An exception to every rule; high velocity impact not always required for bilateral 1st rib fractures

Introduction First rib fractures are commonly reported in high velocity trauma. The neuromuscular sequelae that can ensue, not the physical disruption of the rib, necessitate thorough evaluation for such injuries. Methods We describe a case of a patient who sustained bilateral rib fractures following low-energy trauma.

Medial swivel dislocation of talonavicular joint due to low energy trauma

<p>Medial swivel variant of talonavicular dislocation is rare. Usually, it is caused by high velocity trauma. They are relatively easier to reduce and are associated with fewer complications than pure dorsal dislocations and sub talar dislocations. We report a case of medial swivel dislocation of talonavicular caused by a low energy trauma, its management and one year follow up result.</p>

Relationship Between Body Mass Index and Trauma Causing Knee Injury Associated With Popliteal Artery Injury. Monocentric Experience in a High Volume Surgery Center

Background: Osteoarticular traumas are particularly dangerous among arterial traumas, those associated with the popliteal artery are associated with a high amputation rate. Despite representing a minority of arterial traumas, with an incidence that considerably varies by population and geographic location, traumatic lesions of the popliteal artery are a challenge. This study aimed to verify the impact of Body Mass Index (BMI) on arterial trauma damage and outcome. Methods: Data were retrospectively collected from the emergency and operating rooms’ electronic medical reports at our Institution between 1 January 2005 and 1 May 2018 of all osteoarticular and vascular associated lesion. 41 pts presented with lower limb arterial trauma (43.2%), and popliteal artery lesions occurred in 11 (26.8%). 11 patients were eligible for inclusion in the study. In addition, the lesion mechanism was dislocation by high-velocity trauma in 9 cases and by low-velocity trauma in 3. All 7 males (63.6%) were affected by high-velocity trauma, and 2 of the 3 females by low-velocity trauma. Only one patient had an isolated popliteal artery lesion associated with fractures in the leg or in contralateral limb. Patients with low-velocity traumas were older than 54 years while those with high-velocity were aged from 22 to 71 years. Results: The lesion mechanism was dislocation due to high-velocity trauma in eight patients and due to low-velocity trauma in three. In 10/11 patients (90.9%). revascularization was performed after osteoarticular stabilization. after reduction of the dislocation or fracture. Intraoperative angiography was selectively used. Two patients required above-knee amputation after the procedure: one due to infection of the surgical access and the other due to severe soft tissue injury. One patient died during hospitalization due to trauma-related complications and comorbidities. Conclusions: High-velocity traumas, and low-velocity traumas with a body mass index >35kg/m2 with knee lesions are associated with popliteal artery lesion. Revascularization success is not associated with high or low velocity traumas.

The Role of Body Mass Index in High and Low Velocity Trauma Causing Knee Injury Associated to Popliteal Artery Lesions.

Background: Osteoarticular traumas are particularly dangerous among arterial traumas, those associated with the popliteal artery are associated with a high amputation rate. Despite representing a minority of arterial traumas, with an incidence that considerably varies by population and geographic location, traumatic lesions of the popliteal artery are a challenge. This study aimed to verify the impact of Body Mass Index (BMI) on arterial trauma damage and outcome. Methods: Data were retrospectively collected from the emergency and operating rooms’ electronic medical reports at our Institution between 1 January 2005 and 1 May 2018 of all osteoarticular and vascular associated lesion. 41 pts presented with lower limb arterial trauma (43.2%), and popliteal artery lesions occurred in 11 (26.8%). 11 patients were eligible for inclusion in the study. In addition, the lesion mechanism was dislocation by high-velocity trauma in 9 cases and by low-velocity trauma in 3. All 7 males (63.6%) were affected by high-velocity trauma, and 2 of the 3 females by low-velocity trauma. Only one patient had an isolated popliteal artery lesion associated with fractures in the leg or in contralateral limb. Patients with low-velocity traumas were older than 54 years while those with high-velocity were aged from 22 to 71 years. Results: The lesion mechanism was dislocation due to high-velocity trauma in eight patients and due to low-velocity trauma in three. In 10/11 patients (90.9%). revascularization was performed after osteoarticular stabilization. after reduction of the dislocation or fracture. Intraoperative angiography was selectively used. Two patients required above-knee amputation after the procedure: one due to infection of the surgical access and the other due to severe soft tissue injury. One patient died during hospitalization due to trauma-related complications and comorbidities. Conclusions: High-velocity traumas, and low-velocity traumas with a body mass index >35kg/m2 with knee lesions are associated with popliteal artery lesion. Revascularization success is not associated with high or low velocity traumas.

The Role of Body Mass Index in High and Low Velocity Trauma Causing Knee Injury Associated to Popliteal Artery Lesions.

