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Acute surgical trauma

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https://www.readbyqxmd.com/read/29153451/a-novel-minimally-invasive-surgery-combined-with-early-exercise-therapy-promoting-tendon-regeneration-in-the-treatment-of-spontaneous-achilles-tendon-rupture
#1
Amuding Aisaiding, Jianping Wang, Rouziwanguli Maimaiti, Ayidaer Jialihasia, Rakimbaiev Aibek, Bayixiati Qianman, Nuerai Shawutali, Aynaz Badelhan, Wulan Bahetiya, Aliya Kubai, Mailamuguli Kelamu, Yeermike Nuerdoula, Elihaer Makemutibieke, Yerzat Bakyt, Jianati Wuerliebieke, Jiasharete Jielile
OBJECTIVE: Acute closed spontaneous Achilles tendon rupture often occurs in elderly individuals and is usually accompanied with many complications. Conventional surgical approaches to remove the tendon lesions and enthesophytes are highly traumatic and cause complications. In this study, a previously established minimally invasive surgical approach was modified and combined with a Kazakh exercise therapy to reduce trauma, improve wound healing, and promote tendon regeneration in the management of acute closed spontaneous Achilles tendon rupture...
October 31, 2017: Injury
https://www.readbyqxmd.com/read/29147897/vacuum-assisted-wound-closure-with-mesh-mediated-fascial-traction-achieves-better-outcomes-than-vacuum-assisted-wound-closure-alone-a-comparative-study
#2
Giuseppe Salamone, Leo Licari, Giovanni Guercio, Albert Comelli, Mirko Mangiapane, Nicolò Falco, Roberta Tutino, Noemi Bagarella, Sofia Campanella, Calogero Porrello, Roberto Gullo, Gianfranco Cocorullo, Gaspare Gulotta
BACKGROUND: Open abdomen (OA) permits the application of damage control surgery principles when abdominal trauma, sepsis, severe acute peritonitis and abdominal compartmental syndrome (ACS) occur. METHODS: Non-traumatic patients treated with OA between January 2010 and December 2015 were identified in a prospective database, and the data collected were retrospectively reviewed. Patients' records were collected from charts and the surgical and intensive care unit (ICU) registries...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29145966/outcome-evaluation-of-staged-treatment-for-bicondylar-tibial-plateau-fractures
#3
Vincenzo Giordano, Ney Pecegueiro do Amaral, Hilton A Koch, Rodrigo Pires E Albuquerque, Felipe Serrão de Souza, José Félix Dos Santos Neto
BACKGROUND: The universal accepted strategy for treating high-energy tibial plateau fractures remains a topic of ongoing debate. The challenge for the practicing orthopaedic trauma surgeon is to provide anatomical articular fracture reduction, with successfully managing the complex soft-tissue injury that is commonly present at patient admission. The primary aim of the actual study was to evaluate the results of a staged protocol for the treatment of high-energy bicondylar tibial plateau fractures...
October 2017: Injury
https://www.readbyqxmd.com/read/29141498/incidence-and-natural-progression-of-neurogenic-shock-following-traumatic-spinal-cord-injury
#4
Ian A Ruiz, Jordan W Squair, Aaron A Phillips, Christine D Lukac, Dayan Huang, Patrick Oxciano, Dong Yan, Andrei V Krassioukov
Neurogenic shock, a distributive type of circulatory shock following spinal cord injury (SCI), results in profound hypotension. The consequent hemodynamic instability complicates clinical management, delays surgical intervention, and impacts neurological outcome. Moreover, the reported incidence of this condition varies significantly. Here, we establish the true incidence of neurogenic shock by comparing the most common clinical definitions used to diagnose the condition. Further, we characterize the acute progression and recovery of neurogenic shock...
