MyMedR

Displaying all 2 publications

Abstract:

Sort:

Fulltext The Smashed-Up Shoulder: A Case of Complex Ipsilateral Scapula, Clavicle and Proximal Humerus Fractures With Complete Brachial Plexus Injury

Atan AA, Ab Rahman Z, Zayzan KR, Bahaudin N, Ahmad AR

Cureus, 2021 Nov;13(11):e19918.
PMID: 34976521 DOI: 10.7759/cureus.19918

Simultaneous ipsilateral fractures involving all the bones around the shoulder girdle, namely, the scapula, clavicle and humerus, are rare. We describe an interesting case of a 31-year-old patient who presented after a motor vehicle accident with excruciating pain over his left shoulder and a flail left upper limb. Radiographs and computed tomography (CT) scan revealed the presence of comminuted left scapula, clavicle and proximal humerus fractures. He was also diagnosed with a complete brachial plexus injury of the left shoulder. The patient underwent a tedious surgery involving screw fixation and plating of the scapula, clavicle and proximal humerus. Despite achieving stable fixations of the shoulder and radiographic union of all the fractures, he did not recover from the complete brachial plexus injury 14 months after the trauma. The presence of ipsilateral clavicle, scapula and humerus fracture suggests involvement in high-energy trauma, and therefore, associated injuries especially neurovascular compromise should not be missed. Despite its rarity, management of this complex injury should always be individualised to ensure optimal functional outcomes are achieved.
Functional outcome and quality of life following treatment for post-traumatic osteomyelitis of long bones

Zayzan KR, Yusof NM, Sulong AF, Zakaria Z, Ab Rahman J

Singapore Med J, 2020 Dec 02.
PMID: 33264560 DOI: 10.11622/smedj.2020164

INTRODUCTION: The clinical outcomes and factors associated with treatment failure of post-traumatic osteomyelitis have been investigated by many studies. However, limb functionality and quality of life following treatment for this condition have not been thoroughly studied.
METHODS: This was a cross-sectional study that included 47 patients with post-traumatic osteomyelitis of the lower limb. Functional outcome was assessed using the Lower Extremity Functional Score (LEFS), and quality of life was assessed using the validated Malay version of Short Form-36 version 2.
RESULTS: Mean follow-up time was 4.6 (range 2.3-9.5) years. Median age was 44 years. Osteomyelitis was located in the tibia for 26 patients and in the femur for 21 patients. Osteomyelitis was consequent to internal infection in 38 patients and due to infected open fractures in nine patients. 42 (89.4%) patients had fracture union and control of infection. Bone defect was found to be a significant contributing factor for treatment failure (p = 0.008). The median LEFS for the success group was 65 when compared to 49 for the failure group. Although the success group showed better scores with regard to quality of life, the difference between the two groups was not statistically significant.
CONCLUSION: The success rate for post-traumatic osteomyelitis of the lower limb was high. The presence of a bone defect was associated with treatment failure. Successfully treated patients had significantly better functional outcomes than failed ones.

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links