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https://www.readbyqxmd.com/read/28538607/evaluation-of-highest-level-pediatric-trauma-activation-criteria
#1
Jessica A Zagory, Minna M Wieck, Brooke E Lerner, Suzanne Moody, Richard A Falcone, Rita V Burke
BACKGROUND: Despite the presence of a tiered in-hospital trauma triage system for the past decade, trauma centers still struggle with a definitive list of highest level activation criteria. In 2002, the American College of Surgeons (ACS) mandated 6 criteria for highest level activation. However, it is unknown if pediatric trauma centers follow these criteria. The purpose of this study is to identify and categorize the highest level pediatric trauma criteria used by pediatric trauma centers in the United States...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28538459/patient-comprehension-and-compliance-survey-to-assess-postoperative-pain-regimens-in-the-orthopaedic-trauma-population
#2
Anup K Gangavalli, Ajith Malige, Saqib Rehman, Chinenye O Nwachuku
OBJECTIVE: This study aims to determine the groups of patients who are at risk for noncompliance and misunderstanding of their pain regimen. DESIGN: Survey-based cohort study. SETTING: Suburban Level-I trauma center. PATIENTS/PARTICIPANTS: A total of 171 patients between the ages of 18-89 years who underwent surgical fixation of fractures involving the pelvis, long bones, or periarticular regions of the knee, ankle, elbow, and wrist...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28507850/distally-based-sural-artery-peroneus-flap-dbspf-for-foot-and-ankle-reconstruction
#3
Ahmed Ali Ebrahiem, Raj Kumar Manas, Gustavo Vinagre
BACKGROUND: Reconstruction of soft-tissue defects in lower third of leg, ankle, and foot has been a challenge and reconstructive surgeons have been trying to innovate different flaps. To solve this issue, we propose a distally based sural artery peroneus flap (DBSPF) in which we include superficial portion of the peroneus brevis muscle and its blood supply with the peroneal artery distally. The aim of this study was to evaluate the functional outcome and its usefulness over conventional distal sural artery flap or other local options available...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28504809/effect-of-lymphedema-treatment-for-management-of-acute-pilon-fractures
#4
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/28502602/uncontacted-tire-explosion-causing-trauma-to-bilateral-lower-extremities-a-case-report
#5
Ming-Yang Yu, Yun Su, Xiang-Jun Meng, Bo-Wu Luan, Gui-Shan Gu, Qiang Sun, De-Wei Zhao
It is uncommon for tire explosion related injuries on the lower extremity. The bilateral lower extremities were injured by tire explosion when the patient was seated in a bus. She sustained an open fracture with partial bone loss in the right calcaneus (a comminuted fracture in the right ankle joint) and a closed comminuted fracture in the left tibia and fibula. This damage was caused by uncontacted tire explosion, thanks to a thick floor between the exploded tire and the patient's feet. This type of injury on lower extremity caused by uncontacted tire explosion was uncommon...
March 16, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28493614/accuracy-of-physical-exam-ankle-brachial-index-and-ultrasonography-in-the-diagnosis-of-arterial-injury-in-patients-with-penetrating-extremity-trauma-a-systematic-review-and-meta-analysis
#6
Ian S deSouza, Roshanak Benabbas, Sean McKee, Bardiya Zangbar, Ashika Jain, Lorenzo Paladino, Leon Boudourakis, Richard Sinert
BACKGROUND: Penetrating Extremity Trauma (PET) may result in arterial injury, a rare but limb- and life-threatening surgical emergency. Accurate and timely diagnosis is vital to enable potential intervention and prevent significant morbidity. OBJECTIVES: Using a systematic review/meta-analysis approach, we determined the utility of Physical Examination (exam), Ankle-Brachial Index (ABI), and Ultrasonography (US) in the diagnosis of arterial injury in ED patients who have sustained PET...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28471914/medial-clamp-tine-positioning-affects-ankle-syndesmosis-malreduction
#7
Christopher T Cosgrove, Sara M Putnam, Steven M Cherney, William M Ricci, Amanda Spraggs-Hughes, Christopher M McAndrew, Michael J Gardner
OBJECTIVES: The purpose of this study was to determine if the position of the medial clamp tine during syndesmotic reduction affected reduction accuracy. DESIGN: Prospective Cohort. SETTING: Urban level 1 trauma center. PATIENTS: Seventy-two patients with operatively treated syndesmotic injuries. INTERVENTION: Patients underwent operative fixation of their ankle syndesmotic injuries using reduction forceps...
