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Soft tissue injury management

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https://www.readbyqxmd.com/read/29472891/a-review-of-traumatic-axonal-injury-following-whiplash-injury-as-demonstrated-by-diffusion-tensor-tractography
#1
REVIEW
Sung Ho Jang, Young Hyeon Kwon
Whiplash is a bony or soft tissue injury resulting from an acceleration-deceleration energy transfer in the neck. Although patients with whiplash injury often complain of cerebral symptoms, and previous studies have reported evidence indicating brain injury, such an association has not been clearly elucidated. Traumatic axonal injury (TAI) is tearing of axons due to indirect shearing forces during acceleration, deceleration, and rotation of the brain or to direct head trauma. Diffusion tensor imaging (DTI) has a unique advantage to detect TAI in patients whose conventional brain CT or magnetic resonance imaging (MRI) results were negative following head trauma...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29468667/teachers-knowledge-concerning-dental-trauma-and-its-management-in-primary-schools-in-riyadh-saudi-arabia
#2
Salwa A Alsadhan, Najla F Alsayari, Mashael F Abuabat
OBJECTIVES: The main aim of this cross-sectional study was to assess knowledge concerning traumatic dental injuries and their management among primary schoolteachers in Riyadh, Saudi Arabia. The secondary objective was to evaluate the effect of gender, nationality, marital status, school type, geographical area, age group, level of education and years of experience on teachers' knowledge. METHODOLOGY: Data were collected, through a self-administered questionnaire, from both male and female teachers employed in public and private primary schools in the five geographical areas of Riyadh City...
February 22, 2018: International Dental Journal
https://www.readbyqxmd.com/read/29463292/effectiveness-of-interventions-aimed-at-improving-physical-and-psychological-outcomes-of-fall-related-injuries-in-people-with-dementia-a-narrative-systematic-review
#3
Shannon Robalino, Sarange B Nyakang'o, Fiona R Beyer, Chris Fox, Louise M Allan
BACKGROUND: The annual prevalence of falls in people with dementia ranges from 47 to 90%. Falls are a common reason for hospital admission in people with dementia, and there is limited research evidence regarding the care pathways experienced by this population. In addition to immediate management of an injury, prevention of further falls is likely to be an important part of any successful intervention. This review aims to assess the effectiveness of interventions for improving the physical and psychological wellbeing of people with dementia who have sustained a fall-related injury...
February 20, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29461402/management-of-mangled-extremities-and-orthopaedic-war-injuries
#4
Todd O McKinley, Jean-Claude DʼAlleyrand, Ian Valerio, Seth Schoebel, Kevin Tetsworth, Eric A Elster
In 16 years of conflict, primarily in Iraq and Afghanistan, wounded warriors have primarily been subjected to blast type of injuries. Evacuation strategies have led to unprecedented survival rates in blast-injured soldiers, resulting in large numbers of wounded warriors with complex limb trauma. Bone and soft tissue defects have resulted in increased use of complex reconstructive algorithms to restore limbs and function. In addition, in failed salvage attempts, advances in amputation options are being developed...
March 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29461398/what-is-important-besides-getting-the-bone-to-heal-impact-on-tissue-injury-other-than-the-fracture
#5
Michael J Gardner, Thomas A Higgins, William H Harvin, James P Stannard, Mark A Lee, Brett D Crist
Fracture surgeons do a great job of managing bone issues, but they may overlook the associated soft tissue injuries that play a significant role in the final outcome after musculoskeletal injury. The soft tissue reconstruction ladder can help guide reconstructive procedures based on the least complex procedure that allows the best chance of fracture healing. Muscle injury, volume loss, and deconditioning occur with traumatic injury and during the recovery phase. Neuromuscular stimulation, nutrition, and strength training are potential ways to aid in recovery...
