MRI Findings of Post-Traumatic Osteomyelitis of Distal Phalanx Following Neglected Open Fracture

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.

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Post traumatic deafness: a pictorial review of CT and MRI findings

Insights into Imaging ◽

10.1007/s13244-016-0490-9 ◽

2016 ◽

Vol 7 (3) ◽

pp. 341-350 ◽

Cited By ~ 12

Author(s):

Olivier Maillot ◽

Arnaud Attyé ◽

Eric Boyer ◽

Olivier Heck ◽

Adrian Kastler ◽

...

Keyword(s):

Mri Findings ◽

Pictorial Review ◽

Post Traumatic ◽

Ct And Mri

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Distal phalanx fracture in adults: Seymour-type fracture

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193413510863 ◽

2013 ◽

Vol 39 (3) ◽

pp. 237-241 ◽

Cited By ~ 5

Author(s):

M. Ugurlar ◽

G. Saka ◽

N. Saglam ◽

A. Milcan ◽

T. Kurtulmus ◽

...

Keyword(s):

Closed Reduction ◽

Open Fracture ◽

Extensor Tendon ◽

Distal Phalanx ◽

Mallet Finger ◽

Surgical Methods ◽

Type Fracture ◽

K Wires ◽

Type Of Fracture ◽

Metaphyseal Region

Seymour’s fracture is an extra-articular, transverse, physeal, and juxta-epiphyseal open fracture of the distal phalanx seen in childhood. In this study, we present 10 adult cases of fractures localized to the metaphyseal region, 1–2 mm distal to the insertion of the extensor tendon. Mean age was 38 years. Four patients were treated conservatively with a mallet finger splint. Closed reduction and osteosynthesis with Kirschner wires (K-wires) was performed in three of the patients. Three of the patients had open fractures in whom closed reduction could not be performed. They underwent open reduction and osteosynthesis with K-wires. We recommend that extra-articular distal phalanx fractures mimicking mallet finger in adults are called Seymour-type fracture to establish a common language among clinicians to define this type of fracture. These fractures generally occur by hyperflexion of the distal phalanx and can be treated by conservative or surgical methods. The outcomes of conservative and surgical management of Seymour-type fractures depend on the appropriate reduction as well as efficient physical therapy.

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MRI findings of post-traumatic subperiosteal hematoma of the iliac bone with resultant femoral nerve palsy in an adolescent boy

Pediatric Radiology ◽

10.1007/s00247-016-3581-3 ◽

2016 ◽

Vol 46 (9) ◽

pp. 1350-1353 ◽

Cited By ~ 4

Author(s):

Maegen Wallace ◽

Richard Kruse ◽

Eric P. Eutsler ◽

Lauren W. Averill

Keyword(s):

Nerve Palsy ◽

Femoral Nerve ◽

Iliac Bone ◽

Mri Findings ◽

Femoral Nerve Palsy ◽

Post Traumatic

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Post-traumatic knee MRI findings and associations with patient, trauma, and clinical characteristics: a subgroup analysis in primary care in the Netherlands

British Journal of General Practice ◽

10.3399/bjgp17x693653 ◽

2017 ◽

Vol 67 (665) ◽

pp. e851-e858 ◽

Cited By ~ 1

Author(s):

Kim van Oudenaarde ◽

Nynke M Swart ◽

Johan L Bloem ◽

Sita MA Bierma-Zeinstra ◽

Paul R Algra ◽

...

Keyword(s):

