Flexion-distraction injuries of the upper lumbar spine typically occur in case of a head-on motor vehicle collision, while wearing a lap seat belt without shoulder strap. According to Smith and Kaufer the axis of flexion is situated at the point of contact of the belt with the abdominal wall. This results in a horizontal separation of the anterior, middle and posterior columns. The lesion is called a Chance fracture when it involves primarily bone, rather than ligaments. However, a Chance fracture can happen in unbelted persons: the present case concerns a 30-year-old man who fell from a height.

Accidental Falls↗

PubMed2005

Sciatic nerve block causing heel ulcer after total knee replacement in 36 patients.

Femoral and sciatic nerve blocks are often used for postoperative analgesia following total knee replacement surgery. In this report, we focus on cases of heel ulcers which occurred following the implementation of peripheral nerve block in concert with knee replacement surgery. In some instances, heel ulcers have resulted in delayed rehabilitation and prolonged hospital stays in this group of patients, which makes this phenomenon a potential burden on the healthcare system. Pressure points in the foot should be protected after the implementation of nerve blocks to prevent pressure sores. An awareness of this unusual complication related to knee replacement surgery is necessary to prevent its occurrence and avoid delays in patient rehabilitation and recovery.

Arthroplasty, Replacement, Knee↗