March 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29461394/diagnosis-and-management-of-polytraumatized-patients-with-severe-extremity-trauma
#6
Todd O McKinley, Greg E Gaski, Yoram Vodovotz, Benjamin T Corona, Timothy R Billiar
Multiply injured patients with severe extremity trauma are at risk of acute systemic complications and are at high risk of developing longer term orthopaedic complications including soft-tissue infection, osteomyelitis, posttraumatic osteoarthritis, and nonunion. It is becoming increasingly recognized that injury magnitude and response to injury have major jurisdiction pertaining to patient outcomes and complications. The complexities of injury and injury response that affect outcomes present opportunities to apply precision approaches to understand and quantify injury magnitude and injury response on a patient-specific basis...
March 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29459605/evaluation-of-the-results-of-ilizarov-ring-fixation-in-schatzker-type-vi-tibial-plateau-fracture
#7
D G Mostafa, M I Qavi, M M Bari, M Arifuzzaman, M Kamruzzaman, M K Saha
High-energy tibial plateau fractures associated with severe soft tissue injury are difficult to manage. The risk of wound complications following open reduction and internal fixation is notably high owing to extensive soft tissue dissection. Alternatively, application of Ilizarov ring fixator minimizes soft tissue dissection and provides adequate fracture stabilization to allow early range of motion and correction of any mal-alignment. With this technique, soft tissue complications particularly surgical site infections are expected to be significantly reduced...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29453974/genetically-modified-bone-mesenchymal-stem-cells-with-tgf-%C3%AE-3-improve-wound-healing-and-reduce-scar-tissue-formation-in-a-rabbit-model
#8
Mingyong Li, Lin Qiu, Wei Hu, Xiang Deng, Hanfeng Xu, Youhan Cao, Zijian Xiao, Liangyu Peng, Shawn Johnson, Lyundup Alexey, Paul A Kingston, Qing Li, Yuanyuan Zhang
Extensive scar tissue formation often occurs after severe burn injury, trauma, or as one of complications after surgical intervention. Despite significant therapeutic advances, it is still a significant challenge to manage massive scar tissue formation while also promoting normal wound healing. The goal of this study was to investigate the therapeutic effect of bone mesenchymal stem cells (BMSCs) that were genetically modified to overexpress transforming growth factor-beta 3 (TGF-β 3 ), an inhibitor of myofibroblast proliferation and collagen type I deposition, on full-thickness cutaneous wound healing in a rabbit model...
February 14, 2018: Experimental Cell Research
https://www.readbyqxmd.com/read/29450715/utility-of-mri-for-cervical-spine-clearance-in-blunt-trauma-patients-after-a-negative-ct
#9
Ajay Malhotra, David Durand, Xiao Wu, Bertie Geng, Khalid Abbed, Diego B Nunez, Pina Sanelli
PURPOSE: To determine the utility of cervical spine MRI in blunt trauma evaluation for instability after a negative non-contrast cervical spine CT. METHODS: A review of medical records identified all adult patients with blunt trauma who underwent CT cervical spine followed by MRI within 48 h over a 33-month period. Utility of subsequent MRI was assessed in terms of findings and impact on outcome. RESULTS: A total of 1,271 patients with blunt cervical spine trauma underwent both cervical spine CT and MRI within 48 h; 1,080 patients were included in the study analysis...
