Case report: A complete lower cervical fracture dislocation without permanent neurological impairment.

BACKGROUND: Complete fractures and dislocations of the lower cervical spine are usually associated with severe spinal cord injury. However, a very small number of patients do not have severe spinal cord injury symptoms, patients with normal muscle strength or only partial nerve root symptoms, known as "lucky fracture dislocation". The diagnosis and treatment of such patients is very difficult. Recently, we successfully treated one such patient. CASE PRESENTATION: A 73-year-old male patient had multiple neck and body aches after trauma, but there was sensory movement in his limbs. However, preoperative cervical radiographs showed no significant abnormalities, and computed tomography (CT) and magnetic resonance imaging (MRI) confirmed complete fracture and dislocation of C7. Before operation, the halo frame was fixed traction, but the reduction was not successful. Finally, the fracture reduction and internal fixation were successfully performed by surgery. The postoperative pain of the patient was significantly relieved, and the sensory movement of the limbs was the same as before. Two years after surgery, the patient's left little finger and ulnar forearm shallow sensation recovered, and the right flexion muscle strength basically returned to normal. CONCLUSION: This case suggests that when patients with trauma are encountered in the clinic, they should be carefully examined, and the presence of cervical fracture and dislocation should not be ignored because of the absence of neurological symptoms or mild symptoms. In addition, positioning during handling and surgery should be particularly avoided to increase the risk of paralysis.

Bosworth ankle dislocation fracture - current concept review.

Bosworth fracture (BF) is a rare, but a severe injury to the ankle, characterized by displacement of a fragment of the fractured fibula (mostly of Weber B type) from the tibiofibular incisure to the posterior surface of the distal tibia. In 70% of cases, it is associated with a fracture of the posterior malleolus. This injury is not quite well known, with only 175 cases described in the literature to date. BF requires CT examination, including 3D reconstructions. Closed reduction almost always fails as there is an increased risk of compartment syndrome, mainly after repeated attempts at closed reduction. Therefore, operative treatment is indicated as a standard. The outcome of the operation should be always checked by postoperative CT examination.

Missed Medial Clavicular Physeal Fracture-Posterior Dislocation Complicated by Brachiocephalic Pseudoaneurysm: A Case Report.

CASE: We present a 17-year-old male patient with an initially missed posterior sternoclavicular fracture dislocation who presented with symptoms related to thrombotic emboli arising from a pseudoaneurysm. He was treated 6 weeks after injury with a figure-of-eight tendon allograft repair with good clinical outcomes. CONCLUSION: This is a unique presentation that highlights the significant risk of a missed diagnosis, life-threatening complications that may ensue, and biomechanically superior surgical intervention.

Fractura luxación de Lisfranc en un paciente con enfermedad de Hansen. Presentación de caso / Lisfranc fracture-dislocation in a patient with Hansen´s Disease. Case presentation

Introducción: Las lesiones de la articulación de Lisfranc se producen por traumas de alta energía; pero cuando se presentan en pacientes con enfermedad de Hansen y daño del sistema nervioso periférico, los traumas repetitivos de pequeña intensidad pueden conducir a este tipo de lesión. Objetivo: Presentar un caso interesante dada la asociación en un paciente con Hansen de una lesión de Lisfranc causado por un trauma de baja energía. Presentación de caso: Paciente de 64 años de edad fototipo V, con antecedentes de Hansen Lepromatoso, que por traumas repetitivos de baja intensidad y un proceso séptico sobreañadido, presentó fractura-luxación de Lisfranc del tipo divergente, se comentan los antecedentes, el cuadro clínico, los exámenes laboratorio, ultrasonidos, estudio radiológico y el tratamiento impuesto. Conclusiones: La discapacidad en manos y pies por trastornos neurológicos en pacientes con lepra lepromatosa de más de 5 años de evolución es bastante frecuente, pero asociado a luxofractura de Lisfranc de tipo divergente, por trauma de baja intensidad, no lo es, ya que este tipo de lesión normalmente se produce por traumas de alta energía(AU)

Introduction: Lisfranc joint lesions are produced by high energy traumas, but when they present in patients with Hansen´s disease and damage to the peripheral nervous system, the low intensity repeated traumas can lead to this type of lesion. Objective: To present an interesting case, given a particular association on a patient with Hansen´s disease and a Lisfranc lesion, caused by a low energy trauma. Case presentation: 64 years old Phototype V patient with antecedents of lepromatous Hansen´s disease who presented Lisfranc fracture-dislocation of a divergent type after low intensity repeated traumas, and a septic superadded process. The antecedents, clinical picture, laboratory tests, ultrasounds, radiological study, and the treatment indicated are all analyzed. Conclusions: Disability in hands and feet due to neurological disorders in patients with lepromatous leprosy of more than 5 years of evolution is very frequent, but it is not so frequent when associated to a Lisfranc fracture-dislocation of a divergent type due to low intensity trauma, because this type of lesion is normally caused by high energy traumas(AU)