Acetabular fractures are common and complex injuries occurring due to high velocity trauma. There are proponents of both non-operative and operative management. Operative management requires proper training and planning. Long term follow up of conservative management have shown good to excellent functional and radiological outcome. The article describes two cases of acetabular fractures treated conservatively and showing good clinical outcome.
Introduction: Electric injury of severe nature causing death is known as electrocution. Surviving patients may develop short term or long-term effects on various organs including gangrene, slow necrosis of tissues, neural and psychiatric problems. Case report: A 27 years young male got electric injury accidently, leading to gangrene of left forearm & hand and multiple site slow progressive death of skin requiring below elbow amputation of left upper limb, repeated debridement and management by skin grafting and trans-positional flaps. He did not develop any systemic, neural or psychiatric abnormality. Clinical message: Electric injury patients should be observed for slow development of soft tissue and muscle necrosis even if they don't have any obvious problem on early examination.
Introduction: Congenital pseudarthrosis of tibia is an uncommon condition leading to gradually progressive deformity, shortening of the limb and disability. The condition is notorious for failure of treatment and need of multiple operations. A combination of open reduction, thorough excision of abnormal tissue at the pseudarthrosis site, intramedullary nailing, ring fixator application, and distraction to achieve bone equalization has proved successful. Case Report: A case of congenital pseudarthrosis of the left tibia and fibula associated with neurofibromatosis treated by open reduction, intramedullary nailing, ring fixator application, and distraction at corticotomy to cause compression at the pseudarthrosis site and limb length equalization is being reported due to uncommon occurrence of transient hypertension in the child as a complication of ring fixator. Conclusion: Transient hypertension is a rare complication seen in children after application of ring fixator. Its diagnosis and control require proper perioperative assessment of child regarding blood pressure (BP), monitoring of BP during distraction period and period of application of ring fixator, and its treatment under care of pediatrician.
Introduction: First rib fracture is a very uncommon injury due to protection provided to it by clavicle. In isolation, it may be associated with neurovascular injury rarely but as part of poly trauma the first rib fracture may be associated with vascular injury in significant number of cases. There is definite role of computed tomography scan thorax in diagnosis of this fracture which can be missed on X-ray chest. Management includes early diagnosis of associated life-threatening complications and its prompt treatment. Case Report: A case of poly trauma associated with right first rib fracture with subclavian artery thrombosis resulting in gross ischemia of the right upper limb and fractures in the right upper limb and right lower limb long bones is reported. The patient developed signs of ischemia and lung complications 24 h later. Subclavian artery damage was diagnosed on Doppler ultrasound and angiography. The case was managed by surgical repair of subclavian artery damage and stabilization of fractures. Conclusion: The case is reported to highlight association of first rib fracture with life-threatening complication of subclavian artery laceration causing extensive swelling around shoulder, ischemia to the right upper limb, lung damage, and problem of its detection and management.
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