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Soft tissue injury management

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https://www.readbyqxmd.com/read/29218292/primary-one-stage-reconstruction-in-complex-facial-avulsion-injury
#1
Abhishek Ghosh
Complex facial injuries with soft tissue degloving and bony avulsion are very devastating to the patient. Partial degloving injuries are described but hemifacial degloving with zygoma avulsion are rare. The author presents a case of post-traumatic degloving of the left upper lip, nose, part of forehead, upper and lower eyelids and cheek with avulsion of the left zygoma. The management included immediate resuscitation and early surgery to reposition the skeletal as well as soft tissue avulsion. The wound was thoroughly washed and primary repositioning and fixation were done...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29218283/early-reconstructions-of-complex-lower-extremity-battlefield-soft-tissue-wounds
#2
Ali Ebrahimi, Nasrin Nejadsarvari, Azin Ebrahimi, Hamid Reza Rasouli
BACKGROUND: Severe lower extremity trauma as a devastating combat related injury is on the rise and this presents reconstructive surgeons with significant challenges to reach optimal cosmetic and functional outcomes. This study assessed early reconstructions of complex lower extremity battlefield soft tissue wounds. METHODS: This was a prospective case series study of battled field injured patients which was done in the Department of Plastic Surgery, Baqiyatallah University of Medical Sciences hospitals, Tehran, Iran between 2013-2015...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29211703/intra-articular-findings-during-the-modified-brostrom-procedure-for-lateral-instability-of-the-pediatric-ankle
#3
Brady T Evans, Frances A Tepolt, Emily Niu, Dennis E Kramer, Mininder S Kocher
The purpose of this study was to identify the rates of chondral injury, soft tissue impingement, and bony impingement in pediatric patients undergoing the modified Brostrom procedure with ankle arthroscopy for lateral ankle instability. A retrospective review of all patients undergoing a modified Brostrom procedure with ankle arthroscopy performed by two surgeons at a tertiary care children's hospital between October 2002 and April 2014 was performed. Data were collected regarding demographics, history and initial presentation, nonoperative management, surgical procedure and arthroscopic findings, and clinical follow-up...
January 2018: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/29209809/reduction-and-temporary-stabilization-of-tile-c-pelvic-ring-injuries-using-a-posteriorly-based-external-fixation-system
#4
Murphy P Martin, David Rojas, Cyril Mauffrey
Tile C pelvic ring injuries are challenging to manage even in the most experienced hands. The majority of such injuries can be managed using percutaneous reduction techniques, and the posterior ring can be stabilized using percutaneous transiliac-transsacral screw fixation. However, a subgroup of patients present with inadequate bony corridors, significant sacral zone 2 comminution or significant lateral/vertical displacement of the hemipelvis through a complete sacral fracture. Percutaneous strategies in such circumstances can be dangerous...
December 5, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29200490/management-of-nail-bed-injuries-associated-with-fingertip-injuries
#5
Alexander George, Reena Alexander, C Manju
Background: Management of nail injuries can often be a challenging experience, especially in presence of complex fingertips' injuries that include soft tissue loss and distal phalanx injury. Most studies found in the literature focus on individual injuries and describe methods to tackle those injuries, notwithstanding the fact that the nail, nailbed, distal phalanx, soft tissue and skin of the finger tip form a complex and often more than one element of this complex is injured. This retrospective study therefore focuses on the management of nail bed injuries as a part of the complex finger tip injury and outlines the surgical principles and techniques that were used in their management...
November 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29181350/temporary-fixation-using-a-long-femoral-tibial-nail-to-treat-a-displaced-medial-tibial-plateau-fracture-in-a-90-year-old-patient-a-case-report
#6
V Batta, S Sinha, A Trompeter
Introduction: Tibial plateau fractures are complex injuries in the elderly population. When traditional methods of fixation are not suitable, an alternative method needs to be chosen for a favorable outcome. We demonstrate a previously undescribed treatment for displaced tibial plateau fractures in the very elderly with poor soft-tissue integrity. Case Report: A 90-year-old woman suffered an open, Gustilo Grade IIIA, displaced fracture of the tibial plateau. An intramedullary knee arthrodesis, the femoral-tibial nail was used to temporarily stabilize her fracture...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29169595/open-distal-radius-fractures-timing-and-strategies-for-surgical-management
#7
REVIEW
Matthew L Iorio, Carl M Harper, Tamara Rozental
Open distal radius fractures are rare injuries with few studies to guide treatment. Degree of soft tissue injury and contamination may be a primary consideration to dictate timing and operative intervention. Antibiotics should be started as early as possible and include a first-generation cephalosporin. Surgical fixation remains a matter of surgeon preference: although studies support the use of definitive internal fixation, many surgeons address contaminated injuries with external fixation. Although postoperative outcomes are similar to closed injuries for low-grade open distal radius fractures, high-grade injuries with more complex fracture patterns carry a high risk of complications, poor outcomes, and repeat surgical procedures...
