scholarly journals “Fixator-assisted Nailing” Technique for Closed Segmental Tibia Shaft Fracture with Extensive Soft Tissue Injury – A Case Report

2021 ◽  
Vol 11 (8) ◽  
Author(s):  
Vivek M Sodhai ◽  
Chetan V Pradhan ◽  
Parag K Sancheti ◽  
Ashok K Shyam
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Internal Fixation ◽  
External Fixator ◽  
Road Traffic ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Treatment Strategies ◽  
Soft Tissue Injuries ◽  
Definitive Treatment

Introduction: Segmental tibia fractures with extensive soft tissue injuries are rare and surgical intervention is challenging with no definitive treatment strategies. Case Report: A 52-year-old man presented with closed right segmental tibia and fibula fracture with extensive blistering of skin caused due to road traffic accident. Distal pulses were palpable and there were no signs of compartment syndrome and other systemic injuries. In the presence of extensive blistering, a monoplanar external fixator was applied within 24 h of injury. 3 weeks later, skin condition was conducive for internal fixation, and closed intramedullary multi-locking nailing was performed using the external fixator for reduction. Fracture healed at 15 months and patient had an excellent functional outcome with full knee range of motion at 2-years follow-up without any complications. Conclusion: Fixator-assisted nailing is a simple, minimally invasive, and easily reproducible technique that is useful in reducing the fracture and preventing axial rotation of the intercalary segment minimizing the damage to the periosteal blood supply. Our case also highlights the importance of temporary external fixator in soft tissue healing and making the skin conducive for internal fixation. Keywords: Devascularization, fixator-assisted nailing, intercalary segment, rotational displacement, segmental tibial fracture.

scholarly journals Morel-Lavallée Lesion Following a Low-speed Injury: A Case Report

2020 ◽  
Vol 4 (4) ◽  
pp. 642-643
Author(s):  
Daniel Porter ◽  
Jeff Conley ◽  
John Ashurst
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Lower Extremity ◽  
Tissue Injury ◽  
Fluid Collection ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Low Speed ◽  
Degloving Injury ◽  
Tissue Injuries

Introduction: Soft tissue injuries are a common presenting complaint seen in the emergency department following trauma. However, internal degloving injuries are not commonly seen by the emergency provider. Case Report: A 57-year-old male presented with right lower extremity pain, bruising, and swelling after a low-speed bicycle accident five days prior. Physical examination revealed an edematous and ecchymotic right lower extremity extending from the mid-thigh distally. Computed tomography of the thigh demonstrated a hyperdense foci within the fluid collection suggesting internal hemorrhage and internal de-gloving suggestive of a Morel-Lavallée lesion. Discussion: The Morel-Lavallée lesion is a post-traumatic soft tissue injury that occurs as a result of shearing forces that create a potential space for the collection of blood, lymph, and fat. First described in 1853 by French physician Maurice Morel-Lavallée, this internal degloving injury can serve as a nidus of infection if not treated appropriately. Magnetic resonance imaging has become the diagnostic modality of choice due to its high resolution of soft tissue injuries. Treatment has been focused on either conservative management or surgical debridement after consultation with a surgeon. Conclusion: The emergency physician should consider Morel-Lavallée lesions in patients with a traumatic hematoma formation to avoid complications that come from delayed diagnosis.

scholarly journals Open tibial fracture with severe soft tissue injury and bone loss managed with ipsilateral fibular transport and its complications: a case report

2021 ◽  
Author(s):  
John Mukhopadhaya ◽  
Arvind Gupta ◽  
Amit K. Sinha
Keyword(s):  
Soft Tissue ◽  
External Fixator ◽  
Road Traffic ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
The Body ◽  
Soft Tissue Coverage ◽  
Time Duration ◽  
Ilizarov External Fixator ◽  
Wound Debridement

