The coincidence of forearm and humeral shaft fractures results in a “floating elbow” injury necessitating surgical open reduction and internal fixation of all fractures to allocate for maintenance of elbow joint suitable motion and minimizing stiffness. Here we introduce a case of an ipsilateral humeral shaft fracture and Monteggia and both bone fracture with terrible triad open fracture from a pedestrian car accident (PCA) to his right upper extremity.

Biotechnology is advancing by leaps and bounds to achieve a better recovery with the least possible morbidity in patients with complex joint fractures. Locking screw fixation systems with hydroxyapatite and low contact molded plates have been improved to obtain the best fixation without compromising bone vascularization. Implant placement has also been promoted with minimal approaches, such as MIPO or MISS techniques, thus avoiding damage to soft tissue. However, the complexity of the fracture, our main enemy and is the terrain where we must work, the only factor that cannot be modified.

Spontaneous Hemomediastinum is a rare pathological disorder. Multiple underlying causes and contributory factors can be identified, such as trauma, malignancy, iatrogenic, bleeding disorder or mediastinal organ hemorrhage. Using contrast enhanced computed tomography (CT) of the chest, hemomediastinum can be adequately diagnosed. Spontaneous hemomediastinum may occur due to multiple and cotributory causes such as: secondary to haemorragic disorders, mediastinal tumors or after sudden increase in intrathoracic pressure, (e.g. during coughing, sneezing or vomiting, or sudden sustained hypertension). In this case report, a 76-year-old male is presented with of thyroid artery aneurysm resulting in hemomediastinum causing thoracic pain.

In 2016, the most recent year with national statistics, the annual number of people killed or injured by firearm in the United States was 133,853. While much has been said in the developing world about the lost economic and developmental potential of youth in countries without basic health and educational infrastructure, in the United States homicide by firearm is the third leading cause of injury and death amongst youth aged 15-24, costing billions annually in combined medical and work loss costs. Factoring in suicide by firearm, gun related fatalities account for the number one cause of unintentional injury death in this age group.