Primary Care ◽

The Netherlands ◽

Subgroup Analysis ◽

Clinical Characteristics ◽

Diagnostic Yield ◽

Mri Findings ◽

Predictive Values ◽

Post Traumatic ◽

Mean Differences ◽

Active Patients

BackgroundThe added value of magnetic resonance imaging (MRI) in primary care is still being debated. A high diagnostic yield can be expected in young and active patients with post-traumatic knee complaints.AimTo determine the frequency of MRI abnormalities in young and active patients (aged 18–45 years) and the associations with patient, trauma, and clinical characteristics.Design and settingA subgroup analysis of 174 patients, aged 18–45 years with knee trauma of <6 months, allocated to MRI in a randomised controlled trial on the yield of MRI in primary care. Patients were recruited by 150 GPs in the Netherlands from October 2012 to November 2015.MethodAssociations were expressed using mean differences, odds ratio (OR) and predictive values.ResultsSixty-seven out of 174 patients (39%) had a positive MRI finding, predominantly anterior cruciate ligament (ACL) ruptures (22%) and/or traumatic meniscal tears (15%). Patients with a pre-existing musculoskeletal comorbidity had a two-fold lower prevalence of positive MRI findings (21%), OR 3.0 (95% confidence interval [CI] = 1.3 to 7.0). A ‘sports related trauma’ showed the highest OR of 4.6 (95% CI = 2.2 to 9.3) for a positive MRI finding. Clinical scores were statistically, significantly worse in patients with positive MRI findings, with mean differences ranging from 10 to 20%. Furthermore, increasing duration of complaints was correlated with decreasing prevalence rates of positive MRI findings. Overall, a popping sound and direct swelling showed the highest positive predictive value of 65% for the presence of positive MRI findings.ConclusionThe results from this study enable a preselection of patients to increase the diagnostic yield of MRI in primary care.

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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

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(03)00175-x ◽

2003 ◽

Vol 28 (5) ◽

pp. 388-394 ◽

Cited By ~ 39

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.

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Cortical Atrophy, White Matter Lesions, and Bulb Configuration in Patients with Idiopathic Olfactory Loss and Other Causes of Olfactory Loss

ORL ◽

10.1159/000520567 ◽

2021 ◽

pp. 1-9

Author(s):

Alexander Wieck Fjaeldstad ◽

Therese Ovesen ◽

Rikke Beese Dalby

Keyword(s):

White Matter ◽

Medial Temporal Lobe ◽

Structural Changes ◽

Structural Integrity ◽

White Matter Lesions ◽

Structural Mri ◽

Cortical Atrophy ◽

Mri Findings ◽

Olfactory Loss ◽

Post Traumatic

Introduction: While magnetic resonance imaging (MRI) is not included in the current guidelines for diagnosing olfactory disorders in the most recent position paper on olfactory dysfunction, both 1.5T and 3T MRI are commonly used in the diagnostic workup of many patients with olfactory loss. Often, MRI is used to rule out intracranial tumours, but other useful information may be obtained from MRI scans in these patients. The potential of MRI in olfactory loss depends on sufficient knowledge of structural changes in different aetiologies of olfactory loss. We present common clinical MRI findings in olfactory loss and evaluate the usefulness of structural integrity scores in differentiating between aetiologies. Methods: In this study, we investigated if white matter hyperintensities (WMHs, measured by Fazekas score), global cortical atrophy (GCA), and medial temporal lobe atrophy (MTA) are more common in patients with idiopathic olfactory loss than in patients with acquired olfactory loss due to other aetiologies. Furthermore, we compared olfactory bulb (OB) configurations in different olfactory loss aetiologies. Results: In 88 patients with olfactory loss, WMHs, GCA, and MTA were not more significant findings on MRI in idiopathic olfactory loss (n = 51) compared with other causes of acquired olfactory loss (Fazekas score p = 0.2977; GCA score p = 0.6748; MTA score p = 0.7851). Bulb configurations differed in patients suffering from post-traumatic olfactory loss and may aid in identifying the underlying aetiology in patients where trauma is among the suspected causes of olfactory loss. Conclusion: We recommend that structural MRI with an OB sequence is included in the diagnostic evaluation of olfactory loss with suspected congenital and post-traumatic aetiology and should be considered in idiopathic olfactory loss with suspected central aetiology (e.g., tumour).

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A nested case–control study of risk for pulmonary embolism in the general trauma population using nationwide trauma registry data in Japan

Scientific Reports ◽

10.1038/s41598-021-98692-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hiroki Iriyama ◽

Akira Komori ◽

Takako Kainoh ◽

Yutaka Kondo ◽

Toshio Naito ◽

...

