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Rib fracture

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https://www.readbyqxmd.com/read/28427480/lessons-from-a-large-trauma-center-impact-of-blunt-chest-trauma-in-polytrauma-patients-still-a-relevant-problem
#1
REVIEW
Konstantina Chrysou, Gabriel Halat, Beatrix Hoksch, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complications and decrease polytrauma patients' mortality. METHODS: In this retrospective study we included all polytrauma patients with blunt chest trauma admitted to our tertiary care center emergency department for a 2-year period, from June 2012 until May 2014...
April 20, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28424138/comparative-analysis-of-the-paravertebral-analgesic-pump-catheter-with-the-epidural-catheter-in-elderly-trauma-patients-with-multiple-rib-fractures
#2
Brian S Shapiro, Tarik Wasfie, Mathew Chadwick, Kimberly R Barber, Raquel Yapchai
Presently, trauma guidelines recommend epidural analgesia as the optimal modality of pain relief from rib fractures. They are not ideally suited for elderly trauma patients and have disadvantages including bleeding risk. The paravertebral analgesic pump (PVP) eliminates such disadvantages and includes ease of placement in the trauma setting. This study compares pain control in patients treated by EPI versus PVP. This is a retrospective, historical cohort study comparing two methods of pain management in the trauma setting...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28420038/retrospective-evaluation-of-coyote-attacks-in-dogs-154-cases-1997-2012
#3
Virginia M Frauenthal, Philip Bergman, Robert J Murtaugh
OBJECTIVE: To describe the clinical presentation and outcome of known attacks in client-owned dogs caused by the common coyote, Canis latrans. DESIGN: Retrospective observational study. SETTING: Private referral hospital. ANIMALS: One hundred fifty-four client-owned dogs known to be attacked by coyotes. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Records from a private referral hospital from May 1997 through December 2012 were reviewed...
April 18, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28419479/sonographic-diagnosis-of-a-radiographically-occult-displaced-fracture-of-a-costal-cartilage
#4
Chandra Bortolotto, Egisto Federici, Ferdinando Draghi, Stefano Bianchi
We report the case of a 22-year-old athlete who sustained a blunt thoracic trauma to the right chest causing a costal cartilage fracture. Plain radiographs revealed no abnormalities while sonographic (US) examination performed a week later because of persistent pain led to the diagnosis of a displaced fracture of the right tenth costal cartilage. A follow-up US examination confirmed the healing of the fracture and allowed the patient to return to competitive sport activity. We recommend the use of US in patients with persisting pain after thoracic trauma with negative plain radiographs of the ribs to rule out radiographically occult costal cartilage fractures...
April 17, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28409141/intrathoracic-fracture-dislocation-of-the-humerus-case-report-and-literature-review
#5
Wilson Carlos Sola Junior, Paulo Sérgio Dos Santos
Shoulder fracture-dislocations are uncommon. Those associated with intrathoracic dislocation are very rare conditions, resulting from high-energy trauma; usually, the affected limb is in an abduction position. In Brazil, there is only one report of a teenager with displacement of the epiphysis into the chest cavity; the present is the first adult patient report of intrathoracic dislocation of the humerus. The authors present the case of a patient female, aged 56 years, who was hit by motorcycle and thrown approximately 5 meters away...
March 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28407988/cone-beam-computed-tomography-image-optimization-to-detect-root-fractures-in-endodontically-treated-teeth-an-in%C3%A2-vitro-phantom-study
#6
Martina T Parrone, Boulos Bechara, Samuel Thomas Deahl, Nikita B Ruparel, Rujuta Katkar, Marcel Noujeim
OBJECTIVES: The aim of this study was to evaluate the effect of an optimization filter (OF) and voxel size on the accuracy of root fracture detection. STUDY DESIGN: Half of 40 endodontically treated roots were fractured, and the other half were left intact. All teeth were randomly placed into 5 bovine ribs. Each rib was scanned with the Planmeca ProMax 3-D using 4 different settings: 75 μm and 100 μm voxel size with and without an OF. Five reviewers reported if a fracture was present by using a 5-point scale...
May 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28397278/polydioxanone-plates-are-safe-and-effective-for-l-strut-support-in-functional-septorhinoplasty
#7
Jennifer C Fuller, Patricia A Levesque, Robin W Lindsay
OBJECTIVES/HYPOTHESIS: To evaluate the safety, efficacy, and result stability of polydioxanone (PDS) plate use for L-strut stabilization. STUDY DESIGN: Retrospective analysis of a prospective cohort. METHODS: Patients who underwent functional septorhinoplasty with the use of PDS plates between January 2013 and January 2017 were administered the Nasal Obstruction Symptom Evaluation (NOSE) scale pre- and postoperatively at 2, 4, 6, and 12 months...