February 2018: Hand Clinics
https://www.readbyqxmd.com/read/29164165/platelet-rich-plasma-for-primary-treatment-of-partial-ulnar-collateral-ligament-tears-mri-correlation-with-results
#8
J Banks Deal, Ed Smith, Wendell Heard, Michael J O'Brien, Felix H Savoie
Background: Jobe revolutionized the treatment of medial ulnar collateral ligament (MUCL) tears with his reconstruction technique. However, not all MUCL injuries require operative management; Rettig showed that 42% of MUCL injuries respond to conservative management. This was improved by Podesta, who showed that augmentation of nonoperative management with platelet-rich plasma (PRP) and magnetic resonance imaging (MRI) for detecting partial MUCL tears resulted in significantly higher success rates...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29158651/soft-tissue-complications-in-distal-tibial-fractures-managed-with-medial-locking-plates-a-myth-or-reality
#9
Deepak Jain, Harpal Singh Selhi, Mohammad Yamin, Pankaj Mahindra
Background: Distal tibial fractures are common injuries that are prone to complications and require careful management. The use of medial periarticular locking plates is an established modality in the treatment if these fractures. These plates are inserted using the minimally invasive plate osteosynthesis (MIPO) or open technique. Our study looks at the soft tissue complications associated with the use of medial locking plates in the management of these fractures. Methods: This was a retrospective study carried out at a tertiary care university hospital in an urban setting...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29145966/outcome-evaluation-of-staged-treatment-for-bicondylar-tibial-plateau-fractures
#10
Vincenzo Giordano, Ney Pecegueiro do Amaral, Hilton A Koch, Rodrigo Pires E Albuquerque, Felipe Serrão de Souza, José Félix Dos Santos Neto
BACKGROUND: The universal accepted strategy for treating high-energy tibial plateau fractures remains a topic of ongoing debate. The challenge for the practicing orthopaedic trauma surgeon is to provide anatomical articular fracture reduction, with successfully managing the complex soft-tissue injury that is commonly present at patient admission. The primary aim of the actual study was to evaluate the results of a staged protocol for the treatment of high-energy bicondylar tibial plateau fractures...
October 2017: Injury
https://www.readbyqxmd.com/read/29143592/col5a1-gene-variants-previously-associated-with-reduced-soft-tissue-injury-risk-are-associated-with-elite-athlete-status-in-rugby
#11
Shane M Heffernan, Liam P Kilduff, Robert M Erskine, Stephen H Day, Georgina K Stebbings, Christian J Cook, Stuart M Raleigh, Mark A Bennett, Guan Wang, Malcolm Collins, Yannis P Pitsiladis, Alun G Williams
BACKGROUND: Two common single nucleotide polymorphisms within the COL5A1 gene (SNPs; rs12722 C/T and rs3196378 C/A) have previously been associated with tendon and ligament pathologies. Given the high incidence of tendon and ligament injuries in elite rugby athletes, we hypothesised that both SNPs would be associated with career success. RESULTS: In 1105 participants (RugbyGene project), comprising 460 elite rugby union (RU), 88 elite rugby league athletes and 565 non-athlete controls, DNA was collected and genotyped for the COL5A1 rs12722 and rs3196378 variants using real-time PCR...
November 14, 2017: BMC Genomics
https://www.readbyqxmd.com/read/29129131/increased-wound-complication-with-intramedullary-screw-fixation-of-clavicle-fractures-is-it-thermal-necrosis
#12
Peter Domos, Graham Tytherleigh-Strong, Lee Van Rensburg
PURPOSE: Adult mid-shaft clavicle fractures are common injuries. For displaced fractures, open reduction with plate or intramedullary (IM) fixation is the widely used techniques. All methods have their own potential drawbacks, especially related to local soft tissue complications. There is little information about outcome and management of local wound complications after clavicle fracture fixations. METHODS: Ninety-seven patients underwent open reduction and internal fixation, 17 were treated with IM screw fixation and 80 with plate fixation...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29126847/visualization-of-painful-inflammation-in-patients-with-pain-after-traumatic-ankle-sprain-using-11-c-d-deprenyl-pet-ct
#13
Mikko Aarnio, Lieuwe Appel, Mats Fredrikson, Torsten Gordh, Olof Wolf, Jens Sörensen, Måns Thulin, Magnus Peterson, Clas Linnman
BACKGROUND AND AIMS: Positron emission tomography (PET) with the radioligand [(11)C]-D-deprenyl has shown increased signal at location of pain in patients with rheumatoid arthritis and chronic whiplash injury. The binding site of [(11)C]-D-deprenyl in peripheral tissues is suggested to be mitochondrial monoamine oxidase in cells engaged in post-traumatic inflammation and tissue repair processes. The association between [(11)C]-D-deprenyl uptake and the transition from acute to chronic pain remain unknown...