Keyword(s):

Risk Factors ◽

Open Fracture ◽

Injury Severity ◽

Spinal Injury ◽

Long Bone ◽

Central Vein ◽

Central Vein Catheter ◽

Post Traumatic ◽

Nested Case Control ◽

Control Study

AbstractPost-trauma patients are at great risk of pulmonary embolism (PE), however, data assessing specific risk factors for post-traumatic PE are scarce. This was a nested case–control study using the Japan Trauma Data Bank between 2004 and 2017. We enrolled patients aged ≥ 16 years, Injury Severity Score ≥ 9, and length of hospital stay ≥ 2 days, with PE and without PE, using propensity score matching. We conducted logistic regression analyses to examine risk factors for PE. We included 719 patients with PE and 3595 patients without PE. Of these patients, 1864 [43.2%] were male, and their median Interquartile Range (IQR) age was 73 [55–84] years. The major mechanism of injury was blunt (4282 [99.3%]). Median [IQR] Injury Severity Score (ISS) was 10 [9–18]. In the multivariate analysis, the variables spinal injury [odds ratio (OR), 1.40 (1.03–1.89)]; long bone open fracture in upper extremity and lower extremity [OR, 1.51 (1.06–2.15) and OR, 3.69 (2.89–4.71), respectively]; central vein catheter [OR, 2.17 (1.44–3.27)]; and any surgery [OR, 4.48 (3.46–5.81)] were independently associated with PE. Spinal injury, long bone open fracture in extremities, central vein catheter placement, and any surgery were risk factors for post-traumatic PE. Prompt initiation of prophylaxis is needed for patients with such trauma.

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Symptomatic Epileptogenic Lesions

PRILOZI ◽

10.2478/prilozi-2014-0006 ◽

2014 ◽

Vol 35 (2) ◽

pp. 45-52

Author(s):

Tatjana Chepreganova-Changovska ◽

Dragana Petrovska-Cvetkovska ◽

Marija Srceva-Jovanovski ◽

Venko Filipce

Keyword(s):

Hippocampal Sclerosis ◽

Epileptic Seizures ◽

The Elderly ◽

Seizure Type ◽

Mri Findings ◽

Outpatient Unit ◽

Neurology Clinic ◽

Symptomatic Epilepsy ◽

Post Traumatic ◽

The Brain

Abstract Background and objectives: The main aim of this study is to prove the association of seizure types with the MRI findings of the brain (etiological factor). Also, to prove which type of lesion is mostly represented in which age-group, and with which type of seizure. Methods: A total of 100 patients with symptomatic epilepsy, aged from 16 to 80 years, were hospitalized at the Neurology Clinic or in its Outpatient Unit, in the period from 2009 to 2012. They were neurologically examined and the seizure type registered. All patients underwent MRI of the brain. Results: (56%) men and 44 (44%) women were examined. The represented type of epileptic seizures were 41.0% with SPC + CPC, followed by 15.0% GTCC, and 14.0% CPC with secondary generalization, 12,0% CPC, 10,0% SPC and 8.0% with absences. The epileptic lesions of 25.0% were hippocampal sclerosis, 20.0% post-traumatic injuries, 19.0%, post-vascular and brain tumours, and the lowest percentage of 17.0% with post-infectious lesions. Conclusions: Post-traumatic lesions occur more frequently in the elderly population with the accent on the male, while hippocampal sclerosis occurs in the adolescent and younger population with higher frequency in the female.

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Paediatric Hand Injuries Caused by Spiked Railings

Journal of Hand Surgery (European Volume) ◽

10.1054/jhsb.1999.0206 ◽

1999 ◽

Vol 24 (5) ◽

pp. 615-616 ◽

Cited By ~ 2

Author(s):

T. RASHEED ◽

C. HILL ◽

K. KHAN ◽

M. BRENNEN

Keyword(s):

Open Fracture ◽

Distal Phalanx ◽

Hand Injuries ◽

Digital Nerve ◽

Nerve Injuries ◽

Nail Bed

We report five cases of hand injuries caused by spiked palisade railings. One patient sustained an open fracture of the distal phalanx with a disruption of the nail bed, and two patients had digital nerve injuries. Two patients presented with the railing still impaled in the fingers, one of whom had an ischaemic digit at presentation. All patients were male, between 9 and 12 years of age, and presented in the course of 1 month. Railings of this type would appear to be a significant cause of hand injuries, which may be prevented by legislation or a change in railing design.

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