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Neck trauma

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https://www.readbyqxmd.com/read/29046084/penetrating-neck-injuries-a-guide-to-evaluation-and-management
#1
J L Nowicki, B Stew, E Ooi
Introduction Penetrating neck injury is a relatively uncommon trauma presentation with the potential for significant morbidity and possible mortality. There are no international consensus guidelines on penetrating neck injury management and published reviews tend to focus on traditional zonal approaches. Recent improvements in imaging modalities have altered the way in which penetrating neck injuries are now best approached with a more conservative stance. A literature review was completed to provide clinicians with a current practice guideline for evaluation and management of penetrating neck injuries...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29034244/contemporary-strategies-in-the-management-of-civilian-neck-zone-ii-vascular-trauma
#2
REVIEW
Georgios Karaolanis, Konstantinos Maltezos, Chris Bakoyiannis, Sotiris Georgopoulos
Neck trauma is the leading cause of death mainly in younger persons posing to surgeons the dilemma whether to proceed with reconstruction of vascular injuries either in the presence of coma or in severe neurological deficit. Vascular injuries in zone II predominate over the other injuries located in zones I/III of the neck. Conventional open repair of carotid injuries with primary closure or interposition grafting is always recommended due to the effective long-term results for penetrating injuries or for patients unfit for endovascular intervention...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/29024597/significant-chondrocyte-viability-is-present-in-acetabular-chondral-flaps-associated-with-femoroacetabular-impingement
#3
Vonda J Wright, Christopher Laurence McCrum, Hongshuai Li, Michael J Tranovich, Johnny Huard
BACKGROUND: Patients presenting with cam deformity of the femoral head and neck sustain repeated trauma to the articular cartilage of the superior acetabulum, with chondral delamination injuries found during hip arthroscopy. Two previous studies reveal conflicting chondrocyte viability data in these traumatic cartilage injuries. The full-thickness nature of flaps may suggest that chondrocytes residing in the cartilage flap matrix in the joint environment would remain viable despite shear trauma...
October 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29022791/x-bolt-unforeseen-placement-complication-case-report
#4
A D Clarke, Jbt Herron, J L McVie
With the introduction of the World Hip Trauma Evaluation Four clinical trial, fixation of pertrochanteric neck of femur fractures is becoming a hot topic. In this trial, the novel X-Bolt expanding bolt implant is being compared with the current gold standard of a sliding hip screw. We present a previously undescribed complication when inserting the bolt into the femoral head, where the expandable wings penetrate the femoral neck due to misplacement of the bone crusher or the X-Bolt prosthesis. This unforeseen complication required the introduction of several additional corrective intraoperative steps...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29019639/spine-conditions-cervical-spine-conditions
#5
Marc A Childress
There are a variety of causes of neck pain, including trauma and degenerative changes. The history of onset helps to direct evaluation, including the need for imaging or ancillary testing. Patterns of pain, weakness, and other specific physical examination findings also aid in diagnosis. Management of most soft tissue injuries involves early mobilization, whereas fractures are managed based on patterns of instability. Acute spinal cord injury requires emergent care, to include possible decompressive surgery...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/29017982/clinical-presentation-diagnosis-and-surgical-treatment-of-spontaneous-cervical-intradural-disc-herniations-a-review-of-the-literature
#6
REVIEW
Arunprasad Gunasekaran, Nova Kristine M de Los Reyes, Jerry Walters, Noojan Kazemi
OBJECTIVE: Spontaneous cervical intradural disc herniation (IDH) is a rare occurrence with limited and disparate information available regarding its presentation, diagnosis, and treatment. However, its accurate detection is vital for planning surgical treatment. In this review of the literature, we collected data from all cervical intradural disc herniations described to date. Particular attention is paid to diagnostic findings, surgical approach and causation for cervical IDH, especially at the cervicothoracic junction...
