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Rib fracture

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https://www.readbyqxmd.com/read/29452868/chest-wall-dose-reduction-using-noncoplanar-volumetric-modulated-arc-radiation-therapy-for-lung-stereotactic-ablative-radiation-therapy
#1
Amy S Yu, Peter G Maxim, Billy W Loo, Michael F Gensheimer
PURPOSE: Stereotactic ablative radiation therapy (SABR) to lung tumors close to the chest wall can cause rib fractures or chest wall pain. We evaluated and propose a clinically practical solution of using noncoplanar volumetric modulated arc radiation therapy (VMAT) to reduce chest wall dose from lung SABR. METHODS AND MATERIALS: Twenty lung SABR VMAT plans in which the chest wall volume receiving 30 Gy or higher (V30) exceeded 30 mL were replanned by noncoplanar VMAT with opposite 15° couch kicks...
December 19, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29452863/chest-wall-toxicity-after-hypofractionated-proton-beam-therapy-for-liver-malignancies
#2
Rosanna Yeung, Stephen R Bowen, Tobias R Chapman, Grayden T MacLennan, Smith Apisarnthanarax
PURPOSE: Normal liver-sparing with proton beam therapy (PBT) allows for dose escalation in the treatment of liver malignancies, but it may result in high doses to the chest wall (CW). CW toxicity (CWT) data after PBT for liver malignancies are limited, with most published reports describing toxicity after a combination of hypofractionated proton and photon radiation therapy. We examined the incidence and associated factors for CWT after hypofractionated PBT for liver malignancies. METHODS AND MATERIALS: We retrospectively reviewed the charts of 37 consecutive patients with liver malignancies (30 hepatocellular carcinoma, 6 intrahepatic cholangiocarcinoma, and 1 metastasis) treated with hypofractionated PBT...
December 24, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29447441/design-factors-of-femur-fracture-fixation-plates-made-of-shape-memory-alloy-based-on-the-taguchi-method-by-finite-element-analysis
#3
Cheolwoong Ko, Mikyung Yang, Taemin Byun, Sang-Wook Lee
This study proposed a way to design femur fracture fixation plates made of shape memory alloy based on CT (Computed Tomography) images of Korean cadaveric femurs. To this end, 3 major design factors of femur fracture fixation plates (circumference angle, thickness, and inner diameter) were selected based on the contact pressure when a femur fracture fixation plate was applied to a cylinder model using the Taguchi Method. Then the effects of the design factors were analyzed. It was shown that the design factors were statistically significant at a level of p=0...
February 15, 2018: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29447180/experimental-research-on-the-structural-instability-mechanism-and-the-effect-of-multi-echelon-support-of-deep-roadways-in-a-kilometre-deep-well
#4
Rui Peng, Xiangrui Meng, Guangming Zhao, Yingming Li, Jianming Zhu
We study the structural instability mechanism and effect of a multi-echelon support in very-deep roadways. We conduct a scale model test for analysing the structural failure mechanism and the effect of multi-echelon support of roadways under high horizontal stress. Mechanical bearing structures are classified according to their secondary stress distribution and the strength degradation of the surrounding rock after roadway excavation. A new method is proposed by partitioning the mechanical bearing structure of the surrounding rock into weak, key and main coupling bearing stratums...
