Increased Susceptibility for Thromboembolic Events versus High Bleeding Risk Associated with COVID-19.

The infection with the SARS-CoV-2 virus is associated with numerous systemic involvements. Besides the severe respiratory injuries and cardiovascular complications, it became obvious early on that this disease carries an increased risk of thromboembolic events, but a higher propensity for bleedings as well. We researched the medical literature over significant PubMed published articles debating on the prevalence, category of patients, the moment of occurrence, and evolution of venous thromboembolism (VTE), but also of venous and arterial "in situ" thrombosis (AT), and hemorrhagic events as well. Most researchers agree on an increased prevalence of thromboembolic events, ranging between 25 and 31% for VTE, depending on the analyzed population. For AT and hemorrhagic complications lower rates were reported, namely, about 2-3%, respectively, between 4.8 and 8%, occurring mostly in older patients, suffering from moderate/severe forms of COVID-19, with associated comorbidities. It is important to mention that patients suffering from hemorrhages frequently received thromboprophylaxis with anticoagulant drugs. As a consequence of thromboembolic and hemorrhagic complications which are both important negative prognostic factors, the evolution of patients infected with the SARS-CoV-2 virus is aggravated, determining an augmented morbidity and mortality of this population.

Clinical and morphological aspects of lateral femoral condyle status after an osteochondral fracture. A case report.

Although osteochondral fractures of the lateral femoral condyle are uncommon, fixation of the fragments is recommended, mostly when is about young athletes with such post-traumatic pathology. We present a case of a professional handball player teenager female, with a lateral femur condylar osteochondral fracture after a fall with the right knee in extension and in internal rotation. Magnetic resonance imaging (MRI) showed an osteochondral fracture of the lateral femoral condyle, 34.6 mm on long axis, impossible to manage arthroscopically, because of the size and the location of the detached fragment. The solution was the lateral knee arthrotomy allowing the evacuation of the hemarthrosis and preparation of the fracture site, then reduction and fixation of the fracture with absorbable cannulated pins. This procedure is of choice only when is enough bone in the detached fragment to permit the internal fixation and bone-to-bone healing with cartilaginous tissue stabilization through the fibro-cartilaginous rim that would seal the cartilage surface. Postoperative MRI proves that the fragment is settled in its hooked position with repairing of the articular congruity, so the recovery exercises program allow the regaining of the knee mobility with a restart of her sportive activity later.