October 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28991942/confusion-recurs-2-weeks-after-fall
#7
Nick Koneri, Andrew Muck, Bruce D Adams
A 77-year-old woman presented to the emergency department complaining of a headache following a syncopal episode (while standing) earlier that day. She said that she'd lost consciousness for several minutes, and then experienced several minutes of mild confusion that resolved spontaneously. On physical exam, she was oriented to person and place, but not time. She had a contusion in her left occipitoparietal region without extensive bruising or deformity. The patient had normal cardiopulmonary, abdominal, and neurologic exams...
October 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28980482/the-utility-of-plain-films-for-nonoperative-fifth-metacarpal-fractures-are-follow-up-radiographs-necessary
#8
Nathanael Heckmann, Marie N Dusch, William C Pannell, Michael Bauschard, Ram K Alluri, Lakshmanan Sivasundaram, Alidad Ghiassi
BACKGROUND: Fifth metacarpal fractures are often treated nonoperatively with serial radiographs; however, the utility of these radiographs in altering clinical management has not been investigated. We hypothesize that follow-up plain films will not alter clinical management and are therefore unnecessary for most patients. METHODS: Between 2007 and 2014, patients with a fifth metacarpal fracture at our level I trauma center were retrospectively reviewed. Patients with inadequate documentation or imaging, ipsilateral upper extremity injuries, or who underwent initial surgical fixation were excluded...
October 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28975402/isolated-radial-neck-delayed-union-nonunion-after-conservative-treatment-in-adults-two-case-reports-and-a-literature-review
#9
Christa Babst, Alexander Brunner, Reto Babst
BACKGROUND: Treatment recommendations for isolated radial neck delayed union/nonunion are sparse, but include mainly conservative treatment, electro-stimulation, bone grafting, open reduction and internal fixation (ORIF) and radial head resection. The purpose of this study was to perform a literature review on isolated delayed union/nonunion of radial neck fractures and to evaluate the reported outcomes of proposed treatment strategies. Furthermore, we aimed to generate data-based recommendations for this rare pathology...
October 3, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28965684/universal-health-insurance-and-its-association-with-long-term-outcomes-in-pediatric-trauma-patients
#10
Meesha Sharma, Andrew J Schoenfeld, Wei Jiang, Muhammad A Chaudhary, Anju Ranjit, Cheryl K Zogg, Peter Learn, Tracey Koehlmoos, Adil H Haider
BACKGROUND: Racial disparities in mortality exist among pediatric trauma patients; however, little is known about disparities in outcomes following discharge. METHODS: We conducted a longitudinal cohort study of children admitted for moderate to severe trauma, covered by TRICARE from 2006 to 2014. Patients were followed up to 90days after discharge. All children <18 years with a primary trauma diagnosis, an Injury Severity Score >9 and 90days of follow-up after discharge were included...
September 23, 2017: Injury
https://www.readbyqxmd.com/read/28960489/evaluation-of-radius-microstructure-and-areal-bone-mineral-density-improves-fracture-prediction-in-postmenopausal-women
#11
Emmanuel Biver, Claire Durosier-Izart, Thierry Chevalley, Bert van Rietbergen, René Rizzoli, Serge Ferrari
A majority of low-trauma fractures occurs in subjects with only moderate decrease of areal bone mineral density (aBMD), i.e osteopenia, assessed by dual-energy X-ray absorptiometry (DXA), or low fracture probability assessed by FRAX. We investigated whether peripheral bone microstructure and estimated strength improve the prediction of incident fractures beyond central DXA and FRAX. In this population-based study of 740 postmenopausal women (age 65.0 ± 1.4 years) from the Geneva Retirees Cohort (ISRCTN registry 11865958), we assessed at baseline cortical (Ct) and trabecular (Tb) volumetric bone mineral density (vBMD) and microstructure by peripheral quantitative computed tomography (HR-pQCT), bone strength by micro-finite element analysis, aBMD and trabecular bone score (TBS) by DXA, and FRAX fracture probability...
