scholarly journals Pinckney fracture: do not underestimate trauma of the distal phalanx of the hallux

2021 ◽  
Vol 14 (9) ◽  
pp. e244985
Author(s):  
João Nóbrega ◽  
Joana Ovídio ◽  
Joana Arcângelo ◽  
João Campagnolo
Keyword(s):  
Emergency Department ◽  
Open Fracture ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Distal Phalanx ◽  
Type I ◽  
Nail Bed ◽  
Low Threshold ◽  
Salter Harris ◽  
High Index Of Suspicion

Toe injuries are common in the emergency department and most of them are treated conservatively. In some circumstances, these injuries can present as a physeal fracture with concomitant soft-tissue injury affecting the nail bed and resulting in a hidden open fracture. To adequately treat these patients, a high index of suspicion is needed to diagnose and treat the open fractures and to prevent complications such as infection, osteomyelitis, malunion and premature physeal arrest.We report a case of a patient that was admitted to the hospital with a Salter-Harris type I fracture of the distal phalanx of the hallux. After confirming the diagnosis, antibiotic treatment was started and the fracture was reduced and fixed.The literature on this entity is sparse and most of the management protocols are based on its hand equivalent—the Seymour fracture, emphasising the low threshold for treating these lesions as an open fracture.

scholarly journals Seymour’s Fracture in a 13-years-old Child: A Case Report

2021 ◽  
Vol 11 (55) ◽  
Author(s):  
Tarang S. Khairnar ◽  
Sandeep A. Patwardhan ◽  
Vivek M. Sodhai ◽  
Ashok K. Shyam ◽  
Parag K. Sancheti
Keyword(s):  
Case Report ◽  
Open Fracture ◽  
Ring Finger ◽  
Distal Phalanx ◽  
Nail Bed ◽  
Excellent Outcome ◽  
Physeal Injury ◽  
Injury Reduction ◽  
Absorbable Sutures ◽  
High Index Of Suspicion

Introduction: A nail bed injury concomitant with an underlying physeal injury of the distal phalanx is termed as “Seymour’s fracture.” These are seemingly innocuous injuries commonly misdiagnosed and are subsequently under-treated. These injuries demand treatment like an open fracture to prevent complications such as infection, growth arrest, and nail dystrophies. Case Report: A 13-year-old boy suffered Seymour’s fracture of the left ring finger distal phalanx after a direct injury from a dodge ball. The fracture was treated with thorough debridement with normal saline, physeal injury reduction through the wound, and fixation with k-wire passed through the tip of the ring finger, metaphysic, physis, and the tip of the k-wire ending in the epiphysis of the distal phalanx. The nail bed was sutured with 3–0 monofilament absorbable sutures. The fracture healed at 3 months and a 1-year follow-up showed a completely formed nail without any deformity. Conclusion: Excellent outcome was observed with debridement of the wound, nail bed repair, and fixation with k-wire in our case. Nail bed injuries in children should be treated with a high index of suspicion for Seymour’s fracture as it necessitates treatment like that of an open fracture to avoid complications. Keywords: Mallet finger, Nail bed injury, Open fracture, Physeal injury, Seymour’s fracture.

The Hazards of Skateboard-Riding

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 793-793
Author(s):  
◽  
Fernando Atienza ◽  
Calvin Sia
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Bone Fractures ◽  
Tissue Injury ◽  
Skull Fracture ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Major Surgery ◽  
Cerebral Concussion ◽  
Tissue Injuries

Skateboard-riding has become increasingly popular among Hawaii's children. The thrill of the ride and the challenge of keeping one's balance and working intricate maneuvers while speeding down a hill captures the fancy of many of our young. This sport, however, has produced an alarmingly high toll of injury and illness. Pediatricians and emergency departments of our major hospitals have seen and taken care of large numbers of patients (aged between 3 years and 35 years, but with a distribution overwhelmingly pediatric) with significant injuries which include cerebral concussion, fractures, soft tissue injuries of varying degrees of severity and complications, and injury to internal organs. During a three-month period at the Kauikeolani Children's Hospital, July to August 1975, there were 16 patients admitted with the following: seven cerebral concussions, one skull fracture, five assorted bone fractures, one soft tissue injury and infection, one retroperitoneal hemorrhage, and one instance of major surgery for removal of the spleen. During the months of August and September 1975 the Emergency Department of Straub Clinic reported the following skateboard injuries: 14 fractures, 14 soft tissue injuries, 5 lacerations, and 2 cerebral concussions. Of the 35 patients seen, three were admitted—one with an open fracture, one with cerebral concussion, and one with a skull fracture. During a four-week period (two weeks in June and July and two weeks in August and September) at the Emergency Department of Kaiser Medical Center, 66 cases of skateboard injuries were seen with six patients requiring admission for fractures and brain concussion.

