1/104. Pseudoaneurysm of the profunda femoris artery due to intertrochanteric fracture of the hip.Arterial injury caused by hip fracture is a rare event. We report a case of pseudoaneurysm of the profunda femoris artery that presented 4 weeks after correction of an intertrochanteric hip fracture with a dynamic hip screw. The diagnosis was confirmed by Duplex ultrasound scanning, and it was treated by ligation of the profunda femoris artery at the level of the pseudoaneurysm.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/104. scalp laceration: an obvious 'occult' cause of shock.scalp lacerations are often present in patients requiring emergency care for blunt trauma. These injuries are most commonly seen in unrestrained drivers or occupants involved in motor vehicle crashes in which the victim is partially or totally ejected. patients with scalp lacerations often have associated injuries that redirect the clinician's attention to other injury sites. Some scalp lacerations are severe enough to cause hypovolemic shock and acute anemia. If the patient arrives in shock, the perfusion pressure may be low, and there may be minimal active scalp bleeding. Under such circumstances, the scalp wound may be initially dismissed as trivial and attention appropriately turned to assuring an adequate airway, establishing intravenous lines, initiating volume resuscitation, and searching for more "occult" sources of blood loss. However, as the blood pressure returns toward normal, bleeding from the scalp wound becomes more profuse and presents a hemostatic challenge to the clinician. A case presentation illustrates some of these issues and confirms the effectiveness of an often overlooked but simple technique to control scalp hemorrhage--Raney clip application.- - - - - - - - - - ranking = 3.1931462378024keywords = injury, laceration, trauma (Clic here for more details about this article) |
3/104. Asymmetrical bilateral traumatic hip dislocation with ipsilateral acetabular fracture.We report a case of simultaneous asymmetrical bilateral traumatic hip dislocation, with one hip dislocated anteriorly and the other posteriorly, with ipsilateral acetabular fracture, suffered in a traffic accident by a 36-year-old man. Closed reduction of both hips was performed, followed by delayed internal fixation of the acetabular fracture.- - - - - - - - - - ranking = 0.27981963431517keywords = trauma (Clic here for more details about this article) |
4/104. Pelvic ring injury with urologic trauma: a report of bladder extravasation into the hip joint.A case of blunt trauma is presented with pelvic ring disruption and an extraperitoneal bladder rupture that communicated with the hip joint through an acetabular fracture. Extraperitoneal bladder rupture is usually associated with blunt polytrauma and pelvic ring injuries. Expedient diagnosis and multidisciplinary management are essential to minimize significant early and late complications.- - - - - - - - - - ranking = 4.3357835611782keywords = injury, trauma (Clic here for more details about this article) |
5/104. Sudden death from pelvic hemorrhage after bilateral central fracture dislocations of the hip due to an epileptic seizure.Fracture and dislocation of major joints may be caused by the forceful tonic muscular contractions of seizure activity. A 77-year-old man who was found dead in bed with no sign of external trauma had bilateral central fracture dislocations of the femoral head through the acetabular floor with fatal pelvic hemorrhage and extensive pulmonary fat and bone marrow embolism. He had epilepsy, but the last seizure was 6 years earlier, and he had long discontinued medication. The fractures were attributed to a new unwitnessed seizure. This is the twentieth case of central fracture dislocation of the hip since 1970, when better anesthesia eliminated convulsive therapy-induced fractures. The authors review these 20 cases. seizures followed inflammation, infarction or neoplasia of the brain, eclampsia, metabolic or iatrogenic causes, or epilepsy (6 cases, 2 of which had no prior seizures for 5 years). There were 11 men (mean age, 64 years) and 9 women (mean age, 47 years). Fractures were unilateral in 13 and bilateral in 7. Additional fractures (in vertebrae, shoulders, or femur) were present in eight. Only eight had prior bone disease. Local symptoms led to diagnosis in most, but two were identified incidentally on imaging. The current patient was the only one to die suddenly, but six other patients presented with shock and three died (one of whom had injuries that led to a suspicion of manslaughter). Central fracture-dislocation of the hip is a rare and little known consequence of seizures, with strong potential for misdiagnosis and lethal complications.- - - - - - - - - - ranking = 0.055963926863034keywords = trauma (Clic here for more details about this article) |
