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Background.
Fracture resulting from household electric shock is uncommon. When it occurs, it is usually the result of a fall; however, electricity itself can cause sufficient tetany to produce a fracture. We present the case of bilateral fractures of the distal radii of a 12-year-old boy which were sustained after accidental shock. The literature...
Citations
... Several cases of bone fractures following LV trauma have been described in the literature. The most common fractures involved humerus and scapula [11] with the forearm being the third most common [12,13]. ...
Background
This paper describes a unique case—the first case of multiple fractures of the thoracic vertebrae caused by a low-voltage electric shock.
Case presentation
A 22-year-old male patient was diagnosed with compression fractures of Th2–Th6 caused by a muscle spasm resulting from an electric shock. The patient was treated conservatively using a cervico-thoracic support corset. After rehabilitation, the patient has regained his physiological movement of the spine without any back pain.
Conclusions
Albeit vertebral fractures caused by electric shock injury are extremely rare, clinicians should always keep in mind this diagnosis, especially when clinical symptoms such as pain and limitation of movement are present.
... Even isolated bilateral distal forearm fracture is a rare injury, with only a handful of case reports. [30][31][32][33][34] Whereas therapeutic options and outcomes of unilateral distal radius fracture (DRF) are well known, 35 due to limited information regarding bilateral DRF, its optimal therapy, complications, and outcomes remain unclear. The treatment goal is to retain optimal reduction and stability, which would allow early mobilization to achieve the best functional result. ...
Bilateral elbow dislocation associated with bilateral distal forearm fractures is extremely rare, therefore its optimal treatment, complications, and outcomes remain unclear. We present an illustrative case with a 2‐year follow up of a patient who sustained a complex injury of the upper extremity and underwent combined surgical and conservative treatment. Due to the limited information regarding complex bilateral injuries of the arm, its optimal therapy remains unclear. The major treatment goal should be a joint stabilization and early mobilization to optimize the chances of good functional recovery.
... Extant literature on this topic is lacking, as there are only a handful of isolated case reports and case series. Therefore, clinically useful data on demographics and outcomes is lacking (12)(13)(14)(15)(16)(17)(18)(19)(20). To date, Ehsan and Stevanovic (2009) have conducted the most comprehensive review of bilateral distal radius fractures (93 patients), but the focus of their study was on determining differences between skeletally mature versus skeletally immature patients (mean age 22.5) (21). ...
... A thorough literature review of bilateral distal radius fractures yielded multiple isolated case reports among both adult and pediatric, and male and female patients. Case reports have included patients aged 12 through 80, with mechanisms ranging from electrocution, mechanical falls, stress fractures, and associated conditions including open fractures, scaphoid and scapholunate injuries, and tendon ruptures (12)(13)(14)(15)(16)(17)(18)(19)(20). Only one prior case series is reported in the literature directly comparing 42 adult and 59 pediatric bilateral distal radius fractures. ...
Although distal radius fractures are quite common, bilateral distal radius fractures seldomly occur. Due to this, treatment is primarily based on surgeon experience with unilateral fractures, however bi- lateral fractures add a level of complexity : loss of functional independence. The purpose of this study was to examine a cohort of patients with bilateral distal radius fractures to identify differences in demographics, mechanism of injury, and outcomes to further our understanding of these rare injuries. 23 patients were identified retrospectively over a 5-year period that met inclusion criteria. The medical records were reviewed with multiple demographic and clinical parameters recorded and analyzed. Males were more likely to sustain high-energy mechanisms (80% vs. 53%). Patients <50 years old were more likely to sustain high-energy mechanisms (90% vs. 46%) and were more likely to be treated operatively (80% vs. 62%). The most commonly associated injury was a head injury (30%). All patients treated non-operatively reported minimal/no pain upon final follow-up where 57% of patients treated operatively noted regular pain. 75% of patients with medical comorbidities had minimal/no pain upon final follow- up. Conclusions : Patients with bilateral fractures were more likely to be younger males who suffered from higher energy mechanisms. Age was a critical factor in determining treatment strategy. Rates of associated head injuries were elevated, which is an important factor for the clinician to keep in mind when treating this population. As we further our understanding of this unique population, we can improve our treatment approaches and subsequently attain better outcomes.
... Electrocardiogram with renal function tests with 24 h monitoring is usually sufficient to rule out such complications. [7][8][9] Bone tissue provides the highest resistance to electric current as it is the poorest conductor of electricity. The bone tissue, therefore, absorbs all the energy of the conducted electric current. ...
