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Long-term outcomes in trauma patients

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https://www.readbyqxmd.com/read/28716100/quality-of-life-and-clinical-radiological-long-term-results-after-implant-associated-infections-in-patients-with-ankle-fracture-a-retrospective-matched-pair-study
#1
Patrick Ziegler, Donat Schlemer, Ingo Flesch, Sonja Bahrs, Ulrich Stoeckle, Sebastian Werner, Christian Bahrs
BACKGROUND: Ankle fractures are frequently occurring injuries. Despite the relatively simple operative technique, patients often suffer from postoperative complications. Little is known about postoperative treatment of implant-associated infections of the ankle. Therefore, this study shows and evaluates a treatment algorithm in long- and short-term outcomes compared to infection-free patients. METHODS: Data from patients of over 20 years of a level 1 trauma center and university hospital was retrospectively analyzed including age, gender, comorbidities, smoking status, fracture classification, number of revisions, length of in-patient stay due to fracture and infection, and results of microbiological specimen with the length of antibiotic treatment...
July 17, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28715416/signatures-of-inflammation-and-impending-multiple-organ-dysfunction-in-the-hyperacute-phase-of-trauma-a-prospective-cohort-study
#2
Claudia P Cabrera, Joanna Manson, Joanna M Shepherd, Hew D Torrance, David Watson, M Paula Longhi, Mimoza Hoti, Minal B Patel, Michael O'Dwyer, Sussan Nourshargh, Daniel J Pennington, Michael R Barnes, Karim Brohi
BACKGROUND: Severe trauma induces a widespread response of the immune system. This "genomic storm" can lead to poor outcomes, including Multiple Organ Dysfunction Syndrome (MODS). MODS carries a high mortality and morbidity rate and adversely affects long-term health outcomes. Contemporary management of MODS is entirely supportive, and no specific therapeutics have been shown to be effective in reducing incidence or severity. The pathogenesis of MODS remains unclear, and several models are proposed, such as excessive inflammation, a second-hit insult, or an imbalance between pro- and anti-inflammatory pathways...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28715360/contemporary-management-of-subclavian-and-axillary-artery-injuries-a-western-trauma-association-multicenter-review
#3
Christine J Waller, Thomas H Cogbill, Kara J Kallies, Luis D Ramirez, Justin M Cardenas, S Rob Todd, Kayla J Chapman, Marshall A Beckman, Jason L Sperry, Vincent P Anto, Evert A Eriksson, Stuart M Leon, Rahul J Anand, Maura Pearlstein, Lisa Capano-Wehrle, Clay Cothren Burlew, Charles J Fox, Daniel C Cullinane, Jennifer C Roberts, Paul B Harrison, Gina M Berg, James M Haan, Kelly Lightwine
BACKGROUND: Subclavian and axillary artery injuries are uncommon. In addition to many open vascular repairs, endovascular techniques are used for definitive repair or vascular control of these anatomically challenging injuries. The aim of this study was to determine the relative roles of endovascular and open techniques in the management of subclavian and axillary artery injuries comparing hospital outcomes, and long-term limb viability. METHODS: A multicenter, retrospective review of patients with subclavian or axillary artery injuries from 1/1/2004-12/31/2014 was completed at 11 participating Western Trauma Association institutions...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28713750/comminuted-laryngeal-fracture-following-blunt-trauma-a-need-for-strict-legislation-on-roads
#4
Shraddha Jain, Pragya Singh, Minal Gupta, Bhavna Kamble, Suresh S Phatak
Laryngeal fracture is a rare condition with potential life-long implications related to airway patency, voice quality, and swallowing. Rarity of the condition leads to lack of consensus on the most suitable way to manage this injury. The mode of injury can be prevented by strict legislation on the roads. We report a case of a 28-year-old Indian male who sustained a comminuted displaced fracture of the thyroid cartilage with disruption of anterior commissure due to blunt trauma caused by the metallic side rod of a ladder projecting from the rear of a vehicle in front of the bike on which he was riding...