April 11, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28392950/diffuse-subcutaneous-emphysema-and-pneumomediastinum-secondary-to-a-minor-blunt-chest-trauma
#8
Maximilian Andreas Storz, Eric P Heymann, Aristomenis K Exadaktylos
Full medical evaluation is paramount for all trauma patients. Minor traumas are often overlooked, as they are thought to bear low injury potential. In this case report, we describe the case of a 48-year-old man presenting to our Emergency Department with mild to moderate right-sided shoulder and scapular pain following a fall from his own height ten days previously. Clinical and paraclinical investigations (CT) revealed diffuse right shoulder pain, with crepitations on palpation of the neck, right shoulder, and right lateral chest wall...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28391778/delayed-right-chylothorax-after-left-blunt-chest-trauma-a-case-report
#9
Jonggeun Lee, Jeong Su Cho, Hoseok I, Yeong Dae Kim
BACKGROUND: Chylothorax is a disease that has various causes such as neoplasm, infection, post-surgery trauma, congenital, and venous thrombosis. In approximately 15% of cases of chylothorax, the exact cause is unknown. We report a case of delayed occurrence of right chylothorax in a patient who had multiple segmental ribs fracture on his left side. CASE PRESENTATION: A 70-year-old Asian man had a "rollover" accident in which the cultivator he was driving overturned...
April 10, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28387164/rectus-abdominis-motor-nerves-as-donor-option-for-free-functional-muscle-transfer-a-cadaver-study-and-case-series
#10
Aaron B Mull, Michael C Nicoson, Amy M Moore, Dan A Hunter, Thomas H Tung
BACKGROUND: Current management of brachial plexus injuries includes nerve grafts and nerve transfers. However, in cases of late presentation or pan plexus injuries, free functional muscle transfers are an option to restore function. The purpose of our study was to describe and evaluate the rectus abdominis motor nerves histomorphologically and functionally as a donor nerve option for free functional muscle transfer for the reconstruction of brachial plexus injuries. METHODS: High intercostal, rectus abdominis, thoracodorsal, and medial pectoral nerves were harvested for histomorphometric analysis from 4 cadavers from levels T3-8...
April 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28383845/-surgical-fixation-in-flail-chest-a-local-first-encouraging-experience
#11
M Tonglet, Q Desiron, H Marechal, F Pitance, S Degesves
We report the case of a young woman who suffered from a severe traffic accident with major thoracic trauma consisting of hemopneumothorax and flail chest. At day 5 of mechanical ventilation, a surgical reduction and fixation of the fractured ribs were performed; the patient was liberated from mechanical ventilation the next day and discharged from the intensive care unit two days later. The success of this local first case incites us to further a similar approach in such challenging trauma cases.
July 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28381302/predictors-of-chest-wall-toxicity-after-stereotactic-ablative-radiotherapy-using-real-time-tumor-tracking-for-lung-tumors
#12
Younghee Park, Hee Jung Kim, Ah Ram Chang
BACKGROUND: To evaluate the incidence of chest wall toxicity after lung stereotactic ablative radiotherapy (SABR) and identify risk factors for the development of rib fracture. METHODS: Thirty-nine patients with 49 lesions underwent SABR for primary or metastatic lung tumors using Cyberknife® with tumor tracking systems. Patient characteristics, treatment factors and variables obtained from dose-volume histograms (DVHs) were analyzed to find the association with chest wall toxicity...
April 5, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28377983/variability-of-in-vivo-linear-microcrack-accumulation-in-the-cortex-of-elderly-human-ribs
#13
Amanda M Agnew, Victoria M Dominguez, Paul W Sciulli, Sam D Stout
Excessive accumulation of microdamage in the skeleton in vivo is believed to contribute to fragility and risk of fracture, particularly in the elderly. Current knowledge of how much in vivo damage accrual varies between individuals, if at all, is lacking. In this study, paired sixth ribs from five male and five female elderly individuals (76-92 years, mean age = 84.7 years) were examined using en bloc staining and fluorescent microcopy to quantify linear microcracks present at the time of death (i.e. in vivo microdamage)...
