A 42-year-old male was admitted because of an anterior neck injury due to accidental firing of a nail gun. On chest X-ray, the nail was stuck in the anterior neck, migrated to the chest, and then to the abdomen. Only the trachea was damaged, leaving no injury in the esophagus. The nail in the intestine was removed by colonoscopy. The patient showed complete recovery without complications after fasting and conservative treatment. We report this case with a literature review.
Abdomen ; Adult ; Colonoscopy ; Esophagus ; Fasting ; Fires ; Humans ; Intestines ; Male ; Nails ; Neck ; Neck Injuries ; Thorax ; Trachea

PURPOSE: The bony mallet finger injury is generally managed by conservative treatments. But operative treatments are needed especially when the fractures involve above 30% of articular surface, or when distal phalanx is accompanied by subluxation in the volar side. This is the reason why they often result in chronic instability, articular subluxation and cosmetic dissatisfaction. In this report, We describe new method using the hook plate as an operative treatment of mallet finger deformity. METHODS: Among 13 patients with mallet finger deformity who came from February 2006 to February 2008, six patients were included in surgical indication. Under local anesthesia, H or Y type incision was made at the DIP joint area. After the DIP joint extension, the hook plate was put on the fracture line, and one self tapping screw was used for fixation. 2 hole plate which was one of the holes in 1.5 mm diameter was cut in almost half and bended by approximately 100 degrees. RESULTS: In all six cases which were applied the hook plate, complications such as loss of reduction or nail deformity were not seen. In only one patient, hook pate was removed due to inflammatory reaction after the surgery. In 2 weeks after the operation, active motion of DIP joint was performed. The result was satisfactory not only cosmetically but also functionally. In 6 weeks after the operation, the range of motion of DIP joint was average 64 degrees. CONCLUSION: The purpose of the operative treatment for mallet finger deformity using the hook plate is to provide anatomical reduction with rigid fixation and to prevent contracture at the DIP joint. While other operations takes 6 weeks, the operation using the hook plate took only two weeks to enable active motion. Complication rate was low and the method is rather simple. Thus, the operation using the hook plate is recommended as a good alternative method for the mallet finger deformity treatment.
Anesthesia, Local ; Congenital Abnormalities ; Contracture ; Cosmetics ; Finger Injuries ; Fingers ; Humans ; Joints ; Nails ; Porphyrins ; Range of Motion, Articular

Arterial trauma associated with hip fracture treatment is still a rare complication. We present a case in which an arterial injury was discovered during closed reduction and intramedullary nail fixation of a subtrochanteric hip fracture. The preoperative thigh circumference was increased due to severe swelling, and the vascular injury was located substantially proximal to the fracture and the instrumentation area. An interventional angiogram revealed a damaged vessel originating from one of the minor proximal branches of the right deep femoral artery while filling a 2 cm-sized pseudoaneurysm. Embolization was performed without further complications.
Aneurysm, False ; Femoral Artery ; Glycosaminoglycans ; Hip ; Hip Fractures ; Nails ; Thigh ; Vascular System Injuries

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Nails ; injuries ; surgery ; Suture Techniques

OBJECTIVETo study the curative effects of close nail-pry reduction and internal fixation with hollow screws for treatment of linguiform calcaneus fracture.

METHODSFrom May 2006 to October 2009,32 patients (35 feet) with linguiform calcaneus fracture were treated by close nail-pry reduction and internal fixation with hollow screws, including 23 males and 9 females ranging in age from 25 to 46 years, with a mean of 37.6 years. According to Paley classification, 3 cases were Paley II a, and 29 cases were Paley II b. All cases were close fractures. The time from injury to operation was 3 to 10 days after most swelling subsided. Böhler angle and Gissane angle were measured by X-ray before and after operation. The therapeutic effect was assessed according to ZHANG Tie-liang's foot score.

RESULTSAll the patients were followed-up for 6 to 18 months, with a mean of 12 months. All fractures gained bone healing. The time of fracture healing averaged 12 months. The fractures healed completely and no infection occurred. According to ZHANG Tie-liang's foot scale, the postoperative function was excellent in 18 feet, good in 10 feet, moderate in 5 feet and poor in 2 feet. The Böhler angle and Gissane angle were significant improved after treatment (P < 0.01).

CONCLUSIONThe surgical method of close nail-pry reduction and internal fixation with hollow screws for treatment of linguiform calcaneus fracture can regain the foot function, with minimal injury, fewer complications, earlier recovery and lower costs.

Adult ; Bone Nails ; Bone Screws ; Calcaneus ; injuries ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged

Adolescent ; Adult ; Bone Nails ; Female ; Humans ; Knee Injuries ; surgery ; Male ; Medial Collateral Ligament, Knee ; injuries ; surgery ; Middle Aged

