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Soft tissue injury management

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https://www.readbyqxmd.com/read/28219124/our-experience-in-using-telehealth-for-paediatric-plastic-surgery-in-western-australia
#1
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
#2
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
#3
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...
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
#4
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
#5
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
#6
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
#7
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
#8
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...
February 13, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28167879/early-revision-surgery-for-tibial-plateau-non-union-and-mal-union
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28160036/-treatment-of-recurrent-dupuytren-s-disease
#13
T Pillukat, L Walle, R Stüber, J Windolf, J van Schoonhoven
BACKGROUND: The tendency of recurrence or progression is a frequent problem in Dupuytren's disease. The management of recurrence is adapted to the individual situation and the patient's needs. In mild cases a non-operative approach is recommended. Revision surgery is reserved for disabling situations with acceptable circulation and sensation in absence of dystrophy. It is complicated by a combined formation of scar tissue and new cords. This increases the risk of soft tissue loss and injuries to the neurovascular bundles, which impair sensation and circulation and may result in loss of the finger...
February 3, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28134070/earthquake-related-orthopedic-injuries-in-adult-population-a-systematic-review
#14
Michelangelo Bortolin, Ilaria Morelli, Amalia Voskanyan, Nina R Joyce, Gregory R Ciottone
: Introduction Earthquake-related trauma results in crush injuries and bony- and soft-tissue trauma. There are no systematic reviews analyzing the typical injury patterns and treatments in "Mega-Mass-Casualty" earthquakes. The characterization of an injury pattern specific to disaster type, be it natural or manmade, is imperative to build an effective disaster preparedness and response system. METHODS: The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...
January 30, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28133503/second-place-award-immediate-versus-delayed-operative-treatment-of-low-energy-tibial-plateau-fractures
#15
Harold Scott Ellsworth, Jonathan R Dubin, Christopher M Shaw, Sadie M Alongi, Akin Cil
BACKGROUND: Current management of tibial plateau fractures requires careful soft-tissue management. Often a staged approach with temporary external fixation followed by delayed internal fixation is recommended. While proven in high-energy injuries, its relevance in treating low-energy fractures has not been investigated. The goal of the current study was to assess the short-term complication rates in low-energy tibial plateau fractures treated early (<48 hr). As a secondary aim, we investigated whether surgical approach would affect rates of wound complications...
July 2016: Current Orthopaedic Practice
https://www.readbyqxmd.com/read/28118993/soft-tissue-evidence-of-head-injury-in-infants-and-young-children-is-ct-head-examination-justified
#16
S Zaman, P H Logan, C Landes, S Harave
AIM: To determine whether it is justified to undertake a computed tomography (CT) examination of the head in children under 1 year of age who present with a bruise, swelling, or laceration of >5 cm following head injury in children presenting to a paediatric accident and emergency (A&E) department in the northwest of England. Further aims were to determine whether there was any justification for performing a CT head examination for children with soft-tissue injuries measuring <5 cm, or for children >1 year with evidence of soft-tissue injury, but without any other concerning feature...
April 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28093252/low-energy-open-ankle-fractures-in-the-elderly-outcome-and-treatment-algorithm
#17
Asanka Wijendra, Rupali Alwe, Michael Lamyman, George A Grammatopoulos, Gregoris Kambouroglou
BACKGROUND: With an aging but still active population, open ankle fractures are increasingly presenting as low energy fragility injuries, sharing many characteristics with that of hip fractures. Yet, there is little in the literature on the management and outcome of these fractures. The primary aim of this study was to describe the outcome following open, ankle fragility fracture. Our secondary aim was to identify potential factors that improved outcome. METHODS: All consecutive, low energy open ankle fractures treated at a Level I Trauma Centre over a five-year period were included...
December 10, 2016: Injury
https://www.readbyqxmd.com/read/28090003/primary-hinged-external-fixation-of-terrible-triad-injuries-and-olecranon-fracture-dislocations-of-the-elbow
#18
Kensuke Sakai, Masahiro Shirahama, Naoto Shiba, Kenji Yoshida, Shiro Yoshida
This study aimed to introduce a new treatment that apples primary hinged external fixation for complex fracture-dislocations of the elbow in 12 cases. We retrospectively assessed the functional outcomes of eight patients with terrible triad injuries and three patients with an olecranon fracture-dislocation of the elbow, who were treated at our hospital using a primary hinged external fixator between June 2012 and December 2014. Ten patients underwent repair or replacement of the radial head, while three underwent repair of the olecranon...
January 16, 2017: Kurume Medical Journal
https://www.readbyqxmd.com/read/28089798/a-meta-analysis-of-external-fixation-versus-open-reduction-and-internal-fixation-for-complex-tibial-plateau-fractures
#19
REVIEW
Xing-Wen Zhao, Jian-Xiong Ma, Xin-Long Ma, Xuan Jiang, Yin Wang, Fei Li, Bin Lu
PURPOSE: Both external fixation (ExFx) and open reduction and internal fixation(ORIF) were used to treat complex tibial plateau fractures, but it was not sure which one was better. So we did this meta-analysis to evaluate the outcomes of ExFx and ORIF in managing complex tibial plateau fractures. METHODS: Articles published before August 5, 2016 were selected from PubMed, Cochrane library, and some other electronic database. Relevant journals were also searched manually with no language limited...
January 12, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28088939/complications-in-the-management-of-closed-high-energy-proximal-tibial-plateau-fractures
#20
Kavin Khatri, Vijay Sharma, Darsh Goyal, Kamran Farooque
PURPOSE: To report complications in the management of complex closed proximal tibial fractures. METHOD: A retrospective study was conducted to analyze the infectious and noninfectious complications encountered in the management of high-energy Schatzker type V and VI tibial plateau fractures. All patients were treated at the level 1 trauma centre between January 2011 and March 2014. Sixty two patients were included in the study. The mean patient age was (43.16 ± 11...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
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