February 15, 2018: European Radiology
https://www.readbyqxmd.com/read/29443860/a-novel-rat-model-of-extremity-trauma-for-pre-hospital-pain-management-research
#10
Lusha Xiang, Harold G Klemcke, Nathan A Wienandt, Kathy L Ryan, Carmen Hinojosa-Laborde
BACKGROUND: Pain management is important in pre-hospital care of patients with extremity trauma (ET). The goal of this study was to establish a rat model of ET for pre-hospital pain research, and validate it using pain behaviors and analgesics. METHODS: Rats were anesthetized using isoflurane and ET was induced in one hindlimb via clamping retrofemoral tissues for 30 sec, followed by closed fibula fracture. Rats regained consciousness after ET. Pain responses in the injured hindlimb to thermal hyperalgesia (paw withdrawal latency, PWL), mechanical allodynia (paw withdrawal pressure, PWP), and weight bearing (WB) were determined before and 90 minutes after ET...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29430494/elastic-stable-intramedullary-nailing-of-femoral-shaft-fracture-experience-in-48-children
#11
Rajesh Govindasamy, Ramkumar Gnanasundaram, Saravanan Kasirajan, Syed Ibrahim, Jimmy Joseph Melepuram
Background: Femoral shaft fractures are an incapacitating pediatric injury accounting for 1.6% of all pediatric bony injuries. Management of these fractures is largely directed by age, fracture pattern, associated injuries, built of the child and socioeconomic status of the family. We retrospectively evaluated the use of elastic stable intramedullary nail (ESIN) in surgical management of femoral shaft fractures in children and its complications. Methods: Fifty two children were treated with titanium elastic nails (TEN) from June 2009 to June 2014 at our institution...
January 2018: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29428686/reconstruction-of-a-complex-foot-injury-with-free-remodeled-fibular-osteocutaneous-flap-a-case-report-and-literature-review
#12
Liangsong Song, Zhixin Zhang, Yang Wang, Yang Liu, Zhigang Liu, Lei Chen, Laijin Lu
Management of complex foot injuries, which involve open fractures and severe trauma to soft tissues, represent a challenge to orthopedic clinicians. In the present case report, we treated a complex foot injury with a remodeled fibular osteocutaneous free flap to reconstruct the anterior and lateral areas of the foot. The flap survived completely. At the 9-month follow-up examination, bony union of the graft bone was identified by radiographic examination. The reconstructed foot could bear body weight, and the patient could maintain a bipedal gait without discomfort...
February 8, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29428539/vascular-trauma-in-children-review-from-a-major-paediatric-centre
#13
REVIEW
Sofia Morão, Rita S Ferreira, Nelson Camacho, Vanda Pratas Vital, J Pascoal, M Emília Ferreira, L Mota Capitão, Frederico B Gonçalves
INTRODUCTION: Traumatic non-iatrogenic vascular injuries in children are rare and rarely discussed in literature. Paediatric vascular injuries pose a set of challenges mainly because of continued growth and development in a child or adolescent. The purpose of the study is to characterize management strategies and outcomes in these cases. PATIENTS AND METHODS: Single-centre retrospective review of patients less than age 18 years (paediatric age) with acute, non-iatrogenic traumatic vascular injuries between January 2009 and December 2015...
February 8, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29417207/gradual-fibular-transfer-by-ilizarov-external-fixator-in-post-traumatic-and-post-infection-large-tibial-bone-defects
#14
Mohammed Anter Meselhy, Mohamed Salah Singer, Abdelsamie M Halawa, Gamal Ahmed Hosny, Adel H Adawy, Osama M Essawy
INTRODUCTION: Several reconstructive procedures have been used in management of large tibial bone defects including bone graft, bone transport (distraction osteogenesis) using various external fixators, and vascularized bone graft. Each of these procedures has its limitations and complications. The study describes gradual medial fibular transfer using Ilizarov external fixators in management of patients with large tibial defect, either following infection or trauma. PATIENTS AND METHODS: Between May 2011 and June 2013, 14 patients were prospectively included in the current study...
February 7, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29415765/double-non-contiguous-fractures-in-a-patient-with-spondylo-epiphyseal-dysplasia-with-spinal-ankylosis-treated-with-open-and-percutaneous-spinal-fixation-technique-a-case-report
#15
Takahiro Ushijima, Kenichi Kawaguchi, Tadashi Matsumoto, Masaki Takagi, Tatsuro Kondoh, Gen Nishimura, Aritoshi Iida, Shiro Ikegawa, Nobuhiko Haga, Go Kato
BACKGROUND: Patients with ankylosing spines are susceptible to developing spinal fractures even with minor trauma and can develop early or late neurological injuries. These fractures require early and aggressive surgical management to enable spinal stability and/or neural decompression. Being highly unstable by nature, they require relatively long segment instrumentation and fusion, which can increase paravertebral soft tissue damage and perioperative bleeding. The purpose of this report is to describe a rare case of traumatic double fractures at the cervico-thoracic and thoraco-lumbar transition zones in ankylosing spine with spondylo-epiphyseal dysplasia (SED) of unknown cause, which were successfully treated with a combined open and percutaneous spinal fusion procedure...