... Hence, in the emergency room (ER), the patient must be critically screened for cardiac and renal anomalies. Electrocardiogram with renal function tests with 24 hour monitoring is usually sufficient to rule out such complications [18,19,20]. Screening of pelvis, spine and shoulder is essential in order to avoid missing these rare injuries [8,16,17]. ...
... Screening of pelvis, spine and shoulder is essential in order to avoid missing these rare injuries [8,16,17]. In our review of literature, posterior shoulder dislocations, fractures of the proximal humerus and fracture of scapula have been reported following electric shock injuries due to vigorous muscle contractions around the shoulder [18,21,22]. In the forearm, galeazzi and distal radius fractures have been reported [ 18,23,24]. ...
... In our review of literature, posterior shoulder dislocations, fractures of the proximal humerus and fracture of scapula have been reported following electric shock injuries due to vigorous muscle contractions around the shoulder [18,21,22]. In the forearm, galeazzi and distal radius fractures have been reported [ 18,23,24]. In the spine, L4 burst fractures and transient spinal quadraperesis has been reported [18,25,26]. ...
Introduction
Simultaneous bilateral fractures of the neck of femur is rare. Hypocalcemia, epilepsy, osteoporosis and electrical injuries are known to cause similar injuries.
Case Report
We report a case of a 43-year-old male who sustained an electrical shock injury following which he fell from a height of around 4 feet. Radiological studies confirmed bilateral transcervical neck of femur fracture. Laboratory investigations revealed the patient had extremely low levels of vitamin D (11.1ng/ml). Patient was treated with three 6.5 mm cannulated cancellous screws on each side. Patient had good functional outcome at the end of one year.
Conclusion
We report this case as a rare etiological combination of hypovitaminosis D and electrical injury causing bilateral neck of femur fracture. Such injuries should be diagnosed at the earliest and goal of treatment should be to preserve both the hip joints. Early management would avoid potential complications like non-union and avascular necrosis.
... Moreover, electric current is invisible and could induce injuries at any part of the body or lead directly to death mostly without leaving any detectable marks (Arnoldo et al., 2006;Wang et al., 2008;Kurtulus et al., 2009). The degree of damage caused by electricity depends on type and intensity of electric current and the nature of exposed cells or tissues (Stone et al., 2014). The electrical shock could affect skin, central nervous system, cardiovascular system, skeletal muscles and many other internal organs (Fish, 1993a). ...
In this study, the impact of electrocution on apoptosis and DNA damage was investigated to act as possible
biomarker for electric shock mediated deaths. A total of 40 adult male rats were divided into two equal groups - electrocuted (E) and Control (C), which were further sub-divided into two sub-groups. The main treatment group (E) was electrocuted until death by a 220 V alternating current (AC) and the blood and heart samples were collected immediately after electrocution from the first sub-group [E(0h)] and 1 h postmortem (PM) from second sub-group [E(1h)]. The animals of control group were killed humanely by cervical dislocation, and the samples were collected immediately after death from the first subgroup [C(0h)] and 1h after PM from the second subgroup [C(1h)]. Creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) activities and malonaldehyde (MDA) contents were significantly found to be elevated in rats of electrocuted group [E(0h)] and their levels showed higher elevations in [E(1h)] group. Exposure of rats to electric current till death resulted in a highly significant increase in DNA fragmentation percent immediately or 1h of PM. The expressions of Bcl-2, Bcl-xl were down-regulated while Bax expression was up-regulated in hearts of electrocuted rats in comparison with control rats, influenced by cause of death and time of sampling. The heart taken from C(0h) and C(1h) groups showed normal architecture while more extensive damage
appeared in E(0h) and E(1h) groups. In conclusion, electrocution caused DNA damage and apoptosis in cardiac muscles and these findings could be used as useful biomarkers to support biochemical analysis and histopathological examination in confirming the electrocution as the principle cause of death.
... Electrocardiogram with renal function tests with 24-hour monitoring is usually sufficient to rule out such complications. [13][14][15] Bilateral neck of femur fractures are difficult to treat if not diagnosed early. Hip preservation should be the goal of treatment in young patients, such as in our case. ...
Simultaneous bilateral fractures of the femoral neck are rare injuries in patients without underlying pathological conditions. We report a case of a 50-year-old male, who sustained bilateral femoral neck injury resulting from electric shock with 440 V of direct current. Bilateral femoral neck fracture is rare. Bilateral femoral neck fracture due to electric shock is even rarer. This case report highlights bilateral femoral neck fracture without primary and secondary bone disease. Late presentation and unclassified pattern of fracture are the other features.
