Open clavicle fractures: a case report

Open fractures of the clavicle are rare, whereas closed fractures are quite common. Presented here is a case report of a grade IIIA open clavicle fracture. After reviewing the literature, there appears to be little information on the treatment or outcome of these fractures. One can only surmise that the outcome and complications are similar to those of other open fractures.

Pseudo-dislocation of the sternoclavicular joint

Fractures of the medial third of the clavicle are the rarest of all clavicle fractures. We present two cases of medial clavicle fracture nonunions that were initially thought to be chronic anterior sternoclavicular dislocations and describe the entity of pseudo-dislocation of the sternoclavicular joint. Computed tomography should be performed on all patients with suspected or established injuries of the sternoclavicular region to ensure differentiation between fracture and dislocation.

Use of Ilizarov external fixation for a periprosthetic supracondylar femur fracture

Supracondylar femur fractures above a total knee replacement are rare injuries that may be challenging to treat. We present a case of an elderly woman whose supracondylar femur fracture was not deemed amenable to conventional treatment. This patient underwent fixation of her femur fracture above a total knee replacement using an Ilizarov external fixator. The fixator was removed at 10 weeks, at which time the fracture was solidly healed. At the most recent follow-up, the patient is 19 months postinjury. She is fully weight bearing without walking aids and has a knee range of motion of 0 degree to 110 degrees.

Management priorities in patients with polytrauma

BACKGROUND

The basic principles for the treatment of the polytraumatized patient is early resuscitation, followed by a physical examination and diagnostic studies. These are performed to establish the priorities for life-saving management and further treatment.

DISCUSSION

Trauma management regarding musculoskeletal injuries is discussed in four different distinguished periods: (1) acute or resuscitation period (0-3 h); (2) primary or stabilization period (3-72 h); (3) secondary or regeneration period (days 3-8); and (4) tertiary or rehabilitation period (beyond day 8). For management during the acute period, a trauma algorithm is described, which consists of four different steps: (1) first look; (2) shock treatment; (3) check up; and (4) control and diagnosis. During the acute period, decompression of organ cavities (tension pneumothorax, cardiac tamponade) is performed along with life-saving operations for hemorrhage control of thoracic, abdominal, pelvic or external bleeding. The primary period (3-72 h) of treatment starts when the vital functions have been stabilized. During this period, so-called 'day-one' surgery is performed. During the secondary period (days 3-8), a phase of regeneration, a secondary deterioration of organ function must be prevented. During the tertiary phase (beyond day 8), in most cases, recovery usually continues and final reconstructive operations can be performed.

Mesenchymal chondrosarcoma of the cervical spine in a child

Mesenchymal chondrosarcoma is a rare small-cell neoplasm of bone and soft tissue. After reviewing the literature, we believe that the patient in this report is the youngest in whom mesenchymal chondrosarcoma originating in a cervical vertebra has been diagnosed.

An unusual presentation of telangiectatic osteosarcoma

Telangiectatic osteosarcoma (TOS) is a rare subtype of osteosarcoma that accounts for approximately 2% of all osteosarcomas. Presented is a case of a sacral mass that was originally thought to be a chordoma and was treated surgically but on pathologic examination was diagnosed as a TOS. A review of the literature on other sacral lesions is provided. The intention for presenting this case is twofold: to make physicians aware of the differential diagnoses of sacral lesions and to report an unusual presentation of this rare tumor.

Australia Antigen Content of Commercial Quality-Control Sera

Australia Antigen (HB Ag) content of 30 chemistry control sera and six other control sera was determined by radioimmunoassay. 23 of the 36 sera were found to be strongly HB Ag positive. We conclude that greater than normal care must be exercised in handling these serums and that better methods must be used to prepare control serum.