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Soft tissue injury management

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https://www.readbyqxmd.com/read/28413772/postoperative-complications-with-cryotherapy-in-bone-tumors
#1
REVIEW
Clark Chen, John Garlich, Katie Vincent, Earl Brien
The technique of cryosurgery has been used to control local recurrence in a variety of benign and malignant bone tumors. Early studies revealed significant complication rates (25%) that included fracture, infection, and soft tissue injury. Our method of cryosurgery has yielded excellent tumor control with improved complication rates. The objective of this study is to determine the characteristics of postoperative complications after pouring liquid nitrogen into curettaged bone defects, and to review our current indications and surgical technique in bone tumor management...
June 2017: Journal of Bone Oncology
https://www.readbyqxmd.com/read/28413130/arthroscopic-treatment-of-labral-tears-of-the-hip-in-adolescents-patterns-of-clinical-presentation-intra-articular-derangements-radiological-associations-and-minimum-2-year-outcomes
#2
Sivashankar Chandrasekaran, Nader Darwish, Edwin O Chaharbakhshi, Parth Lodhia, Carlos Suarez-Ahedo, Benjamin G Domb
PURPOSE: To report on patterns of clinical presentation, intra-articular derangements, radiological associations, and minimum 2-year outcomes after hip arthroscopy (HA) in patients 18 years or younger. METHODS: This study was a retrospective case series on patients 18 years or younger who had undergone HA for labral tears that had failed nonoperative management from April 2008 to April 2013 with a minimum 2-year follow-up. Exclusion criteria were previous hip conditions or surgery...
April 13, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28410938/preservation-of-devitalized-bone-in-necrotic-digits-following-crush-injury-with-free-tissue-transfer
#3
Fei Song, Yongwei Pan, Zhe Zhao, Jiuzheng Deng, Changjiao Sun
Traditional management of necrotic digits has been to allow demarcation between viable and nonviable tissues to occur, and thus to indicate the level of amputation required. In this case report, the phalangeal length of the necrotic thumb was maintained in 2 patients who had sustained crush injury. After nonviable soft tissues were debrided, the devitalized bones were covered with soft tissue flaps. All wounds healed without infection. Both cosmetic and functional results of the reconstructed thumbs were satisfactory...
April 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28390182/early-local-delivery-of-vancomycin-suppresses-ectopic-bone-formation-in-a-rat-model-of-trauma-induced-heterotopic-ossification
#4
Jonathan G Seavey, Benjamin M Wheatley, Gabriel J Pavey, Allison M Tomasino, Margaret A Hanson, Erin M Sanders, Devaveena Dey, Kaitlyn L Moss, Benjamin K Potter, Jonathan A Forsberg, Ammar T Qureshi, Thomas A Davis
Heterotopic ossification (HO) is a debilitating sequela of high-energy injuries. It frequently requires surgical excision once symptomatic and there is no practical prophylaxis for combat-injured patients. In this study, we examined the effect of local vancomycin powder on HO formation in a small animal model of blast-related, post-traumatic HO. Male Sprague-Dawley rats were subjected to a polytraumatic extremity injury and amputation with or without methicillin-resistant Staphylococcus aureus infection. Animals were randomized to receive a single local application of vancomycin (20 mg/kg) at the time of injury (POD-0, n = 34) or on postoperative day-3 (POD-3, n = 11)...
April 8, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28385946/the-management-of-open-tibial-fractures-in-children-a-retrospective-case-series-of-eight-years-experience-of-61-cases-at-a-paediatric-specialist-centre
#5
R S Nandra, F Wu, A Gaffey, C E Bache
AIMS: Following the introduction of national standards in 2009, most major paediatric trauma is now triaged to specialist units offering combined orthopaedic and plastic surgical expertise. We investigated the management of open tibia fractures at a paediatric trauma centre, primarily reporting the risk of infection and rate of union. PATIENTS AND METHODS: A retrospective review was performed on 61 children who between 2007 and 2015 presented with an open tibia fracture...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28377659/animal-bite-injuries-in-children-review-of-literature-and-case-series
#6
REVIEW
Aviral Agrawal, Pradeep Kumar, Ruchi Singhal, Virendra Singh, Amrish Bhagol
INTRODUCTION: Maxillofacial region in children is particularly vulnerable to animal bite injuries. These injuries may range from insignificant scratches to life-threatening neck and facial injuries. Children are the common victims, particularly of dog bites. MATERIALS AND METHODS: Three cases of animal bite injuries in children with their clinical presentation and their management are being presented along with review of literature. Surgical management included cleansing and primary closure of the wound...
