Open anterior dislocation of the hip is a very rare injury, especially in adults. It is a hyperabduction, external rotation and extension injury. Its combination with open posterior dislocation of the elbow has not been described in English language-based medical literature. Primary resuscitation, debridement, urgent reduction of dislocation, and adequate antibiotic support resulted in good clinical outcome in our patient. At 18 months follow-up, no signs of avascular necrosis of the femoral head or infection were observed.
Accidents, Traffic ; Elbow Joint ; injuries ; Hip Dislocation ; complications ; pathology ; Humans ; Joint Dislocations ; complications ; Male ; Soft Tissue Injuries ; complications ; Young Adult

PURPOSE: To evaluate the short-term results of two-staged delayed open reduction and internal fixation in tibial pilon fractures with severe soft tissue damages. MATERIALS AND METHODS: Eleven patients, who underwent two-staged delayed open reduction and internal fixation for tibial pilon fractures between January 2002 and July 2003, were followed for more than one year. The mean interval time between first stage and second stage of the procedures was 28.5 days (range, 14-34 days). Radiographs were graded by the criteria of Burwell and Charnley and ankle functions were graded by the criteria of Mast and Teipner. Ankle function, union time and postoperative complications were also analysed. RESULTS: Average union time was 17 weeks (range, 14-20 weeks) in ten of the eleven fractures, but there was one fracture resulting in soft tissue complication and infected nonunion. At the lastest follow-up, review of the radiographic results showed that eight fracture (73%) achieved an anatomic reduction, two (18%) achieved a fair reduction, and one (9%) achieved a poor reduction. And clinical functional assessment showed that there were seven (64%) good results, three (27%) fair results, and one (9%) poor result. CONCLUSION: Two-staged delayed open reduction and internal fixation technique is an excellent option for the treatment of tibial pilon fractures with severe soft tissue injuries.
Ankle ; Follow-Up Studies ; Humans ; Postoperative Complications ; Soft Tissue Injuries ; Tibia

PURPOSE: The zygomatic arch is a key element which composes the facial contour. In many cases of zygomatic arch fracture, it is difficult to fix rigidly the fractured segments. If reduced bone segments were not fixed rigidly, they are proven to be displaced by mastication or unintentional external forces. So, unfixed zygomatic arch fracture after reduction may require a external device of prevention of collapse. We introduce a new protector which stabilizing the fractured segments to prevent for collapse of the reduced zygomatic arch fracture. METHODS: After reduction of zygomatic arch with blind approach(Gillies', Dingman or Keen's approach), bone segments was pulled with percutaneous traction suture in medial aspect of zygomatic arch. Then, the suture was fixed with Aqua splint(R), externally. And intraoperative and postoperative X-ray was done. The splint was removed on 14 days after the operation. RESULTS: 5 patients were treated with this method. 4 patients of total patients had no collapse in zygomatic arch. There was minimal collapse in one patient. Postoperative complications such as facial nerve injury, mouth opening difficulty, contour deformity, infection, scar were not observed. CONCLUSION: In comparison with other techniques, this technique has several advantages which are simple and easy method, short operation time, no scar, less soft tissue injury, and facilitated removal of splint. Therefore, Aqua splint(R) would be a good alternative to prevent for collapse in unstable zygomatic arch fractures
Cicatrix ; Congenital Abnormalities ; Facial Nerve Injuries ; Humans ; Mastication ; Mouth ; Postoperative Complications ; Soft Tissue Injuries ; Splints ; Sutures ; Traction ; Zygoma*

complications of orthognathic surgery and their relevance.MATERIALS AND METHODS: The clinical records and X-rays of 418 patients who underwent surgery at Chosun University Dental Hospital, Korea, over a 12-year period between 1998 and 2009 were examined.RESULTS: The followings are some of the most common complications which happened during the operations: Inadequate osteotomy in 25 cases, excessive bleeding in 11 cases, nerve injuries in 6 cases, soft tissue injuries in 8 cases, and tooth injury, and insertion of foreign bodies in 4 cases respectively. The most frequent complications which happened after surgery are shown below. Paraesthesia in 262 cases, dyspnea in 78 cases, pain in cervical region in 49 cases, open bite in 14 cases, plus 62 cases where other complications occurred. Despite the great variety of complications, severe life threatening complication frequency seems to be extremely low.CONCLUSION: Orthognathic surgery appears to be a relatively safe procedure but complications related to orthognathic surgery do still occur. Accurate evaluation and precise surgery are needed to minimize complications.]]>
Dyspnea ; Foreign Bodies ; Hemorrhage ; Humans ; Incidence ; Korea ; Open Bite ; Orthognathic Surgery ; Osteotomy ; Postoperative Complications ; Soft Tissue Injuries ; Tooth Injuries

