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Soft tissue injury management

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https://www.readbyqxmd.com/read/29896026/results-of-ring-ilizarov-fixator-in-high-energy-schatzker-type-vi-fractures-of-proximal-tibia
#1
Ujjwal Kanti Debnath, Dipak Kumar Jha, Prasanta Kumar Pujari
Background: High-energy fractures of proximal tibia (Schatzker VI) are associated with severe articular depression, separation of both condyles, diaphyseal comminution & dissociation with loss of integrity of the soft-tissue envelope. Complications of plating are well known since last 50years in these difficult fractures. An alternative method was proposed by Ilizarov (ring fixator) and was adopted for the treatment of these complex injuries. Aim of study: To analyse the results of patients who had ring fixator for the management of high-energy fractures (Schatzker VI) of the proximal tibia...
April 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29895608/analysis-of-cases-managed-by-the-otolaryngology-service-in-the-chinese-military-peacekeeping-level-2-medical-treatment-facility-in-mali
#2
Yongqiang Zhao, X Ma, Y Li, Q Fu
OBJECTIVES: As part of the UN peacekeeping mission in Mali, the People's Republic of China have deployed a level 2 medical treatment facility (CHN L2). The aim of this study was to review the cases managed by the otolaryngology service within this facility. METHODS: The medical records of all patients treated by the otolaryngology service at the CHN L2 from 1 March 2015 to 1 March 2018 were retrospectively assessed. RESULTS: 614/10189 (6%) of all cases seen in the hospital during this period were referred to the otolaryngology service...
June 11, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29891390/a-novel-surgical-technique-for-treatment-of-morel-lavall%C3%A3-e-lesion-endoscopic-debridement-combined-with-percutaneous-cutaneo-fascial-suture
#3
Min Liu, Liangle Liu, Xiaosai Zhou, Lifen Wu, Juncheng Wang, Li Qi, Chunyuan Cai
Morel-Lavallée lesions are rare, closed degloving soft tissue injuries in which the skin and subcutaneous tissues are traumatic separated from the underlying fascia. There is lack of consensus regarding optimal management of these lesions. After failure of conservative management, operative intervention is imperative. The purpose of this manuscript is to describe a minimally invasive endoscopic method for treatment of Morel-Lavallée Lesions, which achieves the goal of an open surgical debridement.
June 4, 2018: Injury
https://www.readbyqxmd.com/read/29890263/long-term-outcome-of-treatment-of-vertebral-body-hemangiomas-with-direct-ethanol-injection-and-short-segment-stabilization
#4
P Sarat Chandra, Pankaj Singh, Rajender K, Deepak Agarwal, Vivek Tandon, S S Kale, Chitra Sarkar
BACKGROUND: Vertebral body (VH) hemangiomas with myelopathy are difficult to manage. OBJECTIVE: To evaluate the role of intra-operative ethanol embolization, surgical decompression and instrumented short segment fusion in VH with myelopathy and long-term outcome (>24 months). METHODS: Prospective study: Symptomatic VH with cord compression with myelopathy. Excluded: pathological fractures, and/or deformity or multi-level pathologies. Surgery consisted of intra-operative bilateral pedicular absolute alcohol (<1% hydrated ethyl alcohol) injection, laminectomy and cord decompression at the level of pathology followed by a short segment instrumented fusion using pedicle screws...
June 8, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29888714/the-use-of-sural-island-musculo-fasciocutaneous-flap-in-the-management-of-chronic-osteomyelitis-of-the-tibia
#5
K O Opara, I C Nwagbara
Background: : The management of soft-tissue defects following surgery for chronic osteomyelitis of the tibia is challenging. It often requires complex reconstructive procedures, especially when the distal third of the tibia is involved. We present a relatively simple method of addressing these defects. Aim: : This study aims to report our experience with the use of the sural Island musculo fasciocutaneous flap in the management of osteomyelitis of the tibia. Materials and Methods: : Consecutive patients with osteomyelitis of the tibia requiring soft-tissue cover were managed using the sural Island musculo fasciocutaneous flap, and the outcome was analyzed...
