4 research outputs found
First rib fractures: not always a hallmark of severe trauma-a report of three cases
【Abstract】According to medical literature, fracture
of the first rib is quite rare and the bilateral condition is
especially rare. This type of fracture is usually associated
with severe intrathoracic trauma and other bony or
neurovascular injuries, thus can be considered as a
harbinger of major trauma. However here we present three
cases of low velocity first rib fractures without any major
trauma or multisystem injuries. All the three patients were
treated conservatively and did well on simple analgesics
and rest and had no early or late complications. It can be
seen that not all the first rib fractures are associated with
major trauma or multisystem injuries. There is a variant of
first rib fracture with low velocity injuries which is not
associated with any major complications in contrast to
majority of first rib fractures associated with high velocity
injuries. Causative factor of such injuries may be violent
muscular contraction of scalenus anterior or serratus
anterior, but not direct trauma.
Key words: Rib fractures; Wounds and injuries;
Multiple traum
Complete palmer lunate enucleation is proximal row carpectomy or wrist arthrodesis the only choice?
【Abstract】Perilunate dislocations are rare injuries of the wrist and complete dislocation of the lunate is also rare. There is controversy in literature regarding the optimal management of such injuries. Complete lunate enucleation is associated with high rate of osteonecrosis of lunate thus wrist arthrodesis or proximal row carpectomy has been advocated as primary treatment for such injuries. We report a
case of transradial styloid complete palmar lunate enucleation in a 25-year-old male patient who sustained injury to the left wrist due to fall on outstretched hand. Carpal row
salvage surgery initially by closed reduction and wrist distractor application followed by open reduction and internal fixation with K-wires along with ligamentous repair
resulted in restoration of normal wrist anatomy and good functional outcome. As many of these injuries are missed
on initial presentation and outcome is poor for missed injuries, prompt diagnosis and early surgical management
to restore vascularity of lunate is recommended.
Key words: Wrist; Lunate bone; Dislocation
Triple plating of tibia in a complex bicondylar tibial plateau fracture
High-energy tibial plateau fracture
poses a significant challenge and difficulty for orthopaedic surgeons. Fracture of tibial plateau involves major weight bearing joint and may alter knee kinematics. Anatomic
reconstruction of the proximal tibial articular surfaces,
restoration of the limb axis (limb alignment) and stable fixation permitting early joint motion are the goals of the
treatment. In cases of complex bicondylar tibial plateau fractures, isolated lateral plating is frequently associated with varus malalignment and better results have been
obtained with bilateral plating through dual incisions. However sometimes a complex type of bicondylar tibial plateau fractures is encountered in which medial plateau
has a biplaner fracture in posterior coronal plane as well
as sagittal plane. In such fractures it is imperative to fix the medial plateau with buttressing in both planes. One
such fracture pattern of the proximal tibia managed by triple plating through dual posteromedial and anterolateral incisions is discussed in this case report with emphasis on mechanisms of this type of injury, surgical approach and management.
Key words: Tibial fractures; Bone plates; Kne