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Pelvic fractures

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https://www.readbyqxmd.com/read/28549528/the-penalty-points-system-in-ireland-does-it-remain-effective-14-years-on
#1
C Downey, M Donnelly
INTRODUCTION: Road traffic accidents (RTAs) are the leading cause of trauma related mortality in Ireland. The penalty points system (PPS) was introduced in Ireland in 2002 to incentivise safer driving and reduce injury. Its early effect was studied previously(1) which concluded that there was a slight reduction in RTA related femoral shaft fractures (a sensitive indicator of high energy trauma) and a dramatic reduction in RTA related discharges. We hypothesized that over the following 14 years, the penalty points system might lose its effectiveness...
May 23, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28547894/internal-fixation-of-complicated-acetabular-fractures-directed-by-preoperative-surgery-with-3d-printing-models
#2
Zhao-Jie Liu, Jian Jia, Yin-Guang Zhang, Wei Tian, Xin Jin, Yong-Cheng Hu
The purpose of this article is to evaluate the efficacy and feasibility of preoperative surgery with 3D printing-assisted internal fixation of complicated acetabular fractures. A retrospective case review was performed for the above surgical procedure. A 23-year-old man was confirmed by radiological examination to have fractures of multiple ribs, with hemopneumothorax and communicated fractures of the left acetabulum. According to the Letounel and Judet classification, T-shaped fracture involving posterior wall was diagnosed...
May 26, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28541863/danger-on-the-farm-a-comparison-of-agricultural-and-animal-related-injuries
#3
Jessica L Weaver, Charles W Kimbrough, Kimberly Broughton-Miller, Michelle Frisbie, Jodi Wojcik, Karina Pentecost, Matthew C Bozeman, Nicholas A Nash, Brian G Harbrecht
Animal-related injuries are common in rural areas. Agricultural workers can suffer severe injuries involving farm machinery or falls. The spectrum of injuries related to rural activities is poorly defined and characterizing these injuries will improve injury prevention efforts. Records for injured patients admitted between 2010 and 2013 were retrospectively reviewed. Patients with a mechanism of injury involving a large animal or with the injury site listed as "farm" were included. Patients with agricultural injuries (n = 85) were older with more multisystem injuries than patients injured by animals (n = 132) but the Injury Severity Score was equivalent...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28537411/-treatment-of-pelvic-avulsion-fractures-in-children-and-adolescents
#4
A Stančák, J Kautzner, T Trč, V Havlas
INTRODUCTION: Paediatric avulsion fractures of the pelvis and hip joint are rare injuries most commonly associated with a rapid muscle contraction of the respected apophysis, which is the weakest component of the growing skeleton. The chosen therapy option can be either conservative or surgical. METHODS: We present a cohort of 69 patients treated for an apophyseal avulsion fracture of the anterior superior / inferior iliac spine, the lesser and greater trochanters iliac crest and the ischial tubercle...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28528722/outcomes-after-motor-vehicle-trauma-transfers-to-level-i-trauma-centers-compared-with-direct-admissions
#5
Aleksandr Rozenberg, Timothy Danish, Viktor Y Dombrovskiy, Todd R Vogel
BACKGROUND: The multilevel designation system given to U.S. trauma centers has proven useful in providing injury-level-appropriate care and guiding field triage. Despite the system, patients are often transferred to Level I trauma centers for higher-level care/specialized services. OBJECTIVES: The objective of this study is to assess whether there is a difference in outcomes of patients transferred to Level I centers compared with direct admissions. METHODS: The Nationwide Inpatient Sample was queried to identify patients involved in motor vehicle accidents, using International Classification of Diseases, Ninth Revision, Clinical Modification E-codes...
May 18, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28526568/analysis-of-complications-following-posterior-vertebral-column-resection-for-the-treatment-of-severe-angular-kyphosis-greater-than-100%C3%A2
#6
Yunus Atici, Mehmet Bulent Balioglu, Deniz Kargin, Muhammed Mert, Akif Albayrak, Mehmet Akif Kaygusuz
OBJECTIVE: The aim of this study was to evaluate the complications, efficacy and safety of posterior vertebral column resection (PVCR) in severe angular kyphosis (SAK) greater than 100°. METHODS: The medical records of 17 patients (mean age 17.9 (range, 9-27) years) with SAK who underwent PVCR, were reviewed. Mean follow-up period was 32.2 (range, 24-64) months. Diagnosis of the patients included congenital kyphosis in 11 patients, post-tuberculosis kyphosis in 3 patients and neurofibromatosis in 3 patients...
