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Soft tissue injury management

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https://www.readbyqxmd.com/read/28093252/low-energy-open-ankle-fractures-in-the-elderly-outcome-and-treatment-algorithm
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28087046/morel-lavall%C3%A3-e-injuries-a-multimodality-approach-to-imaging-characteristics
#5
REVIEW
James A Spain, Matthew Rheinboldt, David Parrish, Eric Rinker
Morel-Lavallée lesions are relatively rare closed degloving injuries caused by a shearing force resulting in separation of the dermis and the hypodermis from the subjacent deeper fascia. Although most commonly encountered lateral to the greater trochanter, these injuries may occur throughout the body in a variety of locations. Separation of the hypodermal tissue planes results in a complex serosanguinous fluid collection with areas of internal fat necrosis. The imaging appearance is variable and nonspecific, potentially mimicking superficial hemorrhagic bursitis, or cystic or necrotic primary soft tissue neoplasms...
February 2017: Academic Radiology
https://www.readbyqxmd.com/read/28069140/the-comparison-of-radiography-and-point-of-care-ultrasonography-in-the-diagnosis-and-management-of-metatarsal-fractures
#6
Nalan Kozaci, Mehmet Oguzhan Ay, Mustafa Avci, Inan Beydilli, Sadullah Turhan, Eda Donertas, Ertan Ararat
OBJECTIVE: It was aimed to compare the efficacy of point-of-care ultrasonography (POCUS) with radiography in the diagnosis and management of metatarsal fracture (MTF). METHODS: Patients aged 5-55 years admitted to emergency room due to low-energy, simple extremity trauma and had a suspected MTF, were included in this prospective study. Patients were evaluated by two different emergency physicians in the emergency room. The first physician performed POCUS examination...
December 23, 2016: Injury
https://www.readbyqxmd.com/read/28068792/arthroscopic-reduction-and-internal-fixation-arif-of-a-comminuted-posterior-talar-body-fracture
#7
Rishin Kadakia, Jeff Konopka, Tristan Rodik, Samra Ahmed, Sameh A Labib
: The talus is the second most common fractured tarsal bone. While their incidence may be low, talus fractures are severe injuries that can lead to long-term disability and pain. Displaced talar body fractures are typically treated through an open approach with the aim of obtaining anatomic reduction and stable fixation. There are several case reports in the literature demonstrating successful management of talus fractures arthroscopically. An arthroscopic approach minimizes soft tissue trauma, which can help decrease postoperative wound complications and infections...
January 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28050641/children-presenting-in-delayed-fashion-after-minor-head-trauma-with-scalp-swelling-do-they-require-further-workup
#8
Jonathan N Sellin, Amee Moreno, Sheila L Ryan, Sandi K Lam, Marcella Donaruma-Kwoh, Thomas G Luerssen, Andrew Jea
PURPOSE: It is common to evaluate children who have sustained minor head trauma with computed tomography (CT) of the head. Scalp swelling, in particular, has been associated with intracranial injury. A subset of patients, however, present in delayed fashion, often days after the head trauma, as soft tissue edema progresses and their caregiver notices scalp swelling. We explore the value of further workup in this setting. METHODS: We conducted a retrospective review of a prospectively collected cohort of children ≤24 months of age presenting to the Texas Children's Hospital with scalp swelling more than 24 h following a head trauma...
January 3, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28042278/restorative-rehabilitation-in-a-patient-with-sports-trauma
#9
Haroon Rashid, Fahim Vohra, Graeme R Lillywhite
Sports trauma frequently involves insult to oral soft and hard tissues resulting in loss of tooth structure and tooth loss. Multiple sporting equipment's are employed to prevent irreversible damage to oro-facial structures, and to reduce the overall cost of treatment. However in the undesired consequence of loss of oral structures, multiple treatment options are utilized to restore, esthetics, comfort and function. Osseointegrated implant supported rehabilitation of oral structures in trauma cases provides highly predictable treatment outcomes along with preservation of remaining tissues...
