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Soft tissue injury management

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https://www.readbyqxmd.com/read/29679137/ten-versus-external-fixator-in-the-management-of-pediatric-diaphyseal-femoral-fractures-evaluation-of-the-outcomes
#1
Giuseppe Rollo, Pasquale Guida, Michele Bisaccia, Paolo Pichierri, Marco Filipponi, Riccardo Maria Lanzetti, Auro Caraffa, Alessandro Stasi, Valentina Russi, Domenico Lupariello, Luigi Meccariello
INTRODUCTION: Over the last 20 years, the incidence of pediatric diaphyseal femoral fractures was increased, due to changes in the children's daily activities. The healing times are different according to the chosen treatment and to other factors such as age, type of fracture, involvement of the soft tissues, and concomitance with other injuries. MATERIALS AND METHODS: From 2000 to 2015, 38 pediatric patients with diaphyseal femoral fractures were surgically treated and enrolled in the study...
April 20, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29675625/multidetector-ct-of-iatrogenic-and-self-inflicted-vascular-lesions-and-infections-at-the-groin
#2
REVIEW
Massimo Tonolini, Anna Maria Ierardi, Gianpaolo Carrafiello, Domenico LaganĂ 
The number and complexity of endovascular procedures performed via either arterial or venous access are steadily increasing. Albeit associated with higher morbidity compared to the radial approach, the traditional common femoral artery remains the preferred access site in a variety of cardiac, aortic, oncologic and peripheral vascular procedures. Both transarterial and venous cannulation (for electrophysiology, intravenous laser ablation and central catheterisation) at the groin may result in potentially severe vascular access site complications (VASC)...
April 19, 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29658485/hyperbaric-oxygen-therapy-its-use-in-medical-emergencies-and-its-development-in-hong-kong
#3
J Ks Leung, R Pk Lam
Hyperbaric oxygen therapy is widely accepted as life-saving treatment for decompression illness. Yet its use in acute carbon monoxide poisoning has remained controversial because of inconsistent findings in clinical trials. Hyperbaric oxygen therapy has an adjunctive role in managing gas gangrene, necrotising soft-tissue infection, and crush injury, as supported by case series. Several cases have been reported in the literature detailing the use of hyperbaric oxygen therapy in patients with severe anaemia in whom blood transfusion is not possible...
April 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29657459/stress-radiographs-for-evaluating-acromioclavicular-joint-separations-in-an-active-duty-patient-population-what-have-we-learned
#4
K Aaron Shaw, John Synovec, Josef Eichinger, Christopher J Tucker, Jason A Grassbaugh, Stephen A Parada
Introduction: Acromioclavicular (AC) joint separation is a common entity in athletic patient populations. The surgical treatment of these injuries varies based upon extent of injury, with numerous imaging modalities recommended to differentiate injury severity and treatment options. The use of weighted stress radiographs is controversial in the diagnostic evaluation of AC separation with previous consensus recommending against their use. No study to date has investigated the clinical utilization of diagnostic studies in the evaluation of AC joint separations in a military surgeon population...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29656174/multiplanar-realignment-for-unstable-hangman-s-fracture-with-posterior-c2-3-fusion-a-prospective-series
#5
Pravin Salunke, Madhivanan Karthigeyan, Sushanta K Sahoo, Prashant K Prasad
OBJECTIVE: There is lack of consensus on the preferred approach for unstable Hangman's fracture. The associated soft tissue injuries apart from apparent bony injury add to the complexity of dislocation and needs to be addressed. Here, we evaluated the clinico-radiological characteristics and outcome of patients managed by posterior C2-3 fusion. PATIENTS & METHODS: Nine patients with unstable Hangman's fracture (type II and IIA) were prospectively studied. The displacement of fractured fragments and C2-3 dislocation was studied in multiple planes...
March 27, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29644315/limb-salvage-and-reconstruction-following-a-zebra-attack
#6
Jacob T Carlson, James C Yuen, Matthew R Smeds
Animal bites are fairly rare events but can cause devastating traumatic injuries to the victim. In addition to the soft tissue, vascular, and orthopedic trauma inflicted by these occurrences, bite injuries also have the potential to introduce an inoculum of microbes, which may progress to an infection if not treated properly and expeditiously. We present the case of a healthy male who sustained multiple bite wounds from a domestic zebra to his left upper extremity. This attack caused severe damage, including devascularization of the arm at the brachial artery, disruption of the distal biceps and brachialis, stripping of the forearm nerves, and shearing of the overlying soft tissue...
June 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29625635/management-of-proximal-interphalangeal-joint-fracture-dislocations
#7
REVIEW
Nicholas M Caggiano, Carl M Harper, Tamara D Rozental
Fracture dislocations of the proximal interphalangeal (PIP) joint of the finger are often caused by axial load applied to a flexed joint. The most common injury pattern is a dorsal fracture dislocation with a volar lip fracture of the middle phalanx. Damage to the soft-tissue stabilizers of the PIP joint contributes to the deformity seen with these fracture patterns. Unfortunately, these injuries are commonly written off and left untreated. A late-presenting PIP joint fracture dislocation has a poor chance of regaining normal range of motion...
