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Soft tissue injury management

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https://www.readbyqxmd.com/read/28538454/open-tibia-shaft-fractures-and-soft-tissue-coverage-the-effects-of-management-by-an-orthopaedic-microsurgical-team
#1
James VandenBerg, Daniel Osei, Martin I Boyer, Michael J Gardner, William M Ricci, Amanda Spraggs-Hughes, Christopher M McAndrew
OBJECTIVES: To compare the timing of soft-tissue (flap) coverage and occurrence of complications before and after the establishment of an integrated orthopaedic trauma/microsurgical team. DESIGN: Retrospective cohort study. SETTING: A single level 1 trauma center. PATIENTS: Twenty-eight subjects (13 pre- and 15 post-integration) with open tibia shaft fractures (OTA/AO 42A, 42B, and 42C) treated with flap coverage between January 2009 and March 2015...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28533626/nonhealing-progressive-stress-fractures-of-the-foot-in-a-13-year-old-basketball-player-is-vitamin-k-deficiency-a-risk-factor
#2
Meral Bayramoğlu, Nuray Ünlütürk
[Purpose] To report an adolescent male basketball player with nonhealing stress fractures of the foot and discuss the probable factors. [Subject and Methods] A 13-year-old basketball player presented with right foot pain. He had been playing basketball for three years and practicing 5 days/week. He denied any increase in daily training intensity. Magnetic resonance imaging confirmed stress fractures of the cuboid and cuneiform, with mild edema of the soft tissues between the tarsal bones and tenosynovitis of the flexor hallucis and flexor digitorum longi...
April 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28525675/acellular-dermal-matrix-and-heel-reconstruction-a-new-prospective
#3
Alessandro Scalise, Matteo Torresetti, Federica Verdini, Marianna Capecci, Elisa Andrenelli, Alessandro Mengarelli, Maria Gabriella Ceravolo, Sandro Fioretti, Giovanni Di Benedetto
BACKGROUND: Heel reconstruction represents a challenge for all plastic surgeons due to the anatomical and functional features of this weight-bearing area. In the last decade a combined use of acellular dermal matrices and skin grafts has been proposed as a reliable and less invasive alternative for complex wound management; nevertheless only a few cases have been reported in the literature. METHODS: We describe the long-term outcome of 2 cases of severe degloving trauma of the plantar region with massive soft tissue defects of the foot, that underwent surgical reconstruction with artificial dermis and skin grafts...
May 19, 2017: Journal of Applied Biomaterials & Functional Materials
https://www.readbyqxmd.com/read/28511813/conservative-management-of-mallet-injuries-a-national-survey-of-current-practice-in-the-uk
#4
Z Tolkien, S Potter, N Burr, M D Gardiner, J M Blazeby, A Jain, J Henderson
INTRODUCTION: Mallet injuries are common and usually treated conservatively. Various systematic reviews have found a lack of evidence regarding the best management, and it is unclear whether this uncertainty is reflected in current UK practice. METHODS: An online survey was developed to determine the current practice for the conservative treatment of mallet injury among specialist hand clinicians in the UK, including physiotherapists, occupational therapists and surgeons...
April 23, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28504809/effect-of-lymphedema-treatment-for-management-of-acute-pilon-fractures
#5
John M Whatley, James A Lalonde, Craig C Greene, Kevin B Riche, Danielle M Tatum
Pilon fractures are high-energy injuries that often result in considerable edema and compromise of the soft tissue envelope of the ankle. These injuries are typically staged with an external fixator until the soft tissue is amenable for definitive fixation. This study was conducted to determine the effects of lymphedema treatment for the management of pilon fractures. Patients who underwent open reduction and internal fixation of pilon fractures between 2007 and 2014 at the authors' level II trauma center were identified by Current Procedural Terminology codes indicative of placement of an external fixator (20690) and open reduction and internal fixation of a pilon fracture (27826, 27827, or 27828)...
