ABSTRACT
Lisfranc injuries are relatively rare, accounting for only 0.2% of all injuries. It is even rarer to have this injury bilaterally, and not many case reports have been published on this topic. In this report, we present a case of a bilateral Lisfranc injury in a healthy 17-year-old woman that fell from a flight of stairs landing on both feet. The diagnosis was made by weight-bearing x-rays and computed tomography. Weight-bearing x-rays showed a subtle Lisfranc injury in the right foot with widening between the first and second rays and a disruption involving the overlapping bases of the lesser metatarsals as well as a left comminuted fracture of the proximal third and fourth metatarsals (MT) with intra-articular extension at the proximal fourth MT. CT scan of the right foot showed a fracture of the lateral margin of the medial cuneiform with a displaced bony fragment as well as a comminuted fracture of the third and fourth metatarsals with intra-articular extension and no dislocation. Surgical management, in the form of open reduction and internal fixation, was undertaken for both feet in the same setting. She had an expected course postoperatively and has been doing well, with no pain nor limitation in her activity at her six-month postoperative visit. Moreover, we present a brief review of similar published cases and an overview of Lisfranc injuries.
ABSTRACT
Objective Cesarean section (C-section) is one of the most common surgical procedures worldwide that may be performed to deliver one or more newborns. The objective of our study was to determine the prevalence of C-section delivery among Saudi women attending different clinics of King Khalid University Hospital (KKUH) who were pregnant, previously pregnant, and had delivered. Methods A quantitative observational cross-sectional study using a self-administered questionnaire that has been handed to the participants after explaining the purpose of the study. A total of 524 pregnant and non-pregnant women were enrolled in the study randomly collected from all female clinics of KKUH. The study sample were given a self-administered questionnaire. Data were analyzed using the Statistical Package for Social Sciences (SPSS), version 21 (IBM SPSS Statistics, Armonk, NY) to analyze the data. Results Of the 524 study participants, 32.6% underwent C-section. There was a statistical significance in women aged 23 years old, as well as teachers, in relation to undergoing C-section (p-values = 0.0001 and 0.044, respectively). We concluded that malpresentation is the most common medical indication, with an overall percentage of 25%. There was no evident statistical association between body mass index (BMI), the highest level of education, marital status, Income status, mode of delivery, and the number of normal births or stillbirths. Conclusion It was found that the prevalence of Saudi women attending KKUH who underwent C-section was 32.6%. Medical indications to undergo C-sections, in comparison to the non-medical ones, were higher. Malpresentation was the most common medical indication, with an overall percentage of 25%.