Unusual Mechanism Of Injury Research Articles

Rare case of medial Hoffa fracture with ipsilateral femur shaft fracture with unusual mechanism of injury

Hoffa’s fracture is a rare fracture which involves coronal fracture of the distal femur involving one or both the condyles. We report a rare combination of Hoffa fracture with ipsilateral femur shaft fracture with an unusual mechanism of injury. This case report will help increase awareness about such combined fracture pattern and eventually avoid missing these important intra-articular injuries- Hoffa’s fracture. In a patient with ipsilateral femur shaft fracture and in polytrauma patients, diagnosis of Hoffa’s fracture is very challenging because of presence of other long bone fracture and injuries. Missed Hoffa’s fracture in a patient with ipsilateral femur shaft fracture may restrict post-operative knee range of motion, knee pain, increased risk of early arthritis and joint deformity and stiffness.

Free Tissue Reconstruction of a Liquid Nitrogen Burn: A Case Report and Literature Review.

Due to its boiling point of -196 °C, liquid nitrogen is a cryogenic substance which is commonly used in many industries for its cooling properties. However, this extreme cooling capability means that it also has the potential to inflict severe full-thickness burns. Despite its widespread use in the workplace, very little has been described in the literature regarding complex reconstruction of liquid nitrogen burns. We present a case that is unique, not only in its unusual mechanism of injury but also in that it is the first described case of free tissue reconstruction of cryogenic burns.

Outcome of Pediatric Comminuted Open Supracondylar Humerus Fracture

Abstract Introduction: Supracondylar humerus fracture is the most common fracture around the elbow in children. Closed fractures of the supracondylar humerus are ostensibly more common compared to open injuries. Though closed reduction and pinning are often feasible for Gustilo Anderson Grade 1 open fractures, surgical debridement followed by open reduction and pinning or JESS fixator application may often be required in open supracondylar humerus fractures with higher Gustilo Anderson grades. Materials and Methods: A retrospective study was conducted from 2018 to 2022 on children with open comminuted supracondylar humerus fractures. Open fractures were classified as per Gustilo Anderson’s classification, and fracture patterns were described as per modified Gartland’s and AO classifications. All patients were treated with closed or open-assisted reduction and fixation. Children were reviewed at the third/fourth and eighth weeks and later at 6 months and one year for the cosmetic and functional outcome assessment by Flynn criteria. Orthogonal elbow radiographs were obtained to assess radiographic parameters at each visit, including the final follow-up. Result: Six children with a mean age of 8.3 years (3–12 years) were treated during the study period. One child had grade 3A, two had grade 2, and three had grade 1 open fractures, according to Gustilo Anderson’s classification. The mean duration from injury to presentation was 36.3 h. The mean time from presentation to surgery was 3.3 h (1–5 h). The mean follow-up period was 9.6 months (6–12 months). Four children had excellent outcomes, whereas one child each had fair and poor results according to Flynn’s functional outcome criteria. Conclusion: Children with comminuted open supracondylar humerus fractures with an unusual mechanism of injury and presenting early since injury had better functional outcomes on follow-up as compared to children presenting late, with associated complications undergoing the same.

Isolated sternal fracture after low-energy trauma in a geriatric patient: a case report

BackgroundFalls are a common cause of emergency department (ED) visits for the older population. If osteoporosis is present, even falls from standing height can lead to unusual fractures normally associated with high-energy trauma. In this report, we analyze a rare case of an isolated sternal fracture with an unusual mechanism of injury. Our discussion aims to improve care for older adults with fall-related fractures.Case presentationAn 86-year-old female presented in the ED of our hospital with a complaint of chest pain. She recalled a fall at home the previous day and described how her fist was impacted between the floor and her chest. A physical examination revealed local tenderness in the mid-chest. A lateral chest x-ray indicated a sternal fracture, and a chest computed tomography scan ruled out concomitant injuries. There were no acute changes on her electrocardiogram (ECG). Conservative outpatient treatment was started, and referrals were made with a recommendation to initiate fall prevention measures and osteoporosis screening in primary health care.ConclusionsGeriatric patients can present in the ED with a rare sternal fracture even after only a minor chest trauma. Appropriate imaging and an ECG are warranted to exclude life-threatening additional injuries. An in-depth physical examination and an understanding of the exact mechanism of injury are important to avoid missing fractures in unexpected locations. Modern ED physicians could have an important role in the secondary prevention of fall-related fractures for geriatric patients.

Two lucky survivors of thoracic impalement in childhood: case report and literature review

BackgroundPenetrating thoracic injuries are uncommon in childhood. Massive penetrating injury due to impalement is even more rare and has scarcely been reported. It has a dramatic clinical presentation and is often fatal, depending on the organs injured.Case presentationTwo boys presented with an unusual mechanism of injury. They fell from a height to be impaled by a large stick. Appropriate emergency medical service was not available and surgery was delayed by more than 24 h after the accident. Both children were labelled “lucky” as they survived the injury without any significant sequelae.ConclusionWe discuss two new cases of pediatric thoracic impalement and perform the first literature review on the subject. Emphasis should be given to the initial care which comprises avoiding premature removal, rapid transport, resuscitation, anti-tetanus and antibiotics. All reported cases had a favorable outcome, even those managed within the constraints of low-income countries.