November 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29139194/advantages-of-care-for-patients-with-hip-fractures-in-the-acute-geriatric-unit-hip-study-anoia
#5
Enric Duaso, Francesc Formiga, Patrícia Marimón, Montserrat Sandiumenge, Maria Teresa Salgado, Victor Murga, Andrés Gamboa, Carlos Rodriguez, Jaume Castellà, Enrique Escalante, Célia Lumbreras, Anna Tarrida, Ramón Sellarès
AIM: Hip fracture as a result of bone fragility is characterized by poor health outcomes in the medium and long term. Our goal was to compare a new orthogeriatric model with the old trauma model and evaluate improvements in clinical management. METHODS: We carried out a comparative unicentric study, a historical sample (trauma model) collected from 1 June 2007 to 31 May 2010, versus a prospective sample (orthogeriatric model) collected from 1 June 2010 until 31 May 2013...
November 15, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29138486/the-impact-of-a-specialized-spinal-cord-injury-center-as-compared-with-non-specialized-centers-on-the-acute-respiratory-management-of-patients-with-complete-tetraplegia-an-observational-study
#6
Andréane Richard-Denis, Debbie Feldman, Cynthia Thompson, Martin Albert, Jean-Marc Mac-Thiong
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To compare the proportion of tracheostomy placement and duration of mechanical ventilation (MV) in patients with a complete cervical spinal cord injury (SCI) that were managed early or lately in a specialized acute SCI-center. The second objective was to determine the impact of the timing of admission to the SCI-center on the MV support duration. SETTING: A single Level-1 trauma center specialized in SCI care in Quebec (Canada)...
November 15, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29132575/acute-management-of-the-traumatically-injured-pelvis
#7
REVIEW
Steven Skitch, Paul T Engels
Severe pelvic trauma is a challenging condition. The pelvis can create multifocal hemorrhage that is not easily compressible nor managed by traditional surgical methods such as tying off a blood vessel or removing an organ. Its treatment often requires reapproximation of bony structures, damage control resuscitation, assessment for associated injuries, and triage of investigations, as well as multimodality hemorrhage control (external fixation, preperitoneal packing, angioembolization, REBOA [resuscitative endovascular balloon occlusion of the aorta]) by multidisciplinary trauma specialists (general surgeons, orthopedic surgeons, endovascular surgeons/interventional radiologists)...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29125266/decision-making-in-very-severe-traumatic-brain-injury-glasgow-coma-scale-3-5-a-literature-review-of-acute-neurosurgical-management-of-the-most-severely-threatened-brain-trauma-patients
#8
Jeroen van Dijck, Florence Reith, Inge van Erp, Thomas van Essen, Andrew Maas, Wilco C Peul, Godard de Ruiter
BACKGROUND: Patients presenting with an early GCS score of 3-5 after blunt or penetrating skull-brain assaults are categorized as having sustained a very severe Traumatic Brain Injury (vs-TBI). This category is often overlooked in literature. Impact on patients and families lives however is huge and the question "whether to surgically treat or not" frequently poses a dilemma to treating physicians. Little is known about mortality and outcome, compared to what is known for the group of severe TBI patients (s-TBI) (GCS 3- 8)...
November 10, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29123449/fracture-with-urethral-injury-evaluation-by-retrograde-urethrogram
#9
Abdulkadir Kandemir, Mehmet Balasar, Necdet Poyraz, Mehmet Mesut Piskin
Penile fracture is a rare condition. It primarily involves the rupture of the corpus cavernosum during erection, which may also affect the corpus spongiosum and urethra. We describe the case of a 35-year-old man who presented with acute penile pain, penile swelling, and a hematuria after a blunt trauma during sexual intercourse. The emergency retrograde urethrogram revealed a rare condition, extravasation of the opaque material from the penile urethra into the cavernous structure. The partial rupture of the corpus cavernosum with urethral disruption was repaired surgically...
October 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/29121037/transient-testicular-torsion-from-early-diagnosis-to-appropriate-therapeutic-intervention-a-prospective-clinical-study
#10
Dimitrios Patoulias, Konstantinos Farmakis, Maria Kalogirou, Ioannis Patoulias
Transient testicular torsion (TTT) occurs when the torsion of the spermatic cord is reversed automatically within few minutes, with subsequent restoration of the blood ow to the suffering testis. e main clinical manifestation is acute scrotal pain, which resolves within a short period of time, usually few minutes. In 25% of patients su er from nausea and vomiting, besides the scrotal discomfort. Episodes of torsion can be repeated 1-30 times, leading progressively to development of ischemic trauma of the testis, while in 30-61% of all cases they constitute a precursor of testicular torsion...
