ABSTRACT
Jefferson fracture is a C1 fracture, which happens when an axial load is from the occiput downward to the C1 ring. Usually, it causes outward displacement of the C1 arch, which can injure the vertebral artery. We present a Jefferson fracture with vertebral artery injury, resulting in an asymptomatic ischemic stroke of the left cerebellum. Usually, vertebral artery injuries are asymptomatic since the contralateral vertebral artery and the collateral arteries will adequately supply the cerebellum. Vertebral artery injury (VAI) is typically treated with conservative management with anticoagulants and antiplatelet therapy.
ABSTRACT
Pelvic fractures with sacroiliac extension are significant and complicated orthopedic injuries that pose a challenge in management and favorable outcomes. A 50-year-old obese female presented after a motor vehicle accident with pelvic fracture lateral compression. The patient underwent anterior external fixation with a left sacroiliac screw (SIS) on the next day of admission and was kept in a non-weight-bearing state. During her hospital stay, she developed deep vein thrombosis (DVT) and was treated. During the follow-up on the sixth week, the patient was not complying with her immobilization instructions and was exposing the left lower limb to weight bearing. The radiologic evaluation demonstrated a pulled-out SIS with a stable fracture. Considering that the patient was obese, had a history of DVT and COVID-19 infection, and the fracture was minimally displaced, it was decided to perform a spinopelvic in-situ fixation from L4 to S2 and augment it with a left SIS. The patient tolerated the surgery well and was referred to physiotherapy for early mobilization with full weight bearing. During her six-month and two-year follow-ups, she was well mobilized with no active complaints, and radiographic studies showed good healing, no displacement, no signs of instability, and a stable construct. Our case report presents a very rare and difficult but successful management of a fracture displacement in a non-compliant patient with one pulled-out screw through fast-tracked in situ spinopelvic fixation with early mobilization and full weight bearing. To our knowledge, this is one of the rare reports detailing a patient undergoing in situ spinopelvic fixation due to minimally displaced fracture with comorbidities such as obesity and DVT. Our report demonstrates the viability of accepting pulled-out screws, with respect to the patient's health, the fracture's geometry, a quick follow-up in situ spinopelvic fixation, early mobilization, full weight-bearing outcomes, and a lower risk for complications.
ABSTRACT
Background Developmental dysplasia of the hip (DDH) can involve an immature hip, acetabular dysplasia with or without subluxation, or dislocation of the femoral head. The prevalence of DDH in Saudi Arabia is 10.46 per 1000 live births, highlighting the importance of community knowledge of DDH risk factors and treatment to facilitate early diagnosis, treatment, and avoiding complications. Aim Our goal is to assess community awareness of DDH and the knowledge of its risk factors, treatment, and complications among the population in the Riyadh Region, Saudi Arabia. Methods A cross-sectional study on a sample of 412 participants of the general population in the region of Riyadh, Saudi Arabia was conducted using the snowball sampling technique of sending invitations via social media. All statistical analyses were conducted using SPSS Statistics v.23 (IBM Corp., Armonk, NY). Results Our results revealed that out of the 412 participants almost half reported never hearing about DDH (45.6%). Breech presentation, family history, and female gender were unknown as risk factors to 63%, 58%, and 63.60% of participants respectively. Around 60% of the participant viewed age as the determining factor for DDH treatment. Additionally, 42.70% of participants reported no knowledge about DDH complications, and 72.8% had a low knowledge level regarding DDH. Significant higher knowledge scores were found in females participants (p = 0.026), participants with higher education level (p = 0.01), healthcare professionals (p < 0.001), parents of children who have been screened (p < 0.001), and participants having a first-degree relative with DDH (p < 0.001). Conclusion Our study revealed that residents of the Riyadh Region were unaware of DDH and their knowledge regarding its risk factors, treatment, and complications was poor. Therefore, it is important to implement DDH awareness campaigns to increase the community's knowledge of all aspects of DDH.
ABSTRACT
BACKGROUND: This study was conducted to compare health-related quality of life between adults with Crohn's disease (CD) and healthy controls (CONs). METHODS: A comparative cross-sectional study was conducted on adults with CD and CONs in Saudi Arabia (aged 18-60 years). Sociodemographic data (area of residence, education level, employment, and marital status) were collected from both groups, as well as additional information including disease onset, treatment, and symptomology from the CD group. The validated Arabic version of the quality of life tool was used to assess health-related quality of life. RESULTS: A total of 109 CD patients and 370 CONs participated in this study. The patients with CD had significantly lower health-related quality of life scores for physical functioning [CD 75 (50-90), CON 85 (60-95)], role physical [CD 50 (0-100), CON 100 (50-100)], role emotional [CD 67 (0-100), CON 67 (33-100)], vitality [CD 50 (30-58), CON 50 (40-60)], social functioning [CD 63 (50-75), CON 75 (50-88)], bodily pain [CD 70 (45-90), CON 80 (68-100)], and general health [CD 55 (40-65), CON 65 (55-75)]. The physical and mental domain scores were lower in the CD group [63 (52-75) and 51 (32-69)] than CONs group [75 (63-85) and 63 (55-72)], respectively (p<0.02). CONCLUSION: The CD group had a lower health-related quality of life than the CONs.
