RESUMEN
In this case report, a unique instance of delayed isolated anterior branch axillary nerve injury following shoulder dislocation is highlighted. The patient, a 55-year-old manual laborer, presented with severe deltoid wasting and reduced power 18 months postdislocation, necessitating a specialized treatment approach. The use of axillary nerve neurolysis and an innovative upper trapezius to anterior deltoid transfer via a subacromial path posterior to the clavicle, facilitated by an autologous semitendinosus graft, resulted in significant improvement with 160 degrees of abduction and Grade 4+ power Medical Research Council grading (MRC) at the 5-year follow-up.
Asunto(s)
Nervio Radial , Luxación del Hombro , Heridas y Lesiones , Humanos , Masculino , Persona de Mediana Edad , Axila/diagnóstico por imagen , Nervio Radial/diagnóstico por imagen , Nervio Radial/lesiones , Nervio Radial/cirugía , Luxación del Hombro/complicaciones , Resultado del Tratamiento , Heridas y Lesiones/diagnóstico por imagen , Heridas y Lesiones/etiología , Heridas y Lesiones/cirugíaRESUMEN
PURPOSE: The survival rate of a Flight crash is quite low and this makes the Calicut incident unique. Management of flight crash victims is itself a herculean task and during COVID-19 pandemic it poses another challenge to the treating team since all the patients are under quarantine and the treatment protocols are not well defined. METHODS: On 7/8/2020 at around 7.41 pm, Air India Express aircraft from Dubai to Calicut, while landing on the runway lost its control and skidded off the runway and broke into three parts. We report a detailed analysis of orthopaedic injury patterns and difficulties encountered in the management of these patients with full personal protective equipment (PPE) kit during COVID-19 pandemic. RESULTS: 47 patients from the crash site were brought to our hospital and 38 of them were admitted under the orthopaedic department. 74 doctors and 76 trained nurses along with 58 supporting staff were involved in the management of the mass casualty during that night. Most of the patients suffered injuries to lower extremity and spine which included 11 femur, 13 tibial and 12 spine fractures. Average union time was around 3 months for fractures. Delayed union of fracture femur, avascular necrosis of talus and nonunion of 5th metatarsal base fracture were the reported complications. Surgical site infection was observed in two patients. CONCLUSION: Trauma management team should be prepared to manage difficulties encountered during identification, communication, and treatment of the disaster victims during this COVID-19 era.