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limb trauma

Shokei Matsumoto, Kyoungwon Jung, Alan Smith, Raul Coimbra
BACKGROUND: The necessity of repair remains controversial following major lower extremity venous injuries (MLEVIs). Ligation may cause venous hypertension which should be managed with fasciotomies. Previous studies have shown fasciotomy rate are not affected by the type of management of MLEVIs. The aim of this study is to examine the rate of fasciotomy, amputation, and other complications from a difference between ligation and repair of MLEVIs. METHODS: The National Trauma Data Bank (NTDB) for 2010-2014 was reviewed...
August 7, 2018: Annals of Vascular Surgery
Raymond D Wright
In acute trauma, pelvic ring instability can lead to hemorrhage and hemodynamic instability. Pelvic ring instability and displacement that is not stabilized may lead to chronic pain, sitting imbalance, and limb length inequality. Methods and timing of securing anterior pelvic ring injuries operatively is controversial and debatable. Many orthopaedic trauma surgeons would agree that acceptable methods to treat a disrupted anterior pelvic ring fracture include nonoperative care, external fixation, internal spanning fixators, intramedullary superior ramus screws, and open reduction internal fixation...
September 2018: Journal of Orthopaedic Trauma
Owen D Gustafson, Matthew J Rowland, Peter J Watkinson, Stuart McKechnie, Simon Igo
OBJECTIVES: Identify the prevalence of shoulder impairment in ICU survivors within 6 months of discharge from ICU. Evaluate the impact of shoulder impairment on upper limb functional status in patients treated on an ICU. Identify risk factors for the development of shoulder impairment. DESIGN: Prospective cohort study. SETTING: A tertiary care medical-surgical-trauma ICU at a U.K. hospital over 18 months, with a further 6-month follow-up after hospital discharge...
August 7, 2018: Critical Care Medicine
Tami Bar-Shalita, Anatoly Livshitz, Yulia Levin-Meltz, Debbie Rand, Lisa Deutsch, Jean-Jacques Vatine
OBJECTIVE: Complex Regional Pain Syndrome (CRPS), a chronic pain condition, develops mainly after limb trauma and severely inhibits function. While early diagnosis is essential, factors for CRPS onset are elusive. Therefore, identifying those at risk is crucial. Sensory modulation dysfunction (SMD), affects the capacity to regulate responses to sensory input in a graded and adaptive manner and was found associated with hyperalgesia in otherwise healthy individuals, suggestive of altered pain processing...
2018: PloS One
Caputo Glenda Giorgia, Marchetti Alberto, Governa Maurizio, Dalla Pozza Edoardo
Negative pressure wound therapy, a tool widely applied to treat lower limb traumas, is useful in reconstructive procedures. However, obtaining an air-tight vacuum seal when using a negative pressure dressing around an external fixation device can be complicated and time-consuming. The plastic drape seldom adheres to screws, pins, or wires and, as such, the vacuum-seal is jeopardized.In surgical departments, colostomy paste is widely used, readily available, and applied where pins and wires make contact with the plastic drape...
July 30, 2018: Journal of Orthopaedic Trauma
Brian Day
Personalized (based on a percentage of a patient's limb occlusion pressure) blood flow restriction is emerging as a potential advancement in orthopaedic surgery. Safe application of the technology requires the use of medical devices capable of customizing the pressures applied to individual patients. In those circumstances, it is a low risk and noninvasive technique. By limiting muscle atrophy and aiding in the recovery of strength and function, it has the potential to significantly reduce the morbidity from limb trauma and surgery, and aid in achieving a substantially earlier return to full activity...
August 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Shang-Jung Wu, Wei-Kung Chen
Acute pain is the main cause for patient visits to the emergency department. An important issue faced in emergency medical care is to resolve patient pain. Moreover, limb traumatic pain is noted in 58-66% of emergency trauma patients. This paper explored the effectiveness of using non-pharmacological complementary interventions, including body operation therapies that used trauma limb care and therapeutic touch and mind-body interventions, in order to strengthen the support system and create a healing environment...