June 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29887916/isolated-fractures-of-the-greater-tuberosity-when-are-they-treated-conservatively-a-baseline-study
#6
Benedikt Schliemann, Lukas F Heilmann, Michael J Raschke, Helmut Lill, J Christoph Katthagen, Alexander Ellwein
Background: This study analyzed the indications for conservative management of isolated greater tuberosity (GT) fractures. The rate of secondary interventions for failed conservative treatment was also assessed. Methods: A retrospective data evaluation of isolated GT fractures was performed from the clinical database of two level-I trauma centers from January 2010 to June 2017. Conservatively treated GT fractures were identified and subdivided according to etiology, morphology, and amount of initial displacement...
2018: Obere Extremität
https://www.readbyqxmd.com/read/29887628/management-of-talar-body-fractures
#7
S R Sundararajan, Abdul Azeem Badurudeen, R Ramakanth, Shanmuganathan Rajasekaran
Fractures of talar body are uncommon injuries often associated with fractures of other long bones and in polytraumatized patients. The integrity of the talus is essential for the normal function of the ankle, subtalar, and midtarsal joints. The relative infrequency of this injury limits the number of studies available to guide treatment. They occur as a result of high-velocity trauma and are therefore associated with considerable soft tissue damage. Axial compression with supination or pronation is the common mechanism of injury...
May 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29885963/variables-affecting-functional-outcome-in-floating-knee-injuries
#8
Mahesh Suresh Kulkarni, Monappa Naik Aroor, Sandeep Vijayan, Saurabh Shetty, Sujit Kumar Tripathy, Sharath K Rao
BACKGROUND: The surgical outcome of floating knee injuries is difficult to predict. The high-velocity nature of the injury, complex fracture pattern and associated soft tissue/visceral injuries may have some impact on the functional outcome. The present study evaluates the variables affecting the clinical and radiological outcomes of floating knee injuries. MATERIALS AND METHODS: The clinical, radiological and functional outcome (Karlstrom and Olegrud criteria) of 89 patients with 90 floating knee injuries were evaluated at the end of one year who were managed in our level 1 trauma center between January 2013 and December 2016...
June 1, 2018: Injury
https://www.readbyqxmd.com/read/29885915/spilled-gallstones-simulating-peritoneal-carcinomatosis-a-case-report-and-literature-review
#9
G T Capolupo, G Mascianà, F Carannante, M Caricato
INTRODUCTION: Laparoscopic cholecystectomy (LC) has become the "gold standard" for the treatment of symptomatic gallstones. However, this surgical technique increases the risk of bile duct injury and lost gallstones. Since over 90% of split gallstones never become symptomatic, they often present as incidental findings on CT-scans. Careful removal of as many stones as possible, intense irrigation and suction are recommended. It has been reported that 8.5% of lost gallstones will lead to a complication, most common are abscesses...
May 4, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29876496/preserving-the-lower-extremity-after-severe-devolving-injuries-to-meet-the-patient-s-demand-in-two-cases-limb-salvage-after-degloving-injury
#10
Katja Boernert, Gili Ganot, Martin Keith Ulrich, Lukas Daniel Iselin
Background: Severe injuries of the foot are a life-changing event. They often lead to some form of disability, and are therefore very challenging to manage. Injuries of the extremity, especially the foot and ankle, are distinct predictors of poor outcome in polytrauma patients.Degloving injuries of the lower extremity involving the heel and foot are a rare and unique subgroup of severe foot injuries.Treating degloving injuries is challenging. The surgical approach has to take into consideration both osseous and massive soft tissue injuries aiming to preserve the unique architecture of the lower limb and reconstruct the soft tissue...