<p class="abstract">Massive segmental bone defects of tibia present as a challenging task to manage specially when associated with extensive soft tissue injury. A 30 year old male presented to Paras HMRI hospital, Patna, post road traffic accident with Gustilo Anderson 3B comminuted open tibia shaft fracture and with an external fixator in situ with a grossly inflamed and infected wound. Initially patient was managed with serial wound debridement and skin grafting was done early to obtain adequate soft tissue coverage. The patient then underwent application of Ilizarov external fixator with plan of one level fibular osteotomy for ipsilateral fibular transport. With good outcome of the procedure clinically and radiologically, Ilizarov fixator was removed after time duration of about 1.3 years and limb was immobilized in plaster of Paris (POP) cast which was removed after 8 weeks. Within 1 month of removal of POP cast the patient presented to hospital again with complaints of pain and instability when his leg was run over by his child’s bicycle while playing. Diagnosed as fracture of proximal (transported) fibula he was managed then with locking plates; one of which was used as an internal fixator and the other as external fixator which was outside the body and acted as a support to the operated limb. After about 1 year the external locking plate was removed and patient was able to bear weight on his extremities. Despite various modalities to treat massive tibial gap, fibular transport procedure with Ilizarov external fixator seems to be the most viable option.</p>

scholarly journals Standard cross leg flap, still a work horse for compound fracture leg bones with extensive soft tissue damage: a case report

2016 ◽  
Vol 2 (3) ◽  
pp. 198
Author(s):  
Rajneesh Galwa ◽  
Pookhraj Choudhary ◽  
Ramratan Yadav
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Compound Fracture ◽  
The Right ◽  
Leg Bones

<p><span lang="EN-IN">This case report presents a 32 year old male patient with h/o road traffic accident resulting in compound fracture of the right tibia and fibula with extensive soft tissue injury and exposed tibia of 12×5 cm. The fractures were stabilized with ext. fixator and exposed tibia was covered by a medially based standard Cross Leg flap of dimensions 16×12 cm, though the largest dimensions described for standard cross leg is 22×10 cm.</span></p>

A Calcaneal Fracture with Extrusion of the Posterior Facet

1998 ◽  
Vol 19 (4) ◽  
pp. 248-251 ◽  
Author(s):  
Sanjay Mehta ◽  
Robert F. Ostrum
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Calcaneal Fracture ◽  
Multiple Fractures ◽  
Thickness Skin ◽  
Fracture Dislocations ◽  
Skin Loss

This is a case report of a 19-year-old woman who sustained multiple fractures including a right calcaneal fracture with extrusion of the posterior facet. The medial soft-tissue injury led to a full thickness skin loss. Despite loss of subtalar motion and decreased toe movement, she is satisfied with her result. The importance of the soft-tissue injuries, especially to the skin and tendons, associated with severely displaced calcaneal fracture dislocations is emphasized by this case report.

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.

Mechanisms of Soft Tissue Injury

2021 ◽  
Author(s):  
Oneida A. Arosarena ◽  
Issam N. Eid
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Visual Fields ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Wound Management ◽  
Facial Soft Tissue ◽  
Tissue Injuries ◽  
Free Closure ◽  
High Level

AbstractSoft tissue trauma to the face is challenging to manage due to functional and aesthetic concerns. Management requires careful regional considerations to maintain function such as visual fields and oral competence in periorbital and perioral injuries, respectively. Basic wound management principles apply to facial soft tissue injuries including copious irrigation and tension-free closure. There is no consensus and high-level evidence for antibiotic prophylaxis especially in various bite injuries. Ballistic injuries and other mechanisms are briefly reviewed. Scar revision for soft tissue injuries can require multiple procedures and interventions. Surgery as well as office procedures such as resurfacing with lasers can be employed and will be reviewed.

