Seizure, A Shocking Effect of a Lightning Strike on Aerodrome: A Case Report

Lightning injuries have a high morbidity and mortality because of the electrical effects on the circulatory, respiratory, and central nervous systems. Most lightning-related deaths occur immediately after injury due to fatal arrhythmias or respiratory failure. We describe the case of a patient who experienced a seizure and respiratory distress secondary to a lightning strike and how our team was able to stabilize and transport the patient. Ultimately, in this particular case study, the patient survived with minimal residual neurologic and hemodynamic effects. Based on this clinical vignette, we review the pathophysiology of lightning injuries and the predictive factors of positive outcomes in such unusual accidents.

High-grade pleomorphic sarcoma associated with an orthopedic implant: a rare case report

The use of prosthetic implants and metallic materials is widespread in modern orthopedic surgery. Generally, these materials are non-toxic and inert. Nevertheless, a few cases of malignancy associated with certain implants have been documented in the literature. It has been reported that some components of these implants have carcinogenic properties. In most cases, these tumors are high-grade sarcomas that occur in the bone or soft tissue adjacent to the implant site. Here we present the case of a 53-year-old patient who underwent intramedullary nailing of the tibia and developed a pleomorphic sarcoma at the implant site 18 years later.

An exceptional challenging case: Anterior shoulder dislocation with ipsilateral humeral shaft fracture complicated with an upper extremity compartment syndrome

INTRODUCTION

Combination of shoulder dislocation with ipsilateral shaft humeral fracture is extremely rare and the occurrence of upper extremity compartment syndrome as a complication is even rarer.

CASE PRESENTATION

A 36-year-old male, sustained a road traffic accident as a pedestrian struck by a vehicle. He was diagnosed with an anterior dislocation of the right shoulder with an ipsilateral open transverse fracture of the middle third of the humeral shaft. He was treated with closed reduction and Hackethal bundle nailing. The next day, the patient developed acute compartment syndrome and underwent multiple fasciotomy.

DISCUSSION

This particular combination represents a great surgical challenge in orthopedics and there is no clear consensus until now regarding its management. We review the mechanism and the appropriate treatment of this injury.

CONCLUSION

We think it is critical to emphasize the original character of our case, because it is probably the first report to describe this special injury associated with upper extremity compartment syndrome.

[Fenton's naviculo-capitate fracture syndrome (about a case)]

La fracture scapho-capitale ou syndrome naviculo-capital de Fenton, est une lésion très rare, souvent méconnue. Elle résulte d'un traumatisme du poignet de haute énergie. Son mécanisme est controversé. Les auteurs rapportent l'observation d'un patient,qui a présenté dans les suites d’un accident de la voie publique une fracture du scaphoïde associée à une fracture du capitatum, du triquetrum et de la styloïde cubitale. La voie d'abord dorsale, a permis une réduction et une contention par embrochage de la première rangée, indépendamment de la deuxième rangée. Les ligaments interosseux scapho-lunaire et lunaro-triquétral étaient intacts. Une immobilisation plâtrée antébrachio-palmaire a été mise en place pour 12 semaines. La rééducation a durée six mois. A deux ans de recul, le score fonctionnel de Cooney était bon et l'ensemble des fractures a consolidé sans aucune désaxation intracarpienne. La reprise du travail était au huitième mois après l’accident.

Scapho-capitate fracture or Fenton’s naviculo-capitate fracture syndrome is a very rare and often ignored lesion. It is caused by a high-energy traumatic injury to the wrist. Its mechanism is controversial. This study reports the case of a patient with scaphoid fracture associated with fracture of the capitatum, triquetrum and ulnar styloid due to public road accident. Dorsal approach allowed reduction and containment by internal fixation in the first row, regardless the second row. Scapholunate interosseous ligaments and luno-triquetral were intact. The patient underwent antebrachial-palmar plaster immobilization for 12 weeks. Rehabilitation program lasted for six months. Cooney’s wrist function score was good and all fractures consolidated without intracarpal malalignment at 2 years follow up. The patient resumed work in the eighth month after the road accident.

[Villonodular synovitis of the ankle, an uncommon location: a case report]

Pigmented villonodular synovitis (PVNS) is a rare pseudotumoral proliferative benign condition of unknown etiology, affecting synovial joints. It can also develop in the synovial bursae and in the tendon sheaths. It usually affects large joints, such as the knee and the hip. Ankle is a rare location, with only a few cases reported in the literature. We report a case of a 52 year old patient with a PVS of the right ankle. She received a subtotal synovectomy. After 2 years of follow-up there was no clinical recurrence.