scholarly journals Bilateral Symmetric Fracture of the Iliac Wings: An Unusual Situation after a Car Accident

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Delphine Lambrecht ◽  
Jan Van Oost
Keyword(s):  
Seat Belt ◽  
Young Patients ◽  
High Energy ◽  
Pelvic Fractures ◽  
Hip Pain ◽  
Classification Systems ◽  
Iliac Bone ◽  
Energy Mechanism ◽  
Car Accident ◽  
Deceleration Trauma

Introduction. Pediatric pelvic fractures are uncommon and are usually the result of a high-energy mechanism. Bilateral symmetric fracture of the iliac bone is an extremely uncommon clinical entity that is not yet classified in the current classification systems of pelvic fractures. It mostly occurs among young patients with a history of a seat-belt injury. Patients usually complain of severe hip pain after an accident. Case Report. A 5-year-old male was transported to our hospital after a car accident. He was complaining of vague pain in the pelvic region after he was exposed to an acceleration-deceleration trauma, seated in a children’s car seat. Radiograph of the pelvis revealed a rare image of bilateral symmetric iliac fractures. Iliac bone fracture was suspected, which was also evident on pelvis and hip magnetic resonance imaging. Additional ultrasound of the abdomen was negative. He was hospitalized for observation, and after one day, he could be discharged from the hospital without complications. Policlinic control after three, six, and ten weeks showed favorable clinical and radiographic evolution. Conclusion. Physicians should be aware of our report, which highlights a patient with the rare clinical condition of a bilateral symmetric fracture of the iliac bone after an acceleration-deceleration trauma. The differential diagnosis of acute hip pain should be considered for young patients. Always keep in mind additional injuries because of the high-energy trauma.

Angiography in patients with pelvic fractures and contrast extravasation on CT following high-energy trauma

2021 ◽  
Author(s):  
Jonathan Hammerschlag ◽  
Yehuda Hershkovitz ◽  
Itamar Ashkenazi ◽  
Zahar Shapira ◽  
Igor Jeroukhimov
Keyword(s):  
High Energy ◽  
Pelvic Fractures ◽  
Contrast Extravasation ◽  
High Energy Trauma

The Prevalence of Radiographic Findings of Structural Hip Deformities for Femoroacetabular Impingement in Patients With Hip Pain

2020 ◽  
Vol 48 (3) ◽  
pp. 647-653 ◽  
Author(s):  
Jun Zhou ◽  
Heath P. Melugin ◽  
Rena F. Hale ◽  
Devin P. Leland ◽  
Christopher D. Bernard ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Mixed Type ◽  
Imaging Modality ◽  
Alpha Angle ◽  
Young Patients ◽  
Radiographic Finding ◽  
Hip Pain ◽  
Radiographic Findings ◽  
Protrusio Acetabuli ◽  
Center Edge

Background: Radiography is the initial imaging modality used to evaluate femoroacetabular impingement (FAI), and diagnostic radiographic findings are well-established. However, the prevalence of these radiographic findings in patients with hip pain is unknown. Purpose: The purpose was 3-fold: (1) to determine the overall prevalence of radiographic FAI deformities in young patients presenting with hip pain, (2) to identify the most common radiographic findings in patients with cam-type FAI, and (3) to identify the most common radiographic findings in patients with pincer-type FAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A geographic database was used to identify patients aged 14 to 50 years with hip pain between the years 2000 to 2016. The following were evaluated on radiographs: cam type: typical pistol grip deformity, alpha angle >55°; pincer type: crossover sign (COS), coxa profunda or protrusio acetabuli, lateral center edge angle (LCEA) ≥40°, Tönnis angle <0°; and mixed type: both cam- and pincer-type features. Posterior wall sign (PWS) and ischial spine sign (ISS) were also evaluated. The prevalence of each was determined. Descriptive statistics were performed on all radiographic variables. Results: There were 1893 patients evaluated, and 1145 patients (60.5%; 1371 hips; 374 male and 771 female; mean age, 28.8 ± 8.4 years) had radiographic findings consistent with FAI. Of these hips, 139 (10.1%) had cam type, 245 (17.9%) had pincer type, and 987 (72.0%) had mixed type. The prevalence of a pistol grip deformity and an alpha angle >55° was 577 (42.1%) and 1069 (78.0%), respectively. The mean alpha angle was 66.9°± 10.5°. The prevalence of pincer-type radiographic findings was the following: COS, 1062 (77.5%); coxa profunda, 844 (61.6%); ISS, 765 (55.8%); PWS, 764 (55.7%); Tönnis angle <0°, 312 (22.8%); LCEA ≥40°, 170 (12.4%); and protrusio acetabuli, 7 (0.5%). Conclusion: The overall prevalence of radiographic findings consistent with FAI in young patients with hip pain was 60.5%. Radiographic findings for mixed-type FAI were the most prevalent. The most common radiographic finding for cam-type FAI was an alpha angle >55°. The most common radiographic finding for pincer-type FAI was the COS.

scholarly journals Evaluation of results of three and four-part fracture dislocations of proximal humerus in young adults using philos (proximal humerus internal locking system)

