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Journal of Trauma Management & Outcomes

Emanuel Steiner, Monika Murg-Argeny, Heinz Steltzer
BACKGROUND: Severe traumatic brain injury (TBI) is a great economical and logistic problem in the health care system which reduces the quality of life and productivity of the patient. The purpose of this study is to evaluate the outcome of patients after severe brain trauma according to the course of their rehabilitation. METHODS: Patients with TBI were divided into three groups. Group A; after early rehabilitation (n = 16), B; following a standard rehabilitation procedure after work accidents (n = 34) and C; undergone standard rehabilitation procedure after accidents at home (n = 12)...
2016: Journal of Trauma Management & Outcomes
Sri Hari Sundararajan, Phillip Murillo, Adam Khan, Vyacheslav Gendel, Christopher Gribbin, Sudipta Roychowdhury, John Nosher
BACKGROUND: Angiography allows for excellent characterization and treatment of traumatic pseudoaneurysms. However, ultrasound-guided thrombin injection for pseudoaneurysm thrombosis allows for radiation-free treatment of superficial pseudoaneurysms and superficial expanding hematomas. METHODS: A retrospective review of 5 patient cases treated under this paradigm was performed following institutional review board approval. Outcomes following intervention were recorded and compared amongst the patient cohort...
2016: Journal of Trauma Management & Outcomes
Jessica McKee, Sandy L Widder, J Damian Paton-Gay, Andrew W Kirkpatrick, Paul Engels
BACKGROUND: Alcohol plays a significant role in major traumatic injuries. While the role of alcohol in motor vehicle trauma (MVT) is well described, its role and approaches to prevention in other injury mechanisms is less defined. METHODS: A 10 year retrospective examination of Alberta Trauma Registry (ATR) data was conducted on all major trauma patients (age ≥ 9 and ISS ≥ 12) from 2001-2010. The role and prevalence of alcohol is examined. RESULTS: Of 22,457 patients included in our study, only 60 %(n = 13,552) were screened for alcohol use...
2016: Journal of Trauma Management & Outcomes
Sumeet V Jain, Castigliano M Bhamidipati, Robert N Cooney
BACKGROUND: The regionalization of trauma care, the Emergency Medical Treatment and Active Labor Act of 1986, the advent of Accountable Care Organizations and bundled payments have brought Level 1 trauma centers (TC) to a new crossroads. By protocol, injured patients are preferentially transferred to designated TCs when a higher level of care is indicated. Trauma transfers frequently come during off hours and may not always appear to be related to injury severity. Based on this observation, we hypothesized patients transferred from regional hospitals to Level 1 TCs would have lower injury severity scores (ISS) and unfavorable payor status...
2016: Journal of Trauma Management & Outcomes
Behrad Ziapour, Houman Seyedjavady Haji
BACKGROUND: Occult pneumothorax represents a diagnostic pitfall during the primary survey of trauma patients, particularly if these patients require early positive pressure ventilation. This study investigated the accuracy of our proposed rapid model of ultrasound transducer positioning during the primary survey of trauma patients after their arrival at the hospital. METHODS: This diagnostic trial was conducted over 12 months and was based on the results of 84 ultrasound (US) exams performed on patients with severe multiple trauma...
2015: Journal of Trauma Management & Outcomes
Douglas L Delahanty, Robert Marley, Andrew Fenton, Ann Salvator, Christina Woofter, Daniel Erck, Jennifer Coleman, Farid Muakkassa
BACKGROUND: Prior traumatic experiences have been associated with poorer coping strategies, greater distress, and more posttraumatic stress disorder (PTSD) symptoms following a subsequent cancer diagnosis affecting their survival. However, the impact of prior physical traumatic injury on cancer survival has not been examined. METHODS: The present study matched patients from the same Level 1 Trauma center who appeared in both the trauma and cancer registries. A total of 498 patients met the criteria between 1998 and 2014 who have experienced both a diagnosis of cancer and a physical traumatic injury...
2015: Journal of Trauma Management & Outcomes
Masaki Fujioka, Kenji Hayashida
PURPOSE: Management of finger amputations of the proximal interphalangeal (PIP) joint is still controversial. Regrettably, injured PIP joints seldom regain normal active motion; thus, many investigators recommend revision amputation with skeletal injury at or proximal to the PIP joint. We report the functional outcome of patients with replantation or revascularization following complete or incomplete amputations of the PIP joint. METHODS: A total of 15 digital replantations or revascularization were performed on 11 patients (9 males and 2 females, age, 26-69 years) with severe finger injuries at the PIP joint at our Medical Center from 2010 through 2012...
