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Acute surgical trauma

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https://www.readbyqxmd.com/read/28637118/asymptomatic-chiari-type-i-malformation-should-patients-be-advised-against-participation-in-contact-sports
#1
Robert Spencer, Paul Leach
BACKGROUND: Chiari type I malformation (CM-I) is characterised by caudal displacement of the cerebellar tonsils through the foramen magnum, crowding the craniocervical junction. It is being increasingly diagnosed in asymptomatic patients due to the widespread availability of MRI, and there are case reports of these patients suffering sudden death or neurological injury following head or neck trauma, raising the issue of whether they should be prohibited from contact sport participation, given the likelihood of frequent trauma...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28634742/outcomes-of-coronoid-first-repair-in-terrible-triad-injuries-of-the-elbow
#2
Junren Zhang, Mark Tan, Ernest Beng Kee Kwek
BACKGROUND: Clinical outcomes of terrible triad injuries (TTIs) of the elbow are historically poor. To date, it is still debatable whether the coronoid needs to be fixed and if so, how and in which sequence. METHODOLOGY: Between 2010 and 2013, 13 patients were treated surgically for acute TTIs of the elbow at a Tertiary Level 1 Trauma Centre by a single surgeon, using a standardized protocol, which included coronoid-brachialis complex fixation via pull-through trans-osseous sutures, radial head fixation or prosthetic replacement and a repair of the lateral ulnar collateral ligament...
June 20, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28633652/spontaneous-rupture-of-the-common-hepatic-duct-associated-with-acute-pancreatitis-a-case-report
#3
Makram Moussa, Wissem Triki, Omar Karray, Ines Marzouk, Bouchoucha Sami
BACKGROUND: Rupture of the common bile duct is a life-threatening condition, usually observed after a trauma or in association with choledocholithiasis or an obstructive tumor of the bile duct. However, a spontaneous rupture of the common bile duct is a rare entity. CASE PRESENTATION: We report a new observation of a spontaneous rupture of the common bile duct, associated with biliary peritonitis and pancreatitis, in a 15-year-old North African girl. Etiological aspects, specificities of clinical presentation, means of diagnosis, as well as surgical and perioperative management are discussed...
June 21, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28631747/optimization-of-the-mean-arterial-pressure-and-timing-of-surgical-decompression-in-traumatic-spinal-cord-injury-a-retrospective-study
#4
A Dakson, D Brandman, G Thibault-Halman, S D Christie
STUDY DESIGN: A retrospective comparative study. OBJECTIVES: This study aims to investigate the extent to which early surgical decompression and maintenance of MAP ⩾85 mm Hg for 5 days postinjury affected neurological recovery utilizing internal controls for comparison of outcomes in patients with traumatic spinal cord injury. SETTING: Acute trauma center, Halifax, Nova Scotia, Canada. METHODS: We identified 94 cases of traumatic SCI...
June 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28630776/sudden-onset-rapidly-expansile-cervical-cystic-hygroma-in-an-adult-a-rare-case-with-unusual-presentation-and-extensive-review-of-the-literature
#5
Vivek Dokania, Anagha Rajguru, Harmanjot Kaur, Ketan Agarwal, Sujata Kanetkar, Prajakta Thakur, Femina Patel, Dhirajkumar Shukla
Cystic hygroma (CH) is a benign infiltrative malformation of the lymphatic channels. We report a case of a 28-year-old Indian female who presented with rapidly enlarging right sided neck swelling over the posterior triangle since 5 days. Complete resection of CH is sometimes not amenable because of its infiltrative nature and involvement of surrounding vital structures. However, in our patient successful complete surgical resection was undertaken. The MRI findings of our patient were consistent with brachial cleft cyst; this posed a challenge in the diagnosis of CH...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/28623411/-i-am-not-afraid-of-death-a-survey-on-preferences-concerning-neurosurgical-interventions-among-patients-over-75-years
#6
Claudia Unterhofer, Wing Mann Ho, Katrin Wittlinger, Claudius Thomé, Martin Ortler
INTRODUCTION: Treatment decisions in elderly patients with traumatic brain injury (TBI) are mainly determined by trauma severity and patient age. The aim of this study was to explore personal preferences of potential patients regarding life-prolonging neurosurgical interventions by interviewing ambulatory, autonomous elderly people. METHODS: One hundred consecutive patients older than 75 years frequenting the outpatient clinic of the Department of Neurosurgery were interviewed about their attitudes regarding the hypothetical case of an 81-year-old patient with TBI and a space-occupying acute subdural hematoma (aSDH) using a 21-point questionnaire...