June 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29851032/interventions-for-necrotizing-soft-tissue-infections-in-adults
#11
REVIEW
Camille Hua, Romain Bosc, Emilie Sbidian, Nicolas De Prost, Carolyn Hughes, Patricia Jabre, Olivier Chosidow, Laurence Le Cleach
BACKGROUND: Necrotizing soft tissue infections (NSTIs) are severe and rapidly spreading soft tissue infections of the subcutaneous tissue, fascia, or muscle, which are mostly caused by bacteria. Associated rates of mortality and morbidity are high, with the former estimated at around 23%, and disability, sequelae, and limb loss occurring in 15% of patients. Standard management includes intravenous empiric antimicrobial therapy, early surgical debridement of necrotic tissues, intensive care support, and adjuvant therapies such as intravenous immunoglobulin (IVIG)...
May 31, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29847311/management-of-a-complex-lower-limb-open-fracture-in-a-teenage-patient-a-case-report
#12
Davor Mijatović, Sanda Smuđ Orehovec, Tomislav Đapić, Vilena Vrbanović Mijatović, Marko Mance
The challenges of managing Gustilo IIIB tibial fractures (ie, high energy trauma with a contaminated wound >10 cm in length, severe comminution ["crumbling"] or segmental fractures, and periosteal stripping) in children are unique in part because no clear guidelines exist and the injuries may cause short-term and long-term complications. Repeated wound debridement and secondary reconstruction are required in approximately 20% of these cases in both adults and children. A 13-year-old girl presented with severe polytrauma including an open Gustilo type IIIB fracture of the left lower leg...
May 2018: Ostomy/wound Management
https://www.readbyqxmd.com/read/29846214/the-soleus-muscle-flap-an-overview-of-its-clinical-applications-for-lower-extremity-reconstruction
#13
Ping Song, Lee L Q Pu
Lower extremity reconstruction often poses several challenges for the reconstructive surgeon. Because of limited local tissue options, patients who sustain extensive middle to distal third tibia fractures used to be at higher risk of limb loss without adequate soft tissue coverage. The traditional principle of reconstructing middle and distal third leg wounds with free tissue transfer is being challenged by advances in understanding of local muscle flap anatomy and surgical techniques to improve the efficacy of local flaps...
May 24, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29806657/self-inflicted-face-gunshot-injuries-two-case-reports
#14
Rokas Gelažius, David Kasradze, Albinas Gervickas
Self-inflicted gunshot injuries to the head and neck area are challenging cases. Immediate and complex approach is required due to complexity of head and neck anatomy. The extent of injury largely depends on velocity of a rifle and penetrated tissues. Management of these type of patients consist of vital resuscitation, primary wound management, soft and hard tissue reconstruction and rehabilitation. Here we present two cases of self-inflicted gunshot injuries with low and high velocity rifles.
2018: Stomatologija
https://www.readbyqxmd.com/read/29806312/-research-progress-of-posteromedial-rotatory-instability-of-the-elbow
#15
REVIEW
Nengji Long, Shukun He, Shizhou Wu, Fuguo Huang
Objective: To summarize the research progress in posteromedial rotatory instability (PMRI) of the elbow joint. Methods: The recent researches about the management of PMRI of the elbow joint from the aspects of pathological anatomy, biomechanics, diagnosis, and therapy were analyzed and summarized. Results: The most important factors related to PMRI of the elbow joint are lateral collateral ligament complex (LCLC) lesion, posterior bundle of the medial collateral ligament complex (MCLC) lesion, and anteromedial coronoid fracture...
