RESUMO
Management of septic arthritis is an area of controversy, especially in rare locations like the sternoclavicular joints. In this case report, we present a case of septic sternoclavicular joint, which was resistant to medical treatment and deteriorated during the treatment course. Although medical treatment has proven effective based on previous literature, some cases will still not benefit from it. In this case, our patient responded significantly to surgical treatment regarding upper limb function, faster infection eradication and rehabilitation, and shorter hospitalization and antibiotics duration.
RESUMO
Pipkin I fracture dislocation is a rare injury. They commonly present following high mechanism trauma with possible devastating complications regardless of the treatment option. Treatment consensus depends on fracture reduction, size, site, and displacement. Surgical management is reserved for large fragments. We present a 42-year-old female presented with multiple chest injuries and left sided Pipkin I fracture dislocation Two days following the trauma. The fracture was found to be vertical in nature and was managed by closed reduction and a period of bed rest and skeletal traction. She was followed over a 3-year period and showed satisfactory results. We believe that the vertical nature of the fracture and maintenance of the anatomic reduction led to her successful outcome.
RESUMO
OBJECTIVE: The objective is to investigate one-year mortality rates following femur osteoporotic fractures, and to investigate factors that are associated with higher mortality rates. DESIGN: A retrospective study was conducted from 2010 to 2021 (11 years) of all patients who presented to King Saud Medical City, Saudi Arabia, and had a fragility fracture of the proximal or distal femur. PATIENTS: One hundred eight patients who sustained a proximal or distal femoral fracture, as a result of low-energy trauma, were included. RESULTS: The majority of our cohort (77.8%) had proximal femoral fractures, whereas only 22.2% had a distal femoral fracture. 55.6% were less than 75 years old, and 44.4% were 75 years or older. All patients had fallen from standing height. Hypertension and diabetes were the most common comorbidities among our cohort at 49.1% and 47.2%, respectively, but neither showed a statistically significant increase in the risk of mortality. When assessing the overall mortality, 21.3% of our patients had passed away. Although this finding was not statistically significant, mortality rates were found to be higher in patients with proximal femoral fractures compared to distal femoral fractures (25% vs. 8.3%, respectively, p=0.095). Patients with a normal bone mass density (BMD) had higher mortality rates as opposed to those with abnormal BMD (p=0.001). CONCLUSIONS: Mortality rates are higher in proximal femoral fractures compared to distal femoral fractures. In addition, within our study cohort, patients with normal BMD had higher mortality rates. We recommend prospective studies that compare mortality rates between proximal and distal femoral fractures in patients with osteoporosis, as these studies would provide more accurate data. We also recommend having BMD measured in those patients to avoid further fractures in this patient population.
RESUMO
Lisfranc injuries are relatively rare, accounting for only 0.2% of all injuries. It is even rarer to have this injury bilaterally, and not many case reports have been published on this topic. In this report, we present a case of a bilateral Lisfranc injury in a healthy 17-year-old woman that fell from a flight of stairs landing on both feet. The diagnosis was made by weight-bearing x-rays and computed tomography. Weight-bearing x-rays showed a subtle Lisfranc injury in the right foot with widening between the first and second rays and a disruption involving the overlapping bases of the lesser metatarsals as well as a left comminuted fracture of the proximal third and fourth metatarsals (MT) with intra-articular extension at the proximal fourth MT. CT scan of the right foot showed a fracture of the lateral margin of the medial cuneiform with a displaced bony fragment as well as a comminuted fracture of the third and fourth metatarsals with intra-articular extension and no dislocation. Surgical management, in the form of open reduction and internal fixation, was undertaken for both feet in the same setting. She had an expected course postoperatively and has been doing well, with no pain nor limitation in her activity at her six-month postoperative visit. Moreover, we present a brief review of similar published cases and an overview of Lisfranc injuries.