2018: PloS One
https://www.readbyqxmd.com/read/29445296/the-ultrasound-guided-retrolaminar-block-volume-dependent-injectate-distribution
#5
Marija Damjanovska, Tatjana Stopar Pintaric, Erika Cvetko, Kamen Vlassakov
Purpose: The ultrasound-guided retrolaminar block is one of the newer and simpler alternatives to the traditional, often technically challenging, paravertebral (PV) block. Its feasibility, safety, and efficacy have already been clinically demonstrated in patients with multiple rib fractures using higher volumes of local anesthetic, when compared with the traditional approach. The primary aim of this observational anatomical study was to assess the spread of local anesthetic from the retrolaminar injection point to the PV space and its volume dependence...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29433408/blunt-injury-of-the-innominate-artery-what-surprises-to-expect-a-case-report
#6
Marina Dias-Neto, José F Ramos, José F Teixeira
Injuries of the supra-aortic trunk after blunt chest trauma are rare. This is a case report of a blunt traumatic lesion of the innominate artery (IA) origin that exhibited aortic arch involvement with a focus on imaging and treatment. A 41-year-old fisherman presented an IA injury secondary to a high-impact blunt chest trauma. Upon physical examination, vital signs were stable and upper extremity pulses were present. In addition to several bone fractures (costal ribs, clavicle, scapula, temporal, maxillary, and sphenoid), computed tomography angiography revealed dissection/pseudoaneurysm of the IA sparing the bifurcation...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29429475/-osteosynthesis-of-rib-fractures-unstable-chest-wall-pseudoarthroses-and-acquired-defects-of-the-chest-wall
#7
Kirsten Neckelmann, Rikke Hagelberg
Several patients suffer from rib fractures after traumas, and in severe cases it can be life-threatening. Until recently, attempts to perform surgical fixation in patients with instability have been unsuccessful. Chronic non-union causes persistent pain, disability and loss of quality of life. Implementation of surgical stabilization of rib fractures with tailored plates seems to improve pain relief, especially in cases of non-union but also in patients with instability of the chest wall after severe traumas, where advanced pain treatment (epidural catheter) is insufficient or weaning off fails...
February 5, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29413744/an-in%C3%A2-vitro-biomechanical-study-on-ovine-rib-flexibility-with-increasing-deconstruction-as-an-alternative-to-rib-resection-for-costoplasty
#8
Matthew Hughes, Jason Bernard, Matthew Szarko
STUDY DESIGN: An in vitro biomechanical study into the effect of rib deconstruction on the flexibility in ovine ribs, using three-point bending. OBJECTIVE: To examine the feasibility and possible effectiveness of a more conservative costoplasty using an in vitro animal model. SUMMARY OF BACKGROUND DATA: Costoplasty remains useful in the treatment of adolescent idiopathic scoliosis, rib hump, and associated chest wall deformities. However, traditional costoplasty increases morbidity and blood loss...
March 2018: Spine Deformity
https://www.readbyqxmd.com/read/29411048/comparison-of-analgesic-interventions-for-traumatic-rib-fractures-a-systematic-review-and-meta-analysis
#9
Jesse Peek, Diederik P J Smeeing, Falco Hietbrink, Roderick M Houwert, Marije Marsman, Mirjam B de Jong
PURPOSE: Many studies report on outcomes of analgesic therapy for (suspected) traumatic rib fractures. However, the literature is inconclusive and diverse regarding the management of pain and its effect on pain relief and associated complications. This systematic review and meta-analysis summarizes and compares reduction of pain for the different treatment modalities and as secondary outcome mortality during hospitalization, length of mechanical ventilation, length of hospital stay, length of intensive care unit stay (ICU) and complications such as respiratory, cardiovascular, and/or analgesia-related complications, for four different types of analgesic therapy: epidural analgesia, intravenous analgesia, paravertebral blocks and intercostal blocks...
February 6, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29403245/machined-cervical-interfacet-allograft-spacers-for-the-management-of-atlantoaxial-instability
#10
Mazda K Turel, Mena G Kerolus, Vincent C Traynelis
Background: The use of cervical interfacet spacers (CISs) to augment stability and provide solid arthrodesis at the atlantoaxial joint has not been studied in detail. The aim of this work is to report the outcomes with the use of machined allograft CISs at C1-2. Methods: A retrospective review of 19 patients who underwent an atlantoaxial fusion with the use of CISs was performed. All patients had instability documented with flexion and extension lateral radiographs...
