11/55. Open scapulothoracic dissociation.Scapulothoracic dissociation refers to the traumatic separation of the shoulder from the chest wall. This most commonly occurs as a closed injury. We present a case of open scapulothoracic dissociation and emphasize clinical features unique to this injury. In both closed and open scapulothoracic dissociation, the force necessary to shear the scapula from its thoracic attachments results in vascular disruption and neurologic injury to the upper extremity. As a consequence, patients have a pulseless, flail upper extremity with a significant chest wall hematoma (closed) or active bleeding (open). The first priority is to resuscitate and address life-threatening injuries. If the patient has active bleeding, immediate vascular control to prevent exsanguination is essential. patients with ischemia and an incomplete injury or unreliable neurologic examination need revascularization. Outcome is based on the extent of brachial plexus or cervical nerve root avulsion. patients with loss of neurologic function ultimately benefit from amputation at the appropriate level.- - - - - - - - - - ranking = 1keywords = plexus, chest (Clic here for more details about this article) |
12/55. Operative treatment of a transverse fracture-dislocation at the S1-S2 level.SUMMARY: The authors recently treated a multiply injured patient who sustained a rare fracture-dislocation at the S1-S2 level. The S1 vertebra was displaced forward into the pelvic cavity and was located just in front of the S2 vertebra. Because the patient also had extensive neurologic injury to the lumbar plexus and instability of the pelvic ring, operative treatment was deemed necessary. Surgery to stabilize the pelvis and decompress the lumbar plexus proved successful, and the patient experienced marked improvement in her postoperative neurologic function. Nonoperative treatment has traditionally been recommended for this injury, but advances in spinal surgery have made transverse sacral fractures more amenable to open reduction and fixation. Potential benefits of this operative treatment include relief of pressure from the lumbar plexus, a stable pelvis and facilitation of return of neurologic function.- - - - - - - - - - ranking = 2.8185548710152keywords = plexus (Clic here for more details about this article) |
13/55. Manubriosternal joint dislocation in contact sport.A 17 year old man developed chest pain and shortness of breath immediately after a scrummage while playing rugby football. A lateral chest radiograph showed a dislocated manubriosternal joint, with no associated injuries. This has not been previously reported in a sporting setting. This injury should be considered in flexion-compression injury of the thorax.- - - - - - - - - - ranking = 0.060481709661608keywords = chest (Clic here for more details about this article) |
14/55. Delayed decompression of chronic C1C2 subluxation in a pediatric patient with tetraplegia--is recovery possible?A 2 year-old Malay girl was admitted to our institution with a chesty cough and breathlessness but later found to have a chronic C1/C2 subluxation for one and half year with tetraplegia. Her cervical cord was decompressed and occipito-cervical fusion performed. Her neurological status improved significantly post-operatively and is able to care for her personal hygiene. The authors believe that the ability of the cervical cord to recover in the paediatric age group is remarkable that surgical option should be considered even when all seen lost. We believe that this is the first report in the literature to support this potential.- - - - - - - - - - ranking = 0.030240854830804keywords = chest (Clic here for more details about this article) |
15/55. Apophyseal dislocation of the body of the sternum in a child: a case report.A 4-year-old boy received a blow to the chest and sustained an apophyseal dislocation of the body of the sternum. The dislocation was treated by open reduction and internal fixation. This type of injury is so rare that no studies could be found.- - - - - - - - - - ranking = 0.030240854830804keywords = chest (Clic here for more details about this article) |
16/55. Complete rotation of the leg with associated deformities in poliomyelitis. A case report.This is a report of a 24-year-old man with a heretofore unreported 180 degrees rotation deformity of the right leg on the thigh with the calf and heel in front and the patella and toes behind along with other associated deformities of both lower extremities in poliomyelitis. The right knee was flail and the popliteal pulsations could be felt anteriorly. The rotation deformity was successfully corrected by arthrodesis of the knee without any neurovascular damage. After correction of the other deformities, an erect posture was achieved by this patient.- - - - - - - - - - ranking = 14.627538816264keywords = behind (Clic here for more details about this article) |
17/55. Nontraumatic atlantoaxial subluxation (Grisel syndrome): a rare complication of otolaryngological procedures.OBJECTIVE: At the conclusion of the report, the readers should be able to recognize the rare complication of adenotonsillectomy of Grisel syndrome, discuss its pathogenesis, and provide early, effective treatment. STUDY DESIGN: Analysis of the clinical presentation, plain radiographs, computed tomography scans, and magnetic resonance imaging scans of a child with Grisel syndrome after adenotonsillectomy. methods: Retrospective study of the case record and a review of the literature regarding the pathogenesis, treatment modalities, outcome, and prognosis after early and delayed treatment of Grisel syndrome. RESULTS: Pathophysiology of atlantoaxial subluxation revolves around the periodontoid vascular plexus that drains the posterosuperior pharyngeal region. Infectious and inflammatory emboli cause synovial engorgement, weakening paraspinal ligaments. Radiological studies play an important role in diagnosis. Treatment consists of cervical immobilization, muscle relaxants, analgesics, and antibiotics. Full resolution is expected with early conservative management. Failure to recognize the syndrome can lead to catastrophic results. CONCLUSIONS: Recognition of Grisel syndrome in addition to other rare complications of adenotonsillectomy requires a high index of suspicion. Early intervention is the critical factor for a positive outcome. However, delayed diagnosis is common and can result in catastrophic consequences, including neurological deficits, cosmetic deformity and, in rare instances, paralysis and death in the short term.- - - - - - - - - - ranking = 0.93951829033839keywords = plexus (Clic here for more details about this article) |
18/55. Type III acromioclavicular joint separation associated with late brachial-plexus neurapraxia.We report the case of a 28-year-old woman who developed signs and symptoms of brachial-plexus neurapraxia eight years after a type III acromioclavicular (AC) joint separation. Stabilization of the AC joint resulted in resolution of the symptoms.- - - - - - - - - - ranking = 4.697591451692keywords = plexus (Clic here for more details about this article) |
19/55. Traumatic scapulothoracic dissociation. A case report.A rare case of scapulothoracic dissociation which was not diagnosed initially is reported. Vascular injuries associated with this injury are potentially life threatening. The key to the diagnosis is accurate interpretation of the radiographs: the lateral dislocation of the acromion and lateral shift of the medial scapular border are evident on chest radiographs. Emergency subclavian arteriography is essential to assess the vascular status. A high index of suspicion has to be maintained so that this dangerous injury is not overlooked.- - - - - - - - - - ranking = 0.030240854830804keywords = chest (Clic here for more details about this article) |
20/55. Intracardiac malpositioning of a sternoclavicular fixation wire.A case of intracardiac malpositioning of a sternoclavicular Kirschner pin is reported. After an uneventful closed wire-fixation of sternoclavicular subluxation and a normal postanesthetic recovery, a 17-year-old male patient developed opacification of the right hemithorax and signs of internal bleeding. The lateral chest roentgenogram showed one fixation wire protruding deeply into the anterior mediastinum. sternotomy showed a large pericardial tear communicating with the right pleural cavity and a puncture hole of the right auricle that had caused a blood loss of 3 L into the pleural space. Although the surgical repair was uneventful, the patient eventually died as a sequelae to prolonged cerebral hypoxemia.- - - - - - - - - - ranking = 0.030240854830804keywords = chest (Clic here for more details about this article) |
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