Complications in the management of closed high-energy proximal tibial plateau fractures / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To report complications in the management of complex closed proximal tibial fractures.</p><p><b>METHOD</b>A retrospective study was conducted to analyze the infectious and noninfectious complications encountered in the management of high-energy Schatzker type V and VI tibial plateau fractures. All patients were treated at the level 1 trauma centre between January 2011 and March 2014. Sixty two patients were included in the study. The mean patient age was (43.16 ± 11.59) years with 60 males and 2 females. Infectious complications like superficial and deep infection, wound dehiscence, malalignment in the immediate postoperative period and in follow-up period were noted.</p><p><b>RESULTS</b>The overall complication rate was 30.65% (19 out of 62). Infectious complications were noted in 20.97% cases (13/62). In majority of the cases (8/13), superficial infection was seen which managed with regular dressing and antibiotic administration. The patients (5/13) who had developed deep-seated infection were subjected to repeated debridements, flap coverage, implant removal or amputation depending upon the host response. Thirteen patients had experienced noninfectious complications. Hardware related complications were noticed in six patients and four among them received a secondary procedure. Malalignment was observed in seven patients but only single patient underwent subsequent operative intervention.</p><p><b>CONCLUSION</b>Proximal tibial plateau fractures especially Shatzker type V and VI are associated with extensive soft tissue damage even in closed injuries. The complications encountered in the management of these fractures can be minimized with appropriate patient selection and minimal soft tissue dissection.</p>

Simultaneous bilateral femoral neck fractures after electrical shock injury: a case report / 中华创伤杂志(英文版)

Simultaneous bilateral fractures of the femoral necks are rare injuries, especially when there is no underlying pathological condition. We report a 20-year-old man who sustained bilateral femoral neck fractures resulting from an accidental electric shock with 440 V direct current. Simultaneous bilateral femoral neck fractures after electrical shock injury without falling from a height are rather uncommon in clinic. The main cause of the fracture may be muscle contraction. This case highlights that even in the absence of primary and secondary bone disease, bilateral fractures of the femoral necks can occur following electric shock injury. We successfully managed this case with bilateral cannulated screw fixation without bone grafting. Surgeons caring for patients with electrical injury should be aware of the possibility of skeletal injuries which can go unnoticed, leading to delay in diagnosis and increased risk of complications.