October 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29402425/surgical-treatment-of-rib-fracture-nonunion-a-single-center-experience
#11
M B de Jong, R M Houwert, S van Heerde, M de Steenwinkel, F Hietbrink, L P H Leenen
INTRODUCTION: In contrast to the emerging evidence on the operative treatment of flail chest, there is a paucity of literature on the surgical treatment of rib fracture nonunion. The purpose of this study was to describe our standardized approach and report the outcome (e.g. patient satisfaction, pain and complications) after surgical treatment of a rib fracture nonunion. METHODS: A single centre retrospective cohort study was performed at a level 1 trauma centre...
February 2, 2018: Injury
https://www.readbyqxmd.com/read/29390586/a-case-report-of-phosphaturic-mesenchymal-tumor-induced-osteomalacia
#12
Weiqian Wu, Chongyang Wang, Jianwei Ruan, Feng Chen, Ningjun Li, Fanghu Chen
RATIONALE: Tumor-induced osteomalacia (TIO) is a rare and often misdiagnosed syndrome. Surgical resection is currently the first line treatment for TIO. PATIENT CONCERNS: Here we report the case of a 49-year-old woman presented with intermittent pain in the right chest and bilateral hip that had persisted for over two years. DIAGNOSES: She was diagnosed of TIO caused by a phosphaturic mesenchymal tumor based on the following examinations. Laboratory tests revealed high serum alkaline phosphatase, high urinary phosphorus, hypophosphatemia and normal serum calcium levels...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29381610/facial-fractures
#13
Rajarshi Ghosh, Kulandaswamy Gopalkrishnan
AIMS AND OBJECTIVES: The aim of this study is to retrospectively analyze the incidence of facial fractures along with age, gender predilection, etiology, commonest site, associated dental injuries, and any complications of patients operated in Craniofacial Unit of SDM College of Dental Sciences and Hospital. MATERIALS AND METHODS: This retrospective study was conducted at the Department of OMFS, SDM College of Dental Sciences, Dharwad from January 2003 to December 2013...
January 29, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29373114/the-influence-of-pre-existing-rib-fractures-on-global-human-body-models-consortium-thorax-response-in-frontal-and-oblique-impact
#14
Lauren Wood Zaseck, Cong Chen, Jingwen Hu, Matthew P Reed, Jonathan Rupp
Many post-mortem human subjects (PMHS) considered for use in biomechanical impact tests have pre-existing rib fractures (PERFs), usually resulting from cardiopulmonary resuscitation. These specimens are typically excluded from impact studies with the assumption that the fractures will alter the thoracic response to loading. We previously used the Global Human Body Models Consortium 50th percentile whole-body finite element model (GHBMC M50-O) to demonstrate that up to three lateral or bilateral PERFs do not meaningfully influence the response of the GHBMC thorax to lateral loading...
January 13, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29370956/pediatric-constrictive-asphyxia-a-rare-form-of-child-abuse-a-report-of-two-cases
#15
M E M Vester, R A C Bilo, H G T Nijs, R R van Rijn
We present two cases of infants who died under suspicious circumstances. After clinical and legal investigations, non-accidental constrictive asphyxia inflicted by one of the parents was established. The first case presents a to date not yet reported, unique mechanism of trauma. In order to stop his daughter from crying, the father admitted that he sometimes sat on his baby while she was lying on the bed. Occasionally increasing his force by pulling with his hands on the bottom of the bed. In the second case tight swaddling and encircling chest compression was the causative mechanism...