How to cite this article
Peswani R, Chandrakar BL, Thakkar R. Bilateral Femoral Neck Fracture due to Electric Shock. J Med Sci 2016;2(1):18-20.
... -the impairment of the physiologic conduction systems, such as cardiac contraction and diaphragm excursion, which may result in arrhythmia and apnea; -the electroporation or the electropermeabilization of the cell membranes, which can lead to the deterioration of transmembranar exchanges, intracellular ion and protein balance, and finally, to apoptosis; -the thermal energy generated by the electrical current can determine dermal and internal lesions (burns, necrosis, perforations); -the mechanical injury due to a fall or to the forceful muscle contraction (1,2). The factors that influence the degree of electrical injuries are: the voltage of the current, the duration of the contact, the tissue resistance, and the pathway of the electrical current through the organism (1). ...
... The factors that influence the degree of electrical injuries are: the voltage of the current, the duration of the contact, the tissue resistance, and the pathway of the electrical current through the organism (1). The fractures after electrical injuries are very rare, usually as a result of a fall after electrical shock (1,3). ...
... -vertebrae (1, 2); -neck of femur (1, 3-6); -shoulder: scapula and proximal humerus (1, 7-16); -forearm: Colles, Galeazzi, greenstick and distal radius (1,(17)(18)(19)(20). Fractures after electrocution occur in places with significant and bulky muscular bodies, such as spine, hip and shoulder. ...
A case of left humeral neck fracture following electrocution is reported in a 56-year old man, associated with partial thickness burns on his left hand. A fracture after accidental electrical shock injury represents a very unusual situation, due to muscle contractions. Surgeons involved in the management of the electrocuted patients should be aware of the possibility of musculoskeletal injuries. Neglecting these injuries can lead to delay in diagnosis and to detrimental complications. Celsius.
... 8 Electrical energy has been shown to damage tissue in many ways, either through the direct transmission of current or through electrical thermal energy (caused by current in conductive objects placed on a patient). [8][9][10] However, its association with CTS is hypothesised to be associated with the limited amount of conductive tissue within the carpal tunnel rather than the theory of mechanical compression usually associated with CTS. 8 This theory, therefore, encompasses the idea that the majority of the electrical energy is directed towards the median nerve. It is also theorised that the risk of CTS may not be dependent on the extent of damage to tissue. ...
Carpal tunnel syndrome (CTS) is very rare in children and has been reported very infrequently in the literature. We present an unusual case of CTS in a 14-year-old girl who developed this following an accidental electrical shock. As far as we are aware, this is the first case report of CTS in a child following electrical injury. This rare complication of electrical injury can easily be disregarded or misdiagnosed as neuropraxia, and this can delay appropriate treatment, as evidenced by this case. We propose that CTS should be considered when instigating initial medical care after an electrical injury, and that a referral to a hand surgeon should not be delayed, as these children need urgent surgical intervention to preserve hand function.
2015 BMJ Publishing Group Ltd.
... An unusual case was mentioned (in a news article) of a subject ''breaking the humerus bones, in his upper arms, dislocating his shoulders, and fracturing his shoulder sockets'' purportedly caused by ''muscles convulsing the bones'' during a CEW exposure [161]. Although fractures occurring after common household electric shock are usually the result of falling onto a hard surface, very rare cases of the electricity itself causing enough tetanus to produce a fracture have been reported [162]. Fractures of the humerus were the most frequent. ...
TASER(®) conducted electrical weapons (CEWs) have become an important law-enforcement tool. Controversial questions are often raised during discussion of some incidents in which the devices have been used. The main purpose of this paper is to point out some misconceptions about CEWs that have been published in the scientific/medical and other literature. This is a narrative review, using a multidisciplinary approach of analyzing reports from scientific/medical and other literature sources. In previous reports, durations of incapacitating effects and possible associations of CEWs with deaths-in-custody have often been overstated or exaggerated. Comparisons of CEW effects with "electrocution" are misleading. Clarification of these misconceptions may be important during policymaker decisions, practitioner operations, expert witness testimonies, and court proceedings. Despite misconceptions in the literature, CEWs can still be a valuable tool for law enforcement activities. Scientists, medical professionals, legal advisors, and investigators of police tactics should be aware of these misconceptions.