May 16, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28521832/recurrent-symphysitis-culminating-in-pelvic-ring-fracture-after-hyperextended-transurethral-prostate-resection-and-vaporization-with-symphysis-erosion-a-case-report
#7
Holger Gerullis, Arne Eitzen, Jens Uphoff, Fadi Daaboul, Ajay Chavan, Leander Ermert, Friedhelm Wawroschek, Alexander Winter
BACKGROUND: Short-term and long-term complications of transurethral prostate resection can be different in nature. Capsule perforation and subsequent fistulation after resection and electrovaporization is seldom reported in the literature. CASE PRESENTATION: Here we report the case of a 79-year-old caucasian man with capsule perforation after transurethral prostate resection and electrovaporization resulting in a severe and recurrent symphysitis and subsequent pelvic ring fracture...
May 19, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28521343/tarlov-cyst-causing-sacral-insufficiency-fracture
#8
Ross C Puffer, Marcus J Gates, William Copeland, William E Krauss, Jeremy Fogelson
BACKGROUND AND IMPORTANCE: Tarlov cysts, also known as perineural cysts, have been described as meningeal dilations of the spinal nerve root sheath between the peri- and endoneurium at the dorsal root ganglion. Most often they are found in the sacrum involving the nerve roots. Normally asymptomatic, they have been reported to present with radiculopathy, paresthesias, and even urinary or bowel dysfunction. Sacral insufficiency has not been a well-documented presentation. CLINICAL PRESENTATION: The patient is a 38-year-old female who started to develop left low back pain and buttock pain that rapidly progressed into severe pain with some radiation down the posterior aspect of her left leg...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28520685/pelvic-fracture-pattern-predicts-the-need-for-hemorrhage-control-intervention-results-of-an-aast-multi-institutional-study
#9
Todd W Costantini, Raul Coimbra, John B Holcomb, Jeanette M Podbielski, Richard D Catalano, Allie Blackburn, Thomas M Scalea, Deborah M Stein, Lashonda Williams, Joseph Conflitti, Scott Keeney, Christy Hoey, Tianhua Zhou, Jason Sperry, Dimitra Skiada, Kenji Inaba, Brian H Williams, Joseph P Minei, Alicia Privette, Robert C Mackersie, Brenton R Robinson, Forrest O Moore
BACKGROUND: Early identification of patients with pelvic fractures at risk of severe bleeding requiring intervention is critical. We performed a multi-institutional study to test our hypothesis that pelvic fracture patterns predict the need for a pelvic hemorrhage control intervention. METHODS: This prospective, observational, multicenter study enrolled patients with pelvic fracture due to blunt trauma. Inclusion criteria included shock on admission (systolic blood pressure <90 mm Hg or heart rate >120 beats/min and base deficit >5, and the ability to review pelvic imaging)...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28506314/application-of-intraoperative-limb-length-measurement-by-a-new-osteotomy-device-in-hemiarthroplasty-for-treating-femoral-neck-fracture
#10
Zhanle Zheng, Lei Yang, Yanling Su, Xian Yu, Zhiyong Hou, Yingze Zhang
BACKGROUND: Limb length discrepancy is one of the most common complications after hip arthroplasty. We developed a device - intraoperative limb-length measurement and osteotomy device (ILMOD), and applied it to patients who were treated with hemiarthroplasty for femoral neck fracture to improve limb length discrepancy by providing an accurate osteotomy during hemi-arthroplasty. METHODS: Between April 2012 and October 2013, 65 patients were treated with hip hemiarthroplasty for femoral neck fracture at our trauma center...
