Coronal plane fractures frequently occurred in association with high-energy supracondylar-intercondylar distal femoral fractures; in the present study, the prevalence of associated coronal plane fractures was 38%. The lateral condyle was involved more frequently than the medial condyle was. Coronal plane fractures of both condyles were observed commonly, and the majority of coronal plane fractures were associated with open wounds. Since the surgical tactic for the treatment of a supracondylar-intercondylar distal femoral fracture may be altered by the additional diagnosis of a coronal plane fracture component, preoperative computerized tomographic scanning of the injured distal part of the femur, particularly when there is an associated open wound, is strongly recommended.

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Irradiation commonly is used after resection of soft tissue sarcomas to decrease the local recurrence rate. Brachytherapy spares more normal tissue than external beam irradiation and permits irradiation to the tumor bed in the immediate postoperative period. After vascular anastomosis and irradiation, flap survival can be affected by vascular coagulation in the immediate postoperative period and later by vascular fibrosis secondary to irradiation effects. The purpose of the current retrospective study was to evaluate the survival of free tissue transfer when combined with brachytherapy after resection of soft tissue sarcomas. Thirty-six patients had wide resection of extremity tumors, free flap coverage, and brachytherapy 5 days after surgery. Followup averaged 54 months. There were three major and four minor complications. The major complications included two patients with free flaps who required revision of anastomosis before radiation therapy (they had brachytherapy 5 days after the second surgery without additional complications) and one patient who had a deep wound infection develop 2 months after the index procedure and required a second flap. Minor complications included one hematoma, one partial skin graft loss, and two superficial infections. Brachytherapy can be done safely at the site of microvascular anastomosis in the immediate postoperative period.

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In the United States, there are approximately 10,000 new cases of spinal cord injury (SCI) every year. 1 The incidence of neurologic injury depends on the level of fracture in the spine (1%-6% in the lumbar region). 1 Fractures involving the cervical, thoracic, and upper lumbar (L1) spine may damage the spinal cord.Injuries in the thoracolumbar region may damage nerve roots as well as the cord above the conus level. In such instances, patients may present with a mixed pattern of upper and lower motor neuron injuries. Injuries below L2 may damage only the nerve roots. Cauda equina syndrome can result from compression, stretching of the nerves (axonotmesis), or frank nerve root avulsion or tear (neurotmesis). 1,2 Compression at the level of cauda equina has been reported secondary to several factors such as fracture fragments, disc frag-