Der Unfallchirurg
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Posttraumatic deformities in the lower limb are mainly multidirectional, with angulation, translation, and rotatory deformities. Acute corrections with internal fixation are often not possible due to the soft tissue damage and the extent of the deformity. The Taylor Spatial Frame (TSF) allows correction in a virtual hinge with 6 axes, thus enabling the correction of multidirectional deformities simultaneously. ⋯ The main advantage of the TSF compared with other external frames is the ability to perform simultaneous correction of angular, axial, translational, and rotatory deformities. This enables a reduced correction time and increased patient comfort.
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Neonatal traumatic epiphyseolysis of the humeral head is rare, and only a few cases are reported in the literature. We present a case of a 13-day-old female newborn with malposition and relaxation of the left upper limb. The clinical examination showed distinct range of motion particularly for abduction. ⋯ This status was not followed by renewed repositioning. The x-ray examination 5 months later and MRI 9 months later showed a centered position of the epiphysis. In conclusion, neonatal traumatic epiphyseolysis of the proximal humeral head occurs rarely but should be considered, particularly with unclear relaxation of the limb.
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Type B injuries of the thoracolumbar spine (AO classification) indicate the need for surgical treatment. Type B1 injuries include disruption of the posterior ligament complex (PLC), which can be underdiagnosed when using x-ray and CT. The aims of this study were to determine the frequency of misclassification to compile similarities of type B1 injuries. ⋯ Type B injuries are frequently misinterpreted. To achieve a correct diagnosis, all clinical and radiological signs must be considered. 29% of all type B1 injuries cannot be detected on x-ray or CT scan.
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Patients suffering from sickle cell disease show an increased ischemic intolerance due to continuous pro-inflammatory activation and dysfunction of the endothelium by recurrent vaso-occlusive episodes. The presented case shows the manifestation of a postoperative compartment syndrome of the lower leg following the intraoperative use of blood arrest in a patient with previously unknown sickle cell disease. Preexisting vulnerability for tissue hypoxia in patients at risk should be a major concern for intraoperative use of blood arrest during surgery of the extremities.