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Soft tissue injury management

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https://www.readbyqxmd.com/read/28293330/functional-latissimus-dorsi-transfer-for-upper-extremity-reconstruction-a-case-report-and-review-of-the-literature
#1
Aditya Sood, Paul J Therattil, Gerardo Russo, Edward S Lee
Objective: The latissimus dorsi flap is a workhorse for plastic surgeons, being used for many years for soft-tissue coverage of the upper extremity as well as for functional reconstruction to restore motion to the elbow and shoulder. The authors present a case of functional latissimus dorsi transfer for restoration of elbow flexion and review the literature on technique and outcomes. Methods: A literature review was performed using MEDLINE and the Cochrane Collaboration Library for primary research articles on functional latissimus dorsi flap transfer...
2017: Eplasty
https://www.readbyqxmd.com/read/28292542/prevention-of-infection-in-open-fractures
#2
REVIEW
Charalampos G Zalavras
Open fractures are complex injuries that are associated with increased risk for complications, such as infection and nonunion. The goals of open fracture management are prevention of infection, fracture union, and restoration of function. These goals are best achieved by careful patient and injury assessment, early administration of systemic antibiotics supplemented by local delivery of antibiotics in severe injuries, thorough surgical debridement, wound management with soft tissue coverage if needed, and stable fracture fixation...
March 11, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28286622/the-role-of-reverse-shoulder-arthroplasty-in-management-of-proximal-humerus-fractures-with-fracture-sequelae-a-systematic-review-of-the-literature
#3
REVIEW
James Holton, Tahir Yousri, George Arealis, Ofer Levy
Fracture sequelae of the proximal humerus poses a complex management decision due to the frequent deformity and its consequences on the peri-articular soft tissues. These patients are frequently elderly with significant medical comorbidities. Due to the age of the patient there is frequently rotator cuff deficiency and therefore the reverse shoulder arthroplasty (RSA) becomes the arthroplasty of choice. We have performed a systematic review of the literature and report nine studies presenting RSA for the treatment of fracture sequelae of the proximal humerus...
February 20, 2017: Orthopedic Reviews
https://www.readbyqxmd.com/read/28280873/radial-nerve-palsy-in-humeral-shaft-fractures-with-internal-fixation-analysis-of-management-and-outcome
#4
T R Schwab, P F Stillhard, S Schibli, M Furrer, C Sommer
INTRODUCTION: The incidence of radial nerve injury after humeral shaft fractures is on average 11.8% (Shao et al., J Bone Jt Surg Br 87(12):1647-1652, 2005) representing the most common peripheral nerve injury associated with long bone fractures (Korompilias et al., Injury, 2013). The purpose of this study was to analyze our current policy and long-term outcome, regarding surgically treated humeral shaft fractures in combination with radial nerve palsy. MATERIALS AND METHODS: We retrospectively analyzed the data of patients with surgically treated humeral shaft fractures from 01/01/2003 to 28/02/2013...
March 9, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28272857/management-of-acute-complex-traumatic-wound-with-a-dermal-regeneration-template-case-report
#5
R R V Patel, M Giaquinto-Cillers, J Kotze, R S Hartnick, L W van der Merwe, E B Holford
BACKGROUND: Acute complex traumatic wounds of the lower limbs are usually managed by a combination of multiple debridements, dressing changes, and specialized surgical procedures which may include tissue transfers for the reconstruction of the soft tissue injury. The recovery is lengthy, and the outcome dependent on the initial injury, the surgical procedures undertaken and rehabilitation programs with a multidisciplinary team. METHOD: A nine-year-old male patient presented to Kimberly Hospital with an extensive soft tissue injury of the leg associated with a tibia fracture caused by a high velocity pedestrian vehicle accident...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28255470/ultrasound-utility-in-the-diagnosis-of-a-morel-lavall%C3%A3-e-lesion
#6
Scott LaTulip, Rameshwar R Rao, Alan Sielaff, Nik Theyyunni, John Burkhardt
Morel-Lavallée lesions are uncommon injuries that can be associated with significant comorbidities if not detected early. Rapid diagnosis in the Emergency Department could significantly improve patient outcomes. We describe the diagnosis of such a lesion through the use of ultrasound imaging in the Emergency Department to utilize a fast, cost-effective imaging technique that does not subject the patient to radiation exposure. Our patient received surgical consultation but improved with conservative management...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28252476/athletic-hip-injuries
#7
T Sean Lynch, Asheesh Bedi, Christopher M Larson
Historically, athletic hip injuries have garnered little attention; however, these injuries account for approximately 6% of all sports injuries and their prevalence is increasing. At times, the diagnosis and management of hip injuries can be challenging and elusive for the team physician. Hip injuries are seen in high-level athletes who participate in cutting and pivoting sports that require rapid acceleration and deceleration. Described previously as the "sports hip triad," these injuries consist of adductor strains, osteitis pubis, athletic pubalgia, or core muscle injury, often with underlying range-of-motion limitations secondary to femoroacetabular impingement...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28240620/infection-rates-and-treatment-of-low-velocity-extremity-gunshot-injuries
#8
Mai P Nguyen, Jonathan C Savakus, Jeffrey A O'Donnell, Nicholas F Prayson, Michael S Reich, Joseph F Golob, Amy A McDonald, John J Como, Heather A Vallier
OBJECTIVES: To determine the rates of infection in low-energy gunshot wounds (GSWs) to the extremity. DESIGN: Retrospective review. SETTING: Level I trauma center. PATIENTS/PARTICIPANTS: Patients (N=140) with at least 90-day follow-up for extremity-only low-energy GSW injuries from 2010-2014 were retrospectively reviewed. Treatment was recorded, including type and duration of antibiotics and details of non-operative and operative management...