COMPOSITE CONCHAL LOSS FROM BLUETOOTH HEADSET DEVICE: AN INTERESTING CASE REPORT

It is a well-known fact that talking on the phone while driving increases the risk of an accident. Bluetooth headset provides simple and uncomplicated route to hands-free communication. While driving, the use of hands-free phone devices such as earpieces and Bluetooth headset is equally as dangerous as talking on a cell phone normally. Here, we are reporting a very unique case of a 25-year-old male who sustained severe ear injury (full-thickness conchal defect of the size of earpiece of Bluetooth headset device; a very unusual mechanism of injury) in a road traffic accident while wearing a Bluetooth headset device. Two-stage repair was done using a retroauricular flap for full-thickness conchal defect. The post-operative cosmetic outcome achieved by this technique was satisfactory.

Helmet-induced ocular trauma: A rare mechanism

A 32-year-old male presented with chief complaint of ocular injury in the left eye, in spite of wearing a helmet, in a road traffic accident. His uncorrected visual acuity in the injured eye was 6/9, and he had a full thickness lid laceration. There was a 25 mm upper eyelid laceration at the level of the eyebrow, splitting it horizontally. Early repair resulted in less tissue edema and better wound decontamination. We report this case to highlight an unusual mechanism of injury by the pro shield of a helmet and to show the need for eye protection in spite of wearing a helmet.

Radial Artery Pseudoaneurysm - An Unusual Mechanism of Injury

Radial Artery Pseudoaneurysm - An Unusual Mechanism of Injury

Aspects of expert opinions of avulsion fractures

The apophyses as secondary ossification centers are connected with the bone by cartilage. During the growth phase of puberty, the apophyseal plate is a mechanical weak spot. Especially, apophyses in the hip and pelvic area are exposed to considerable tensile and sheer stresses due to the strong muscles which are inserted here. The frequency of injuries to the apophyses correlates with the extent of sporting activities. For athletes participating in "Youth Train for the Olympics", this is the most common injury of all. Most often, the apophysis of the rectus femoris muscle is affected at the anterior inferior iliac spine. In adults, after complete ossification of the apophyseal plate such injuries are rare. However, in a very unusual mechanism of injury with maximum forced hip flexion and simultaneous maximum knee extension, avulsions of the ischial tuberosity are observed in adults. During the causality test-especially in the legal area of statutory accident insurance-the question is always whether the alleged course of events has to be regarded as a legally significant (partial) cause or if a longer period of time has been involved, so that the resulting morbid apophysis detachment was predominately due to fate, in which the alleged event must be interpreted as legally immaterial.

Anterior dislocation of shoulder in eclampsia: a case report

This case report presents a 25-year-old female patient with anterior dislocation of right shoulder secondary to seizures as a complication of eclampsia. This is an unusual mechanism of injury, but similar to other uncontrolled muscular contractions caused by electroconvul-sive therapy, etc. To the best of our knowledge only one such case has been reported in the English literature. Closed reduction under general anaesthesia was successfully achieved. High suspicion in patients complaining of pain over shoulder joint is necessary for early diagnosis of this condition.

All Anterior Dislocation - A Unique Injury

Bilateral shoulder Dislocations with ipsilateral hip dislocation is a very rare entity. To our knowledge not a single case has been reported with this type of injury. We report a case were the anterior dislocation trio occurred one after the other in an unusual mechanism of injury.

A case of neglected bilateral anterior shoulder dislocation: a rare entity with unusual mechanism of injury.

Bilateral shoulder dislocations are rare, and if they occurred, posterior type of dislocations is common. Bilateral anterior shoulder dislocations are very rare and occur due to trauma with unique mechanism of injury. We report a case of unreduced simultaneous bilateral anterior dislocations of shoulder without associated fractures in a forty-year-old man following a unique mechanism of injury; both hands of the patient were pulled from either side. To the best of our knowledge, this unusual mechanism of injury has not been reported in the literature.