OBJECTIVETo analyze the reliability of magnetic resonance imaging (MRI) in detecting posterior ligament complex injury in thoracolumbar fractures.

METHODSNinety-five patients with thoracolumbar fracture were evaluated by palpation of the inter-spinal gap, plain radiography, and MRI before operation. In addition to conventional MRI sequences, a fat-suppressed T2-weighted sagittal sequence was performed. Surgery was performed by a posterior approach. During the operation, posterior ligament complex was examined.

RESULTSA wide inter-spinal gap was palpated in 41 patients and was found in 55 patients on plain radiography. According to MRI, injury to the supraspinal ligament was suspected in 85 patients, the inter-spinal ligament in 83 patients, and the ligamentum flavum in 26 patients. There were 82 supraspinal ligament injuries, 80 inter-spinal ligament injuries, and 20 ligamentum flavum injuries in operative findings. The relations between plain radiography and operative findings, between MRI interpretation and operative findings were statistically significant.

CONCLUSIONA fat-suppressed T2-weighted sagittal sequence of MRI is a highly sensitive, specific, and accurate method to detect posterior ligament complex injury and which is recommended for the accurate evaluation of posterior ligament complex injury in thoracolumbar fractures.

Adult ; Female ; Humans ; Joint Capsule ; injuries ; Ligaments, Articular ; injuries ; Lumbar Vertebrae ; injuries ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Soft Tissue Injuries ; diagnosis ; Spinal Fractures ; complications ; Thoracic Vertebrae ; injuries

PURPOSE: Anteromedial surface of the leg is susceptible to trauma, which frequently induces soft tissue defect. When the size of a soft tissue defect is small to moderate, a local muscle flap is an easy and reliable alternative to a free flap. The authors performed medial hemisoleus flaps for reconstruction of soft tissue defects on the anteromedial surface of legs. The aim of this study was to evaluate clinical outcomes and effectiveness of the medial hemisoleus flap. MATERIALS AND METHODS: Twelve patients underwent the medial hemisoleus flap for reconstruction of a soft tissue defect on the anteromedial surface of the leg from February 2009 to December 2013. There were eight males and four females with a mean age of 47.8 years (15 to 69 years). The mean size of defects was 4.7x4.2 cm (2x2 to 9x6 cm). Flap survival and postoperative complications were evaluated. RESULTS: Mean follow-up period was 39.6 months (7 to 64 months) and all flaps survived. There were two cases of negligible necrosis of distal margin of the flap, which were healed after debridement. All patients were capable of full weight bearing ambulation at the last follow-up. CONCLUSION: The medial hemisoleus flap is a simple, reliable procedure for treatment of a small to moderate sized soft tissue defect on the anteromedial surface of the leg.
Debridement ; Female ; Follow-Up Studies ; Free Tissue Flaps ; Humans ; Leg* ; Male ; Necrosis ; Postoperative Complications ; Soft Tissue Injuries ; Walking ; Weight-Bearing

PURPOSE: Soft tissue reconstruction is essential for recovery of finger function and aesthetics in any traumatic defect. The authors applied a reverse homodigital artery island flap for soft tissue defect on distal part of digits. The aim of this study is to evaluate the efficacy of the procedure. MATERIALS AND METHODS: Seven cases of soft tissue defects of finger tip were included in this study. There were six male and one female, mean age was 43 years and mean follow-up period was 38 months. The length of flaps ranged from 2.0 to 2.5 cm and width ranged from 1.0 to 2.0 cm. Flap survival, postoperative complications were evaluated. RESULTS: All flaps survived without loss. Donor sites were repaired with primary closure in five cases and skin graft in two cases. None of the patients showed significant complications and their average finger motion was 255degrees in total active motion at the last follow-up. CONCLUSION: The authors suggest that the reverse homodigital artery island flap could be a versatile treatment option for the soft tissue defect on distal part of digits.
Arteries* ; Esthetics ; Female ; Fingers ; Follow-Up Studies ; Humans ; Male ; Postoperative Complications ; Skin ; Soft Tissue Injuries ; Tissue Donors ; Transplants