February 23, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28219124/our-experience-in-using-telehealth-for-paediatric-plastic-surgery-in-western-australia
#9
Debesh Rimal, Ju Hui Huang Fu, David Gillett
BACKGROUND: Western Australia accounts for one-third of Australia's total land mass. Princess Margaret Hospital is the only dedicated plastic surgery tertiary referral centre providing services to over 500 000 children across the state. The aim of this study is to share our experience using telehealth for service provision and delivery of care in a geographically challenging setting. METHODS: A retrospective review was conducted, and data were extracted from patients' notes...
February 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28214061/open-physeal-fracture-of-the-distal-phalanx-of-the-hallux-case-study-diagnosis-and-management
#10
Brandon Morris, Scott Mullen, Paul Schroeppel, Bryan Vopat
Open physeal fractures of the distal phalanx of the hallux are the lesser described counterpart to the same fracture of the finger, known by its eponym as a "Seymour fracture". Displaced Salter-Harris phalangeal fractures present with a concomitant nailbed or soft tissue injury. Often these fractures occur in the summer months when open-toe footwear can be worn, however, they may occur indoors as well. Frequently, the injury results from direct axial load of the toe, or "stubbing", which causes the fracture and associated soft tissue injury...
February 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28211591/magnetic-resonance-imaging-of-the-knee-an-overview-and-update-of-conventional-and-state-of-the-art-imaging
#11
Nicholas C Nacey, Matthew G Geeslin, Grady Wilson Miller, Jennifer L Pierce
Magnetic resonance imaging (MRI) has become the preferred modality for imaging the knee to show pathology and guide patient management and treatment. The knee is one of the most frequently injured joints, and knee pain is a pervasive difficulty that can affect all age groups. Due to the diverse pathology, complex anatomy, and a myriad of injury mechanisms of the knee, the MRI knee protocol and sequences should ensure detection of both soft tissue and osseous structures in detail and with accuracy. The knowledge of knee anatomy and the normal or injured MRI appearance of these key structures are critical for precise diagnosis...
February 17, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28210403/an-overview-of-maxillofacial-trauma-in-oral-and-maxillofacial-tertiary-trauma-centre-queen-elizabeth-hospital-kota-kinabalu-sabah
#12
Chee Wei Lee, Qi Chao Foo, Ling Vuan Wong, Yiu Yan Leung
The aims of this study were to provide an overview of maxillofacial trauma and its relationship to patient's demographic data and alcohol consumption within the state of Sabah. It was a retrospective study of maxillofacial trauma cases treated by Oral and Maxillofacial Surgery Department, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, from January 1, 2009, until December 31, 2013. A total of 630 maxillofacial trauma cases were included. Details of the trauma were collected from patients' record, including patients' cause of injuries, injuries suffered, treatment indications, and treatment received...