scholarly journals The Relationship between Risk Factors of Head Trauma with CT Scan Findings in Children with Minor Head Trauma Admitted to Hospital

2017 ◽  
Vol 5 (3) ◽  
pp. 319-323 ◽  
Author(s):  
Babak Masoumi ◽  
Farhad Heydari ◽  
Hamidreza Hatamabadi ◽  
Reza Azizkhani ◽  
Zahra Yoosefian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Ct Scan ◽  
Head Trauma ◽  
Predictive Value ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Normal Brain ◽  
Brain Ct ◽  
Brain Ct Scan

BACKGROUND: In emergency medicine for determining the intracranial injury (ICI) in children with head trauma, usually brain CT scan is performed. Since brain CT scan, especially in children, has some disadvantages, it is better to find a procedure which could help to choose only the children with real head trauma injury for brain CT scan.AIMS: The aim of this study is to find such procedure. This study was descriptive, analytic and non-interventional.METHODS: We reviewed the archived files of children with head trauma injuries referred to the emergency department of Imam Hossein Hospital within two years. Patient’s CT scan findings and head trauma risk factors were evaluated in this study.RESULTS: Out of 368 patients, 326 patients had normal brain CT scan. 28 of them showed symptoms of ICI consisting intraventricular haemorrhage (IVH), contusion, subarachnoid haemorrhage (SAH), subdural haemorrhage (SDH), epidural hematoma (EDH), and pneumocephalus. Twenty-seven patients showed skull FX, which 14 of them had an Isolated fracture, and 13 of them also showed symptoms of ICI. Since patients with isolated FX usually discharge quickly from Emergency Department; their data did not include in results of the study. The patients have been divided into two groups: 1- ICI, 2- without ICI. RR (relative risk), CI (Confidence interval) and sensitivity, positive predictive value (PPV), negative predictive value (NPV) and association of these risk factors with ICI were assessed with the Chi-2 test. In the end to determine the indications of CT scan, the presence of one of these five risk factors is important including abnormal mental status, clinical symptoms of skull FX, history of vomiting, craniofacial soft tissue injury (including subgaleal hematomas or laceration) and headache.CONCLUSIONS: For all other patients without these risk factors, observation and Follow Up can be used which has more advantages and less cost.

Heterotopic Ossifications of the Forearm: A Cause of Post-Traumatic Loss of Pronation-Supination

2021 ◽  
Vol 8 (5) ◽  
Author(s):  
Hajar A ◽  
◽  
Khadija L ◽  
Jamal EF ◽  
Issam E-N ◽  
...  
Keyword(s):  
Open Fracture ◽  
Thermal Injury ◽  
Surgical Intervention ◽  
Tissue Injury ◽  
Early Stage ◽  
Soft Tissue Injury ◽  
Traumatic Loss ◽  
Ectopic Bone ◽  
Post Traumatic ◽  
Ossification Process

HO is defined by the development of ectopic mature bone within nonosseous tissues. It is a well-described phenomenon that complicates forearm fractures, especially when there is an open fracture, a significant soft tissue injury, and associated neural axis or thermal injury. HO mainly forms near metal hardware and may lead to the formation of radio-ulnar synostosis. CT is superior to plain radiographs, as it identifies the ectopic bone earlier, defines its exact localization, and helps planning the surgical intervention. Radiologic features are variable; in the early stage, CT shows a low-attenuation mass with indistinct surroundings. As the ossification process progresses, zones of mineralization are visible before leading to the formation of mature cortical bone at the periphery (Figure 1 and 2: arrows). Hastings classification describes 5 classes according to how HO affects the forearm range of motion.

