ABSTRACT
Scapulothoracic dissociation is a rare upper extremity injury caused by high-velocity trauma over anterolateral shoulder leading to disruption of scapulothoracic articulation. It is considered as a limb threatening injury. Very few cases of scapulothoracic dissociation have been reported in medical literature. In this article, we report a unique case of open injury involving laterally displaced and comminuted scapula accompanied by redundant acromioclavicular joint, total brachial plexus injury, and complete transection of brachial artery. The patient underwent a forequarter amputation after a failed vascular repair.
ABSTRACT
The aim of this study was to assess chemotherapy treatment characteristics, neutropenic event occurrence and related risk factors in bone and soft tissue sarcoma patients in China. Knowledge of such risk factors aids healthcare providers in focusing resources on those who are at most risk and targeting prophylactic colony-stimulating factors (CSFs) for those patients. The study included 113 children and adults with different types of sarcoma who had been treated with neoadjuvant chemotherapy for bone and soft tissue sarcoma in order to identify risk factors for hematological toxicity of chemotherapy for bone and soft tissue sarcoma. Risk factors were determined using multivariate logistic regression analysis. Factors such as age <20 years, Karnofsky Performance Status Scale (KPS) score <60, malnutrition, number of previous chemotherapies >3 and combination therapy with >3 drugs were significantly associated with occurrence of grade III/IV neutropenia, suggestive of severe bone marrow suppression. Patients with such characteristics are at most risk of severe bone marrow suppression, and preventing discontinuation of treatment would be valuable for treating patients more effectively.