May 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28501106/concurrent-endocrine-and-other-surgical-procedures-an-institutional-experience
#6
Rachel Morris, Tina W F Yen, Kara Doffek, Azadeh A Carr, Stuart D Wilson, Douglas B Evans, Tracy S Wang
INRODUCTION: The number of endocrine procedures, specifically parathyroidectomy, thyroidectomy, and adrenalectomy, being performed is increasing. There is a paucity of literature on the feasibility of combining these procedures with other surgical procedures. Therefore, the aim of this study was to determine the effect of performing concurrent surgical procedures on postoperative outcomes. METHODS: This is a single institution retrospective review of multiple prospectively maintained databases of patients who underwent elective thyroidectomy, parathyroidectomy, and/or adrenalectomy in combination with another procedure...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28496392/differences-in-the-management-of-pediatric-facial-trauma
#7
REVIEW
Tara L Braun, Amy S Xue, Renata S Maricevich
Craniofacial trauma is common in the pediatric population, with most cases limited to soft tissue and dentoalveolar injury. Although facial fractures are relatively rare in children compared with adults, they are often associated with severe injury and cause significant morbidity and disability. Initial evaluation of a child with facial trauma generally involves stabilizing the patient and identifying any severe concomitant injuries before diagnosing and managing facial injuries. The management of pediatric facial fractures is relatively more conservative than that of adults, and nonsurgical management is preferred when possible to prevent the disruption of future growth and development...
May 2017: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/28496386/soft-tissue-management-in-facial-trauma
#8
REVIEW
Tara L Braun, Renata S Maricevich
The management of soft tissue injury after facial trauma poses unique challenges to the plastic surgeon, given the specialized nature of facial tissue and the aesthetic importance of the face. The general principles of trauma management and wound care are applied in all cases. The management of severe injuries to the face is discussed in relation to the location and the mechanism of injury. Facial transplants have arisen in the past decade for the management of catastrophic soft tissue defects, although high morbidity and mortality after these non-life-saving operations must be considered in patient selection...
May 2017: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/28487800/a-combined-bony-and-soft-tissue-thoracic-chance-fracture-late-displacement-following-conservative-treatment
#9
James Thomas Bourne, Alexander David Laing Baker, Manoj Khatri
We report the first case of a combined bony and soft tissue Chance fracture in the thoracic spine, with late presenting displacement following conservative management. Chance fractures are flexion-distraction injuries to the spine. They consist of disruption and longitudinal separation of the posterior elements of the vertebra, with the fracture extending through the pedicles and into the vertebral body. Both bony and soft tissue Chance fractures of the lumbar spine have been reported, as well as bony Chance fractures in the thoracic spine...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28484544/bilateral-posterior-fossa-and-temporo-occipital-extra-dural-hematomas-a-simple-novel-technique
#10
Ashish Aggarwal, Pravin Salunke, Sameer Futane, Harsimrat Bir Sodhi
Posterior fossa extra-dural hematoma is rare and early diagnosis and management is associated with good outcome. Twenty four year male presented with somnolence and soft tissue swelling of occipital region following road traffic accident. CT scan revealed bilateral posterior fossa with bilateral temporo-occipital Extradural Hematoma (EDH) with mass effect. He was operated through a trifoliate incision and craniotomies leaving a strip of bone over the transverse and occipital sinus. The blood loss with such technique was minimal and the control of sinus tear was easier as the dura on either sides of the sinus can to tied to each other to hitch the sinus up to the bone thereby, providing a good tamponade...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28481627/outcomes-after-percutaneous-reduction-and-fixation-of-low-energy-lisfranc-injuries
#11
Michael Vosbikian, Joseph T O'Neil, Christine Piper, Ronald Huang, Steven M Raikin
BACKGROUND: Lisfranc injuries are often missed initially or not anatomically reduced, leading to midfoot collapse, arthrosis, and pain. Operative management of these injuries is also fraught with complications, particularly with respect to the soft tissues. Wound dehiscence and infection are not uncommon. The goal of this study was to analyze the outcomes of a minimally invasive technique in reduction and percutaneous fixation of low-energy minimally displaced Lisfranc injuries and determine if it is a safe alternative to more traditional, open approaches...