Collagenous Biocomposites for the Repair of Soft Tissue Injury

1991 ◽  
Vol 252 ◽  
Author(s):  
David Christiansen ◽  
George Pins ◽  
Ming Che Wang ◽  
Michael G. Dunn ◽  
Frederick H. Silver
Keyword(s):  
Tissue Regeneration ◽  
Type I Collagen ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Collagen Scaffold ◽  
High Strength ◽  
Tissue Scaffolds ◽  
Animal Tissue ◽  
Type I ◽  
Tissue Models

ABSTRACTResults of implantation studies in a variety of animal tissue models demonstrate that the rate of biogradation of a collagen scaffold should parallel the rate of wound healing observed in particular anatomic sites. This rapid degradation maximizes tissue regeneration and minimizes encapsulation of the implant. The following paper reviews the effects of crosslinking on the rate of tissue ingrowth and regeneration. In addition, preliminary mechanical data on newly developed soluble type I collagen fibers is presented as a possible advance in the production of high strength collagen based tissue scaffolds.

The use of Prophylactic Flucloxacillin in Treatment of Open Fractures of the Distal Phalanx within an Accident and Emergency Department: A Double-Blind Randomized Placebo-Controlled Trial

2003 ◽  
Vol 28 (5) ◽  
pp. 388-394 ◽  
Author(s):  
J. STEVENSON ◽  
G. MCNAUGHTON ◽  
J. RILEY
Keyword(s):  
Emergency Department ◽  
Open Fracture ◽  
Controlled Trial ◽  
Distal Phalanx ◽  
Open Fractures ◽  
Controlled Study ◽  
Double Blind ◽  
Accident And Emergency ◽  
Significant Difference ◽  
Accident And Emergency Department

Open fractures of the distal phalanx commonly present to the Accident and Emergency Department. Controversy surrounds the use of prophylactic antibiotics in treating this injury. A double-blind, prospective, randomized placebo-controlled study was undertaken comparing the use of prophylactic flucloxacillin to placebo in addition to meticulous wound toilet. One hundred and ninety-three adult patients with an open fracture of the distal phalanx were studied. Seven patients developed superficial infections, an overall infection rate of 4%. No patient developed osteitis or a deep wound infection. There were three cases of infection in the 98 patients (3%) in the antibiotic group and four cases of infection in the 95 patients (4%) in the placebo group. A difference of proportion test confirmed no significant difference. It is concluded that the addition of prophylactic flucloxacillin to thorough wound toilet and careful soft-tissue repair of open fracture of the distal phalanx confers no benefit.

scholarly journals Functional and Radiological evaluation of management of tibial plateau fractures: A prospective study

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1365-1371
Author(s):  
Priyank Bhatt ◽  
Sunil Nikose
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
High Speed ◽  
Tibial Plateau ◽  
Road Traffic ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Fracture Pattern ◽  
Tibial Plateau Fractures ◽  
Type I

The knee is a crucial joint, as it performs various functions such as standing, walking, running, sitting etc. Tibial plateau fractures constitute 1% of overall fractures and 8% of fractures occurring in the geriatric age group. Knee injuries must be properly and adequately treated to keep the knee in a good functional state. The transition to a fast-paced lifestyle on account of rapid industrialization, urbanization and mechanization has led to a significant increase in the traumatic incidences - especially polytrauma, comminuted Fractures and soft tissue injury.  High-speed injury acquired in vehicular accidents and a rise in road traffic injuries together creates a forever increasing issue. The static lower extremity can be encountered by an object in motion, frequent in roadside injury, resulting in the infamous "Bumper Fracture". Open Reduction with Internal Fixation (ORIF) is currently recommended. Hence, a study has been conducted to learn the mode of injury, fracture pattern, outcome of open reduction and internal fixation, complications encountered and associated injuries. 50  Patients were studied prospectively and pre and post-operative evaluation were done using modified Rasmussen clinical and radiological criteria and Womac knee score. Open reduction and internal fixation provide reasonable outcome with regards to functional and radiological outcome in younger patients and type I and II fractures.

Sign in / Sign up

Export Citation Format

Share Document