2018 ◽  
Vol 6 (2) ◽  
pp. 585
Author(s):  
Amit Thakur ◽  
Khalid Muzzafar ◽  
Sumeet Singh Charak ◽  
Bias Dev ◽  
Abdul Ghani
Keyword(s):  
Proximal Humerus ◽  
Young Patients ◽  
Soft Tissue Injuries ◽  
Functional Results ◽  
High Energy ◽  
High Rate ◽  
Fracture Dislocation ◽  
Rotator Cuff Insufficiency ◽  
Fracture Dislocations ◽  
Adequate Management

Background: The fractures of proximal humerus constitute about 5% of fractures in adults third in number to fracture colles and hip usually in elderly patients due to a low energy trauma. In young patients the fractures are mostly due to high energy trauma and as such are associate with other soft tissue injuries. A sub group of young patients have a three or four fracture dislocation of shoulder joint. The aim of this study was to find the results of fixation by PHILOS in these young patients.Methods: This study was done in a teritiary referral centre over a period of about 1 year. All patients were operated within three weeks. Open fractures, patients with age more than 50 years were excluded from the study. All patients underwent open reduction and fixation using commercially available PHILOS. A minimum of 6 months follows up was essential for inclusion into the study. Final functional results were evaluated by Constant Murley scoring.Results: 14 patients were included in the study. The average age of patients was 38.42years. All fractures united. We had 71.4% excellent or good results. The complications noted were shoulder stiffness in 3, inadequate post op reduction, rotator cuff insufficiency, head necrosis, secondary osteo arthritis 1 each.Conclusions: Despite the relatively high rate of complications encountered in the management of these complicated high-energy fractures, the PHILOS plating system could be considered an adequate management of these patients.

scholarly journals Factors affecting mortality and reoperations in high-energy pelvic fractures

2018 ◽  
Vol 28 (7) ◽  
pp. 1273-1282 ◽  
Author(s):  
Peyman Bakhshayesh ◽  
Lars Weidenhielm ◽  
Anders Enocson
Keyword(s):  
High Energy ◽  
Pelvic Fractures ◽  
Factors Affecting

scholarly journals The effect of patient, fracture and surgery on outcomes of high energy neck of femur fractures in patients aged 15–50

2018 ◽  
Vol 29 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Wayne Hoskins ◽  
Johnny Rayner ◽  
Rohan Sheehy ◽  
Harry Claireaux ◽  
Roger Bingham ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Outcome Measures ◽  
Surgical Procedures ◽  
Young Patients ◽  
Significant Risk ◽  
High Energy ◽  
Femoral Neck Fractures ◽  
Secondary Outcome ◽  
Femur Fractures

Introduction: High-energy femoral neck fractures in young patients can be devastating, with the risk of osteonecrosis, nonunion, malunion and lifelong morbidity. The aim of this study is to define the effects of patient, fracture and surgical factors on the outcome of high-energy femoral neck fractures in patients aged from 15 to 50 years. Methods: A retrospective review was conducted of high-energy femoral neck fractures in patients aged 15–50 managed surgically at a Level 1 Trauma Centre, using a prospectively recorded trauma database. Low energy trauma (including falls from <1 m), medical conditions adversely affecting bone density, and pathological fractures were excluded. A clinical and radiological review was performed. The primary outcome measures were the development of osteonecrosis or nonunion leading to total hip arthroplasty (THA). Secondary outcome measures included osteotomy or other surgical procedures, quality of reduction and malunion. Results: 32 patients meeting the inclusion criteria were identified between January 2008 and July 2015. The mean follow-up was 58.5 months (range 980–3,048 days). 3 patients (9.4%) required THA. No other surgical procedures were performed. None of the 29 other patients developed radiologically apparent osteonecrosis. Fracture type, displacement, anatomical reduction and fixation type were not statistically significant risk factors affecting these outcomes. For all patients, an average of 8% loss of femoral neck height and 10% femoral neck offset were seen. Conclusions: At a mean 4.9-year follow-up, the incidence of high-energy femoral neck fractures leading to THA was 9.4%, as a consequence of osteonecrosis or nonunion. Malunion was common.

International Classification of External Causes of Injury: a cross sectional study on its coverage rate in Iran

2019 ◽  
Author(s):  
Fatemeh Salehi ◽  
Leila Ahmadian ◽  
Shabnam Padidar
Keyword(s):  
Similar Rate ◽  
Cross Sectional Study ◽  
Coverage Rate ◽  
Classification Systems ◽  
International Classification ◽  
Cross Sectional ◽  
Car Accidents ◽  
External Causes ◽  
Car Accident