2017: Folia Medica Cracoviensia
https://www.readbyqxmd.com/read/29114633/surgical-management-of-degenerative-meniscus-lesions-the-2016-esska-meniscus-consensus
#11
P Beaufils, R Becker, S Kopf, M Englund, R Verdonk, M Ollivier, R Seil
Purpose  A degenerative meniscus lesion is a slowly developing process typically involving a horizontal cleavage in a middle-aged or older person. When the knee is symptomatic, arthroscopic partial meniscectomy has been practised for a long time with many case series reporting improved patient outcomes. Since 2002, several randomised clinical trials demonstrated no additional benefit of arthroscopic partial meniscectomy compared to non-operative treatment, sham surgery or sham arthroscopic partial meniscectomy...
June 2017: Joints
https://www.readbyqxmd.com/read/29106922/measuring-anatomic-severity-in-pediatric-appendicitis-validation-of-the-american-association-for-the-surgery-of-trauma-appendicitis-severity-grade
#12
Matthew C Hernandez, Stephanie F Polites, Johnathon M Aho, Nadeem N Haddad, Victor Y Kong, Humza Saleem, John L Bruce, Grant L Laing, Damian L Clarke, Martin D Zielinski
OBJECTIVE: To assess whether the American Association for the Surgery of Trauma (AAST) grading system accurately corresponds with appendicitis outcomes in a US pediatric population. STUDY DESIGN: This single-institution retrospective review included patients <18 years of age (n = 331) who underwent appendectomy for acute appendicitis from 2008 to 2012. Demographic, clinical, procedural, and follow-up data (primary outcome was measured as Clavien-Dindo grade of complication severity) were abstracted...
October 26, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29106758/transcriptomic-analysis-of-synovial-extracellular-rna-following-knee-trauma-a-pilot-study
#13
Anthony J Griswold, Jose Perez, Karen Nuytemans, Thomas Strong, Liyong Wang, Danica D Vance, Hayley Ennis, Marvin K Smith, Thomas M Best, Jeffery M Vance, Margaret A Pericak-Vance, Lee D Kaplan
Traumatic knee injuries often result in damage to articular cartilage and other joint structures. Such trauma is a strong risk factor for the future development and progression of osteoarthritis (OA). The molecular mechanisms and signaling pathways modulating response to knee joint trauma remain unclear. Moreover, investigations of biomarkers influencing responses have been targeted rather than broad, unbiased discovery studies. Herein we characterize the complete complement of extracellular RNA (exRNA) in the synovial fluid of 14 subjects following knee injury...
November 6, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29102048/ethyl-pyruvate-reduces-acute-lung-damage-following-trauma-and-hemorrhagic-shock-via-inhibition-of-nf-%C3%AE%C2%BAb-and-hmgb1
#14
Borna Relja, Nils Wagner, Niklas Franz, Scott Dieteren, Katharina Mörs, Julia Schmidt, Ingo Marzi, Mario Perl
OBJECTIVE: After blunt thoracic trauma (TxT) and hemorrhagic shock with resuscitation (H/R) intense local inflammatory response and cell loss frequently impair the pulmonary function. Ethyl pyruvate (EP) has been reported to improve the pathophysiologic derangements in models of acute inflammation. Here, we studied the effects of EP on inflammation and lung damage after TxT+H/R. METHODS: Twenty four female Lewis rats (180-240g) were randomly divided into 3 groups: two groups underwent TxT followed by hemorrhagic shock (35±3mmHg) for 60min and resuscitation with either Ringers-Lactat (RL) alone or RL supplemented with EP (EP, 50mg/kg)...