January 2017: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28712989/is-amputation-a-viable-treatment-option-in-lower-extremity-trauma
#5
Manuela Barla, Bertrand Gavanier, Mickaël Mangin, Joffrey Parot, Camille Bauer, Didier Mainard
INTRODUCTION: There is currently no consensus on how to treat patients with lower extremity trauma. Should amputation be performed early on to avoid complications or should the limb be saved at any price?The goal of this study was to show that early amputation is a viable treatment option in lower extremity trauma cases. MATERIAL AND METHODS: Twenty patients who underwent early amputation and 16 patients who underwent limb-salvage were included with a minimum follow-up of 1 year...
July 13, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28710974/predictors-of-recovery-in-cyclists-hospitalised-for-orthopaedic-trauma-following-an-on-road-crash
#6
Ben Beck, Christina L Ekegren, Peter Cameron, Elton R Edwards, Andrew Bucknill, Rodney Judson, Richard Page, Raphael Hau, Mark Stevenson, Belinda J Gabbe
BACKGROUND: As cycling-related injury rates are on the rise, there is a need to understand the long term outcomes of these patients in order to quantify the burden of injury and to inform injury prevention strategies. This study aimed to investigate predictors of return to work and functional recovery in a cohort of cyclists hospitalised for orthopaedic trauma from crashes occurring on-road. METHODS: A retrospective analysis of data from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) was conducted for patients who were hospitalised for orthopaedic trauma following a cycling crash that occurred on-road between July 2007 and June 2015...
July 12, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/28705216/surgical-management-of-hawkins-type-iii-talar-neck-fracture-through-the-approach-of-medial-malleolar-osteotomy-and-mini-plate-for-fixation
#7
Hui Liu, Zhida Chen, Wenrong Zeng, Yuanfei Xiong, Yongzhi Lin, Huacheng Zhong, Jin Wu
BACKGROUND: Fractures of the talar neck are relatively uncommon yet current interventions suffer from a high incidence of complications and poor functional outcomes. In the present study, we report a surgical treatment of Hawkins type III talar neck fracture through the approach of medial malleolar osteotomy and mini-plate for fixation and discuss the therapeutic effects after long-term follow-up. METHODS: From January 2010 to January 2015, 21 patients with 22 fractures were treated using this approach within days of sustaining the injury...
July 14, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28699144/palliative-care-needs-assessment-in-the-neuro-icu-effect-on-family
#8
Claire J Creutzfeldt, Marina G Hanna, C Sherry Cheever, Abhijit V Lele, Charles Spiekerman, Ruth A Engelberg, J Randall Curtis
BACKGROUND: Examine the association of a daily palliative care needs checklist on outcomes for family members of patients discharged from the neurosciences intensive care unit (neuro-ICU). METHODS: We conducted a prospective, longitudinal cohort study in a single, thirty-bed neuro-ICU in a regional comprehensive stroke and level 1 trauma center. One of two neuro-ICU services that admit patients to the same ICU on alternating days used a palliative care needs checklist during morning work rounds...
July 11, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28695182/adolescent-total-knee-arthroplasty
#9
John R Martin, Alan K Sutak, Todd A Milbrandt, Valerie A Martin, Robert T Trousdale
BACKGROUND: Management of adolescent patients with end-stage arthritis is challenging. Nonoperative treatments may be ineffective and total knee arthroplasty (TKA) is rarely performed. Currently, minimal long-term data are available on the outcomes in this patient population. Our goal was to describe TKA for patients with end-stage arthritis who were aged 20 years and younger. METHODS: The Joint Registry at our institution was used to identify 19 patients (29 TKAs) aged 20 years and younger that underwent a primary TKA...
June 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28694600/long-term-resolution-of-delayed-onset-hypoglossal-nerve-palsy-following-occipital-condyle-fracture-case-report-and-review-of-the-literature
#10
Sudhakar Vadivelu, Zihan Masood, Bryan Krueger, Rudy Marciano, David Chen, Cliff Houseman, Salvatore Insinga
The authors present the case of a patient that demonstrates resolution of delayed onset hypoglossal nerve palsy (HNP) subsequent to occipital condyle fracture following a motor vehicle accident. Decompression of the hypoglossal nerve and craniocervical fixation led to satisfactory long-term (>5 years) outcome. There is a scarcity of literature in recognizing HNPs following trauma and a lack of pathophysiological understanding to both a delayed presentation and to resolution versus persistence. This is the first report demonstrating long-term resolution of hypoglossal nerve injury following trauma to the craniocervical junction...
