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limb trauma

Giuseppe Rollo, Michele Bisaccia, Javier Cervera Irimia, Giuseppe Rinonapoli, Andrea Pasquino, Alessandro Tomarchio, Lorenzo Roca, Valerio Pace, Paolo Pichierri, Marco Giaracuni, Luigi Meccariello
Introduction: The SNAC wrist (Scaphoid nonunion advanced collapse) is one of the complications following scaphoid fractures treated conservatively and one of the causes of wrist arthritis that the hand surgeon has to face most frequently. In these cases surgical management is usually warranted. Materials and Methods: In the set time frame of 6 years we treated 15 SNAC wrist cases. On average patients underwent surgery five years after the trauma. All patients were treated via dorsal incision with partial carpal arthrodesis and total scaphoidectomy, associated with denervation of the posterior interosseous nerves...
October 2018: Medical Archives
Masayuki Kaneko, Mamoru Narukawa
BACKGROUND AND OBJECTIVE: Empagliflozin and canagliflozin decreased the risk of major adverse cardiovascular events (MACE) compared with placebo in randomized clinical trials which were conducted to evaluate their cardiovascular risks. However, canagliflozin increased the risks of amputation and bone fracture, and the reasons for these observed differences remain unclear. The objective of this study was to evaluate the safety risks, specifically the risks of amputation and bone fracture, associated with sodium-glucose cotransporter 2 (SGLT2) inhibitors by using the difference in restricted mean survival time (RMST), an alternative measure to the hazard ratio...
November 30, 2018: Clinical Drug Investigation
Maneesh Singhal, Ravikiran Naalla, Aniket Dave, Moumita De, Deepti Gupta, Shashank Chauhan
Background: As the morbidity and mortality due to trauma are ever increasing, there is proportionally growing need of trauma care facilities across the country. In the context of expanding designated trauma care facilities, the role of plastic and reconstructive surgeon needs to be analysed and defined at least at a Level 1 trauma centre. Materials and Methods: We included the patients who were operated under the department of plastic, reconstructive & burns surgery at a Level 1 urban trauma centre between January 2016 and December 2017...
May 2018: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Shikha Verma, Binod Kumar Thakur, Vandana Raphael, Devinder Mohan Thappa
Background: Subcutaneous mycoses, although rare, are frequently reported from northeast India. Their spectrum varies with geographic region. Materials and Methods: We evaluated clinical records and histopathological features of subcutaneous mycoses cases seen during April 2013 to March 2017. Results: A total of 70 patients (44 males and 26 females) of subcutaneous mycoses were analyzed. Sixty-one percent of patients were 20-60 years old. Duration of the disease ranged from 3 months to 25 years...
November 2018: Indian Journal of Dermatology
Fukashi Serizawa, Miyako Tanaka, Takuya Shimizu, Daijirou Akamatsu, Masato Ohara, Hitoshi Goto, Takashi Kamei
OBJECTIVE: Patients presenting with edema, skin redness, pain, and itching in their lower legs are common and encountered often in daily practice. However, although commonly recognized diseases, such as deep venous thrombosis (DVT), stasis dermatitis due to varicose veins, lymphedema, and cellulitis, are diagnosed correctly in most cases, micro-arteriovenous fistulas (AVFs) may often be overlooked due to low awareness and rarity. This study was carried out to evaluate the prevalence of micro-AVF in patients presenting with foot skin symptoms...
November 27, 2018: Annals of Vascular Surgery
S Yu Lukin, Yu P Soldatov, M V Stogov
Experimental and clinical studies have shown that a skeletal trauma causes a whole complex of pathophysiological disorders, both local and systemic. The main factors determining the severity of the trauma, as well as the nature of the course of the post-traumatic period, are the degree of hypoxia (acidosis), hypercoagulation and immune disorders. To influence these pathophysiological disorders in the patients presenting the with skeletal traumas, various approaches have been proposed, including the use of antihypoxants and antioxidants, the methods and means for the stimulation and support of the immune system, medications to regulate hemostasis...