June 2017: Bone Reports
https://www.readbyqxmd.com/read/28372525/acute-forces-required-for-fatal-compression-asphyxia-a-biomechanical-model-and-historical-comparisons
#14
Mark W Kroll, G Keith Still, Tom S Neuman, Michael A Graham, Lanny V Griffin
Background Fatalities from acute compression have been reported with soft-drink vending machine tipping, motor vehicle accidents, and trench cave-ins. A major mechanism of such deaths is flail chest but the amount of force required is unclear. Between the range of a safe static chest compression force of 1000 N (102 kg with earth gravity) and a lethal dynamic force of 10-20 kN (falling 450 kg vending machines), there are limited quantitative human data on the force required to cause flail chest, which is a major correlate of acute fatal compression asphyxia...
January 1, 2017: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/28363365/chest-wall-trauma
#15
REVIEW
Sarah Majercik, Fredric M Pieracci
Chest wall trauma is common, and contributes significantly to morbidity and mortality of trauma patients. Early identification of major chest wall and concomitant intrathoracic injuries is critical. Generalized management of multiple rib fractures and flail chest consists of adequate pain control (including locoregional modalities); management of pulmonary dysfunction by invasive and noninvasive means; and, in some cases, surgical fixation. Multiple studies have shown that patients with flail chest have substantial benefit (decreased ventilator and intensive care unit days, improved pulmonary function, and improved long-term functional outcome) when they undergo surgery compared with nonoperative management...
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28359538/radiation-induced-rib-fractures-after-stereotactic-body-radiation-therapy-predict-to-prevent
#16
Robin Wijsman, Pètra M Braam, Johan Bussink
No abstract text is available yet for this article.
March 27, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28358976/analysis-of-bony-and-internal-organ-injuries-associated-with-26-357-adult-femoral-shaft-fractures-and-their-impact-on-mortality
#17
Nidharshan S Anandasivam, Glenn S Russo, Jennifer M Fischer, Andre M Samuel, Nathaniel T Ondeck, Matthew S Swallow, Sophie H Chung, Daniel D Bohl, Jonathan N Grauer
The spectrum of injuries associated with femoral shaft fractures and those injuries' association with mortality have not been well delineated previously. Patients in the National Trauma Data Bank who presented with femoral shaft fractures from 2011 to 2012 were analyzed in 3 age groups (18-39, 40-64, and 65+ years). For each group, modified Charlson Comorbidity Index (CCI), mechanism of injury (MOI), injury severity score (ISS), and associated injuries were reported. Multivariate logistic regression was used to identify predictors of mortality...
March 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28350717/missed-fractures-in-infants-presenting-to-the-emergency-department-with-fussiness
#18
Jamie S Kondis, Jared Muenzer, Janet D Luhmann
OBJECTIVES: The aim of this study was to evaluate incidence of prior fussy emergency visits in infants with subsequently diagnosed fractures suggestive of abuse. METHODS: This was a retrospective chart review of infants younger than 6 months who presented to the pediatric emergency department (ED) between January 1, 2006, and December 31, 2011. Inclusion criteria included age 0 to 6 months, discharge diagnosis including "fracture," "broken" (or break), or "trauma" or any child abuse diagnosis or chief complaint of "fussy" or "crying" as documented in the electronic medical record by the triage nurse...
March 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28349756/extruded-talus-treated-with-reimplantation-and-primary-tibiotalocalcaneal-arthrodesis
#19
H R Mohammad, J A'Court, A Pillai
Extruded talus is a rare serious result from a high-energy injury to a supinated and plantar flexed foot. Treatment remains controversial with a lack of congruent evidence for talar reimplantation. A 34-year-old woman was involved in a road traffic accident at 40 mph. Imaging revealed a left talus extruded anterolaterally with a talar neck fracture. Additional injuries included right acetabular fracture, transverse process fractures and rib fractures, which were treated conservatively. The talus was reimplanted and the talar neck fixed with a cortical screw...
April 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28340013/implications-of-thoracic-epidural-analgesia-on-hospital-charges-in-rib-fracture-patients
#20
Courtney D Jensen, Jamie T Stark, Lewis E Jacobson, Jan M Powers, Kathy L Leslie, Jeffrey M Kinsella-Shaw, Michael F Joseph, Craig R Denegar
Objective.:  Rib fractures are present in more than 150,000 patients admitted to US trauma centers each year. Those who fracture two or more ribs are typically treated with oral analgesic drugs and are discharged with few complications. The cost of this care generally reflects its brevity. When a patient fractures three or more ribs, there is an elevated risk of complication. In response, treatments are often broadened and their durations prolonged; this affects cost. While health, function, and survival have been widely explored, patient billing has not...
March 7, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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