June 16, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28618921/surgical-evacuation-of-acute-subdural-hematoma-in-octogenarians-a-ten-year-experience-from-a-single-trauma-centerfunding
#7
Michael J McGinity, Joel E Michalek, Jesse S Rodriguez, John R Floyd
BACKGROUND: Elderly patients presenting with an acute subdural hematoma (aSDH) have historically had unfavorable outcomes. METHODS: We retrospectively reviewed patient records from 2005 through 2015 that were ≥80 years of age and underwent surgical evacuation of aSDH. RESULTS: Thirty-four patients met inclusion criteria, with a mean age of 84 years (range 80-91). Glascow Outcome Scale (GOS) of 4-5 was deemed a good outcome and a GOS 1-3 was deemed to be a poor outcome...
June 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28611229/variation-in-definition-of-prolonged-mechanical-ventilation
#8
Louise Rose, Michael McGinlay, Reshma Amin, Karen Ea Burns, Bronwen Connolly, Nicholas Hart, Philippe Jouvet, Sherri Katz, David Leasa, Cathy Mawdsley, Danny F McAuley, Marcus J Schultz, Bronagh Blackwood
Consistency of definitional criteria for terminology applied to describe subject cohorts receiving mechanical ventilation within ICU and post-acute care settings is important for understanding prevalence, risk stratification, effectiveness of interventions, and projections for resource allocation. Our objective was to quantify the application and definition of terms for prolonged mechanical ventilation. We conducted a scoping review of studies (all designs except single-case study) reporting a study population (adult and pediatric) using the term prolonged mechanical ventilation or a synonym...
June 13, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28604489/risk-factors-and-prognosis-for-acute-progression-of-myelopathic-symptoms-in-patients-with-ossification-of-the-posterior-longitudinal-ligament-after-minor-trauma
#9
Jong-Myung Jung, Chun Kee Chung, Chi Heon Kim, Yunhee Choi
STUDY DESIGN: Retrospective Cohort study. OBJECTIVE: To identify the risk factors for acute progression of myelopathic symptoms (PMS) associated with ossification of the posterior longitudinal ligament (OPLL) after minor trauma and to compare the prognosis between an acute PMS group and a chronic PMS group. SUMMARY OF BACKGROUD DATA: Although the prevalence of OPLL among patients with cervical myelopathy is high, few studies have been published regarding the risk factors for acute PMS associated with OPLL after minor trauma...