April 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28689194/risk-factors-and-outcomes-associated-with-post-traumatic-headache-after-mild-traumatic-brain-injury
#11
Yilmaz Tansel, Gerwin Roks, Myrthe de Koning, Myrthe Scheenen, Harm van der Horn, Gerben Plas, Gerard Hageman, Guus Schoonman, Jacoba Spikman, Joukje van der Naalt
OBJECTIVES: To determine the prevalence and potential risk factors of acute and chronic post-traumatic headache (PTH) in patients with mild to moderate traumatic brain injury (TBI) in a prospective longitudinal observational multicentre study. Acute PTH (aPTH) is defined by new or worsening of pre-existing headache occurring within 7 days after trauma, whereas chronic PTH (cPTH) is defined as persisting aPTH >3 months after trauma. An additional goal was to study the impact of aPTH and cPTH in terms of return to work (RTW), anxiety and depression...
July 8, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28688950/ten-year-outcome-of-zirconia-ceramic-cantilever-resin-bonded-fixed-dental-prostheses-and-the-influence-of-the-reasons-for-missing-incisors
#12
Matthias Kern, Nicole Passia, Martin Sasse, Christine Yazigi
OBJECTIVES: This clinical study evaluated the long-term outcome and survival rate of all-ceramic cantilever resin-bonded fixed dental prostheses (RBFDPs) made of zirconia-ceramic with a single-retainer design to replace missing incisors. In addition, whether the reason for missing incisors has an influence on the longevity of RBFDPs was analyzed. MATERIALS AND METHODS: One hundred and eight zirconia ceramic cantilever RBFDPs were provided for 87 patients. Seventy-five RBFDPs replaced maxillary incisors and 33 mandibular incisors...
July 5, 2017: Journal of Dentistry
https://www.readbyqxmd.com/read/28687444/long-term-follow-up-for-patients-with-nonprogressive-epilepsia-partialis-continua-in-a-single-center-in-china
#13
Song Yan, Yan-Chun Deng, Xiao-Li Wang, Meng-Meng Hu, Yong-Hong Liu, Lei Ma
Epilepsia partialis continua (EPC) is a rare variant of epilepsy. Cases from China are rare. We present a case series of seven patients to analyze its clinical features, imagining findings, etiology, drug use, and long-term outcome in a single epilepsy center. We made assessments of drug effects twice (Stage I - when they left our hospital; Stage II in March 2017 - by telephone interviews to rate their long-term outcome). The mean duration of the second follow-up was 4.8years. Of the seven patients, four patients characterized motor and sensory EPC and three motor EPC...
July 4, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28682674/free-flap-transfer-for-coverage-of-transmetatarsal-amputation-stump-to-preserve-residual-foot-length
#14
Hyung Min Hahn, Kwang Sik Jeong, Myong Chul Park, Dong Ha Park, Il Jae Lee
Surgical management of soft-tissue defects of the forefoot and midfoot caused by trauma or diabetic complications can be challenging because locoregional tissue is insufficient to provide adequate flap. This deficiency necessitates higher-level amputations, such as Chopart or even transtibial amputation, resulting in far more debilitating functional outcomes than are seen with partial foot amputation. The purpose of this study was to examine the surgical outcomes after transmetatarsal amputation and a free-flap transfer to preserve foot length...