January 10, 2018: Forensic Science International
https://www.readbyqxmd.com/read/29368085/selective-nonoperative-management-of-liver-gunshot-injuries
#16
Pradeep Navsaria, Andrew Nicol, Jake Krige, Sorin Edu, Sharfuddin Chowdhury
PURPOSE: Nonoperative management (NOM) of gunshot liver injuries (GLI) is infrequently practiced. The aim of this study was to assess the safety of selective NOM of GLI. METHODS: A prospective, protocol-driven study, which included patients with GLI admitted to a level 1 trauma center, was conducted over a 52-month period. Stable patients without peritonism or sustained hypotension with right-sided thoracoabdominal (RTA) and right upper quadrant (RUQ), penetrating wounds with or without localized RUQ tenderness, underwent contrasted abdominal CT scan to determine the trajectory and organ injury...
January 24, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29358272/fam46a-mutations-are-responsible-for-autosomal-recessive-osteogenesis-imperfecta
#17
Mathilde Doyard, Séverine Bacrot, Céline Huber, Maja Di Rocco, Alice Goldenberg, Mona S Aglan, Perrine Brunelle, Samia Temtamy, Caroline Michot, Ghada A Otaify, Coralie Haudry, Mireille Castanet, Julien Leroux, Jean-Paul Bonnefont, Arnold Munnich, Geneviève Baujat, Pablo Lapunzina, Sophie Monnot, Victor L Ruiz-Perez, Valérie Cormier-Daire
BACKGROUND: Stüve-Wiedemann syndrome (SWS) is characterised by bowing of the lower limbs, respiratory distress and hyperthermia that are often responsible for early death. Survivors develop progressive scoliosis and spontaneous fractures. We previously identified LIFR mutations in most SWS cases, but absence of LIFR pathogenic changes in five patients led us to perform exome sequencing and to identify homozygosity for a FAM46A mutation in one case [p.Ser205Tyrfs*13]. The follow-up of this case supported a final diagnosis of osteogenesis imperfecta (OI), based on vertebral collapses and blue sclerae...
January 22, 2018: Journal of Medical Genetics
https://www.readbyqxmd.com/read/29357829/caffeine-is-a-risk-factor-for-osteopenia-of-prematurity-in-preterm-infants-a-cohort-study
#18
Ebtihal Ali, Cheryl Rockman-Greenberg, Michael Moffatt, Michael Narvey, Martin Reed, Depeng Jiang
BACKGROUND: Caffeine, the most commonly used medication in Neonatal Intensive Care Units, has calciuric and osteoclastogenic effects. METHODS: To examine the association between the cumulative dose and duration of therapy of caffeine and osteopenia of prematurity, a retrospective cohort study was conducted including premature infants less than 31 weeks and birth weight less than 1500 g. Osteopenia of prematurity was evaluated using chest X-rays on a biweekly basis over 12 weeks of hospitalization...
January 22, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29356743/18f-naf-pet-ct-finding-in-a-patient-with-abdominal-discomfort-after-schistosomiasis
#19
Wei Zhang, Li Chen, Qiang Wan, Yue Chen
A 77-year-old man with back pain and abdominal distention underwent F-NaF PET/CT examination to evaluate potential bone lesions. Multiple foci of increased activity were noted in the chest, which corresponded to bilateral ribs and suggested possible occult fractures. Surprisingly, increased F-NaF uptake was observed in the region of pelvis, which corresponded to calcification along the colon wall, a sequela of intestinal Japanese schistosomiasis that the patient experienced 30 years ago.
January 19, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29353526/using-3-dimensional-modeling-to-customize-titanium-plates-for-repair-of-chest-wall-trauma
#20
Justin A Smith, Vanessa P Ho, Christopher W Towe
BACKGROUND: Open reduction and internal fixation of rib fractures is recommended to decrease mortality, shorten the duration of mechanical ventilation, and lower hospital length of stay. Prosthetic titanium plates are frequently used to repair chest wall trauma, and are typically contoured to the patient's anatomy at the time of implant in the operating room. We describe the use of 3-dimensional (3D) digitally corrected rapid prototyping to generate a model of a patient's skeletal anatomy for the purposes of preoperative customization of standard titanium plates for fixation of rib fractures...
January 1, 2018: Surgical Innovation
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