October 2016: European Journal of Dentistry
https://www.readbyqxmd.com/read/28040088/restoration-of-long-bone-defects-treated-with-the-induced-membrane-technique-protocol-and-outcomes
#10
Peter V Giannoudis, Paul J Harwood, Theodoros Tosounidis, Nikolaos K Kanakaris
This prospective study was undertaken at a regional tertiary referral centre to evaluate the results of treatment of bone defects managed with the induced membrane (IM) technique. Inclusion criteria were patients with bone defects secondary to septic non-union, chronic osteomyelitis and acute fracture with bone loss. Pathological fractures with bone loss were excluded. Data collection included patient demographics, pathology, previous surgical intervention, size of bone defect, type of graft implanted, time-to-union and complications/reinterventions...
December 2016: Injury
https://www.readbyqxmd.com/read/28033150/complex-distal-radius-fractures-an-anatomic-algorithm-for-surgical-management
#11
Peter Charles Rhee, Robert J Medoff, Alexander Y Shin
Most distal radius fractures result from low-energy mechanisms and can be successfully treated nonsurgically or with a variety of surgical techniques if indicated. High-energy distal radius fractures can involve extensive comminution or bone loss with concomitant ligament, soft-tissue, and neurovascular injuries. In patients with complex distal radius fractures, reconstruction of the distal radius, ulna, and triangular fibrocartilage complex can be challenging. Effective restoration of the bony architecture requires intimate knowledge of the anatomy of the distal radius, a thorough understanding of the goals of treatment, versatility in surgical approaches, and familiarity with multiple fixation options...
February 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28018069/bilateral-sequential-knee-dislocation-in-a-patient-with-connective-tissue-disorder-report-of-an-unusual-case-and-lessons-learnt
#12
Waheeb Al-Azzani, Konrad Wronka, James Lewis, Adel Ghandour, Angus Robertson
Tibiofemoral knee dislocation is a rare but serious limb-threatening injury. Without prompt recognition and management, amputation or long-term functional impairment may result. The authors present a case of bilateral sequential knee dislocation, secondary to low-energy trauma, in a patient with Systemic Lupus Erythematosus and antiphospholipid syndrome. Adequate stability was achieved on both occasions by reconstruction of the postero-lateral corner and MCL. During the first reconstruction, ipsi-lateral autograft, as well as hamstring tendons from the contra-lateral side, were used to strengthen the graft...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27986236/surgical-management-and-reconstruction-training-smart-course-for-international-orthopedic-surgeons
#13
Hao-Hua Wu, Kushal R Patel, Amber M Caldwell, R Richard Coughlin, Scott L Hansen, Joseph N Carey
BACKGROUND: The burden of complex orthopedic trauma in low- and middle-income countries (LMICs) is exacerbated by soft-tissue injuries, which can often lead to amputations. This study's purpose was to create and evaluate the Surgical Management and Reconstruction Training (SMART) course to help orthopedic surgeons from LMICs manage soft-tissue defects and reduce the rate of amputations. METHODS: In this prospective observational study, orthopedic surgeons from LMICs were recruited to attend a 2-day SMART course taught by plastic surgery faculty in San Francisco...
July 2016: Annals of Global Health
https://www.readbyqxmd.com/read/27938394/complications-after-surgical-management-of-distal-lower-leg-fractures
#14
Mirjam V Neumann, Peter C Strohm, Kilian Reising, Joern Zwingmann, Thorsten O Hammer, Norbert P Suedkamp
BACKGROUND: Osseous healing of distal lower leg fractures can be prolonged and is often associated with wound healing problems because of the marginal soft - tissue and vascular supply in this area. Postoperative complications are frequent, and according to the literature, open reduction and plate fixation is thought to be associated with higher complication rates. The objective of this study was to evaluate the most common postoperative complications following intramedullary nailing or plate osteosynthesis of distal lower leg injuries with a focus on combined tibio-fibular fractures...