November 7, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29126283/surgical-management-of-penile-lesions-secondary-to-foreign-body-reaction-a-case-report-and-systematic-review
#14
Pedro L S Faveret, Fábio Santiago
Background: To improve the penile contour, some men choose to undergo implantation or injection of nonbiological materials. Foreign body reactions in penile tissue may produce scarring, deformity, ulceration, necrosis, and even gangrene. Consensus is lacking regarding the most effective surgical procedure for reconstruction of these penile lesions. Objectives: The authors describe one case study and the first systematic review focusing on reconstructive surgical management for penile lesions secondary to foreign body reaction...
November 6, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29100662/management-of-partial-fingertip-amputation-in-adults-operative-and-non-operative-treatment
#15
REVIEW
Kunal Sindhu, Steven F DeFroda, Andrew P Harris, Joseph A Gil
BACKGROUND: Hand and finger injuries account for approximately 4.8 million visits to emergency departments each year. These injuries can cause a great deal of distress for both patients and providers and are often initially encountered in urgent care clinics, community hospitals, and level one trauma centers. Tip amputation injuries vary widely in mechanism, ranging from sharp lacerations to crush injuries that present with varying degrees of contamination. The severity of damage to soft tissue, bone, arteries and nerves is dependent upon the mechanism and guides treatment decision-making...
October 31, 2017: Injury
https://www.readbyqxmd.com/read/29096342/bipolar-fracture-dislocation-of-clavicle-a-report-of-osteosynthesis-and-early-soft-tissue-reconstruction
#16
Renaldi Prasetia, Hermawan Nagar Rasyid
INTRODUCTION: Bipolar dislocation of the clavicle, also called bifocal or pan-articular dislocation or floating clavicle, is an uncommon traumatic injury. The injury of this case is also concomitant with distal third clavicle and coracoid fracture. This article aimed to report the experience of performing osteosynthesis and early soft tissue reconstruction on these injuries. CASE REPORT: We reported a case of bipolar clavicle fracture-dislocation in concomitant with coracoid fracture in a man, aged 32 years old, successfully treated 24days after accident by fixation of both fractures and early simultaneous reconstruction of sternoclavicular- acromioclavicular-coracoclavicular joints...
October 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29095073/surgical-management-of-haemophilic-pseudotumors-experience-in-a-developing-country
#17
Yu He, Xi Zhou, Haomin Cui, Guixing Qiu, Xisheng Weng, Baozhong Zhang, Yong Liu
AIM: Hemophilic pseudotumors result from repeated episodes of bleeding into bone, subperiosteum, and soft tissue. Since clotting factors became available, uncontrolled perioperative bleeding is a less significant problem for surgeons in developed countries. However, they are more difficult to come by in China. Additionally, patients often have to undergo surgery for giant masses and suffer complications. We wanted to present our experience in the surgical management of hemophilic pseudotumors over a 40-year period...
November 2, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29091038/assessment-of-the-biomechanical-effects-of-prophylactic-sacral-dressings-on-tissue-loads-a-computational-modeling-analysis
#18
Ayelet Levy, Amit Gefen
The sacrum is the most susceptible anatomical site for developing pressure injuries, including deep tissue injuries, during supine lying. Prophylactic dressings generally are designed to reduce friction, alleviate internal tissue shear, manage the microclimate, and overall cushion the soft tissues subjected to sustained deformations under the sacrum. Using computational modeling, the authors developed a set of 8 magnetic resonance imaging-based, 3-dimensional finite element models of the buttocks of a healthy 28-year-old woman for comparing the biomechanical effects of different prophylactic sacral dressing designs when used during supine lying on a standard hospital foam mattress...
October 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/29081016/a-review-of-imaging-modalities-used-in-the-diagnosis-and-management-of-scrotal-trauma
#19
REVIEW
Alexis Wang, Ian Stormont, M Minhaj Siddiqui
Genitourinary tract injuries account for 3 to 10% of trauma patients, and scrotal trauma is particularly prevalent in males 10 to 30 years of age. Prompt diagnosis and timely surgical intervention are essential to prevent future complications of infertility, delayed orchiectomy, infection, and testicular atrophy. While clinical examination provides valuable information, it may be inconclusive due to soft tissue swelling and difficult to perform due to testicular pain with palpation. Conversely, testicular rupture does not always present with pain or tenderness...
October 28, 2017: Current Urology Reports
https://www.readbyqxmd.com/read/29079067/clinical-mimics-an-emergency-medicine-focused-review-of-cellulitis-mimics
#20
Garrett Blumberg, Brit Long, Alex Koyfman
BACKGROUND: Cellulitis is a common clinical condition with low rates of morbidity and mortality if treated appropriately. Mimics of cellulitis presenting with erythema, edema, warmth, and pain can be associated with grave morbidity and mortality if misdiagnosed. OBJECTIVE: This review investigates the signs and symptoms of cellulitis, mimics of cellulitis, and an approach to the management of both cellulitis and its mimics. DISCUSSION: The current emergency medicine definition of cellulitis includes erythema, induration, warmth, and swelling...
October 2017: Journal of Emergency Medicine
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