Knee megaprosthesis: a salvage solution for severe open and complex distal femoral fracture associated with an ipsilateral brachial plexus injury (a case report with literature review)

Complex distal femoral fractures in the young patient often occur as a result of high velocity trauma. Timely recognition and treatment is verything in such a situation, and it needs a robust staged management pathway to optimize the chance of limb preservation. We report a case of a motorcyclist admitted to the department of orthopedics at Chambery hospital, France, with a complex comminuted and open distal femoral fracture of the left leg, associated with a brachial plexus injury to the ipsilateral upper limb. On arrival to the emergency department, damage control stabilization and surgery was commenced, debridement of contaminated non-viable tissue, abundant antiseptic lavage and application of external fixation coupled with the use of antibiotic spacer. Following normalization of inflammatory markers and ensuring no clinical signs of infection, subsequent management consisted of joint reconstruction to achieve a functional knee. The external fixator and femoral spacer wasremoved and a modular megaprosthesis was implanted with a lateral gastrocnemius flap to cover the exposed knee joint and reinforce the extensor apparatus. Nerve graft to the left brachial plexus injury was performed at University Hospital of Grenoble. Our patient entered an intensive rehabilitation program and at 1 year follow-up achieved good knee function and sensation to the left upper limb

Pneumothorax complicating isolated clavicle fracture

Isolated clavicle fractures are among the commonest of traumatic fractures in the emergency department. Complications of isolated clavicle fractures are rare. Pneumothorax has been described as a complication of a fractured clavicle only rarely in English literature. In all the reported cases, the pneumothorax was treated by a thoracostomy and the clavicle fracture was treated conservatively. In our case, the pneumothorax required a chest drain insertion and the clavicle fracture was treated surgically with good result

Luxation obturatrice de la hanche: un traumatisme rare en pratique sportive

Les luxations antérieures traumatiques de la hanche sans fracture du cotyle ou de la tête fémorale sont rares. Elles sont souvent secondaires à des accidents de haute énergie cinétique. La prise en charge thérapeutique nécessite un chirurgien vigilant et prévenu du risque de complications. Nous rapportons le cas d'une luxation obturatrice (antéro-inférieure) chez un jeune de 18 ans pratiquant le rolle

Dynamics of multipartite quantum correlations under decoherence

Quantum discord is an optimal resource for the quantification of classical and non-classical correlations as compared to other related measures. Geometric measure of quantum discord is another measure of quantum correlations. Recently, the geometric quantum discord for multipartite states has been introduced by Jianwei Xu [arxiv:quant/ph.1205.0330]. Motivated from the recent study [Ann. Phys. 327 (2012) 851] for the bipartite systems, I have investigated global quantum discord (QD) and geometric quantum discord (GQD) under the influence of external environments for different multipartite states. Werner-GHZ type three-qubit and six-qubit states are considered in inertial and non-inertial settings. The dynamics of QD and GQD is investigated under amplitude damping, phase damping, depolarizing and flipping channels. It is seen that the quantum discord vanishes for p>0.75 in case of three-qubit GHZ states and for p>0.5 for six qubit GHZ states. This implies that multipartite states are more fragile to decoherence for higher values of N. Surprisingly, a rapid sudden death of discord occurs in case of phase flip channel. However, for bit flip channel, no sudden death happens for the six-qubit states. On the other hand, depolarizing channel heavily influences the QD and GQD as compared to the amplitude damping channel. It means that the depolarizing channel has the most destructive influence on the discords for multipartite states. From the perspective of accelerated observers, it is seen that effect of environment on QD and GQD is much stronger than that of the acceleration of non-inertial frames. The degradation of QD and GQD happens due to Unruh effect. Furthermore, QD exhibits more robustness than GQD when the multipartite systems are exposed to environment.Comment: 15 pages, 4 figures, 4 table

Triple Threat Ttrauma: A Rare Case Report of Avulsion Fracture of the Posterior Cruciate Ligament, Lateral Collateral Ligament, and diaphyseal Tibia Fracture

We present the case of a 24-year-old male who sustained a fall from a motorcycle resulting in a rare combination of injuries, including avulsion fractures of the posterior cruciate ligament (PCL) and femoral lateral collateral ligament (LCL), along with an ipsilateral diaphyseal tibia fracture. This case report aims to highlight the importance of early diagnosis, appropriate management, and comprehensive rehabilitation for such complex knee injuries. We discuss the patient's presentation, radiographic findings, surgical intervention, postoperative care and long-term outcomes.To our knowledge this kind of injury has never been documented in the literature

Bilateral clavicle fracture: A case report

Clavicle fractures are among the most common fractures in adults. Nevertheless, bilateral fractures are rarely reported in the literature. We present the case of a 35-year-old male patient who was admitted with a bilateral clavicle fracture following a motorcycle accident. The patient underwent open reduction and bilateral intramedullary fixation with Kirschner wires. After six months of follow-up, the functional result was satisfactory; the patient achieved full range of motion in both shoulders and was free from pain. X-rays showed a complete fusion of the fracture on both sides