May 2018: Hand Clinics
https://www.readbyqxmd.com/read/29595654/traumatic-c1-2-rotatory-subluxation-with-dens-and-bilateral-articular-facet-fractures-of-c2-a-case-report
#8
Dong-Gune Chang, Jong-Beom Park, Hyuk-Jin Jang
RATIONALE: To the best of our knowledge, this is an extremely rare case of traumatic C1-2 rotatory subluxation associated with multiple C2 fractures. PATIENT CONCERNS: We report the case of a 63-year-old man with type 2 traumatic C1-2 rotatory subluxation (Fielding and Hawkins classification) associated with type III dens (Anderson and D'Alonzo classification) and bilateral articular facet fractures of C2. This injury occurred as a result of falling down in a drunken state...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29590411/wartime-soft-tissue-coverage-techniques-for-the-deployed-surgeon
#9
Vilas Saldanha, Nathan Tiedeken, Brandon Godfrey, Nichole Ingalls
Background: Since the start of the conflict in the Middle East in 2001, military orthopedic surgeons have faced complex orthopedic injuries including high-energy soft tissue wounds, traumatic amputations, and open fractures. Although orthopedic surgeons are well trained in the management of osseous injuries, the treatment of soft tissue injuries can be technically challenging and unfamiliar. Early washout, debridement of devitalized tissue, external fixation of bony injuries, and antibiotic therapy remain the foundation of early wound management...
March 26, 2018: Military Medicine
https://www.readbyqxmd.com/read/29589503/treatment-and-functional-outcomes-of-complex-tibial-fractures-in-children-and-adolescents-using-the-ilizarov-method
#10
J Messner, L Johnson, D M Taylor, P Harwood, S Britten, P Foster
Aims The aim of this study was to report the clinical, functional and radiological outcomes of children and adolescents with tibial fractures treated using the Ilizarov method. Patients and Methods Between 2013 and 2016 a total of 74 children with 75 tibial fractures underwent treatment at our major trauma centre using an Ilizarov frame. Demographic and clinical information from a prospective database was supplemented by routine functional and psychological assessment and a retrospective review of the notes and radiographs...
March 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29588023/managing-soft-tissues-in-severe-lower-limb-trauma-in-an-ageing-population
#11
Timothy M Noblet, Philippa C Jackson, Patrick Foster, David Martin Taylor, Paul J Harwood, Jay D Wiper
PURPOSE: With an ageing population, the incidence of trauma in those aged over 65 years is increasing. Strategies for dealing with these patients must be developed. At present the standard management of open tibial fractures in the UK is described by the BOAST4 guidelines (from the British Orthopaedic Association and British Association of Plastic & Aesthetic Surgeons). It is not clear to what extent these are appropriate for older patients. We describe our experience of managing elderly patients presenting with open tibial fractures...
March 13, 2018: Injury
https://www.readbyqxmd.com/read/29584611/a-descriptive-retrospective-study-of-using-an-oblique-downward-design-gluteus-maximus-myocutaneous-flap-for-reconstruction-of-ischial-pressure-ulcers
#12
Chang-Yi Chou, Yu-Shan Sun, Yu-Jen Shih, Yuan-Sheng Tzeng, Shun-Cheng Chang, Niann-Tzyy Dai, Chin-Ta Lin
Despite advances in reconstruction techniques, ischial pressure ulcers continue to present a challenge for the plastic surgeon. The purpose of this retrospective study was to evaluate outcomes of using an oblique downward gluteus maximus myocutaneous (GMM) flap for coverage of grade IV ischial ulcers. Data regarding defect size, flap size, operation time, duration of wound healing, and surgical outcome were abstracted from the medical records of patients whose ischial pressure ulcers had been reconstructed using GMM island flaps between January 2010 and December 2015...
March 2018: Ostomy/wound Management
https://www.readbyqxmd.com/read/29576644/complex-tibial-plateau-fractures-treated-by-hybrid-external-fixation-system-a-correlation-of-followup-computed-tomography-derived-quality-of-reduction-with-clinical-results
#13
Konstantinos Kateros, Spyridon P Galanakos, Georgios Kyriakopoulos, Stamatios A Papadakis, George A Macheras
Background: Tibial plateau fractures are common due to high energy injuries. The principles of treatment include respect for the soft tissues, restoring the congruity of the articular surface and reduction of the anatomic alignment of the lower limb to enable early movement of the knee joint. There are various surgical fixation methods that can achieve these principles of treatment. Recognition of the particular fracture pattern is important, as this guides the surgical approach required in order to adequately stabilize the fracture...