December 9, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27922956/the-complicated-facial-war-injury-pitfalls-and-mismanagement
#15
Ghassan S Abu-Sittah, Joe Baroud, Christopher Hakim, Cynthia Wakil
OBJECTIVE: The aim of this paper is to share the authors' experience in the management of complicated facial war injuries using free tissue transfer. A discussion on the most commonly encountered pitfalls in management during the acute and complicated settings is presented in an effort to raise insight on facial war wound complications. METHODOLOGY: Two patients of complicated facial war injuries are presented to exemplify the pitfalls in acute and chronic management of the mandibular region in the first patient and the orbito-maxillary region in the second...
December 5, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27922625/infections-in-the-spinal-cord-injured-population-a-systematic-review
#16
L Y Garcia-Arguello, J C O'Horo, A Farrell, R Blakney, M R Sohail, C T Evans, N Safdar
STUDY DESIGN: Spinal cord injury (SCI) patients are an increasing population due to recent military conflicts. SCI patients are at an increased risk of infection, but the epidemiology management and prevention strategies for these infections are unclear. OBJECTIVE: To review the incidence, microbiology and management of pneumonia, skin and soft tissue infections (SSTI), urinary tract infections (UTI) and bloodstream infections in the SCI population via literature review...
December 6, 2016: Spinal Cord
https://www.readbyqxmd.com/read/27918379/nontuberculous-mycobacteria-in-children-a-focus-on-bloodstream-infections
#17
Laila S Al Yazidi, Ben J Marais, Briony Hazelton, Alexander Outhred, Alison Kesson
BACKGROUND: Nontuberculous mycobacteria (NTM) are ubiquitous organisms with variable disease-causing potential. Bloodstream infections caused by NTM in children are poorly described. METHODS: We describe a retrospective case series of children with culture-confirmed mycobacterial disease managed at The Children's Hospital at Westmead from July 2005 - June 2015. RESULTS: Sixty-five patients had 149 positive NTM cultures; 55 (83.0%) episodes in 54 patients were considered clinically significant...
December 1, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27909666/arthroscopic-reduction-and-internal-fixation-for-pipkin-type-i-femoral-head-fracture-technical-note
#18
Aditya Kekatpure, Taesoo Ahn, Soong Joon Lee, Mi Youn Jeong, Jae Suk Chang, Pil Whan Yoon
Femoral head fractures after posterior dislocation of the hip are uncommon and are conventionally treated by an open method. Hip arthroscopy can be a valuable treatment option for the management of femoral head fractures. Arthroscopy allows for a less invasive option when compared with arthrotomy and can allow faster recovery with minimal soft-tissue injury. We describe the arthroscopic reduction and internal fixation of Pipkin type I femoral head fractures with a detailed stepwise description of the surgical technique, including technical pearls and pitfalls, potential complications, and advantages and disadvantages...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27904790/current-concepts-in-the-treatment-of-gross-patellofemoral-instability
#19
Grant Buchanan, LeeAnne Torres, Brian Czarkowski, Charles E Giangarra
: Patellofemoral instability is a painful and commonly recurring condition, which often must be managed surgically. Diagnosis can be aided by the use of a variety of physical exam signs, such as the Q angle, Beighton hypermobility score, glide test, J sign, patellar tilt test, and apprehension test. Imaging modalities including x-ray, CT, and MRI guide both diagnosis and management by revealing trochlear dysplasia, bony malalignment, and ligamentous injury that contribute to instability...
December 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27900291/elastin-a-possible-genetic-biomarker-for-more-severe-ligament-injuries-in-elite-soccer-a-pilot-study
#20
Rosa Artells, Ricard Pruna, Alexandre Dellal, Nicola Maffulli
BACKGROUND: The study of new genetic biomarkers in genes related to connective tissue repair and regeneration may help to identify individuals with greater predisposition to injury, who may benefit from targeted preventive measures, and those who require longer recovery time following a muscle, ligament or tendon injury. The present study investigated whether single nucleotide polymorphisms of the Elastin gene could be related to MCL injury. METHODS: 60 top class football players were studied to identify single nucleotide polymorphisms for the Elastin (ELN) gene using Allelic Discrimination analysis...
April 2016: Muscles, Ligaments and Tendons Journal
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