An elderly female with a complex medical history including CHF, atrial fibrillation and diabetes presented to the ER after a fall with complaints of pain in her right wrist. On exam, her right wrist was grossly distorted. Her xray is above. She was taken to the operating room urgently by the Orthopedic Surgeon for repair.

Facial injury with orbital fracture

43 year old male was brought as a trauma patient after a motor vehicle accident. He sustained multiple facial fractures including left orbital fracture (see image above).

Multiple rib fractures with a flail chest segment

The upper image is a 3-D reconstruction of the chest of the patient who was involved in a motor vehicle accident. The arrows are pointing to the rib fracture sites. Several ribs were broken in two or more places creating a flail chest segment with a paradoxical chest movement. Considering the extent of the ribs fractures, the patient was taken to OR for a chest wall stabilization (image below).

Traumatic Pneumonectomy

27 year old male came as a trauma patient after he was involved in a high speed car crash. He sustained bilateral pulmonary contusions and right hemopneumothorax. He continued to bleed from his right chest. He was taken to OR for thoracotomy.

Intraoperatively, he was found to have severe right lung damage. Pneumonectomy (lung removal) had to be performed to prevent exsanguination.

On a Chest XR above please note complete absence of the right lung as well as the evidence of thoracotomy.

Bilateral Acetabular Fractures

56 year old male came as trauma patient after he was involved in a motor vehicle accident. The patient was intoxicated with alcohol at the time of the accident. CT pelvis with a 3-D reconstruction revealed bilateral acetabular fractures. (see arrows above)
The patient underwent orthopedic stabilization of his fractures.

Implantable bone growth stimulator.

The patient with a thoracic spine injury and a complete cord transsection at T8-9 level was taken to surgery for spine stabilization. After the spinal instrumentation, bone growth stimulator was implanted by the neurosurgeon (see image above).

Bone growth stimulators apply a direct electrical current to the fracture site promoting new bone formation and fracture healing.
Bone growth stimulator are indicated for the patients with who are at high risk for spinal fusion failure when any of the following criteria is met:
1. One or more failed fusions
2. Grade II or worse spondylolisthesis
3. A multiple level fusion entailing 3 or more vertebrae (e.g., L3 to L5, L4 to S1, etc.),
4. One or more of the following risk factors for fusion failure are present, gross obesity (BMI greater than 40), current smoking, diabetes, renal disease, active alcoholism;

This was a very unfortunate case.

The patient was involved in a rollover motor vehicle accident. CT spine revealed thoracic spine injury at T4 and T9 levels.

Despite a high dose intravenous steroids per spinal cord injury protocol and subsequent surgical stabilization, the patient remained paraplegic (weak in both lower extremities).

37 year old male presented as a trauma patient after motor vehicle accident. CT chest revealed left pneumothorax. Chest tube was inserted.