Background: Osteoarticular traumas are particularly dangerous among arterial traumas, those associated with the popliteal artery are associated with a high amputation rate. Despite representing a minority of arterial traumas, with an incidence that considerably varies by population and geographic location, traumatic lesions of the popliteal artery are a challenge. This study aimed to verify the impact of Body Mass Index (BMI) on arterial trauma damage and outcome. Methods: Data were retrospectively collected from the emergency and operating rooms’ electronic medical reports at our Institution between 1 January 2005 and 1 May 2018 of all osteoarticular and vascular associated lesion. 41 pts presented with lower limb arterial trauma (43.2%), and popliteal artery lesions occurred in 11 (26.8%). 11 patients were eligible for inclusion in the study. In addition, the lesion mechanism was dislocation by high-velocity trauma in 9 cases and by low-velocity trauma in 3. All 7 males (63.6%) were affected by high-velocity trauma, and 2 of the 3 females by low-velocity trauma. Only one patient had an isolated popliteal artery lesion associated with fractures in the leg or in contralateral limb. Patients with low-velocity traumas were older than 54 years while those with high-velocity were aged from 22 to 71 years. Results: The lesion mechanism was dislocation due to high-velocity trauma in eight patients and due to low-velocity trauma in three. In 10/11 patients (90.9%). revascularization was performed after osteoarticular stabilization. after reduction of the dislocation or fracture. Intraoperative angiography was selectively used. Two patients required above-knee amputation after the procedure: one due to infection of the surgical access and the other due to severe soft tissue injury. One patient died during hospitalization due to trauma-related complications and comorbidities. Conclusions: High-velocity traumas, and low-velocity traumas with a body mass index >35kg/m2 with knee lesions are associated with popliteal artery lesion. Revascularization success is not associated with high or low velocity traumas.

Pericapsular Nerve Group Block: An Excellent Option for Analgesia for Positional Pain in Hip Fractures

Fractures in and around the hip are common presentations in the emergency department. It is commonly seen in the elderly as a result of osteoporotic changes. However, younger age groups are also affected, especially as a result of high velocity trauma. Irrespective of age, hip fractures are extremely painful, and it is difficult to position the patients for anesthesia procedures. Most of these cases are performed under subarachnoid block (SAB) or combined spinal-epidural anesthesia (CSEA), which requires the patient to be in sitting or lateral position. Here, we report a series of ten cases where pericapsular nerve group (PENG) block was administered prior to positioning the patients for SAB or CSEA. This block is a recently described regional anesthesia technique that provides excellent analgesia for hip fractures. It also provides very good analgesia for patient positioning during procedures such as SAB or CSEA.

Extramedullary versus Intramedullary bone fixation Treatment of peritrochanteric fractures

Background In the last few decades the rate of peritrochanteric fractures has increased because of increased rate of high velocity trauma accident and bone rarefaction due to osteoporosis in old age. DHS and PFN are the gold standard treatments used in treatment of these fractures. Nineteen studies were identified for analysis from 2007 to 2017 that meet our points of comparison. Aim of the Work Assessing of efficacy and complications of treatmeant of preitrochantric fracture by DHS versus PFN. Materials and Methods Outcomes from included trials will be combined using the systematic review manger software and manually screened for eligibility to be included. PRISMA flowchart will be produced based on the search results and the inclusion /exclusion criteria. After pooling of the collected data from the desired search studies, the relative risk of each of intended outcome measures of interest will be calculated and compared between each of the two main methods of peritrochanteric bone fixation treatment to reach a satisfactory conclusion. Evidence of publication bias will be sought using the funnel plot method. Results PFN is better for treating unstable peritrochanteric fractures as it has less complications and better efficacy than DHS. Conclusion The present study supports the treatment of peritrochanteric fractures with PFN, as it has less failure of fixation, decreased wound infection, less duration of surgery and less non-union complication than DHS.

The role of Body Mass Index in high and low velocity trauma causing knee injury associated to popliteal artery lesions

BackgroundOsteoarticular traumas are particularly dangerous among arterial traumas, those associated with the popliteal artery are associated with a high amputation rate. Despite representing a minority of arterial traumas, with an incidence that considerably varies by population and geographic location, traumatic lesions of the popliteal artery are a challenge. This study aimed to verify the impact of BMI on arterial trauma damage and outcome.MethodsData were retrospectively collected from the emergency and operating rooms’ electronic medical reports at our Institution between 1 January 2005 and 1 May 2018 of all osteoarticular and vascular associated lesion. 41 pts presented with lower limb arterial trauma (43.2%), and popliteal artery lesions occurred in 11 (26.8%). 11 patients were eligible for inclusion in the study. In addition, the lesion mechanism was dislocation by high-velocity trauma in 9 cases and by low-velocity trauma in 3. All 7 males (63.6%) were affected by high-velocity trauma, and 2 of the 3 females by low-velocity trauma. Only one patient had an isolated popliteal artery lesion associated with fractures in the leg or in contralateral limb. Patients with low-velocity traumas were older than 54 years while those with high-velocity were aged from 22 to 71 years.ResultsThe lesion mechanism was dislocation due to high-velocity trauma in eight patients and due to low-velocity trauma in three. In 10/11 patients (90.9%) revascularization was performed after osteoarticular stabilization. after reduction of the dislocation or fracture. Intraoperative angiography was selectively used. Two patients required above-knee amputation after the procedure: one due to infection of the surgical access and the other due to severe soft tissue injury. One patient died during hospitalization due to trauma-related complications and comorbidities.ConclusionsRevascularization success is not associated with high- or low-velocity traumas. Furthermore, unlike high-velocity traumas, low-velocity traumas are associated with a body mass index >35kg/m2.