2018: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
Abdul Q Alarhayem, Stephen M Cohn, Oliver Cantu-Nunez, Brian J Eastridge, Todd E Rasmussen
BACKGROUND: Six hours has long been considered the threshold of ischemia after peripheral artery injury. However, there is a paucity of evidence regarding the impact of operative delays on morbidity and mortality in patients with lower extremity arterial injuries. METHODS: We analyzed the records of 3,441,259 injured patients entered into the National Trauma Data Bank Research Dataset from 2012 to 2015. Patients (≥16 years) with lower extremity arterial injuries were identified by International Classification of Diseases, Ninth Revision injury and procedure codes...
November 26, 2018: Journal of Vascular Surgery
Khaled M Emara, Shady A Mahmoud, Ramy A Diab, Mahmoud A Elshobaky, Ahmed K Emara
The aim of this study was to assess the safety and efficacy of percutaneous low-energy osteotomy and casting in treatment of pathological coronal knee deformities in children equal or younger than 6 years. A prospective nonrandomized case series study was conducted. A total of 62 (109 limbs) patients with pathological coronal knee deformities were treated by percutaneous low-energy osteotomy and casting and observed over 3-10 years. The pathological nature was variable (rickets, Blount disease, dysplasia, after trauma, or after infection)...
November 21, 2018: Journal of Pediatric Orthopedics. Part B
Warren A Vieira, Catherine D McCusker
Disease of, or trauma to, the human jaw account for thousands of reconstructive surgeries performed every year. One of the most popular and successful treatment options in this context involves the transplantation of bone tissue from a different anatomical region into the affected jaw. Although, this method has been largely successful, the integration of the new bone into the existing bone is often imperfect, and the integration of the host soft tissues with the transplanted bone can be inconsistent, resulting in impaired function...
November 26, 2018: International Journal of Molecular Sciences
Lindsey Blalock
INTRODUCTION: Current wound treatment options for complex wounds include advanced wound therapies. One such treatment, negative pressure wound therapy (NPWT), has evolved to include automated instillation of topical wound solutions with a user-specified dwell time (NPWTi-d). A novel reticulated open-cell foam dressing with through holes (ROCF-CC) was developed to assist wound cleansing by removing thick wound exudate and infectious material. OBJECTIVE: The author's experience using NPWTi-d with ROCF-CC on complex wounds is presented...
November 22, 2018: Wounds: a Compendium of Clinical Research and Practice
Alexander W Y Chen, Kaveh Oraii Yazdani, Luciano Candilio
Upper limb deep vein thrombosis (DVT) is a less common phenomenon than lower limb DVT. Repeated trauma secondary to sport- or job-related arm movements and positions has been recognized as the predisposing factor for upper limb DVT. We describe a 38-year-old male computer programmer admitted with swelling and pain in his left upper limb. Venous duplex ultrasound confirmed the presence of axillary vein thrombosis. Coagulation studies for secondary thrombosis were unremarkable. The patient was treated with full anticoagulation using low molecular weight heparin and warfarin...
April 2018: Journal of Tehran Heart Center
J Fürmetz, J Sass, T Ferreira, J Jalali, L Kovacs, F Mück, N Degen, P H Thaller
INTRODUCTION: Three-dimensional (3D) surgical planning and patient-specific implants are becoming increasingly popular in orthopedics and trauma surgery. In contrast to the established and standardized alignment assessment on two-dimensional (2D) long standing radiographs (LSRs) there is neither a standardized nor a validated protocol for the analysis of 3D bone models of the lower limb. This study aimed to create a prerequisite for pre-operative planning. METHODS: According to 2D analysis and after meticulous research, 24 landmarks were defined on 3D bone models obtained from computed axial tomography (CT) scans for a 3D alignment assessment...
November 22, 2018: Knee
Samantha Jones, Sarah Tyson, Michael Young, Matthew Gittins, Naomi Davis
OBJECTIVE: To describe the demographics, mechanisms, presentation, injury patterns and outcomes for children with traumatic injuries. SETTING: Data collected from the UK's Trauma and Audit Research Network. DESIGN AND PATIENTS: The demographics, mechanisms of injury and outcomes were described for children with moderate and severe injuries admitted to the Major Trauma Network in England between 2012 and 2017. RESULTS: Data regarding 9851 children were collected...
