Open fractures with bone loss are a common occurrence following high energy trauma. But usually the bone fragments are lost on the roadside and are not usable. We report a patient who was involved in a head-on collision between two wheelers and presented with a bone fragment embedded in his thigh. Radiological survey revealed no bony injury in that patient. Another patient, who presented at the same time, sustained a segmental fracture of shaft femur and was found to have lost a bone fragment that was similar to the one found in previous patient. CT scan with 3D reconstruction revealed this missing fragment to be the same as that found in previous patient. Both patients had a history of head-on collision while travelling on a two-wheeler. Present case report throws some highlights on the probable mechanism of injury.
Accidents, Traffic ; Bone and Bones ; injuries ; Foreign Bodies ; Thigh ; injuries

As one of the most common fractures of the foot, the blood supply characteristics and unique anatomy of proximal fifth metatarsal fracture makes a high risk of delayed union or non-union of fractures occurring at the junction of the diaphyseal-metaphyseal. At present, the classification system of proximal fifth metatarsal fracture is complicated and not yet unified, and Lawrence and Botte classification is more recommended. The system divides proximal fifth metatarsal fracture into three types:avulsion fractures of tuberosity(Zone I), fractures at the metaphysis-diaphysis junction, which extend into the fourth-fifth intermetatarsal facet (Zone II) and the proximal diaphyseal fractures(Zone III). Based on the classification system, each type of fracture has a corresponding treatment plan and prognosis. There are a variety of surgical methods for proximal fifth metatarsal fracture. For the fracture of Zone II and Zone III, percutaneous intramedullary screw is the first choice. In addition, clinicians should also have a thorough understanding of common complications of fracture and associated disposal methods.
Bone Screws ; Foot ; Foot Injuries ; Fractures, Bone ; Humans ; Metatarsal Bones

In the history of medicine, many surgeons have been tried to reconstruct lost tissue and correct deformity, attempts to use implant materials have probably paralleled those involving autogenous tissue. Recently there has been an acceleration in the understanding of the requirements and potentials of implant materials caused by collaboration between material scientists, biomaterials engineers, clinicians, and clinical investigators. Alloplastic materials have become an essential part of reconstructing the function and contour of the craniofacial skeleton. Bone is a specialized form of connective tissue, which provides support, and protects vital and detion and summarizes their mechanical properties and clinical aspects.
Animal ; Bone Diseases/surgery* ; Bone Substitutes* ; Bone Transplantation* ; Facial Bones/surgery* ; Facial Bones/injuries ; Human ; Skull/surgery* ; Wounds and Injuries/surgery

Animals ; Biomechanical Phenomena ; Bone Development ; Bone Remodeling ; Bone and Bones ; injuries ; Fracture Healing ; physiology ; Fractures, Bone ; pathology

Ethmoid Bone ; injuries ; Facial Bones ; injuries ; Humans ; Nasal Bone ; injuries ; Orbital Fractures ; surgery ; Osteogenesis, Distraction ; Skull Fractures ; surgery

OBJECTIVETo explore the effect of reduction and fixation with multi-Kirschner wires for treatment of Lisfranc fracture-dislocations.

METHODSThere were 49 patients (37 male and 12 female aged from 20 to 28 years old) involved in the study. According to the Myserson damage typing, type A in 12 cases, B1 in 3, B2 in 28, C1 in 4 and C2 in 2. Kirschner wires were applied to fix and reconstruct the three-column in three directions according to the structural characteristic of midfoot. Reconstruction of three-column needed not only to reduce and to fix every single column, but also to establish union of the columns.

RESULTSAccording to the evaluation of AOFAS for midfoot, 14 cases were excellent (90 to100), 22 cases good (80 to 89), 8 cases fair (70 to 79) and 5 cases poor (60 to 69), with an average score of 84.200+/-9.663.

CONCLUSIONThe diagnosis and treatment of Lisfranc fracture-dislocations should comply with the theory of three-column reconstruction of foot arch, which can achieve the static balance of biomechanics and provide a stable environment for healing of fracture and soft tissue. Reduction and fixation with multi-Kirschner wires is an effective treatment method for Lisfranc fracture-dislocations.

Adult ; Bone Wires ; Female ; Fracture Fixation ; methods ; Fractures, Bone ; surgery ; Humans ; Joint Dislocations ; surgery ; Joints ; injuries ; Male ; Metatarsal Bones ; injuries ; Middle Aged ; Tarsal Bones ; injuries

No abstract available.
Carpal Bones/*injuries ; Female ; Fractures, Bone/*complications ; Hand Injuries/*complications ; Humans ; Male ; Radius Fractures/*complications

Multiple volar dislocations of carpometacarpal (CMC) joints are uncommon and have been reported rarely. A 25 years old male presented with injury to his left hand 6 days following a road traffic accident. Clinical examination revealed gross swelling of the hand and diffuse tenderness over the carpometacarpal area. His radiographs of the hand showed volar dislocation of the second, third and fourth CMC joints in association with an extra-articular fracture of the base of thumb metacarpal. He was treated by open reduction and percutaneous fixation using Kirschner wires. The functional results were excellent at one year follow-up.
Adult ; Carpometacarpal Joints ; injuries ; Fractures, Bone ; complications ; Humans ; Joint Dislocations ; complications ; Male ; Metacarpal Bones ; injuries

The hand consists of five sesamoids. Two of them are present at the metacarpophalangeal (MCP) joint of the thumb. Fracture of the sesamoid bones of the thumb is a rare injury and the literature on the radial side is seldom reported. We reported a case of a patient with a fracture of the radial sesamoid at the MCP joint of the thumb in order to increase attention regarding this type of injuries. A 44-year-old male, high level gymnastic trainer, was helping one of his athletes during an exercise while he reported a hyperextension trauma to the MCP joint of the right thumb. One week after trauma, he presented to the hand surgeon complaining of a painful thumb at the MCP joint level on its palmar aspect. Standard A-P and lateral X-rays revealed a fracture of the radial sesamoid and the fracture was treated with a splint for 3 weeks. He was able to resumed his entire work 6 weeks after the injury. The sesamoid fractures is an indicator of the magnitude of the hyperextension injury and sometimes associated with tears of the volar plate ligament of the MCP joint. And a failure to recognize the ligament injury may lead to a long-term hyperextension instability on pinching.
Fractures, Bone ; diagnostic imaging ; Humans ; Metacarpophalangeal Joint ; injuries ; Radiography ; Sesamoid Bones ; Thumb ; injuries

The treatment of severely traumatic patients was changing from total care treament to the damage control surgery, as a result in the inflammatory reaction caused by trauma, in which the inflammatory marks, such as interleukin-6 and serum procalcitonin in the blood increased, and caused hypothermia, acidosis, and disturbance of blood coagulation, and resulted in the acute respiratory distress syndrome and multiple organs failure. A long-term operation as the second hit made the disease worse. In the patients, the femoral fracture was treated with external fixator; the pelvic fracture was treated with external fixator, and the uncontrolled haemorrhage in the pelvis was treated through direct hemostasis, angiography and embolism of arteries, and the tamponade of pelvis; the purpose of treatment of spinal fracture was keeping the stability of spine, avoiding the secondary injury on the spinal cord. It must pay attention to the injury of the adjacent organs and infection in the opening spinal injury. The result of operation was better in the incomplete spinal cord injury.
Bone and Bones ; immunology ; injuries ; surgery ; Fractures, Bone ; complications ; immunology ; surgery ; therapy ; Humans ; Orthopedic Procedures