January 2017: International Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28374715/-clinical-experience-with-various-techniques-integrated-treat-the-wounded-with-gunshot-fractures-of-limbs
#7
V K Kozlov, B G Akhmedov, A M Chililov
AIM: To increase an efficiency of complex treatment of patients with diaphyseal gunshot fractures of long bones by introduction of modern minimally invasive surgical techniques of internal osteosynthesis into clinical practice of civil health care and to improve the outcomes in victims. MATERIAL AND METHODS: Prospective comparative clinical trial included 104 victims from the Republic of Yemen with gunshot wounds of limbs of various severity for the period 2009-2011...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28371497/staged-management-of-missed-lisfranc-injuries-a-report-of-short-term-results
#8
Pin Feng, Ya-Xing Li, Jia Li, Xiang-Yu Ouyang, Wei Deng, Yu Chen, Hui Zhang
OBJECTIVE: Lisfranc joint injury is a rare injury and can be easily missed at the initial treatment. Once ignored, late reduction is very difficult and requires extensive dissection. Surgical outcome is not as good as in the case of an early reduction. The aim of this cohort study was to analyze the midterm clinical and radiographic outcomes of staged reduction and fixation in a consecutive series of patients with old Lisfranc injuries. METHODS: Fifteen patients (16 feet) with missed Lisfranc injuries were treated with staged reduction...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28362252/maxillofacial-trauma-managing-potentially-dangerous-and-disfiguring-complex-injuries
#9
Devjanl Das, Lea Salazar
Patients with maxillofacial trauma require a careful evaluation due to the anatomical proximity of the maxillofacial region to the head and neck. Facial injuries can range from soft-tissue lacerations and nondisplaced nasal fractures to severe, complex fractures, eye injuries, and possible brain injury. Though the Advanced Trauma Life Support (ATLS) guidelines provide a framework for the management of trauma patients, they do not provide a detailed reference for many subtle or complex facial injuries. This issue adds a more comprehensive and systematic approach to the secondary survey of the maxillofacial area and emergency department management of injuries to the face...
April 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28359591/single-stage-management-of-gustilo-type-iii-a-b-tibia-fractures-fixed-with-nail-covered-with-fasciocutaneous-flap
#10
G I Nambi, Abhijeet Ashok Salunke, S G Thirumalaisamy, V Lenin Babu, K Baskaran, T Janarthanan, K Boopathi, Yong Sheng Chen
PURPOSE: To evaluate the role of immediate and definitive management of Gustilo type III A/B tibia fractures with intramedullary nailing and fasciocutaneous flap. METHODS: From August 2010 to July 2012, 22 patients with Gustilo Grade III A/B tibia fractures were managed with a single stage treatment of ipsilateral fasciocutaneous flap & reamed intramedullary nailing and were included in the study. The severity of the injury was calculated with Ganga Hospital injury severity score...
April 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28352600/soft-tissue-reconstruction-of-complete-circumferential-defects-of-the-upper-extremity
#11
Zhi Yang Ng, Shaun Shi Yan Tan, Alexandre Gaston Lellouch, Curtis Lisante Cetrulo, Harvey Wei Ming Chim
BACKGROUND: Upper extremity soft tissue defects with complete circumferential involvement are not common. Coupled with the unique anatomy of the upper extremity, the underlying etiology of such circumferential soft tissue defects represent additional reconstructive challenges that require treatment to be tailored to both the patient and the wound. The aim of this study is to review the various options for soft tissue reconstruction of complete circumferential defects in the upper extremity...
March 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28330802/orofacial-trauma-in-rural-india-a-clinical-study
#12
Sunita Malik, Gurdarshan Singh, Gagandeep Kaur, Sunil Yadav, Hitesh C Mittal
PURPOSE: Orofacial trauma is becoming a leading medical problem worldwide. Most of the studies pertaining to orofacial trauma have been done in urban areas but very little scientific literature is available for rural areas. METHODS: A prospective medical institute-based study of orofacial injury patients was carried out from May 2013 to April 2016 (36 Months). Data regarding incidence, age and sex distribution, causes, types and site of injury, treatment modalities and trauma associated complications were collected and analysed...
February 24, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28324822/outcome-evaluation-of-minimally-invasive-surgery-versus-extensile-lateral-approach-in-management-of-displaced-intra-articular-calcaneal-fractures-a-randomised-control-trial
#13
Ankit Khurana, Mandeep S Dhillon, Sharad Prabhakar, Rakesh John
BACKGROUND: Minimally invasive surgery has a significant and evolving role in the treatment of DIACFs, but there is limited literature on this topic. OBJECTIVES: To compare the clinico-radiological outcomes of DIACFs fixed with MIS technique with ORIF. METHODS: This randomised control trial (RCT) included 21 closed Sanders type 2 and 3 DIACFs which were selected from 70 who presented. Extensile lateral approach was used in the ORIF group; while MIS techniques included either percutaneous reduction or small incisions with indirect fragment manipulation...
February 20, 2017: Foot
https://www.readbyqxmd.com/read/28293330/functional-latissimus-dorsi-transfer-for-upper-extremity-reconstruction-a-case-report-and-review-of-the-literature
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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