20-year-old man presented to our emergency department after he was hit by a forklift. He developed haemorrhagic shock from a subcutaneous haematoma in his left thigh and required monitoring in the surgical intensive care unit. He stabilised with aggressive fluid resuscitation with crystalloids and blood transfusion. The recovery was complicated by an infection of the subcutaneous haematoma. Following open drainage of the infected subcutaneous haematoma, he improved and was discharged. To the best of our knowledge, this is the first reported case of a subcutaneous haematoma causing haemorrhagic shock.
Accidents, Traffic ; Diagnosis, Differential ; Hematoma ; complications ; diagnosis ; Humans ; Male ; Shock, Hemorrhagic ; diagnosis ; etiology ; Soft Tissue Injuries ; complications ; diagnosis ; Young Adult

BACKGROUND: The reconstruction of volar surface defects is difficult because of the special histologic nature of the tissue involved. The plantar surface is the most homologous in shape and function and could be considered the most ideal of reconstructive options in select cases of volar surface defects. In this paper, we evaluate a single institutional case series of volar tissue defects managed with second toe plantar free flaps. METHODS: A single-institution retrospective review was performed on 12 cases of reconstruction using a second toe plantar free flap. The mean age was 33 years (range, 9 to 54 years) with a male-to-female ratio of 5-to-1. The predominant mechanism was crush injury (8 cases) followed by amputations (3 cases) and a single case of burn injury. Half of the indications (6 cases) were for soft-tissue defects with the other half for scar contracture. RESULTS: All of the flaps survived through the follow-up period. Sensory recovery was related to the time interval between injury and reconstruction-with delayed operations portending worse outcomes. There were no postoperative complications in this series. CONCLUSIONS: Flexion contracture is the key functional deficit of volar tissue defects. The second toe plantar free flap is the singular flap whose histology most closely matches those of the original volar tissue. In our experience, this flap is the superior reconstructive option within the specific indications dictated by the defect size and location.
Amputation ; Burns ; Cicatrix ; Contracture ; Finger Injuries ; Fingers ; Follow-Up Studies ; Free Tissue Flaps ; Postoperative Complications ; Retrospective Studies ; Soft Tissue Injuries ; Toes

PURPOSE: The purpose of this study was to evaluate clinical results for open reduction and internal fixation of unstable extraarticular metacarpal fractures using low profile titanium plates. METHODS: Sixty-two consecutive patients (76 metacarpals) with unstable extraarticular metacarpal fractures who prospectively underwent internal fixation with plating were enrolled. Minimum follow-up was 1 year. There were 48 males and 14 females; average age was 39 years (range, 15-71 years). The location of the fractures was shaft in 65 metacarpals and the type was transverse in 22 cases, oblique in 46 cases, and communited in 8 cases. Of the 62 patients, 11 were open; 9 of these had additional soft tissue injury. The surgical outcome was assessed by clinical and radiographic outcomes and complications. RESULTS: Bone union was successfully achieved in all patients on the average period of 6.4 weeks. The final range of total active motion was excellent for 64 cases, good for 6 cases, fair for 5 cases, and poor for 1 case. Postoperative complications occurred in 9 patients (15 metacarpals). Statistical analysis revealed that patient age, occupation, multiple metacarpal fractures, and soft tissue injury were significantly correlated with incidence of complications at last follow-up. CONCLUSION: Low profile titanium plating showed the low complication rate and good results in treating unstable extraarticular metacarpal fractures.
Follow-Up Studies ; Humans ; Incidence ; Male ; Metacarpal Bones ; Occupations ; Postoperative Complications ; Prospective Studies ; Soft Tissue Injuries ; Titanium