June 9, 2017: Spine
https://www.readbyqxmd.com/read/28594494/carpal-tunnel-syndrome-initial-management-and-the-treatment-of-recalcitrant-patients
#10
Karan Dua, A Lee Osterman, Joshua M Abzug
Carpal tunnel syndrome (CTS) is a focal compressive neuropathy of the median nerve at the level of the wrist. CTS is the most common type of compressive neuropathy that occurs in the upper extremity. Typically, patients with CTS have paresthesia, pain, and numbness in the radial three and one-half digits. Nighttime symptoms are more common earlier in the disease process, with daytime symptoms becoming more frequent as CTS progresses. Electrodiagnostic studies may be performed to confirm a diagnosis of CTS or to obtain a baseline before surgical treatment; however, electrodiagnostic studies may be normal in a subset of patients who have CTS...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28590348/incidence-of-adult-respiratory-distress-syndrome-ards-in-trauma-patients-a-systematic-review-and-meta-analysis-over-a-period-of-three-decades
#11
Roman Pfeifer, Nicole Heussen, Emilia Michalewicz, Ralf-Dieter Hilgers, Hans-Christoph Pape
BACKGROUND: In trauma patients, acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality. Changes in diagnostics, management and treatment may have influenced the incidence of ARDS. Therefore, the purpose of this manuscript is to evaluate whether there is a difference in the incidence of posttraumatic ARDS 1) over time, 2) attributable to geographic distribution, and 3) related to admitting surgical subspecialities. METHODS: A comprehensive search of articles published in English and German language was conducted using PubMed, MEDLINE, and the ISI Web of Science...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28589159/demographics-and-injuries-associated-with-knee-dislocation-a-prospective-review-of-303-patients
#12
Gilbert Moatshe, Grant J Dornan, Sverre Løken, Tom C Ludvigsen, Robert F LaPrade, Lars Engebretsen
BACKGROUND: Information on the incidence, injury mechanisms, ligament injury patterns, and associated injuries of knee dislocations is lacking in the literature. There is a need to characterize ligament injury patterns and associated injuries in knee dislocations to avoid missing common associated diagnoses and to plan surgical treatment. PURPOSE: To evaluate patient demographics, ligament injury patterns and associated injury patterns, and associated injuries in patients with knee dislocation...
May 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28550970/thoracotomy-in-the-emergency-department-for-resuscitation-of-the-mortally-injured
#13
J Christopher DiGiacomo, L D George Angus
PURPOSE: Emergency department resuscitative thoracotomy is an intervention of last resort for the acutely dying victim of trauma. In light of improvements in pre-hospital emergency systems, improved operative strategies for survival such as damage control and improvements in critical care medicine, the most extreme of resuscitation efforts should be re-evaluated for the potential survivor, with success properly defined as the return of vital signs which allow transport of the patient to the operating room...
May 10, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28548997/anterior-inferior-plating-results-in-fewer-secondary-interventions-compared-to-superior-plating-for-acute-displaced-mid-shaft-clavicle-fracture
#14
Rafael Serrano, Amrut Borade, Hassan Mir, Anjan Shah, David Watson, Anthony Infante, Mark A Frankle, Mark A Mighell, H Claude Sagi, Daniel S Horwitz, Roy W Sanders
OBJECTIVES: To determine if a difference in plate position for fixation of acute, displaced, mid-shaft clavicle fractures would affect the rate of secondary intervention. DESIGN: Retrospective Comparative Study SETTING:: two academic Level 1 Regional Trauma Centers PATIENTS:: 510 patients treated surgically for an acutely displaced mid-shaft clavicle fracture between 2000-2013 were identified and reviewed retrospectively at a minimum of 24 months' follow-up (F/U)...
April 5, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28547674/diagnostic-accuracy-of-various-modalities-relative-to-open-bone-biopsy-for-detection-of-long-bone-posttraumatic-osteomyelitis
#15
Vivek Chadayammuri, Benoit Herbert, Jiandong Hao, Andreas Mavrogenis, Juan C Quispe, Ji Wan Kim, Heather Young, Mark Hake, Cyril Mauffrey
BACKGROUND: Long bone posttraumatic osteomyelitis (PTOM) is a relatively common complication following surgical fixation of open fractures. There is a lacking consensus on ideal strategies for diagnostic evaluation of long bone PTOM. While open bone biopsy and culture is considered the 'gold diagnostic standard,' its cost and invasiveness are often prohibitive and have prompted the search for alternate diagnostic methods. OBJECTIVE: To evaluate the sensitivity and specificity of various diagnostic modalities relative to open bone biopsy and culture for the detection of long bone PTOM...