August 2018: Hu Li za Zhi the Journal of Nursing
Tracy J Cheun, Lalithapriya Jayakumar, Maureen K Sheehan, Matthew J Sideman, Lori L Pounds, Mark G Davies
BACKGROUND: Critical hand ischemia owing to below-the-elbow atherosclerotic occlusive disease is relatively uncommon. The aim of this study was to examine the outcomes in patients presenting with critical ischemia owing to below-the-elbow arterial atherosclerotic disease who underwent nonoperative and operative management. METHODS: A database of patients undergoing operative and nonoperative management for symptomatic below-the-elbow atherosclerotic disease between 2006 and 2016 was retrospectively queried...
July 28, 2018: Journal of Vascular Surgery
Zeynep Unluer, Yazan Al-Ajam, Sammy Al-Benna
BACKGROUND: Data regarding donor-site morbidity, postoperative clinical course, and functional outcome after hemisoleus muscle flap reconstruction are rare. The aim of this study was to determine the clinical and functional outcome of distally based medial hemisoleus flaps used for the reconstruction of defects in the lower half of the leg. METHODS: Data regarding 31 patients who underwent medial hemisoleus flap reconstruction between 2011 and 2017 were analyzed retrospectively...
July 27, 2018: Annals of Plastic Surgery
Areg Grigorian, Samuel E Wilson, Nii-Kabu Kabutey, Roy M Fujitani, Christian de Virgilio, Sebastian Schubl, Viktor Gabriel, Samuel Chen, Victor Joe, Jeffry Nahmias
BACKGROUND: Popliteal arterial injury (PAI) is the second most common infrainguinal arterial injury after femoral artery injury with an incidence < 0.2%. A 2003 analysis of the National Trauma Data Bank (NTDB) reported a below the knee amputation (BKA) rate of 7.1% in patients with PAI as well as higher risk in those with an associated fracture or nerve injury. Given advances in vascular surgical techniques, improved multidisciplinary care and expeditious diagnosis with computed tomography angiography, we hypothesized the national rate of BKA in patients with PAI has decreased and sought to identify risk factors for BKA in patients with PAI...
July 24, 2018: Annals of Vascular Surgery
Kouamé Innocent M'Bra, Aya Adélaïde Natacha Kouassi, Bada Justin Leopold Niaore Sery, Loukou Blaise Yao, Kouamé Jean Eric Kouassi, Pierre Germain Ochou, Yao Aboh Ganyn Robert Arnaud Asséré, Grah Franck Lohourou, Koffi Léopold Krah, Michel Kodo
This study reports the complications occurred during the management of open fractures of the lower limbs, resulting in secondary amputations, observed in clinicians' practice in recent years as well as different risk factors and possible deficiencies in management at the origin of these complications. We conducted a retrospective study over a period of 06 years (January 2006 - January 2012). It included patients with open fracture of the lower limb initially treated in our institution and whose complications resulted in amputation...
2018: Pan African Medical Journal
Michele Zukauskas de Andrade Gomes, Carlos Eduardo Pinfildi
BACKGROUND: The activities carried out by soldiers in the army involve great physical demands and require intense trainings to perform combat-specific tasks. Musculoskeletal injury is a potential threat to the health and physical integrity of the soldier. This study aimed to evaluate the prevalence of lower limb musculoskeletal injuries among soldiers and to propose a training protocol to prevent the most frequent injuries. METHODS: This observational (cross-sectional) study recruited a sample of 103 soldiers who required medical attention, from a total 202 new battalion soldiers...
July 27, 2018: Military Medical Research
Ivan S Tarkin, Mitchell S Fourman
PURPOSE OF REVIEW: The role of retrograde hindfoot nailing in the treatment of acute orthopedic trauma is explored. RECENT FINDINGS: Tibio-talar calcaneal (TTC) nailing is an acceptable treatment alternative for the low-demand geriatric patient with peri-articular ankle trauma permitting immediate weight-bearing with low rates of complication and return to functionality. Hindfoot nailing can be used for limb salvage in the younger active patient; yet, joint-preserving reconstruction is preferred when feasible...
