ABSTRACT
We present a case of left proximal femoral artery transection injury in 1½-year-old male child due to a fall over a bike handle after sustaining a road traffic accident. He was presented to the emergency room with a cut proximal end of the left femoral artery and a fracture upper end of the shaft of the femur seen at the wound site. Following initial resuscitation, the patient was planned for wound exploration, fracture stabilization, and femoral artery repair which were executed, and salvage of the lower limb of 1½-year-old child was achieved. We conclude that teamwork, training, and experience in repairing pediatric vessels and timely pediatric vascular repair play a pivotal role in the salvage of a limb and improvement of the quality of life of a child.
ABSTRACT
A 25-year-old male truck driver presented to Emergency Department following unrestrained heavy motor vehicle crash (MVC), when the high-speed truck collided to a wall. He sustained blunt chest trauma from steering wheel and open fracture of right tibia with compartment syndrome. On primary survey, patient was in shock with patent airway. Focused assessment sonography for trauma (FAST) suggested cardiac tamponade for which ultrasound-guided pericardial catheter was placed. After resuscitation patient was taken to the operation theatre. Clam-shell thoracotomy revealed rents in left atrial appendages which were repaired. Fasciotomy of leg was performed and external fixator was applied for open tibia fracture. The patient developed surgical site infection that was treated with local antibiotic and regular dressings. After two weeks, fasciotomy wound was closed with split-skin grafting. At nine-month follow-up, patient was able to resume his occupation as a heavy motor vehicle driver.
ABSTRACT
A six-year-old boy was playing at his home, trying to climb up on a metallic gate which was attached with a hooked chain, and suddenly the child slipped down. The hook of the chain, including its 'U' shape segment got embedded into the posteromedial aspect of his thigh, through a small entry wound. An anteromedial aspect of the thigh carries a neuro-vascular bundle of the lower limb. To remove the hooked part from muscles near to femoral vessels without damaging them requires surgical skill and consideration for vascular emergencies. At the same time, the procedure is an important step. After resuscitation, the patient is taken into the emergency operation theatre, and the hook was safely removed under vision. In the postoperative period, the child recovered well, and the wound was healthy at the time of discharge.
ABSTRACT
About 48,000 workers die at the workplace in India due to occupational accidents of which 38 fatal accidents take place every day in the construction sector. Indigenous innovative methods (Jugaad) devised to accomplish tasks at work are common in our country. We report the case of an abdominal injury sustained while using rope tied around the torso for suspension, termed as 'Reverse suspension syndrome' by authors due to analogy in mode to Suspension syndrome but exactly opposite kinematics of injury. As described in the report, Reverse suspension syndrome is a dangerous mechanism of trauma involving transmission of major energy and severe visceral injuries. Workup to rule out bowel, ureter, great vessels, spine and cord injuries is recommended. The outcome is good if the patient presents in time. To the best of our knowledge, this mechanism of injury hasn't been described in the literature so far.