March 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/28678814/long-term-health-status-and-trajectories-of-seriously-injured-patients-a-population-based-longitudinal-study
#15
Belinda J Gabbe, Pam M Simpson, Peter A Cameron, Jennie Ponsford, Ronan A Lyons, Alex Collie, Mark Fitzgerald, Rodney Judson, Warwick J Teague, Sandra Braaf, Andrew Nunn, Shanthi Ameratunga, James E Harrison
BACKGROUND: Improved understanding of the quality of survival of patients is crucial in evaluating trauma care, understanding recovery patterns and timeframes, and informing healthcare, social, and disability service provision. We aimed to describe the longer-term health status of seriously injured patients, identify predictors of outcome, and establish recovery trajectories by population characteristics. METHODS AND FINDINGS: A population-based, prospective cohort study using the Victorian State Trauma Registry (VSTR) was undertaken...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28670409/traumatic-spinal-cord-injury-long-term-motor-sensory-and-urinary-outcomes
#16
Rouzbeh Motiei-Langroudi, Homa Sadeghian
STUDY DESIGN: Retrospective study. PURPOSE: To evaluate how motor, sensory, and urinary outcomes of spinal cord injury (SCI) patients were influenced in the long term. OVERVIEW OF LITERATURE: SCI is a potentially disabling and devastating neurological outcome that can occur because of spinal column fractures. Most studies have not evaluated or have failed to show the influence of different surgical approaches and other parameters on neurological recovery...
June 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28663054/early-detection-of-cerebral-microbleeds-following-traumatic-brain-injury-using-mri-in-the-hyper-acute-phase
#17
Tim P Lawrence, Pieter M Pretorius, Martyn Ezra, Tom Cadoux-Hudson, Natalie L Voets
BACKGROUND: Traumatic brain injury (TBI) is a leading cause of death and disability in people under 45. Advanced imaging techniques to identify injury and classify severity in the first few hours and days following trauma could improve patient stratification and aid clinical decision making. Traumatic cerebral microbleeds (TCMBs), detectable on magnetic resonance susceptibility weighted imaging (SWI), can be used as markers of long-term clinical outcome. However, the relationship between TCMBs and injury severity in the first few hours after injury, and their natural evolution, is unknown...
June 27, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28660196/endovascular-repair-of-traumatic-isthmic-ruptures-special-concerns
#18
REVIEW
Nikolaos Patelis, Athanasios Katsargyris, Chris Klonaris
Injury of the aortic isthmus is the second most frequent cause of death in cases of blunt traumatic injury. Conventional open repair is related to significant morbidity and mortality. Thoracic endovascular aortic repair (TEVAR) has increasing role in traumatic isthmic rupture, as it avoids the thoracotomy-related morbidity, aortic cross clamping, and cardiopulmonary bypass. Additionally to the technical difficulties of open repair, multi-trauma patients may not tolerate the manipulations necessary to undergo open surgery, due to concomitant injuries...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28653646/early-predictors-of-outcome-after-mild-traumatic-brain-injury-upfront-an-observational-cohort-study
#19
Joukje van der Naalt, Marieke E Timmerman, Myrthe E de Koning, Harm J van der Horn, Myrthe E Scheenen, Bram Jacobs, Gerard Hageman, Tansel Yilmaz, Gerwin Roks, Jacoba M Spikman
BACKGROUND: Mild traumatic brain injury (mTBI) accounts for most cases of TBI, and many patients show incomplete long-term functional recovery. We aimed to create a prognostic model for functional outcome by combining demographics, injury severity, and psychological factors to identify patients at risk for incomplete recovery at 6 months. In particular, we investigated additional indicators of emotional distress and coping style at 2 weeks above early predictors measured at the emergency department...
July 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28643996/age-related-outcome-of-patients-after-traumatic-brain-injury-a-single-centre-observation
#20
Rolf Erlebach, Alberto Pagnamenta, Stephanie Klinzing, Federica Stretti, Silvia Cottini, Reto Schüpbach, Peter Steiger, Giovanna Brandi
BACKGROUND: Study-purpose is to analyze clinical features of patients with traumatic brain injury (TBI), their age-related outcomes and determinants of long- term outcome. METHODS: This retrospective cohort study was conducted in a level I University Swiss trauma center. Consecutive patients with moderate to severe TBI admitted for more than 48 hours to the Intensive Care Unit were included. Patients' and trauma characteristics, management during ICU-stay, prognostic scores and long- term outcomes were analyzed...
June 22, 2017: Minerva Anestesiologica
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