May 15, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28492861/vena-cava-filter-use-in-trauma-and-rates-of-pulmonary-embolism-2003-2015
#11
Alan D Cook, Brian W Gross, Turner M Osler, Katelyn J Rittenhouse, Eric H Bradburn, Steven R Shackford, Frederick B Rogers
Importance: Vena cava filter (VCF) placement for pulmonary embolism (PE) prophylaxis in trauma is controversial. Limited research exists detailing trends in VCF use and occurrence of PE over time. Objective: To analyze state and nationwide temporal trends in VCF placement and PE occurrence from 2003 to 2015 using available data sets. Design, Setting, and Participants: A retrospective trauma cohort study was conducted using data from the Pennsylvania Trauma Outcome Study (PTOS) (461 974 patients from 2003 to 2015), the National Trauma Data Bank (NTDB) (5 755 095 patients from 2003 to 2014), and the National (Nationwide) Inpatient Sample (NIS) (24 449 476 patients from 2003 to 2013) databases...
May 10, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28480574/description-of-the-incidence-clinical-presentation-and-outcome-of-proximal-limb-and-pelvic-fracture-in-hong-kong-racehorses-2003-2014
#12
L McGlinchey, M J Hurley, C Riggs, S M Rosanowski
REASONS FOR PERFORMING THE STUDY: Few studies have described the incidence of proximal limb and pelvic fractures (PLPF) occurring in Thoroughbred racehorses on race-day and during training. There is limited information regarding clinical presentation and future racing career in PLPF cases. OBJECTIVES: Describe the incidence, clinical presentation and outcome of PLPF sustained by horses in racing and training at the Hong Kong Jockey Club (HKJC) between 2003 and 2014...
May 8, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28473090/acr-appropriateness-criteria-%C3%A2-suspected-physical-abuse-child
#13
Sandra L Wootton-Gorges, Bruno P Soares, Adina L Alazraki, Sudha A Anupindi, Jeffrey P Blount, Timothy N Booth, Molly E Dempsey, Richard A Falcone, Laura L Hayes, Abhaya V Kulkarni, Sonia Partap, Cynthia K Rigsby, Maura E Ryan, Nabile M Safdar, Andrew T Trout, Roger F Widmann, Boaz K Karmazyn, Susan Palasis
The youngest children, particularly in the first year of life, are the most vulnerable to physical abuse. Skeletal survey is the universal screening examination in children 24 months of age and younger. Fractures occur in over half of abused children. Rib fractures may be the only abnormality in about 30%. A repeat limited skeletal survey after 2 weeks can detect additional fractures and can provide fracture dating information. The type and extent of additional imaging for pediatric patients being evaluated for suspected physical abuse depends on the age of the child, the presence of neurologic signs and symptoms, evidence of thoracic or abdominopelvic injuries, and social considerations...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28466615/angiographic-embolization-in-pediatric-abdominal-trauma
#14
Yechiel Sweed, Jonathan Singer-Jordan, Sorin Papura, Norman Loberant, Alon Yulevich
BACKGROUND: Trauma is the leading cause of childhood morbidity and mortality. Abdominal bleeding is one of the common causes of mortality due to trauma. Angiography and embolization are well recognized as the primary treatments in certain cases of acute traumatic hemorrhage in adults; however, evidence is lacking in the pediatric population. OBJECTIVES: To assess the safety and efficacy of transcatheter arterial embolization (TAE) for blunt and penetrating abdominal and pelvic trauma in the pediatric age group...
November 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28463936/selective-vs-nonselective-embolization-vs-no-embolization-in-pelvic-trauma-a-multicenter-retrospective-cohort-study
#15
Aimee Hymel, Sabrina Asturias, Frank Zhao, Ryan Bliss, Thea Moran, Richard H Marshall, Elizabeth Benjamin, Herb A Phelan, Peter C Krause, Geoffrey S Marecek, Claudia Leonardi, Lance Stuke, John P Hunt, Jennifer L Mooney
BACKGROUND: Traumatic hemorrhage from pelvic fractures is a significant challenge and angioembolization has become standard. Optimal treatment is undefined in two clinical scenarios. The first is in the presence of a negative angiogram. Can arterial embolization treat venous bleeding by decreasing the arterial pressure head? If the angiogram is positive, is non-selective embolization (NSE) or selective embolization (SE) better? The purpose of this study is to determine if embolization following a negative angiogram aids in hemorrhage control and when the angiogram is positive, which level of embolization is superior? METHODS: A multicenter retrospective review was conducted including blunt trauma patients with pelvic fractures who underwent angiography...