February 7, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29413767/the-role-of-intramedullary-fixation-in-ankle-fractures-a-systematic-review
#16
REVIEW
R W Jordan, A W P Chapman, D Buchanan, P Makrides
BACKGROUND: Ankle fractures are one of the most commonly occurring fractures in the elderly population. The overall incidence has been reported to be up to 184 fractures per 100,000 persons per year, of which 20-30% occur in the elderly. Medical co-morbidities, osteoporosis, suboptimal skin quality and poor toleration of non-weight bearing status all contribute to difficulties in managing these injuries in this population. Intramedullary implants are advantageous as they utilise smaller incisions, minimise soft tissue disruption and may allow early weight bearing...
February 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29409431/the-predictive-value-of-ultrasound-scanning-in-certain-hand-and-wrist-conditions
#17
Khalid Al-Hourani, David Gamble, Paul Armstrong, Greg O'Neill, James Kirkpatrick
BACKGROUND: Fast and accurate diagnosis of conditions of the hand and wrist is essential in guiding management. We aimed to analyse the predictive value of ultrasound in identifying different pathologies in the hand and wrist by correlating pre-operative ultrasound findings with per-operative surgical findings. METHODS: We retrospectively reviewed the case notes of all patients under the care of the senior author on whom a hand/wrist ultrasound had been performed between January 2007-May 2013...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29403232/evaluation-of-knowledge-awareness-and-occurrence-of-dental-injuries-in-participant-children-during-sports-in-new-delhi-a-pilot-study
#18
Mridula Goswami, Puneet Kumar, Urvashi Bhushan
Aim: To evaluate the occurrence of dental injuries in children, the level of knowledge of the participants about preventive measures, and management of dental trauma during sports, in New Delhi. Materials and methods: A cross-sectional study was carried out among 450 children aged 6 to 16 years. A structured interviewer-guided questionnaire was used to determine the prevalence of oral injuries sustained during sport activities, the use of mouthguard as well as the athlete's awareness regarding use of mouthguard...
October 2017: International Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/29402720/a-review-of-upper-limb-injuries-in-bear-maul-victims-consistent-pattern-and-inverse-relation-in-severity-with-facial-and-scalp-injuries
#19
Towseef Ahmad Bhat, Amara Gulzar, Aejaz Ahmad Bhat, Tariq Ahmad Bhat, Zameer Ali
PURPOSE: Bear maul injuries are the most common wild animal inflicted injuries in India. More than 300 bear maul injuries report to our hospital per year. METHODS: Twenty-one consecutive patients over a period of 1 year reported to our department for orthopaedic management of bear maul injuries. All the patients were referred either from peripheral hospitals or from other surgical departments of our hospital. RESULTS: All the patients had facial/scalp injuries of variable severity...
November 24, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29396757/epidemiology-of-open-tibia-fractures-in-a-population-based-database-update-on-current-risk-factors-and-clinical-implications
#20
Christian David Weber, Frank Hildebrand, Philipp Kobbe, Rolf Lefering, Richard M Sellei, Hans-Christoph Pape
BACKGROUND: Open tibia fractures usually occur in high-energy mechanisms and are commonly associated with multiple traumas. The purposes of this study were to define the epidemiology of open tibia fractures in severely injured patients and to evaluate risk factors for major complications. METHODS: A cohort from a nationwide population-based prospective database was analyzed (TraumaRegister DGU®). Inclusion criteria were: (1) open or closed tibia fracture, (2) Injury Severity Score (ISS) ≥ 16 points, (3) age ≥ 16 years, and (4) survival until primary admission...
February 2, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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