April 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28461964/arthroscopic-management-of-articular-and-peri-articular-fractures-of-the-upper-limb
#8
REVIEW
Luca Dei Giudici, Andrea Faini, Luca Garro, Agostino Tucciarone, Antonio Gigante
The management of articular fractures is always a matter of concern. Each articular fracture is different from the other, whatever the classification system used and the surgical or non-surgical indications employed by the surgeon. The main goals remain anatomical reduction, stable fixation, loose body removal and minimal invasiveness.Open procedures are a compromise. Unfortunately, it is not always possible to meet every treatment goal perfectly, since associated lesions can pass unnoticed or delay treatment, and even in a 'best-case' scenario there can be complications in the long term...
September 2016: EFORT Open Rev
https://www.readbyqxmd.com/read/28442207/tibio-talo-calcaneal-fusion-after-limb-salvage-procedures-a-retrospective-study
#9
Lukas Zak, Gerald E Wozasek
BACKGROUND: The treatment of limb threatening trauma on the distal tibia or hindfoot often results in posttraumatic osteoarthritis requiring tibiotalocalcaneal (TTC) arthrodesis. The purpose of this study was to present a case series of patients undergoing various techniques of joint fusion after bone reconstruction and deformity correction as a salvage procedure. The study should help trauma surgeons making decisions in limb salvage and deformity correction in complex lower leg and foot injuries by presenting options and treatment strategies...
April 15, 2017: Injury
https://www.readbyqxmd.com/read/28439310/syndesmosis-injuries-in-the-pediatric-and-adolescent-athlete-an-analysis-of-risk-factors-related-to-operative-intervention
#10
D E Kramer, M X Cleary, P E Miller, Y-M Yen, B J Shore
PURPOSE: To review all paediatric ankle syndesmotic injuries occurring at our institution and identify risk factors associated with operative intervention. METHODS: Among 22 873 evaluations for ankle trauma, we found 220 children suffering from syndesmotic injuries (incidence: 0.96%). We recorded demographic data, details of the injury, features on examination and treatment variables. Univariable and multivariable logistic regression modelling was performed to identify risk factors associated with operative intervention...
2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28430746/serial-radiographs-do-not-change-the-clinical-course-of-nonoperative-stable-ota-ao-44-b1-ankle-fractures
#11
Lucas S Marchand, Zachary M Working, Ajinkya A Rane, Lance G Jacobson, Erik N Kubiak, Thomas F Higgins, David L Rothberg
OBJECTIVE: To assess radiographic markers of ankle stability in stable OTA/AO 44-B1 ankle fractures. DESIGN: Retrospective review. SETTING: Academic Level-I trauma hospital. PATIENTS: One hundred thirty-four patients with stable OTA/AO 44-B1 (Danis-Weber B, Supination-External Rotation-II) ankle fractures. INTERVENTION: Analysis of mortise view radiographs at the time of initial evaluation and final follow-up...
May 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28430016/the-use-of-intravenous-lidocaine-for-the-management-of-acute-pain-secondary-to-traumatic-ankle-injury
#12
Billy Sin, Diana Gritsenko, Grace Tam, Kimberly Koop, Eva Mok
Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28417204/injuries-to-the-chopart-joint-complex-a-current-review
#13
REVIEW
Halah Kutaish, R Stern, L Drittenbass, M Assal
Chopart complex injuries (CCIs) are thought to be uncommon; however, recent literature states the rate of misdiagnosis to be between 20 and 41%. Chopart complex injuries are not ankle injuries, with which they are initially confused due to a similar mechanism of trauma in many cases. Injury to the Chopart complex commonly affects multiple structures. The key to optimal treatment is a high index of clinical suspicion combined with timely accurate imaging studies. Careful diagnostic workup with high-quality radiographs of the foot in neutral position should be obtained...
April 17, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28415868/-epidemiological-data-of-hungarian-skiers-and-snowboarders-medical-problems
#14
Péter Felkai, Ingrid Lengyel, Miklós Szokoly, Gábor Forgó
INTRODUCTION AND AIM: There are no high mountains or any advantageous circumstances for winter sports in Hungary, yet within the 10 million population there are about half a million people (the exact number is 550,000) who tend to go for skiing or snowboarding abroad. Authors compared the injury statistical data with results described in the international literature in order to develop conclusions about the differences in the injury patterns and frequency between the Hungarian ones' and those found in countries with plenty of winter sport possibilities...
