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PubMed1997

CT findings of bronchial transection.

A case of right bronchial rupture demonstrated by computed tomography (CT) is reported. Chest radiographs of a 55-year-old man who sustained blunt chest trauma showed bilateral pneumomediastinum, hydropneumothorax, and subcutaneous emphysema with fracture of the left 3rd and 4th ribs. CT showed wall defect over the right main bronchus with the air in airway contiguous to that in the mediastinum. Bronchoscopy and thoracostomy confirmed the CT findings and the patient was treated by bronchorrhaphy with end-to-end anastomosis. The airway should be meticulously evaluated in cases of mediastinal and subcutaneous emphysema, especially after trauma.

Bronchi↗
PubMed2006

Pattern of injuries in fatal falls from buildings.

When bodies are brought for autopsy it is sometimes unclear whether the injuries are due to a fall from a height or due to blunt trauma from other causes, especially when the bodies are found near buildings with no eyewitnesses available. Studies discussing the injury patterns in adults after falls exclusively from buildings are rare. A five-year retrospective study was carried out on 151 cases of fatal falls from buildings brought for autopsy. The aim was to assess the pattern of these injuries and identify features helpful in discriminating between these and injuries due to blunt trauma from other causes. The majority of cases comprised subjects who fell from heights of 10-20 feet (3-6m) with most falls occurring late at night or in the early morning. The pattern that emerged is quite distinct from ground level falls and pedestrian injuries. Abrasions are the commonest injury and bruises very rare. Lacerations are mostly on the head and skull fractures are evenly distributed between the vertex, base and vertex plus base. Subarachnoid haemorrhage is the commonest intracranial lesion. Extradural haemorrhage alone is rare. Fractures of ribs and cervical vertebrae are common and fractures of thoracic vertebrae and long bones are uncommon. Safety measures to prevent such falls have been suggested.

Accidental Falls↗
PubMed2003

Fall-related fractures in persons with spinal cord impairment: a descriptive analysis.

Falls are a significant cause of injury, disability, and death in the elderly, but little is known about the risk of wheelchair-related falls. The purpose of this study is to describe the incidence, etiology, location of fracture, treatment, and health care utilization of fall-related fractures in persons with spinal cord impairment (SCI). A retrospective review of 45 medical records of patients with SCI who sustained fractures, nonconcomitant with the onset of their initial injury, was completed at a Veterans Health Administration (VHA) SCI service over a 10-year period. Of the 24 veterans who sustained fall-related fractures, three (12%) were found to have repeated falls with fractures. Falls were sustained during activities (more than one wheelchair activity contributed to a fall; e.g., transfer activity with brake failure in a van) including transfer (44%), reaching (11%), propelling (15%), moving in bed (22%), transferring or riding in a vehicle (30%), and showering (7%). Factors contributing to falls included loss of balance, equipment failure, muscle spasms, excessive speed, not wearing protective straps, and narcolepsy. Among the 31 fractures sustained in 27 fall episodes in 24 subjects, lower extremity fractures accounted for 97% of the injuries and a fractured 7th rib accounted for one injury (3%). Tibial fractures occurred more frequently than femoral or ankle fractures. Four (15%) fall episodes resulted in bilateral fractures. The treatment of choice was to immobilize the fractured extremity with a soft, well-padded splint. Surgical fixation was performed in only two cases. Over 80% of the patients with fall-related fractures were admitted for inpatient stays with a mean of 66 inpatient days per patient. Hospital days were most often the result of home inaccessibility, inadequate support at home, or surgical intervention.

Accidental Falls↗
PubMed1991

Transgenic mice that express a mini-gene version of the human gene for type I procollagen (COL1A1) develop a phenotype resembling a lethal form of osteogenesis imperfecta.