6/104. venous thromboembolism after hip fracture surgery in a patient with haemophilia B and factor v Arg506Gln (factor v Leiden).We describe a patient with mild haemophilia B who developed symptomatic venous thromboembolism after hip arthroplasty for a traumatic fracture. A deep vein thrombosis developed in the operated leg while he was receiving a high-purity factor ix concentrate. Subsequently, he was determined to be a heterozygous carrier for the factor v Arg506Gln (Leiden) mutation. This case illustrates the importance of providing thromboprophylaxis for all patients with haemophilia receiving coagulation factor replacement and who undergo surgical procedures known to be associated with a high risk of venous thromboembolism. In patients with haemophilia and a family history of venous thromboembolism, preoperative screening for the presence of the factor v Arg506Gln mutation and other thrombophilias may be useful.- - - - - - - - - - ranking = 0.055963926863034keywords = trauma (Clic here for more details about this article) |
7/104. Traumatic unilateral avulsion of the anterior superior and inferior iliac spines with anterior dislocation of the hip: a case report.A sixteen-year-old boy involved in a high-speed motor vehicle accident sustained an anterior hip dislocation and avulsion of the anterior ilium extending from the anterior superior iliac spine to the anterior inferior iliac spine. The hip was emergently reduced, and further imaging was obtained to evaluate the bony injury. Computed tomography confirmed the presence of a large displaced bony fragment representing avulsion of the anterior superior and inferior iliac spines and a smaller fragment from the reflected head of the rectus femoris. The patient underwent open reduction and internal fixation of the ilium two days after the initial injury. Postoperatively, he was allowed to bear weight as tolerated with crutches but to avoid active hip flexion. He went on to an uneventful recovery, and at last report (approximately six months after injury), he had returned to full activity. An extensive review of the literature failed to show a similar injury of ipsilateral avulsion of the anterior superior and inferior iliac spines and reflected head of the rectus femoris.- - - - - - - - - - ranking = 4keywords = injury (Clic here for more details about this article) |
8/104. Pseudocyst formation after intertrochanteric fracture fixation: a case report.We describe a 62-year-old woman who developed two pseudocysts, 25 x 15 cm and 20 x 12 cm, in the left proximal thigh as a complication 19 years after internal fixation of an intertrochanteric fracture. She received a 135 degrees dynamic hip screw and side plate in May 1979. She continued to live at home without major discomfort until May 1997. Two huge pseudocysts were noted in the left proximal thigh without trauma history. angiography was normal. Computerized tomography scan revealed two voluminous cystic lesions without septa in the left proximal thigh, with accumulated fluid. During surgery, two huge cysts were found in the left proximal thigh, and their orifices were found slightly proximal to the curvature of the side plate. The pathology showed that the cysts consisted of a nonepithelialized wall of granulation tissue compatible with a pseudocyst. The patient had no further problems 2 years after surgery. We found no reports in the literature of this rare complication. The development of the pseudocysts may have been the result of chronic low-grade trauma due to irritation between the soft tissue and the implant. Orthopedic surgeons should be aware of the possible development of this rare complication following internal fixation of an intertrochanteric fracture.- - - - - - - - - - ranking = 0.11192785372607keywords = trauma (Clic here for more details about this article) |
9/104. Preoperative arterial embolization in heterotopic ossification: a case report.We report a case of preoperative embolization in a 64-year-old patient suffering from total stiffness of the right hip joint due to heterotopic ossification following brain injury and pertrochanteric fracture of the right femur. A previous attempt of operative treatment could not be performed successfully due to bleeding complications. After the embolization of the correlating hypervascularisation, the surgical procedure was redone and finished with good result and minimal bleeding complications during the operation and a tolerable drop of the haemoglobin concentration postoperatively.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
10/104. Dealing with post-traumatic arthrosis of the hip.The conversion of the arthritic post-traumatic hip may be more similar to revision surgery than routine primary hip replacement. Careful preoperative planning and templating is essential. Soft-tissue balance to produce stability is challenging, and patients may need bracing with a THR orthosis postoperatively to assure soft-tissue healing and stability. Acetabular bone stock may be significantly compromised, and the preoperative identification of bone stock deficiencies may not always be possible. The surgeon should be prepared with adequate allograft, acetabular reconstruction rings, and alternative procedures such as fusion or resection arthroplasty in these challenging cases.- - - - - - - - - - ranking = 0.27981963431517keywords = trauma (Clic here for more details about this article) |
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