April 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
https://www.readbyqxmd.com/read/29806289/-injury-characteristics-and-therapeutic-strategy-of-patients-injured-in-8%C3%A2-8-jiuzhaigou-earthquake
#16
Bo Shi, Gang Liu, Lin Li, Shitian Tang, Jun Wang, Mingrui Xie, Xiaoyu Dai, Jianyong He, Yun Zhang, Yi Tang, Jianbo Xianyu, Dong Wang, Mei He, Weiyun Xu, Zhongjin Song, Ying Ma, Fuguo Huang, Yueming Song
Objective: To summarize the injury characteristics and therapeutic strategy of patients injured in "8·8" Jiuzhaigou earthquake. Methods: The clinical data of 48 patients injured in "8·8" Jiuzhaigou earthquake who were admitted to Mianyang Central Hospital were analyzed retrospectively. There were 25 males and 23 females with an average age of 36 years (range, 5-87 years). The average interval from injury to admission was 30 hours (range, 3-53 hours)...
March 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
https://www.readbyqxmd.com/read/29797771/review-article-best-practice-management-of-closed-hand-and-wrist-injuries-in-the-emergency-department-part-5-of-the-musculoskeletal-injuries-rapid-review-series
#17
REVIEW
Kirsten Strudwick, Megan McPhee, Anthony Bell, Melinda Martin-Khan, Trevor Russell
Acute hand and wrist injuries are a common presentation to the ED and are associated with large individual and societal costs. Appropriate management of these injuries in the ED is crucial given that optimal hand function is essential for daily activities and quality of life. This rapid review investigated best practice for the assessment and management of common closed hand and wrist injuries in the ED. Databases were searched in 2017, including PubMed, CINAHL, EMBASE, TRIP and the grey literature, including relevant organisational websites...
May 24, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29796980/predicting-return-to-work-in-a-heterogeneous-sample-of-recently-injured-workers-using-the-brief-%C3%A3-mpsq-sf
#18
M K Nicholas, D S J Costa, S J Linton, C J Main, W S Shaw, R Pearce, M Gleeson, R Z Pinto, F M Blyth, J H McCauley, C G Maher, R J E M Smeets, A McGarity
Purpose (1) to examine the ability of the Örebro Musculoskeletal Pain Screening Questionnaire-short version (ÖMPSQ-SF) to predict time to return to pre-injury work duties (PID) following a work-related soft tissue injury (regardless of body location); and (2) to examine the appropriateness of 50/100 as a suitable cut-off score for case identification. Methods Injured workers (IW) from six public hospitals in Sydney, Australia, who had taken medically-sanctioned time off work due to their injury, were recruited by insurance case managers within 5-15 days of their injury...
May 23, 2018: Journal of Occupational Rehabilitation
https://www.readbyqxmd.com/read/29796861/acute-femoral-shortening-for-reconstruction-of-a-complex-lower-extremity-crush-injury
#19
Philip K Lim, Bharat Sampathi, Nathan M Moroski, John A Scolaro
Traumatic through-knee or transfemoral amputations with concomitant ipsilateral femoral fractures are extremely rare injuries. The initial goal of management is patient resuscitation and stabilization. Subsequent interventions focus on limb salvage and the creation of a residual limb that can be fitted successfully for a functional lower extremity prosthesis. We present the case of a patient who sustained a traumatic through-knee amputation ipsilateral to an open comminuted femoral fracture. Soft tissue injury prohibited initial primary closure over the distal femoral condyles...
May 23, 2018: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29787959/high-voltage-electrical-injury-complicated-by-compartment-syndrome-and-acute-kidney-injury-with-successful-limb-salvage-a-case-report-and-review-of-the-literature
#20
Christopher Wei Guang Ho, Shi-Hui Yang, Chu Hui Wong, Si Jack Chong
INTRODUCTION: Although an uncommon form of admission to a burns centre, the deep, penetrating nature of noxious currents mean that electrical burns have the most catastrophic consequences of all burn injuries. Understanding the physics of electricity is crucial to explaining the mechanisms of tissue damage and organ failure in electrical injuries which necessitate special management above and beyond that of regular thermal burns. PRESENTATION OF CASE: We present a young man who suffered significant occupation-related electrical burns that was complicated by compartment syndrome, rhabdomyolysis and acute kidney injury...
May 16, 2018: International Journal of Surgery Case Reports
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