Unusual Mechanism of Injury Resulting in a Thoracic Chance Fracture in a Rodeo Athlete: A Case Report

To introduce the characteristics of a Chance fracture and increase awareness of the mechanism of injury that may occur during athletic activity. A T12 Chance fracture was diagnosed in an 18-year-old male rodeo athlete. The rider was forced into extreme lumbothoracic hyperflexion when the horse bucked within the chute, pinning the rider's legs to his chest. Burst fracture, abdominal organ rupture, spinal dislocation, spinal cord injury, disk herniation, pars interarticularis fracture, spinal nerve injury, paralysis. The patient underwent an open reduction and fixation of the thoracic fracture. Posterior stabilization was obtained with nonsegmental instrumentation. Allograft and autografts were used for posterolateral arthrodesis at T11-T12 and T12-L1. Motor vehicle crashes with occupants wearing lap-type-only restraints account for nearly all previously reported Chance fractures. When only lap seatbelts are worn, the pelvis is stabilized, and the torso continues moving forward with impact. The stabilized body segment for this individual was reversed. Nearly 3 years after the initial surgery, fixation, and infection, the bareback rider has returned to full participation in rodeo. To our knowledge, this is the first reported diagnosis of a T12 Chance fracture in a rodeo athlete. When animals buck, athletes can be forced into hyperflexion, exposing them to Chance fractures. Therefore, anyone treating rodeo athletes must suspect possible spinal fracture when this mechanism is present and must treat all athletes with early conservative management and hospital referral.

Bilateral Asymmetric Dislocations of Hip Joints: An Unusual Mechanism of Injury

Asymmetric bilateral dislocations of the hips are rare injuries. Among the small number of reports in the literature, most have attributed the cause to high-velocity motor crashes. These dislocations are often seen to be associated with fractures of the proximal femur or the acetabulum. We present a case of a 45-year-old man with bilateral asymmetric dislocation of hips which were purely ligamentous in nature, without any fracture. He sustained his injuries due to a fall while getting on a moving bus. It was an unusual mechanism of injury as compared to the other cases of asymmetric hip dislocations reported in published studies. Both hips were reduced under general anaesthesia within three hours of the trauma. Skin traction and non-weight-bearing rehabilitation were continued for six weeks. After 35 months of followup, the patient remains asymptomatic. Early diagnosis and timely reduction of such dislocations under anaesthesia are necessary for prevention of complications.

Unusual mechanism of injury to the extensor pollicis longus tendon in a professional rugby player

Unusual mechanism of injury to the extensor pollicis longus tendon in a professional rugby player

Spinal cord concussion in a professional ice hockey player

Spinal cord concussion (SCC) is an uncommon injury resulting in transient quadriplegia. The pathophysiology of SCC has been related to underlying spinal canal stenosis in many cases, yet is not always identified. The authors present the case of a professional ice hockey player, without evidence of canal compromise, who sustained an SCC during a regulation game after being struck by a puck in the upper cervical spine. The unusual mechanism of injury is discussed along with a comprehensive review of the literature.

Challenges in the management of ocular snake-bite injuries

Ocular snake-bite injuries are quite rare away from natural habitats. However, when exotic animals are kept in captivity, the injuries sustained and their management can pose challenges when they present to their local eye department. This report describes an atypical eye injury inflicted by a python and its successful management involving surgical, laser and medical interventions. The case highlights the possible pitfalls resulting from the unusual mechanism of injury and the steps to avoid them. The article goes on to discuss the background of the injuries that can be caused by venomous and non-venomous snakes.

Slipped upper femoral epiphysis – a case of a 'dodgem hip'

A 15-year-old male patient of slim habitus presented three times over 3 days to the emergency department. Four weeks prior to the first attendance, he apparently injured his left knee in a sudden jolt whilst going on a 'bumper car' (dodgems) at a funfair. Since this incident, he had walked with a limp due to the pain in his left knee. He had sustained a slipped upper femoral epiphysis (SUFE) through this unusual mechanism of injury.

Bilateral Asymetrical Hip Dislocation Due To An Unusual Mechanism

Simultaneous anterior and posterior dislocation of both hips is extremely rare. We report a case of asymmetrical bilateral dislocation of previously normal hips in a 65 year old female. In this case, an unusual mechanism of injury resulting in such a pattern of dislocation is discussed.

Causes of delayed diagnosis of scapular fractures

To study the causes of delayed diagnosis of scapular fractures in blunt trauma cases, and to advise on early fracture detection. Between February 2003 and September 2004, 64 consecutive patients (3 females) with a median (range) age of 35 (8-60) years, treated at Al-Ain Hospital for scapular fractures, were prospectively collected. Fractures diagnosed after more than 24h from admission were considered missed; 8 people with missed scapular fractures were compared with a control group of 56 who had timely diagnosis, regarding the mechanism and distribution of injury, injury severity score, and type and quality of radiological methods used. The median (range) abbreviated injury scale scores for the missed scapular fracture group and the control group were 4 (0-5) and 2 (0-2), respectively. The missed scapular fracture group stayed significantly longer in the intensive care unit compared with the control group, with a median (range) stay of 15 (5-37) days compared with 9 (1-26) days. Associated injuries overshadowed the scapula on chest trauma radiographs. If computed tomography did not cover the whole scapula, some fractures might not be shown. Convulsive seizures were the only significantly different mechanism of injury between the missed fracture and the control groups. Delayed diagnosis of scapular fractures can be due to extensive chest injuries overshadowing the scapula on the chest trauma radiographs, inappropriately performed computer tomography or an unusual mechanism of injury.