2015: Journal of Trauma Management & Outcomes
Ananya Panda, Atin Kumar, Shivanand Gamanagatti, Ashu Seith Bhalla, Raju Sharma, Subodh Kumar, Biplab Mishra
BACKGROUND: Traumatic bilateral adrenal injuries are uncommon. Adrenal injuries are overall associated with worse outcome than non-adrenal injuries. However, direct comparative evidence between unilateral and bilateral adrenal injuries is unavailable in literature. This study aims to investigate clinical significance of bilateral adrenal hematomas in terms of injury severity, morbidity and mortality. METHODS: All blunt trauma abdomen patients with adrenal gland involvement on initial CECT scans of abdomen presenting to our Level 1 trauma centre over 21 months were prospectively included and followed-up...
2015: Journal of Trauma Management & Outcomes
Fahad H Khan, Kamal M Yousuf, Anel R Bagwani
BACKGROUND: Traumatic vascular injuries of the extremities are a major challenge especially in the third world countries. These injuries are mostly due to poor traffic laws, street crimes, firearms and blast associated injuries. We therefore would like to share our 10 years of experience in dealing with vascular injuries in Pakistan. METHODS: This was a retrospective observational study conducted in the department of vascular surgery of Liaquat National Hospital, Karachi, Pakistan...
2015: Journal of Trauma Management & Outcomes
Max J Scheyerer, Robert Döring, Nina Fuchs, Philipp Metzler, Kai Sprengel, Clement M L Werner, Hans-Peter Simmen, Klaus Grätz, Guido A Wanner
BACKGROUND: A significant proportion of patients admitted to hospital with multiple traumas exhibit facial injuries. The aim of this study is to evaluate the incidence and cause of facial injuries in severely injured patients and to examine the role of plastic and maxillofacial surgeons in treatment of this patient collective. METHODS: A total of 67 patients, who were assigned to our trauma room with maxillofacial injuries between January 2009 and December 2010, were enrolled in the present study and evaluated...
2015: Journal of Trauma Management & Outcomes
Pehr Sommar, Yamin Granberg, Martin Halle, Ann-Charlott Docherty Skogh, Kalle T Lundgren, Karl-Åke Jansson
BACKGROUND: Severe trauma to the extremities often includes a combination of fractures and soft tissue injuries. Several publications support that the patient outcome is better when skeletal stabilization is followed by early soft-tissue coverage. In an effort to optimize the treatment of these patients, we established a formalized collaboration in 2008 between the Departments of reconstructive plastic surgery and orthopedics at the Karolinska University Hospital. METHODS: A retrospective review was conducted for all patients who had suffered severe extremity trauma and received either a free or a pedicled flap for extremity reconstruction...
2015: Journal of Trauma Management & Outcomes
Nils Christian Utheim, Roger Josefsen, Per Hjalmar Nakstad, Torfinn Solgaard, Olav Roise
BACKGROUND: Lower cranial nerve (IX-XII) palsy is a rare condition with numerous causes, usually non-traumatic. In the literature it has been described only a few times after trauma, mostly accompanied by a fracture of the occipital condyle. Although these types of fractures have rarely been reported one could suspect they have been under-diagnosed. During the past decade they have been seen more frequently, most probably due to increased use of CT- and MRI-scanning. The purpose of this review is to increase the awareness of complications following injuries in the craniocervical region...
2015: Journal of Trauma Management & Outcomes
Courtney E Collins, Nicole Cherng, Theodore McDade, Babak Movahedi, Timothy A Emhoff, Giles F Whalen, Jennifer LaFemina, Jon D Dorfman
BACKGROUND: The increasing use of computed tomography (CT) scans in the evaluation of trauma patients has led to increased detection of incidental radiologic findings. Incidental findings (IFs) of the abdominal viscera are among the most commonly discovered lesions and can carry a risk of malignancy. Despite this, patient notification regarding these findings is often inadequate. METHODS: We identified patients who underwent abdominopelvic CTs as part of their trauma evaluation during a recent 1-year period (9/2011-8/2012)...
