoms improved. 72 hours later, her fasciotomy wounds were closed and her symptoms continued to improve. 9 weeks post injury her forearm fracture had radiological union. 6 months post injury her TENS nails were removed.8 months post injury, she had no functional motor deficit but residual sensory deficit in median nerve distribution.</div></div><div><h3>Conclusion</h3><div>CS requires a high index of suspicion in the paediatric population. In addition to cardinal 5P's signs of CS, a triad of 3A's has been proposed for diagnosis of CS in children. Long term outcomes are favourable in atypical presentations or delayed diagnosis cases.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"57 ","pages":"Article 101170"},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of tibiotalocalcaneal (TTC) nailing in ankle fractures in diabetic patients with Charcot neuropathy","authors":"Sayed Mohamed Elgoyoushi,&nbsp;Ahmed Nabawy Morrah,&nbsp;Ahmed Mahmoud Kholeif,&nbsp;Ahmad Amr Elbadry","doi":"10.1016/j.tcr.2025.101158","DOIUrl":"10.1016/j.tcr.2025.101158","url":null,"abstract":"<div><div>This study aimed to evaluate the clinical and radiographic outcomes of tibiotalocalcaneal (TTC) nailing in diabetic patients with Charcot neuropathy and ankle fractures. A total of 84 patients underwent TTC nailing between December 2022 and June 2024. Functional outcomes were assessed using the Foot and Ankle Outcome Score (FAOS). Significant improvement was observed, increasing from a preoperative mean of 19.9 ± 3.81 to 72.6 ± 11.66 at six months postoperatively (<em>p</em> &lt; 0.001). Union was achieved in 75 % of patients, with delayed union in 17.9 % and nonunion in 7.1 %. Postoperative complications included superficial infections (7.1 %) and deep infections (3.6 %). No significant correlations were found between final FAOS scores and patient demographics or diabetes-related factors. TTC nailing is a reliable treatment option for this high-risk population.</div><div>Clinical trial number: not applicable.</div></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":"57 ","pages":"Article 101158"},"PeriodicalIF":0.0,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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}