Mandibular angle fractures: a demographic review, with particular reference to post-operative complications.

BACKGROUND: Mandibular angle fractures (MAF) have a recognized complexity of treatment and an increased risk of incurring complications. METHODS: This retrospective study included 45 consecutive patients who were diagnosed with an isolated MAF and no other facial fractures. The average age was 27.3 (SD = 7.7). RESULTS: A comparatively low rate of complications (11.1%) and a low rate of reoperation (1.8%) are reported, along with a significant role of smoking in complications (p = 0.022). A non-significant association was noted between complications, male gender and assault as an aetiological factor. CONCLUSIONS: Review of the data from this study confirms that complication rates for patients attending the National Maxillofacial Unit are similar to or better than that of international studies. An overview of the aetiology of fracture complications is included.

Editorial Commentary: Patients With Thin Hip Capsules, Capsular Redundancy, Capsular Defects, Hypermobility, Dysplasia, and Female Patients Are at Increased Risk of Hip Instability.

Patients with thin hip capsules, capsular redundancy, capsular defects, hypermobility, dysplasia, and female patients are at increased risk of hip instability. As our understanding of the factors that contribute to hip instability has increased, so too has our ability to identify "at-risk" patients, in whom we should avoid surgery or perform capsular repair or plication following hip arthroscopy to achieve optimal results. We must tailor our surgical planning accord to gender, bony morphology, capsular volume, and properties of the tissue.

Recurrent Carotid artery blow out in a head & neck patient.

INTRODUCTION AND IMPORTANCE: Carotid artery blowout syndrome is a rare complication of head and neck cancer treatment. It defines a rupture of the carotid artery wall through vessel wall necrosis. This is typically precipitated by radiotherapy, direct tumour invasion, or a combination of these factors. We describe a rare case of three consecutive carotid artery blowouts in a head and neck cancer patient. CASE PRESENTATION: A 58-year-old man with a history of T3NO hypopharyngeal squamous cell carcinoma (SCC) treated with chemotherapy and radiation presented with a four-month history of progressive dysphagia and right sided neck pain. Flexible nasendoscopy revealed laryngeal oedema and slough. A panendoscopy and biopsy showed no evidence of tumour recurrence. The patient was discharged and represented with worsening dyspnoea. He subsequently experienced a large volume hemorrhage necessitating ligation of his right external carotid artery. He underwent pharyngolaryngectomy indicated due to the extent of laryngeal radiation necrosis. Thereafter he suffered two additional acute carotid bleeds from his right common carotid necessitating ligation in theatre. CLINICAL DISCUSSION AND CONCLUSION: This case report illustrates the key issues to be considered in patients with locally advanced hypopharyngeal squamous cell carcinoma and subsequent management of acute carotid blowout syndrome, which without prompt management, can be fatal.