2015: Journal of Trauma Management & Outcomes
John Vedelago, Elizabeth Dick, Robert Thomas, Brynmor Jones, Olga Kirmi, Jennifer Becker, Afshin Alavi, Wladyslaw Gedroyc
We describe two cases of intravascular embolization of shotgun pellets found distant to the entry site of penetrating firearm injury. The cases demonstrate antegrade embolization of a shotgun pellet from neck to right middle cerebral artery, and antegrade followed by retrograde venous embolization through the left lower limb to pelvis. Radiologists and Trauma Physicians should be aware that post shotgun injury, the likelihood of an embolised shot pellet is increased compared to other types of firearm missile injury, and should therefore search away from the site of injury to find such missiles...
2014: Journal of Trauma Management & Outcomes
Lene Østerballe, Frederik Helgstrand, Thomas Axelsen, Jens Hillingsø, Lars Bo Svendsen
INTRODUCTION: Hepatic pseudoaneurysm (HPA) is a rare complication after liver trauma, yet it is potentially fatal, as it can lead to sudden severe haemorrhage. The risk of developing posttraumatic HPA is one of the arguments for performing follow-up CT of patients with liver injuries. The aim of this study was to investigate the occurrence of HPA post liver trauma. METHODS: A retrospective study from 2000-2010 of conservatively treated patients with blunt liver trauma was performed to investigate the incidence and nature of HPA...
2014: Journal of Trauma Management & Outcomes
Steven Ferree, Jacqueline Jem van Laarhoven, R Marijn Houwert, Falco Hietbrink, Egbert Jan Mm Verleisdonk, Luke Ph Leenen
BACKGROUND: Although extensive research for the optimal treatment of clavicle fractures has been performed, comparative studies between monotrauma and polytrauma patients are lacking. OBJECTIVE: To compare fracture distribution and treatment in monotrauma and polytrauma patients with a clavicle fracture. METHODS: Single center retrospective cohort study. Fractures were classified by the Robinson classification. Monotrauma patients sustained only a clavicle fracture or a clavicle fracture plus a minor abrasion, hematoma, or superficial skin lesion leading to an Injury Severity Score (ISS) of 4 or 5 respectively...
2014: Journal of Trauma Management & Outcomes
Jan Friederichs, Mario Morgenstern, Volker Bühren
BACKGROUND: Scapula fractures with injuries of the Superior Shoulder Suspensory Complex are often referred to as floating shoulders. However, present studies do not allow comparative evidence on indication for surgical treatment mostly due to the lack of precise definitions and comparable classifications. The aim of this study was to retrospectively analyze common types of complex shoulder injuries and develop a feasible classification allowing a therapeutic algorithm. METHODS: The study group consisted of 107 patients with scapula fractures combined with ipsilateral injuries of the shoulder girdle treated in a single trauma center between 2003 and 2010...
2014: Journal of Trauma Management & Outcomes
Hans P Granhed, David Pazooki
BACKGROUND: About 10% of adult patients in high-energy trauma sustain multiple rib fractures. Some of these patients suffer from flail chest leading to respiratory insufficiency. During last years interest and results for operative treatment has improved. The literature today all show positive results for surgical versus conservative treatment, specifically with regard to time spent in mechanical ventilator, complication rates and length of hospital stay. METHODS: Between September 2010 and July 2012, 60 patients with flail chest or multiple rib-fractures resulting in unstable thoracic cage were operated...
2014: Journal of Trauma Management & Outcomes
Katriona Brooksbank, Paul J Jenkins, Iain C Anthony, Alisdair Gilmour, Margaret P Nugent, Lech A Rymaszewski
BACKGROUND: Mallet finger injuries are usually successfully treated non-operatively with a splint. Most patients are reviewed at least twice in a clinic after the initial presentation in A&E. A new protocol promoting "self-care" was introduced at our institution. Patients were provided with structured verbal and written information, and given access to a telephone helpline. METHODS: A prospective electronic patient record was used to identify all patients who presented to the emergency department with a mallet finger with a minimum six month follow-up...
2014: Journal of Trauma Management & Outcomes
Ayman El-Menyar, Husham Abdelrahman, Hassan Al-Thani, Ahmad Zarour, Ashok Parchani, Ruben Peralta, Rifat Latifi
BACKGROUND: The mechanism and outcome of traumatic abdominal injury (TAI) varies worldwide. Moreover, data comparing TAIs in each abdominal compartment are lacking. We aimed to assess from the academic point of view, TAI based on its anatomical compartments. PATIENTS & METHODS: We conducted a retrospective study for TAI patients between 2008 and 2011 in Qatar. Patients were categorized according to the involved anatomical compartment (C): intrathoracic (ITC), retroperitoneal (RPC), true abdomen (TAC), and pelvic abdomen (PAC) group...
2014: Journal of Trauma Management & Outcomes
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