July 26, 2018: Current Reviews in Musculoskeletal Medicine
Ulrika Tampe, Lukas W Widmer, Rüdiger J Weiss, Karl-Åke Jansson
BACKGROUND: Open tibial fractures are serious, complicated injuries. Previous studies suggested an increased risk of death, however, this has not been studied in large population-based settings. We aimed to analyze mortality including causes of death in all patients with open tibial fractures in Sweden. Moreover, we wanted to compare mortality rates with the Swedish population and determine whether treatment-related or demographic variables were independently associated with death. METHOD: We searched the Swedish National Hospital Discharge Register for all patients with open tibial fracture between 1998 and 2010...
July 25, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Ingmar Fleps, Muriel Vuille, Angela Melnyk, Stephen J Ferguson, Pierre Guy, Benedikt Helgason, Peter A Cripton
Falls to the side are the leading cause of hip fractures in the elderly. The load that a person experiences during a fall cannot be measured with volunteers for ethical reasons. To evaluate injurious loads, while considering relevant energy input and body posture for a sideways fall, a subject-specific cadaveric impact experiment was developed. Full cadaveric femur-pelvis constructs (N = 2) were embedded in surrogate soft tissue material and attached to metallic surrogate lower limbs. The specimens were then subjected to an inverted pendulum motion, simulating a fall to the side with an impact to the greater trochanter...
2018: PloS One
Awadalla Adam, Mohamed Yousef, Babiker A Wahab, Ahmed Abukonna, Mustafa Z Mahmoud
Purpose: Early identification of deep venous thrombosis (DVT) in trauma patients would result in an early initiation of treatment, thereby decreasing the frequency of complications. The aim of the current study was to evaluate the role of duplex ultrasound (DUS) in the evaluation of deep venous blood flow in fractured lower extremities to rule out DVT prior to orthopedic surgery. Material and methods: In this prospective study a total of 58 patients (42 males and 16 females; mean age of 51...
2018: Polish Journal of Radiology
David S Kauvar, Diane Miller, Thomas J Walters
BACKGROUND: The effect of battlefield extremity tourniquet (TK) use on limb salvage and long-term complications following vascular repair is unknown. This study explores the influence of TK use on limb outcomes in military lower extremity arterial injury. METHODS: The study database includes cases of lower extremity vascular injury from 2004-2012 with data recorded until discharge from military service. We analyzed all limbs with at least one named arterial injury from the femoral to the tibial level...
July 17, 2018: Journal of Trauma and Acute Care Surgery
Zi Hao Phang, Mohd Fadhli B Miskon, Sa'adon B Ibrahim
BACKGROUND: Blunt trauma causing brachial artery injury in a young patient is very rare. Cases of brachial artery injury may be associated with closed elbow dislocation or instability. Elbow dislocation may not be evident clinically and radiologically on initial presentation. CASE PRESENTATION: This is a case of a 37-year-old, right-hand dominant, Malay man who fell approximately 6 meters from a rambutan tree and his left arm hit the tree trunk on his way down. He was an active tobacco smoker with a 20 pack year smoking history...
July 18, 2018: Journal of Medical Case Reports
Leila Taghiyar, Samaneh Hosseini, Fatemeh Safari, Fatemeh Bagheri, Nesa Fani, Martin J Stoddart, Mauro Alini, Mohamadreza Baghaban Eslaminejad
Limb/digit amputation is a common event in humans caused by trauma, medical illness, or surgery. Although the loss of a digit is not lethal, it affects quality of life (QoL) and imposes high costs on amputees. In recent years, the increasing interest in limb regeneration has led to enhanced scientific knowledge. However, the limited ability to develop functional limb regeneration in the clinical setting suggests that a challenging issue remains in limb regeneration. Recently, the emergence of regenerative engineering is a promising field to address this challenge and close the gap between science and clinical applications...
July 16, 2018: Journal of Tissue Engineering and Regenerative Medicine
Frank Liaw, Odhrán Murray, Yan Yu Tan, Timothy Hems
Background: Diabetic peripheral neuropathy puts patients at increased risk of acute injury by foreign bodies and also contributes to delayed presentation and diagnosis. Case report: We describe a 57-year-old patient with poorly controlled type 1 diabetes who presented with a three-week history of worsening swelling and erythema in the metacarpophalangeal joint of his left thumb. He denied any previous trauma or injury and was initially treated with intravenous antibiotics...
2018: Open Orthopaedics Journal
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