November 23, 2018: Archives of Disease in Childhood
Joseph B Webster
Traumatic amputation can result from injuries sustained both within and outside the military setting. Individuals with trauma-related amputations have unique needs and require specialized management with an interdisciplinary team approach and care coordination across the continuum of care to facilitate optimal outcomes. Management considerations include issues with the amputation itself, issues related to injury of other body parts, and the management of longer-term secondary conditions. Some of these issues are more prevalent and of greater severity in the early recovery period, whereas others develop later and have the potential for progressive worsening over time...
February 2019: Physical Medicine and Rehabilitation Clinics of North America
Andrea Fabbri, Giuseppe Carpinteri, Germana Ruggiano, Elisabetta Bonafede, Antonella Sblendido, Alberto Farina, Amedeo Soldi
INTRODUCTION: Low-dose methoxyflurane, administered via a hand-held inhaler, has been used for short-term pain relief in emergency medicine in Australia and New Zealand for over 40 years, and was recently approved in Europe for the rapid relief of moderate-to-severe trauma-related pain in adults. There is currently a lack of data for methoxyflurane versus active comparators, therefore this trial will investigate the efficacy and safety of inhaled methoxyflurane compared with standard of care (SoC) in the treatment of acute trauma-related pain in pre-hospital and ED settings in Italy...
November 22, 2018: Advances in Therapy
David Brenner, Gabriella Iohom, Padraig Mahon, George Shorten
BACKGROUND: Axillary and infraclavicular brachial plexus blocks are commonly used for upper limb surgery. Clinicians require information on the relative benefits of each to make a rational selection for specific patients and procedures. OBJECTIVES: The main objective of the study was to compare axillary and infraclavicular brachial plexus block in terms of the incidence and severity of tourniquet pain. DESIGN: Single blinded, randomised trial...
November 19, 2018: European Journal of Anaesthesiology
F Gilbert, C Schneemann, C J Scholz, R Kickuth, R H Meffert, R Wildenauer, U Lorenz, R Kellersmann, A Busch
BACKGROUND: Vascular damage in polytrauma patients is associated with high mortality and morbidity. Therefore, specific clinical implications of vascular damage with fractures in major trauma patients are reassessed. METHODS: This comprehensive nine-year retrospective single center cohort study analyzed demography, laboratory, treatment and outcome data from 3689 patients, 64 patients with fracture-associated vascular injuries were identified and were compared to a control group...
November 20, 2018: BMC Musculoskeletal Disorders
Nate Milburn, Lori Yap, Gargi Raval
Heterotrophic ossification (HO) is a well-described phenomenon in patients with spinal cord injury, head injury, burns, hip replacement, and general trauma. However, it has also been described through a relative paucity of case reports that repeated microtrauma from the use of weight-bearing leg prostheses is an additional possible cause of HO. In our case, we examine a patient who developed an extreme case of HO after he began an exercise regimen with assistance from a running limb. This abnormal formation was actually advantageous because it created a more snug fit of the prosthetic device and improved the patient's ability to run...
November 14, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Rebecca J Wilson, Joshua Chadwick Drake, Di Cui, Matthew Lonergan Ritger, Yuntian Guan, Jarrod A Call, Mei Zhang, Lucia Marie Leitner, Axel Gödecke, Zhen Yan
Ischemia-reperfusion (IR) due to temporary restriction of blood flow causes tissue/organ damages under various disease conditions, including stroke, myocardial infarction, trauma and orthopedic surgery. In the limbs, IR injury to motor nerves and muscle fibers causes reduced mobility and quality of life. Endurance exercise training has been shown to increase tissue resistance to numerous pathological insults. To elucidate the impact of endurance exercise training on IR injury in skeletal muscle, sedentary and exercise-trained mice (5 weeks of voluntary running) were subjected to ischemia by unilateral application of a rubber band tourniquet above the femur for 1 hour followed by reperfusion...
November 15, 2018: Journal of Applied Physiology
Pin-Han Wang, Kuan-Ting Liu, Yen-Hung Wu, I-Jeng Yeh
RATIONALE: Thyrotoxic periodic paralysis is characterized by a sudden onset of hypokalemia and paralysis. This condition mainly affects the lower extremities and is secondary to thyrotoxicosis. The underlying hyperthyroidism is often subtle without typical symptoms such as palpitations, tremors, anxiety, and weight loss; this causes a difficulty in early diagnosis. Here, we reported a case of periodic paralysis in a patient with hyperthyroidism whose potassium level was within the normal range...
November 2018: Medicine (Baltimore)
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