OBJECTIVE: To investigate the effectiveness of finger reconstruction using nail flap anastomosing the nerve branch of the first toe nail bed. METHODS: Between January 2016 and December 2022, 18 patients (18 fingers) with thumb or finger nail bed defects were admitted. There were 12 males and 6 females, with an average age of 32 years (range, 19-42 years). Four cases were finger tip tissue damage caused by machine compression, and 4 cases were distal tissue necrosis after finger replantation. There were 9 cases of thumb injury, 3 cases of index finger injury, 5 cases of middle finger injury, and 1 case of ring finger injury. There were 11 cases of distal nail damage and 7 cases of distal nail root (including nail root) damage. The time from injury to admission was 1-5 hours, with an average of 2 hours. After debridement and anti-infection treatment for 5-7 days, the wounds in size of 1 cm×1 cm to 4 cm×3 cm were reconstructed by using nail flaps anastomosing the nerve branches of the first toe nail bed. The size of the nail flaps ranged from 1.5 cm×1.5 cm to 4.5 cm×3.5 cm. The donor sites were repaired with the flaps in 16 cases and skin graft in 2 cases. RESULTS: All nail flaps, flaps, and skin grafts survived after operation and the wounds healed by first intention. All patients were followed up 6-12 months (mean, 10 months). The nails of 18 cases were all grown, in which 16 cases had smooth nails with satisfactory appearances, 1 case had uneven nails, and 1 case had obvious scar hyperplasia around the suture opening. At 6 months after operation, the two-point discrimination of the skin flap was 4-8 mm (mean, 6 mm). Meanwhile, the skin grafts and flaps at the donor sites regained protective sensation, good abrasion resistance, and had no negative effect upon walking and wearing shoes. CONCLUSION The application of a nail flap that anastomoses the nerve branch of the first toe nail bed for finger reconstruction has minimal damage and can achieve good nail bed repair results.
Male ; Female ; Humans ; Adult ; Nails/injuries* ; Plastic Surgery Procedures ; Finger Injuries/surgery* ; Surgical Flaps/innervation* ; Skin Transplantation/methods* ; Toes/injuries* ; Soft Tissue Injuries/surgery* ; Treatment Outcome

OBJECTIVETo observe the therapeutic effects of iliac nail in the treatment of lumbar sacral and pelvis reconstruction.

METHODSForm January 2004 to February 2010,10 patients (4 males and 6 females, ranging age from 25 to 75 years, with an average of 46.5 years ) were treated. Among the patients, 5 cases were L5S1 vertebral tuberculosis, 2 cases were sacral giant-cell tumors and 3 cases were severe osteoporosis combined with lumbar sacral slipping. The main symptoms manifested low back pain, limited activity and dysphasia before treatment. Iliac nail and lumbar-sacral pedicle screw were used for reconstruction of lumbar-sacral spine and pelvis. Nakai scale was used to evaluate therapeutic effects, Suk scale for osseous fusion.

RESULTSAll operations were succeful, obtained primary healing. All the patients were followed up, and the mean time of follow-up was 24 months (ranged from 18 to 36 months). The complications, such as weakness and decreased sensation of lower libs and activity, increased spinal cord injury, were not occurred after operation. According to Nakai scale, 7 cases got excellent result, 2 good and 1 fair. All bone graft were bony fusion with an average time of 3.5 months.

CONCLUSIONIliac nail can fixed well between lumbar vertebra and pelvis and solve the problem of fixation due to pathological changes of lumbosacral region. It is an ideal method of less blood loss and operating time.

Adult ; Aged ; Bone Nails ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Internal Fixators ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Pelvis ; injuries ; surgery ; Sacrum ; injuries ; surgery

PURPOSE: To evaluate the radiographic results of patients with subtrochanteric femoral fracture using minimal incision and cephalomedullary nail technique. MATERIALS AND METHODS: This study was performed on 54 patients, 54 cases of hip, recruited among patients who underwent minimal incision and Cephalomedullary nail from September 2005 to August 2008 and were available for 1-year or longer follow up. The gender ratio was 37 males and 17 females, and the mean age at the time of surgery was 57.4 years (range; 16~81 years). According to injury mechanism, traffic accident was 29 cases, fall down form high height was 18 cases, slip down was 7 cases. In classification by Seinsheimer, type II was 23 cases (m/c), type III was 18 cases, type IV was 13 cases. Average follow up period was 14 months (12~18). Radiographic evaluation was performed for time taking union, mal-union and complication. RESULTS: 53 of the 54 cases united. 39 of 54 reductions were anatomic. 19 fractures had a monir varus deformity of proximal fragment (between 2degrees and 5degrees). There was no varus deformity of more than 5degrees. 1 case that had been treated with PFN had nail breakage without trauma. There were no other complications. CONCLUSION: Surgical treatment of subtrochanteric fractures with minimal incision and Cephalomedullary nail technique can reslut in excellent reduction without complications including inflammation & malunion. Careful attention to detail for using Lowman clamp is demanding to decrease soft tissue injury.
Accidents, Traffic ; Congenital Abnormalities ; Female ; Femoral Fractures ; Follow-Up Studies ; Hip ; Hip Fractures ; Humans ; Inflammation ; Male ; Nails ; Soft Tissue Injuries

Powered by compressed air, a nail gun is an essential alternative tool to a hammer on any construction site. This useful machine launches nails at high speed, automatically embedding them in a piece of wood in only a fraction of a second. In spite of its convenience, life-threatening and fatal nail gun injuries can occur when a nail gun is misused, such as in a suicide attempt, or when the operator has insufficient training because combustion nail guns are capable of firing projectiles at velocities higher than 150 m per second. Although injuries by nail guns are rarely reported, there have been reports of nail gun injuries to the head and the trachea in Korea. In the emergency room, the authors experienced a patient injured by an accidental shooting of a nail gun while working in construction. In that accident, a nail penetrated the patient's cervical vertebra through the left cheek. This report is aimed at studying medical treatment for patients with penetrating injuries caused by nail guns.
Cheek ; Compressed Air ; Emergencies ; Firearms ; Fires ; Head ; Humans ; Korea ; Nails ; Neck ; Neck Injuries ; Spine ; Suicide ; Trachea ; Wood