Abstract Background Injuries are a major health issue worldwide and their prevention requires access to accurate statistics in this area. This can be achieved by using the data collected through the international classification systems. This study aimed at investigating the coverage rate of the International Classification of External Causes of Injury (ICECI) regarding the external causes of injury in Shahid Bahonar Hospital.Method This cross-sectional descriptive-analytical study was performed on 322 injured individuals visiting the emergency unit of Shahid Bahonar Hospital. The data were gathered through patients’ records, a designed form and interviews. The collected data were encoded based on the ICECI textbook by two encoders. Their agreement rate was calculated using the Kappa estimate of agreement. The coverage rate of the classification system and the degree of completeness of the required data for encoding in the patients’ records was measured. Data were analyzed by the SPSS software, ver. 19.Results The findings showed that 70% of the studied external causes of injury were covered by the ICECI system. Among the 322 cases, 138 (43%) had been referred due to car accidents. The injured were mostly drivers of land transport vehicles who had been unintentionally involved in a car accident. The least mechanism for injury was bite injury with 5 (2%) cases which had occurred at home or public transport with a similar rate and totally unintentional. ICECI was capable of classifying 92% of the data related to incident causes. The most incongruous coverage of this system belonged to the "activity when injured" axis (n=18). Lack of precise data recording in the medical files resulted in missing data in at least one of the axis of the incident causes in most records.Conclusion Given that some information regarding the external cause of injury was not categorized by the ICECI system, this research can identify the shortcomings of the system and help its developers to amend it in future revisions.

scholarly journals Traumatic Obturator Hip Dislocation with Marginal Femoral Head Fracture in a 15-Year-Old Adolescent: A High-Energy Trauma—A Case Report and a Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Yoann Durand ◽  
Clémence Bruyère ◽  
Marco Saglini ◽  
Aurélien Michel-Traverso
Keyword(s):  
Femoral Head ◽  
Hip Dislocation ◽  
High Energy ◽  
Hip Pain ◽  
X Rays ◽  
Hip Function ◽  
One Year ◽  
High Level ◽  
Joint Limitation

We report the case of a 15-year-old boy brought to the emergency department after a bike accident, complaining of an isolated left hip pain. The X-rays showed an obturator hip dislocation treated by closed reduction under general anaesthesia, followed by 6 weeks of discharge. The follow-up MRI performed 6 weeks after the trauma showed an avascular femoral head necrosis, for which we performed multiple retrograde femoral head drilling, completed by the injection of autologue stem cells from the iliaq crest. One year later, the patient has no hip pain, no joint limitation, and can practice BMX at a high level again. The purpose of this report is to make the physicians aware of this rare problem that may be damaging for hip function, especially in young people.

Thoracolumbar, lumbar, and sacral fractures

2011 ◽  
Author(s):  
Philip Sell
Keyword(s):  
Surgical Treatment ◽  
Spinal Injury ◽  
Spinal Fractures ◽  
High Energy ◽  
Classification Systems ◽  
Junctional Zone ◽  
Cord Injury ◽  
Fracture Classification Systems ◽  
Non Surgical Treatment

♦ High-energy trauma often results in serious spinal fractures. The junctional zone between the relatively stiff thoracic spine and the more mobile lumbar spine is particularly susceptible to injury♦ The role of decompression in spinal cord injury remains uncertain at level three or four evidence♦ Unstable fractures may be stabilized using modern fracture fixation methods enabling easier nursing care in polytrauma and earlier mobilization than non-surgical treatment♦ There is level two evidence that stable thoracolumbar fractures have similar outcomes with surgical and non-surgical treatment♦ There are many fracture classification systems that are not validated or have poor inter- and intraobserver error. Recent modern validated systems may in the future assist in the rational planning of interventions for spinal injury.

scholarly journals Single versus separate implant fixation for concomitant ipsilateral femoral neck and shaft fractures: A systematic review

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Kunal Mohan ◽  
Prasad Ellanti ◽  
Helen French ◽  
Niall Hogan ◽  
Tom McCarthy
Keyword(s):  
Systematic Review ◽  
Femoral Neck ◽  
Young Patients ◽  
Treatment Strategies ◽  
High Energy ◽  
Current Evidence ◽  
Implant Fixation ◽  
High Energy Trauma ◽  
Shaft Fractures ◽  
Significant Difference

Concomitant ipsilateral femoral neck and shaft fractures are uncommon, occurring in 1-9% of femoral shaft fractures. While this injury typically occurs in young patients following high-energy trauma, little consensus has been established regarding the optimal fixation approach. A multitude of treatment strategies exist, with limited evidence as to which is more favorable. The aim of this study was to appraise current evidence, comparing management with either one single or separate devices for both fractures. A systematic review was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies published between 1992 and 2018 comparing the rate of postoperative nonunion, malunion, delayed union, avascular necrosis, infection or reoperation between at least one method of single device fixation and one method of separate device fixation were included. Six non-randomized cohort studies assessing 173 patients were suitable for inclusion, each comparing single device cephalomedullary nail fixation of both fractures with a combination of devices. All patients presented following high-energy trauma, at a median age of 32 years. While low complication rate and favorable outcomes were found across both groups, no significant difference could be inferred between either treatment strategy. This injury continues to occur in the traditionally described patient group, and results in acceptable postoperative outcomes. A paucity of randomized studies limits the ability to recommend a single or separate device treatment approach, and as such prospective, randomized trials with adequately powered sample sizes are required to definitively compare surgical management strategies in this rare but complex injury.

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