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Lightning injuries have a high morbidity and mortality because of the electrical effects on the circulatory, respiratory, and central nervous systems. Most lightning-related deaths occur immediately after injury due to fatal arrhythmias or respiratory failure. We describe the case of a patient who experienced a seizure and respiratory distress secondary to a lightning strike and how our team was able to stabilize and transport the patient. Ultimately, in this particular case study, the patient survived with minimal residual neurologic and hemodynamic effects. Based on this clinical vignette, we review the pathophysiology of lightning injuries and the predictive factors of positive outcomes in such unusual accidents.
Assuntos
Lesões por Ação do Raio , Humanos , Lesões por Ação do Raio/complicações , Lesões por Ação do Raio/terapia , Convulsões/etiologia , AcidentesRESUMO
The use of prosthetic implants and metallic materials is widespread in modern orthopedic surgery. Generally, these materials are non-toxic and inert. Nevertheless, a few cases of malignancy associated with certain implants have been documented in the literature. It has been reported that some components of these implants have carcinogenic properties. In most cases, these tumors are high-grade sarcomas that occur in the bone or soft tissue adjacent to the implant site. Here we present the case of a 53-year-old patient who underwent intramedullary nailing of the tibia and developed a pleomorphic sarcoma at the implant site 18 years later.
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INTRODUCTION: Combination of shoulder dislocation with ipsilateral shaft humeral fracture is extremely rare and the occurrence of upper extremity compartment syndrome as a complication is even rarer. CASE PRESENTATION: A 36-year-old male, sustained a road traffic accident as a pedestrian struck by a vehicle. He was diagnosed with an anterior dislocation of the right shoulder with an ipsilateral open transverse fracture of the middle third of the humeral shaft. He was treated with closed reduction and Hackethal bundle nailing. The next day, the patient developed acute compartment syndrome and underwent multiple fasciotomy. DISCUSSION: This particular combination represents a great surgical challenge in orthopedics and there is no clear consensus until now regarding its management. We review the mechanism and the appropriate treatment of this injury. CONCLUSION: We think it is critical to emphasize the original character of our case, because it is probably the first report to describe this special injury associated with upper extremity compartment syndrome.
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Simultaneous ipsilateral floating hip and floating knee are extremely rare. To the best of our knowledge, only four cases have been described in the literature. This uncommon injury is mostly caused by high-velocity impact and associated with life-threatening lesions. We report a unique case of concomitant ipsilateral floating hip and floating knee following road traffic accident. The patient presented ipsilateral hip dislocation and acetabular, femoral, and tibial fractures associated with chest trauma. The aim of this report is to highlight the severity and rarity of this combination and to describe the therapeutic recommendations.
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Pigmented villonodular synovitis (PVNS) is a rare pseudotumoral proliferative benign condition of unknown etiology, affecting synovial joints. It can also develop in the synovial bursae and in the tendon sheaths. It usually affects large joints, such as the knee and the hip. Ankle is a rare location, with only a few cases reported in the literature. We report a case of a 52 year old patient with a PVS of the right ankle. She received a subtotal synovectomy. After 2 years of follow-up there was no clinical recurrence.