May 25, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28538629/outcomes-following-traumatic-injury-in-patients-with-preexisting-psychiatric-illness
#16
Erika Falsgraf, Kenji Inaba, Amory de Roulet, Megan Johnson, Elizabeth Benjamin, Lydia Lam, Kazuhide Matsushima, Aaron Strumwasser, Demetrios Demetriades
BACKGROUND: Patients with psychiatric illness have been shown to experience higher rates of traumatic injury. Injury patterns, treatment decisions, and outcomes have not been well characterized in patients with psychiatric illness after injury, in particular those who undergo acute surgical intervention. The purpose of this analysis was to determine mortality, complications, and surgical intervention rates in patients with psychiatric illness following traumatic injury. METHODS: This is a retrospective study of trauma patients ≥18 years old admitted to LAC+USC Medical Center between January 2008 and March 2015...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538626/the-capacity-of-icd-10-cm-pcs-to-characterize-surgical-care
#17
Garth H Utter, Kevin M Schuster, Preston R Miller, Nathan T Mowery, Suresh K Agarwal, Robert J Winchell, Marie L Crandall
The International Classification of Diseases, 10th edition, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) have been in effect since October 1, 2015 and offer much greater capacity than previous classifications to characterize the nature and treatment of surgical conditions. However, the diagnosis codes of ICD-10-CM are unevenly specific across the spectrum of surgical conditions and currently do not adequately allow description of important distinctions in disease severity for many common surgical conditions...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538329/perioperative-care-for-pediatric-patients-with-penetrating-brain-injury-a-review
#18
Marco Mikhael, Elizabeth Frost, Maria Cristancho
Traumatic brain injury (TBI) continues to be the leading cause of death and acquired disability in young children and adolescents, due to blunt or penetrating trauma, the latter being less common but more lethal. Penetrating brain injury (PBI) has not been studied extensively, mainly reported as case reports or case series, due to the assumption that both types of brain injury have common pathophysiology and consequently common management. However, recommendations and guidelines for the management of PBI differ from those of blunt TBI in regards to neuroimaging, intracranial pressure (ICP) monitoring, and surgical management including those pertaining to vascular injury...
May 19, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28522220/surgical-reconstruction-of-ruptured-anterior-cruciate-ligament-prolongs-trauma-induced-increase-of-inflammatory-cytokines-in-synovial-fluid-an-exploratory-analysis-in-the-kanon-trial
#19
S Larsson, A Struglics, L S Lohmander, R Frobell
OBJECTIVE: Prospectively monitor how treatment of acutely ruptured anterior cruciate ligament (ACL) affects biomarkers of inflammation and proteolytic degradation over 5 years. DESIGN: We studied 119 subjects with acute ACL injury from the randomized controlled KANON-trial (Clinical trial ISRCTN 84752559) who had synovial fluid, serum and urine samples available from at least two out of six visits over 5 years after acute ACL rupture. All subjects followed a similar rehabilitation protocol where, according to randomization, 60 also had early ACL reconstruction and 59 had the option to undergo a delayed ACL reconstruction if needed...
May 15, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28520680/acute-pediatric-monteggia-fractures-a-conservative-approach-to-stabilization
#20
Ian Foran, Vidyadhar V Upasani, Charles D Wallace, Elise Britt, Tracey P Bastrom, James D Bomar, Andrew T Pennock
BACKGROUND: In 2015, a multicenter study group proposed a treatment algorithm for pediatric Monteggia fractures based upon the ulnar fracture pattern. This strategy recommends surgical stabilization for all complete ulna fractures. The purpose of this study was to evaluate whether an initial nonoperative approach to pediatric Monteggia fractures resulted in poorer outcomes and a higher rate of complications. METHODS: This institutional review board approved retrospective study evaluated all Monteggia fractures presenting to a level 1 pediatric trauma center between 2008 and 2014...
May 17, 2017: Journal of Pediatric Orthopedics
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