March 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28205474/utility-of-magnetic-resonance-imaging-in-the-surgical-management-of-drug-extravasation-a-case-report
#13
Yet Yen Yan, Tein Jin Tan
We report a case of phenytoin extravasation complicated by eschar formation. Pre-operative MRI study showed a large non-enhancing area over the dorsum of the imaged right wrist and hand corresponding with the site of phenytoin extravasation and raising the suspicion of subcutaneous tissue necrosis. The MRI findings correlated well with the intra-operative findings. We believe that pre-operative MRI in drug extravasation cases can characterise the type of soft tissue injury and define the extent of injury. This helps the surgeon in the surgical approach and treatment options...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28199291/distal-radius-fractures-in-the-elderly
#14
L Scott Levin, Joshua C Rozell, Nicholas Pulos
Distal radius fractures are common in elderly patients, and the incidence continues to increase as the population ages. The goal of treatment is to provide a painless extremity with good function. In surgical decision making, special attention should be given to the patient's bone quality and functional activity level. Most of these fractures can be treated nonsurgically, and careful closed reduction should aim for maintenance of anatomic alignment with a focus on protecting fragile soft tissues. Locked plating is typically used for fracture management when surgical fixation is appropriate...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28198794/open-tibia-shaft-fractures-and-soft-tissue-coverage-the-effects-of-management-by-an-orthopedic-trauma-microsurgical-team
#15
James VandenBerg, Daniel Osei, Martin I Boyer, Michael J Gardner, William M Ricci, Amanda Spraggs-Hughes, Christopher McAndrew
OBJECTIVES: To compare the timing of soft-tissue (flap) coverage and occurrence of complications before and after the establishment of an integrated orthopedic trauma/microsurgical team. DESIGN: Retrospective Cohort StudySETTING:: A single level 1 trauma centerPATIENTS:: 28 subjects (13 pre- and 15 post-integration) with open tibia shaft fractures (OTA/AO 42A, 42B, 42C) treated with flap coverage between January 2009 and March 2015. INTERVENTION: Flap coverage for open tibia shaft fractures treated before ("pre-integration") and after ("post-integration") implementation of an integrated orthopedic trauma/microsurgical team...
February 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28192826/the-management-of-bone-defects-in-periarticular-knee-injuries-a-review-article
#16
Brian Buck, Yvonne M Murtha
Traumatic bone defects of the distal femur and proximal tibia present treatment challenges for the orthopaedic traumatologist. In addition to bone loss, significant soft tissue compromise and cartilage defects leave the patient and surgeon with few reconstructive options for proper long-term joint function. These injuries are often complicated by delayed healing, nonunion, malunion, infection, and poor subjective patient outcomes. There are a variety of clinical problems associated with the treatment of periarticular fractures about the knee...
March 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28167879/early-revision-surgery-for-tibial-plateau-non-union-and-mal-union
#17
Dominic L Van Nielen, Christopher S Smith, David L Helfet, Peter Kloen
BACKGROUND: Although relatively rare, non-unions and mal-unions of tibial plateau fractures present significant challenges for the orthopedic surgeon. With careful pre-operative planning, tibial plateau mal-union or non-union revision surgery with intra-articular and varus opening osteotomies can provides good functional results when performed early (within 1 year) after primary surgical procedure. QUESTIONS/PURPOSES: We present our treatment algorithm for approaching and treating non-union or mal-union of tibial plateau fractures...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28167063/complex-foot-injury-early-and-definite-management
#18
REVIEW
Tim Schepers, Stefan Rammelt
Complex foot injuries occur infrequently, but are life-changing events. They often present with other injuries as the result of a high-energy trauma. After initial stabilization, early assessment should be regarding salvagability. All treatment strategies are intensive. The initial treatment includes prevention of progression ischemia/necrosis, prevention of infection, and considering salvage or amputation. Definitive treatment for salvage includes anatomic reconstruction with stable internal fixation and early soft tissue coverage followed by aggressive rehabilitation...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28167056/managing-complications-of-calcaneus-fractures
#19
REVIEW
Michael P Clare, William S Crawford
Calcaneus fractures remain among the most complicated fractures for orthopedic surgeons to manage because of the complexity of various fracture patterns, the limited surrounding soft tissue envelope, and the prolonged rehabilitation issues impacting function after successful treatment. Despite this, appropriate management of complications associated with calcaneus fractures is critical for the complete care of this injury, whether treated operatively or nonoperatively. The authors present the common complications encountered with fractures of the calcaneus and management thereof...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28164055/proximal-tibial-epiphysis-injury-flexion-type-salter-harris-type-1
#20
Pratik Israni, Mangesh Panat
INTRODUCTION: Fractures of the proximal tibial epiphysis rare. It has been estimated that fractures of the upper tibial epiphysis account for 0.5-3.1% of all epiphyseal injuries. Who had no neurovascular deficit, with fixed extension deformity at the left knee was treated early with closed reduction techniques. CASE REPORT: We present a case of a 16-year-old boy who while playing cricket on the road was hit by a car. The patient presented in emergency room with extremely swollen knee and soft tissue swelling (hemarthrosis), he was unable to lift his leg actively due to severe pain because of hamstrings spasm, and he had no wound over his left knee and had no other associated injuries...
September 2016: Journal of Orthopaedic Case Reports
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