A mini-gene version of the human gene for a pro-alpha 1(I) chain of type I procollagen (COL1A1) was prepared that contained -2.5 kilobases of the promoter region and the 5'- and 3'-ends of the gene but lacked a large central region containing 41 exons. The construct was modeled after a sporadic in-frame deletion of the human gene that produced a lethal variant of osteogenesis imperfecta, because it caused synthesis of shortened pro-alpha 1(I) chains that associated with normal pro-alpha 1(I) and pro-alpha 2(I) chains and caused degradation of both the shortened and normal pro-alpha chains through a process called procollagen suicide. The mini-gene was used to prepare transgenic mice. Eight of 15 transgenic mice expressed varying levels of the gene. All except one of the Fo founders were phenotypically normal, but several of the founders were apparently mosaic since they produced F1 progeny that died shortly after birth with a distinctive phenotype. The phenotype included extensive fractures of ribs and long bones similar to the fractures seen in lethal variants of osteogenesis imperfecta. Mice with the lethal phenotype expressed much higher levels of the mini-gene than transgenic mice without the lethal phenotype. Experiments with cultured skin fibroblasts from the transgenic mice demonstrated that shortened pro-alpha 1(I) chains synthesized from the mini-gene became disulfide-linked to pro-alpha 1(I) chains synthesized from the endogenous mouse gene. The results demonstrate that a mutated type I procollagen gene based on the model of procollagen suicide can be used to produce a severe phenotype of osteogenesis imperfecta that is genetically transmitted.

Animals↗
PubMed1998

Fractured cervical spine and aortic transection.

A 17-year-old victim of a road traffic accident presented. Following investigation diagnoses of fractured first cervical vertebra, aortic transection, diffuse cerebral oedema, fractured right ribs 2-4 and pubic rami were made. Management of this case presented a number of anaesthetic dilemmas: management of the airway, use of cross-clamp vs. shunting or heparinization and bypass, cardiovascular and neurological monitoring, maintenance of cardiovascular stability during and post cross-clamp, minimizing the risk of post-operative renal and neurological dysfunction.

Accidents, Traffic↗
PubMed1986

[Calcinosis of the supraspinal ligament--a rare secondary finding].

The supraspinal ligament calcification of thoracic spine is a rare roentgenographic finding. If this calcificated ligament is fractured several times it may be possible to misinterpret it as rib serial fractures, if it is overshadowed by dorsal ribs in the side projection of thorax. According to Resnick (4) such a ligamentous calcification is found within the overall framework of the "DISH"-syndrome.

Aged↗
PubMed1987

Sclerosis of a rib associated with a healed fracture of a contiguous thoracic vertebra.

A patient who suffered a fracture of the body of the 10th dorsal vertebra as a result of an automobile accident was examined seven years later. He complained of local pain over the gibbus site. All movements in the back and the joints of the extremities were within normal limits. Radiographs disclosed a healed compressed fracture of the body of the 10th thoracic vertebra with bony bridges contiguous with the 9th and 11th thoracic vertebrae. An unusual finding was the presence of a uniform sclerosis of a single rib at the level of the fracture site. Other bones of the rib cage, as well as the lumbar and pelvic bones, were normal. The basis for the abnormal density of the affected rib may be due to abnormal stress factors (Wolff's law).

Adult↗
PubMed1991

Strut fixation of an extensive flail chest.

The indications for and preferred approaches to operative stabilization of posttraumatic chest wall instability are uncertain. We suggest this simple, rapid, and effective approach to surgical stabilization by Luque rod strutting of the flail segment when operation is required.

Aged↗
PubMed1979

Technique for the management of anterior flail chest.

A technique for the management of anterior flail chest consisting of osteosynthesis and the positioning of two long Kirschner wires behind the sternum in the form of a St Andrew's cross is described. The procedure is easy to perform, the patient is ambulant early, and the results are good.

Fracture Fixation, Internal↗
PubMed2004

Trauma of an ectopic kidney. A case report.

Ectopic kidney is a rare pathology. It is usually misknown and often revealed by a complication. We report a case of a 30-year-old male patient who presented in emergency with a right thoraco-abdominal trauma and a benign head trauma. Injury evaluation revealed a right ectopic pelvic kidney with a grade IV laceration. Furthermore, there was a hepatic contusion in the sixth segment and a fracture of the ninth, tenth and eleventh right ribs. Therapeutic attitude consisted on a successful conservative and nonoperative treatment for both lesions. CT scan is of utmost importance in diagnosis. Management is the same as for normally positioned kidney.

Abdominal Injuries↗