May 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28469487/early-results-of-minimally-invasive-percutaneous-plate-osteosynthesis-for-fractures-of-the-distal-tibia-a-retrospective-case-series-and-review-of-the-literature
#12
Gabriel A Akra, Stefanos Lazarides, Ananda M Nanu
Minimally invasive percutaneous plate osteosynthesis was developed on the concept that preservation of the soft tissue envelope during surgical management of distal tibial fractures is of paramount importance. We report on our early experience using this technique over a 1-year period with 14 such injuries that were treated by a locking compression plate via minimally invasive surgery. The surgical reduction was excellent in most of the cases and all fractures healed uneventfully. One superficial infection and a wound slough were the only complications recorded...
2017: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28461913/high-energy-pilon-fractures-management-state-of-the-art
#13
REVIEW
Jordi Tomás-Hernández
High-energy pilon fractures are challenging injuries. Multiple options are described for the definitive surgical management of these fractures, but there is no level I evidence for optimal management. The current management and recommendations for treatment will be reviewed in this article.Anatomical reduction of the fracture, restoration of joint congruence and reconstruction of the posterior column with a correct limb axis minimising the soft-tissue insult are the key points to a good outcome when treating pilon fractures...
October 2016: EFORT Open Rev
https://www.readbyqxmd.com/read/28450098/crush-injuries-of-the-hand
#14
REVIEW
Avi D Goodman, Christopher J Got, Arnold-Peter C Weiss
Crush injuries of the hand are a rare but devastating phenomenon, with historically poor outcomes. A compressive force, usually caused by a high-energy mechanism such as a motor vehicle or industrial accident, crushes and transiently increases the pressures within the hand. This force acts on the incompressible blood in the vasculature and leads to a dramatic rise in tissue pressures and damage to multiple tissue types, including bones, blood vessels, nerves, and soft tissues. A wide zone of injury results from a delayed inflammatory reaction involving the zone bordering the crushed cells, which may initially belie the severity of the injury...
April 25, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28445273/staged-management-of-open-lisfranc-injury-experience-from-14-patients
#15
Wenqi Gu, Zhongmin Shi
There are still controversies on the management and outcome of open Lisfranc injury in available studies. This study evaluates the staged management of Lisfranc injury and its complications.Patients who received a staged strategy for open Lisfranc injury were reviewed.One patient with degloving injury suffered from partial skin and hallux necrosis which was treated by debridement, hallux amputation, definitive internal fixation, and local flap transfer on the 12th day after first stage management. A definitive internal fixation and simultaneous skin graft or flap coverage were performed in another 3 patients with soft tissue defects...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28443251/partial-heel-pad-avulsion-with-open-calcaneal-tuberosity-fracture-with-tendo-achilles-rupture-a-case-report
#16
Shameem Ahmed, Syed Ifthekar, R Pathan Rameez Ahmed Khan, Rahul Ranjan
INTRODUCTION: The management of heel pad avulsion injuries has been challenging because of the precarious blood supply. The difficulties get compounded when it is associated with tendo-achilles rupture and calcaneal fracture. Here, it is a description of a case with the above features managed with a unique technique. CASE REPORT: A 63-year-old woman presented to casualty with injury to right ankle after a road traffic accident. On clinical and radiological examination, there was avulsion of heel pad with calcaneal tuberosity fracture and tendo-achilles rupture...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28435557/internal-fixation-of-transverse-patella-fractures-using-cannulated-cancellous-screws-with-anterior-tension-band-wiring
#17
I Khan, M Y Dar, S Rashid, M F Butt
Aims: To evaluate the effectiveness and safety of anterior tension band wiring technique using two cannulated cancellous screws in patients with transverse (AO34-C1) or transverse with mildly comminuted (AO34-C2) patellar fractures. Materials and Methods: This is a prospective study of 25 patients with transverse fracture or transverse fracture with mildly comminuted patella fractures. All the patients were treated with open reduction and internal fixation using two parallel cannulated screws and 18G stainless steel wire as per the tension band principle...
July 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28413772/postoperative-complications-with-cryotherapy-in-bone-tumors
#18
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
#19
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
#20
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
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