April 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28394750/impact-of-body-mass-index-and-bacterial-resistance-in-osteomyelitis-after-antibiotic-prophylaxis-of-open-lower-extremity-fractures
#15
Derek Bremmer, Brandon Bookstaver, Mark Cairns, Kenneth Lindley, Martin Durkin, David Koon, April Miller Quidley
BACKGROUND: We investigated the clinical effectiveness of antimicrobial prophylaxis in lower-extremity open fractures following the Eastern Association for the Surgery of Trauma Guidelines. METHODS: This observational, retrospective, single-center study included adults with lower-extremity open fractures of the ankle, tibia, fibula, or femur. The primary endpoint was the incidence of osteomyelitis within 12 months of the fracture. Secondary endpoint comparisons were the time of antibiotic initiation and drug selection...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28392074/associations-of-timing-of-surgery-with-postoperative-length-of-stay-complications-and-functional-outcomes-3-6-years-after-operative-fixation-of-closed-ankle-fractures
#16
M G Naumann, U Sigurdsen, S E Utvåg, K Stavem
AIMS: To evaluate the associations of timing of surgery with postoperative length of stay (LOS), complications, and functional outcomes 3-6 years after open reduction and internal fixation (ORIF) in closed ankle fractures. PATIENTS AND METHODS: Historical cohort study by chart review of 1011 patients for postoperative LOS and complications; 959 individuals were invited to participate in a postal survey with functional outcomes questionnaires. Complications were classified as perioperative, early, or late...
March 31, 2017: Injury
https://www.readbyqxmd.com/read/28365167/outcomes-of-the-ilizarov-frame-use-in-elderly-patients
#17
Efthymios Iliopoulos, Natasha Morrissey, Seok Cho, Arshad Khaleel
AIM: The use of circular frame is widely accepted. This is an outcome review on use of circular Ilizarov frame in elderly patients. MATERIALS & METHODS: Data from all patients treated with an Ilizarov circular frame between January 2002 and December 2014, who were 65 years of age or over at surgery was collected. Seventy Ilizarov circular frames were applied during this period in our unit at a mean age of 71.2 years. Clinical, radiological and quality of life questionnaire (SF-12) data were gathered...
March 30, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28361015/development-of-an-internally-braced-prosthesis-for-total-talus-replacement
#18
Markus Regauer, Mirjam Lange, Kevin Soldan, Steffen Peyerl, Sebastian Baumbach, Wolfgang Böcker, Hans Polzer
Total loss of talus due to trauma or avascular necrosis, for example, still remains to be a major challenge in foot and ankle surgery with severely limited treatment options. Implantation of a custom made total talar prosthesis has shown promising results so far. Most important factors for long time success are degree of congruence of articular surfaces and ligamentous stability of the ankle. Therefore, our aim was to develop an optimized custom made prosthesis for total talus replacement providing a high level of primary stability...
March 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28341786/effectiveness-of-foot-fasciotomies-in-foot-and-ankle-trauma
#19
Katherine M Bedigrew, D J Stinner, J F Kragh, B K Potter, S B Shawen, J R Hsu
BACKGROUND: Foot compartment syndrome (FCS) has been reported to cause neuropathic pain, claw or hammer toes, and motor and sensory disturbances. The optimal treatment of FCS is controversial. The purpose of this study was to determine if foot fasciotomies improve patient outcomes in high-energy, combat-related lower extremity trauma. METHODS: Medical records of patients with documented FCS from May 2007 to January 2009 were retrospectively reviewed. Consecutive, matched control patients were identified based on similar hindfoot, mid-foot and/or forefoot injuries who did not undergo foot fasciotomy during the same period...
March 23, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28336099/direct-fixation-of-fractures-of-the-posterior-pilon-via-a-posteromedial-approach
#20
Harm Hoekstra, Wouter Rosseels, Stefan Rammelt, Stefaan Nijs
The treatment of fractures of the posterior pilon is a timely issue. Restoration of the integrity of the incisura fibularis and subsequent anatomic reduction of the fibula are essential for reconstruction of the ankle mortise after trauma, and syndesmotic stability. Inappropriate treatment ultimately will lead to a poor functional outcome and quality of life. Open reduction and direct internal fixation through a posterolateral or posteromedial approach are increasingly preferred over indirect reduction and anteroposterior screw fixation...
March 19, 2017: Injury
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