March 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29574816/current-and-evolving-trends-in-the-management-of-facial-fractures
#14
N Vujcich, D Gebauer
The oral and maxillofacial region has a complex regional anatomy including hard and soft tissues. Trauma in this region may affect the airway, cause potentially life threatening bleeding and head injuries. The senses of olfaction, sight and hearing can also be disrupted as well as a profound psychological impact following disfigurement. This oral and maxillofacial trauma update provides information on demographics, incidence, pathophysiology, diagnosis, fracture patterns and management of facial trauma. It also discusses the role of new advancements in the management of facial trauma...
March 2018: Australian Dental Journal
https://www.readbyqxmd.com/read/29558996/management-of-irreducible-unilateral-facet-joint-dislocations-in-subaxial-cervical-spine-two-case-reports-and-a-review-of-the-literature
#15
Yu Zhou, Zhenyu Zhou, Lifeng Liu, Xuecheng Cao
BACKGROUND: Skeletal and soft tissue damage are often associated with unilateral facet dislocations, which undoubtedly lead to instability of the spine and further increase difficulties in cervical reduction. This type of irreducible facet dislocation is usually accompanied with potential catastrophic consequences including neurological deficit and severe disability. Therefore, a consistent and evidence-based treatment plan is imperative. CASE PRESENTATION: The literature regarding the management of traumatic unilateral locked cervical facet dislocations was reviewed...
March 21, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29556506/a-rare-case-of-severe-third-degree-friction-burns-and-large-morel-lavallee-lesion-of-the-abdominal-wall
#16
Darnell J Brown, Kuo Jung G Lu, Kristina Chang, Jennifer Levin, John T Schulz, Jeremy Goverman
Background: Morel-Lavallee lesions (MLLs) are rare internal degloving injuries typically caused by blunt traumatic injuries and most commonly occur around the hips and in association with pelvic or acetabular fractures. MLL is often overlooked in the setting of poly-trauma; therefore, clinicians must maintain a high degree of suspicion and be familiar with the management of such injuries, especially in obese poly-trauma patients. Case presentation: We present a 30-year-old female pedestrian struck by a motor vehicle who sustained multiple long bone fractures, a mesenteric hematoma, and full-thickness abdominal skin friction burn which masked a significant underlying abdominal MLL...
2018: Burns and Trauma
https://www.readbyqxmd.com/read/29555896/talar-neck-fracture-with-dislocation-combined-with-bimalleolar-ankle-fracture-a-case-report
#17
Ahmad M Radaideh, Ziad A Audat, Abdullah A Saleh
BACKGROUND Fractures of the talus are uncommon injuries that usually involve the talar neck, rather than the talar body. This report is of a rare case of combined left talar neck fracture and adjacent joint dislocation with an ipsilateral bimalleolar ankle fracture. CASE REPORT A 37-year-old man presented with an injury to his left foot following a motor vehicle accident. When he presented to the hospital emergency department, his left foot and ankle were swollen, the overlying skin was intact but badly contused, and there was no neurovascular deficit...
March 20, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29555119/the-principles-and-practice-of-open-fracture-care-2018
#18
Amna Diwan, Kyle R Eberlin, Raymond Malcolm Smith
The principles of open fracture management are to manage the overall injury and specifically prevent primary contamination becoming frank infection. The surgical management of these complex injuries includes debridement & lavage of the open wound with combined bony and soft tissue reconstruction. Good results depend on early high quality definitive surgery usually with early stable internal fixation and associated soft tissue repair. While all elements of the surgical principles are very important and depend on each other for overall success the most critical element appears to be achieving very early healthy soft tissue cover...
February 21, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29541848/transverse-flap-duodenoplasty-tfd-a-new-technique-in-autologous-bowel-reconstructive-surgery
#19
Daniele Alberti, Laura Righetti, Adrian Bianchi, Gian Luigi de'Angelis, Giovanni Boroni
BACKGROUND: Bowel dilatation is a common adaptive mechanism after intestinal resection. The symptomatic dilated dysmotile duodenum is difficult to manage, since conventional bowel tailoring and lengthening techniques are potentially hazardous because of the anatomy of the duodenal blood supply, the proximity to the pancreas, and the risk of injury to the common bile duct. METHODS: A 2-month-old child with short bowel and a symptomatic massively dilated duodenum was treated with a Transverse Flap Duodenoplasty (TFD)...
March 14, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29537950/management-of-bone-defects-in-orthopedic-trauma
#20
Mark J Gage, Frank A Liporace, Kenneth A Egol, Toni M McLaurin
Treatment of traumatic bone defects is dictated by a multitude of clinical factors including the defect size, patient comorbidities, soft tissue condition, and the possibility of infection present in the defect. With a variety of treatment strategies described, it is critical to choose the approach that will maximize outcomes in addressing this difficult problem. When addressing small-scale defects, bone grafting is the primary treatment. For large-scale defects, there are two major options to consider: induced membrane technique and distraction osteogenesis...
March 2018: Bulletin of the Hospital for Joint Diseases
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