While rib fractures are common in blunt thoracic trauma, dislocations of the costovertebral joints (CVJs) are extremely rare and typically involve the first, eleventh, or twelfth rib. We report a rare case of dislocation of the left fourth and sixth CVJs in a 36-year-old man who was run over by a car. The rib heads were displaced anteriorly, abutting the aorta. Additional injuries included bilateral hemopneumothoraces, pneumomediastinum, pulmonary contusions, grade 3 splenic injury, left adrenal hematoma, retroperitoneal hematoma, Morel-Lavallée lesions at bilateral hips, and multiple fractures, including at the ribs and pelvis. There was also a fracture of the fourth thoracic vertebral body, which was occult on initial CT, but seen on subsequent CTs. The CVJ dislocations were managed conservatively, without short-term complications. Prompt surgical intervention has been recommended in cases where sharp rib fracture fragments are displaced close to the aorta to prevent fatal aortic injuries. However, there is a literature gap on the management of rib heads that are dislocated against the aorta. Our experience suggests that conservative management may be acceptable in some of these cases. This case report aims to increase radiologists' awareness of CVJ injuries, which are important for thoracic spine stability, and highlights the association between CVJ dislocations and spinal injuries.
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http://dx.doi.org/10.1007/s00256-023-04415-3 | DOI Listing |
Medicine (Baltimore)
December 2024
Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China.
Rationale: Sacrococcygeal pilonidal disease (SPD) is a chronic inflammatory condition primarily affecting young males. This case report details the perioperative anesthetic management of a patient undergoing SPD surgery under subarachnoid anesthesia.
Patient Concerns: A 48-year-old obese male (body mass index 28 kg/m2) presented with recurrent sacrococcygeal swelling, pain, and purulent discharge for 2 months.
Front Surg
December 2024
Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China.
One of the primary challenges in hand microsurgical reconstruction lies in addressing severe hand injuries, particularly those involving multiple finger amputations, as autologous replantation might not fully restore hand functionality. In such scenarios, fully shaped reconstruction of a severed finger combined with Ectopic banking could yield superior reconstructive outcomes and enhance the amputated limb's function. This case report presents a unique approach that combines ectopic replantation of an amputated finger with interphalangeal reconstruction methods to restore both the form and function of the hand.
View Article and Find Full Text PDFQuant Imaging Med Surg
December 2024
Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.
Background: Radiation-induced brain injury (RBI) is a common complication in patients with nasopharyngeal carcinoma (NPC) who have undergone radiotherapy (RT), which is characterized by significant cognitive and psychological impairments. Although radiation-induced regional structural abnormalities have been well-reported, the effects of RT on the whole brain structural covariance networks are mostly unknown. Here, we performed a source-based morphometry (SBM) study to solve this issue.
View Article and Find Full Text PDFQuant Imaging Med Surg
December 2024
Wulituo Hospital of Shijingshan District, Beijing, China.
Background: Cognitive impairment mechanisms in children with preoperative brain tumors are not well understood. This study aimed to determine the correlation between the changes of resting-state functional magnetic resonance imaging (rs-fMRI) and the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV) in patients with brain tumors before surgery and in healthy controls (HCs).
Methods: rs-fMRI data were acquired using 3-T magnetic resonance imaging (MRI) scanners for 21 patients with pediatric brain tumor and 19 age- and gender-matched HCs.
Quant Imaging Med Surg
December 2024
Department of Cardiovascular Ultrasound, Fourth Affiliated Hospital, Harbin Medical University, Harbin, China.
Background And Objective: About half of all heart failures are heart failures with preserved ejection fraction (HFpEFs). As the population ages and metabolic disorders become more common, the prevalence of HFpEF continues to increase annually. Patients with HFpEF typically show a decline in various reserve capacities after exercise.
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