May 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28463744/practicality-of-exchanging-transparent-3d-ct-for-radiography-for-pelvic-fractures
#16
Ryan Hutten, Laurie M Lomasney, Vasilios Vasilopoulos, Albert Song, Andrew Chiang, Mitchell Bernstein, Hobie Summers
OBJECTIVE: We assess the utility of transparent 3D reconstructed CT images for evaluation of traumatic pelvic bony injuries compared to traditional radiographs. METHODS: Radiographs and 3D reconstructed CT were anonymized and randomized before review by 4 board certified physicians using a standardized questionnaire and compared to a gold-standard axial CT by a fifth board certified physician. RESULTS: 49 patients were included. We found significant agreement (K=[0...
April 27, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28459424/does-physician-reimbursement-correlate-to-risk-in-orthopaedic-trauma
#17
Vasanth Sathiyakumar, Rachel V Thakore, Cesar S Molina, William T Obremskey, Manish K Sethi
This study investigated whether current Medicare reimbursements for orthopaedic trauma procedures correlate with complications. A total of 18,510 patients representing 33 orthopaedic trauma procedures from 2005 to 2011 were studied. Adverse events and Medicare payments for each orthopaedic trauma procedure were collected. Linear regressions determined correlations between complications and Medicare payments for orthopaedic trauma procedures. A weak correlation between Medicare payments and complications was found for all procedures (r = ...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28458849/u-type-bilateral-sacral-fracture-with-spino-pelvic-dissociation-caused-by-epileptic-seizure
#18
Qian Wang, Ian Verrall, Rowan Walker, Kevin Tetsworth, Herwig Drobetz
Sacral fracture with spino-pelvic  dissociation is a rare and unstable injury caused by high-energy trauma, often with serious haemodynamic and neurological implications. Diagnosis is easily delayed or missed as it is often masked by severe associated injuries. Here, we present an unusual case of spino-pelvic dissociation sustained during a seizure episode in a young epileptic patient on long-term anticonvulsant therapy with previous thoracolumbar spinal arthrodesis. This unique case brings to light the need for clinicians to consider sacral fractures in patients presenting with low back pain with no preceding trauma who otherwise may have risk factors for pathological fractures...
March 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28458065/outcomes-of-lumbopelvic-fixation-in-the-treatment-of-complex-sacral-fractures-using-minimally-invasive-surgical-techniques
#19
Ehsan Jazini, Tristan Weir, Emeka Nwodim, Oliver Tannous, Comron Saifi, Nicholas Caffes, Timothy Costales, Eugene Koh, Kelley Banagan, Daniel Gelb, Steven C Ludwig
BACKGROUND CONTEXT: Complex sacral fractures with vertical and anterior pelvic ring instability treated with traditional fixation methods are associated with high rates of failure and poor clinical outcomes. Supplemental lumbopelvic fixation (LPF) has been applied for additional stability to help with fracture union. PURPOSE: To determine whether minimally invasive LPF provides reliable fracture stability and acceptable complication rates in cases of complex sacral fractures...
April 27, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28455469/management-of-massive-acetabular-bone-defects-in-revision-arthroplasty-of-the-hip-using-a-reconstruction-cage-and-porous-metal-augment
#20
T J Mäkinen, M Abolghasemian, E Watts, S G Fichman, P Kuzyk, O A Safir, A E Gross
AIMS: It may not be possible to undertake revision total hip arthroplasty (THA) in the presence of massive loss of acetabular bone stock using standard cementless hemispherical acetabular components and metal augments, as satisfactory stability cannot always be achieved. We aimed to study the outcome using a reconstruction cage and a porous metal augment in these patients. PATIENTS AND METHODS: A total of 22 acetabular revisions in 19 patients were performed using a combination of a reconstruction cage and porous metal augments...
May 2017: Bone & Joint Journal
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