Skeletal and soft tissue injuries after manual and mechanical chest compressions

2019 ◽  
Vol 5 (3) ◽  
pp. 259-265 ◽  
Author(s):  
Niklas Friberg ◽  
Simon Schmidbauer ◽  
Charles Walther ◽  
Elisabet Englund
Keyword(s):  
Cardiac Arrest ◽  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Chest Compressions ◽  
Sternal Fracture ◽  
Tissue Injuries ◽  
Severe Soft Tissue ◽  
Severe Soft Tissue Injury

Abstract Aims To determine the rate of injuries related to cardiopulmonary resuscitation (CPR) in cardiac arrest non-survivors, comparing manual CPR with CPR performed using the Lund University Cardiac Assist System (LUCAS). Methods and results We prospectively evaluated 414 deceased adult patients using focused, standardized post-mortem investigation in years 2005 through 2013. Skeletal and soft tissue injuries were noted, and soft tissue injuries were evaluated with respect to degree of severity. We found sternal fracture in 38%, rib fracture in 77%, and severe soft tissue injury in 1.9% of cases treated with CPR with manual chest compressions (n = 52). Treatment with LUCAS CPR (n = 362) was associated with significantly higher rates of sternal fracture (80% of cases), rib fracture (96%), and severe soft tissue injury (10%), including several cases of potentially life-threatening injuries. Conclusion LUCAS CPR causes significantly more CPR-related injuries than manual CPR, while providing no proven survival benefit on a population basis. We suggest judicious use of the LUCAS device for cardiac arrest.

scholarly journals Osteochondral fracture of the patella without soft tissue injury and with no dislocation: A case report

2021 ◽  
Vol 78 ◽  
pp. 48-53
Author(s):  
Majed N. Alosaimi ◽  
Mohammed M. Almutairi ◽  
Saad M. Alshahrani ◽  
Mansour N. Alqahtani ◽  
Abdullah S. Alghamdi
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Osteochondral Fracture

scholarly journals Gradual correction of proximal tibia deformity for Blount disease in adolescent and young adults

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987398 ◽  
Author(s):  
Aik Saw ◽  
Zi Hao Phang ◽  
Mohammed Khalid Alrasheed ◽  
Roshan Gunalan ◽  
Mohammed Ziyad Albaker ◽  
...  
Keyword(s):  
Young Adults ◽  
Soft Tissue ◽  
External Fixator ◽  
Surgical Outcome ◽  
Tissue Injury ◽  
Femoral Condyle ◽  
Soft Tissue Injury ◽  
Gradual Correction ◽  
Soft Tissue Complication ◽  
Blount Disease

Purpose: Management of Blount disease in adolescents and young adults is complex and associated with high risk of morbidities. Gradual correction with external fixator can minimize soft tissue injury and allow subsequent adjustment in degree of correction. This study investigates the surgical outcome and complication rate of gradual correction of neglected Blount disease through single-level extra-articular corticotomy. Methods: Patients treated for Blount disease using external fixator from 2002 to 2016 were recruited for the study. We used Ilizarov and Taylor Spatial Frame (TSF) external fixator to perform simultaneous correction of all the metaphyseal deformities without elevating the tibia plateau. Surgical outcome was evaluated using mechanical axis deviation (MAD), tibial femoral angle (TFA), and femoral condyle tibial shaft angle (FCTSA). Results: A total of 22 patients with 32 tibias have been recruited for the study. The mean MAD improved from 95 ± 51.4 mm to 9.0 ± 37.7 mm (medial to midpoint of the knee), mean TFA improved from 31 ± 15° varus to 2 ± 14° valgus, and mean FCTSA improved from 53 ± 14° to 86 ± 14°. Mean duration of frame application is 9.4 months. Two patients developed pathological fractures over the distracted bones, one developed delayed consolidation and other developed overcorrection. Conclusions: Correction of Blount disease can be achieved by gradual correction using Ilizarov or TSF external fixator with low risk of soft tissue complication. Longer duration of frame application should be considered to reduce the risk of pathological fracture or subsequent deformation of the corrected bone.

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