October 16, 2017: Immunobiology
https://www.readbyqxmd.com/read/29101470/pancreatic-fracture-a-rare-complication-following-scoliosis-surgery
#15
Mélodie Juricic, Kalitha Pinnagoda, Walid Lakhal, Jérome Sales De Gauzy, Olivier Abbo
STUDY DESIGN: Grand Round case report. OBJECTIVE: We report a pancreatic fracture associated with Wirsung duct disruption, following a scoliosis surgery in a cerebral palsy adolescent. Spinal fusion surgery is the standard treatment for severe neuromuscular scoliosis. Many complications such as digestive ones account for its complexity. Postoperative acute pancreatitis is well described, although its pathophysiology remains unclear. To our knowledge, pancreatic fracture following scoliosis correction has never been described to date...
November 3, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29097415/gadolinium-dtpa-enhancement-characteristics-of-the-rat-sciatic-nerve-after-crush-injury-at-4-7t
#16
B J Hill, K R Padgett, V Kalra, A Marcillo, B Bowen, P Pattany, D Dietrich, R Quencer
BACKGROUND AND PURPOSE: Traumatic peripheral nerve injury is common and results in loss of function and/or neuropathic pain. MR neurography is a well-established technique for evaluating peripheral nerve anatomy and pathology. However, the Gd-DTPA enhancement characteristics of acutely injured peripheral nerves have not been fully examined. This study was performed to determine whether acutely crushed rat sciatic nerves demonstrate Gd-DTPA enhancement and, if so, to evaluate whether enhancement is affected by crush severity...
November 2, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29095150/spleen-preserving-distal-pancreatectomy-in-isolated-pancreatic-trauma
#17
Bora Barut, Felat Ciftci, Cuneyt Kayaalp
INTRODUCTION: Isolated pancreatic trauma is a rare condition and commonly come up in children or young adults.The poor initial symptoms lead to delay diagnosis and treatment. The treatment of isolated distal pancreatic trauma including the Wirsung's duct is generally distal pancreatectomy. In an emergency setting, splenectomy is a common additional organ resection requirement with the distal pancreatectomy. However, in circumstances, spleen preserving distal pancreatectomy can provide advantages in these age groups even in emergency conditions...
September 12, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29088951/update-on-critical-care-for-acute-spinal-cord-injury-in-the-setting-of-polytrauma
#18
John K Yue, Ethan A Winkler, Jonathan W Rick, Hansen Deng, Carlene P Partow, Pavan S Upadhyayula, Harjus S Birk, Andrew K Chan, Sanjay S Dhall
Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29079244/surgical-techniques-for-repair-of-atraumatic-tibialis-anterior-tendon-ruptures-a-report-of-two-cases
#19
Romy Patel, Lawrence Fallat
Tendon ruptures of the foot and ankle are overwhelmingly due to direct or blunt force trauma; however, spontaneous tendon ruptures have been less commonly documented in the published data. Surgical techniques for the repair of atraumatic ruptures differ from those for acute traumatic ruptures owing to the delayed patient presentation. Spontaneous tendon ruptures usually result from predisposing factors that have compromised the structural integrity of the tendon before the rupture occurs. We present 2 cases of atraumatic rupture of the tibialis anterior tendon, each repaired using a different surgical technique...
November 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29077677/a-multicenter-evaluation-of-the-optimal-timing-of-surgical-stabilization-of-rib-fractures
#20
Fredric M Pieracci, Julia Coleman, Francis Ali-Osman, Alicia Mangram, Sarah Majercik, Thomas W White, Elan Jeremitsky, Andrew R Doben
INTRODUCTION: The optimal timing of surgical stabilization of rib fractures (SSRF) remains debated. We hypothesized that 1) demographic, radiologic, and clinical variables are associated with time to surgery and 2), shorter time to SSRF improves acute outcomes. METHODS: Prospectively collected SSRF databases from four trauma centers were merged and analyzed (2006-2016). The independent variable was days from hospital admission to SSRF [early (< 1 day), mid (1-2 days), and late (3-10 days)]...
October 25, 2017: Journal of Trauma and Acute Care Surgery
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