September 28, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28958658/a-minimum-ten-years-of-follow-up-of-alumina-head-on-delta-liner-total-hip-arthroplasty
#12
Won-Sik Choy, Yong-Han Cha, Chung-Youb Jeon, Kyu-Sang Lee, Ha-Yong Kim
BACKGROUND: In the early days when delta ceramics were developed, there was a period of using delta ceramic liner and alumina ceramic head. Therefore, the purpose of this study is to investigate the clinical and radiological outcomes of total hip arthroplasty using delta ceramic liner on alumina ceramic head after a minimum of 10 years of follow-up and to evaluate problems of early delta ceramic liner. METHODS: Alumina on delta cementless total hip arthroplasty was performed in 92 hips (85 patients) from August 2005 to March 2007 at our hospital...
September 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28958364/radiology-for-trauma-and-the-general-surgeon
#13
REVIEW
Patrick K Kim
Conventional radiography (plain film), ultrasonography, and computed tomography (CT) are important modalities for the evaluation of patients with trauma. In meta-stable or unstable patients, the combination of chest radiograph, pelvis radiograph, and focused assessment for sonography in trauma (FAST) or extended FAST rapidly triages the torso. CT has become a standard for definitive imaging in blunt trauma. CT angiography is the modality of choice for suspected vascular injuries of the neck and extremities...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28953020/spontaneous-carotid-artery-dissection
#14
Daniel J Perez
Symptomatic spontaneous internal carotid artery dissection is responsible for up to 20% of strokes in patients under age 45 years. A carotid artery dissection occurs when arterial walls separate and create a false lumen. Risk factors include neck trauma, recent infection, family history, smoking, hypertension, oral contraceptives, migraine headaches, and connective tissue disease. Dissections can produce local pain, facial paralysis, and pupillary defects. Treatment includes anticoagulation and, in the event of pharmaceutical failure or recurrence, surgery...
October 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28951638/non-parallel-screw-fixation-for-femoral-neck-fractures-in-young-adults
#15
Sherif Galal, Mohamed Nagy
INTRODUCTION: Current literature shows divergence of views regarding screws positioning in femoral neck fractures fixation. The goal of this study is to evaluate the efficiency of divergent screw fixation for fracture neck of femur (NOF). METHODS: The study was conducted at an academic Level 1 Trauma Center. This is a retrospective study conducted from October 2013 to October 2016. The study included 41 patients (33 males, 8 females) suffering from fracture NOF who were fixed using BDSF technique (26 within 24 h...
July 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28950788/computed-tomography-angiography-is-the-definitive-vascular-imaging-modality-for-penetrating-neck-injury-a-south-african-experience
#16
A S Madsen, V Y Kong, G V Oosthuizen, J L Bruce, G L Laing, D L Clarke
BACKGROUND AND AIMS: Computed tomography angiography has become central to the diagnostic algorithm for penetrating neck injury, but despite its widespread use the literature to support this adoption is limited. We reviewed our experience with computed tomography angiography for the identification of vascular trauma in hemodynamically stable patients with penetrating neck injury at a major trauma center in South Africa. MATERIALS AND METHODS: A prospectively kept trauma registry capturing data in real time was retrospectively reviewed...
September 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28948571/isolated-loc-in-head-trauma-associated-with-significant-injury-on-brain-ct-scan
#17
Muhammad Waseem, Patrick Iyahen, Hilary Bryan Anderson, Kevin Kapoor, Ramnath Kapoor, Mark Leber
BACKGROUND: A report of loss of consciousness (LOC) is frequently considered reason enough to obtain a computed tomography (CT) scan in the evaluation of head trauma. We conducted this study to reduce exposure to radiation from CT, while still not overlooking clinically significant injuries. OBJECTIVE: The objective of the study is to determine the correlation between LOC status and brain CT scan results in patients with blunt head trauma and to determine whether there is a subset of patients for whom CT scan need not be performed, without missing clinically significant intracranial injuries...
September 25, 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28943421/rotational-vertebral-artery-dissection-secondary-to-an-anomalous-entrance-into-transverse-foramen-case-report
#18
Stephen A Johnson, Andrew F Ducruet, J B Bellotte, Charles E Romero, Robert M Friedlander
BACKGROUND: Rotational vertebral artery occlusion is a rare syndrome characterized by vertebrobasilar insufficiency secondary to position-dependent occlusion of the vertebral artery. Most cases reported in the literature have been attributed to osteophytic compression, either from the occipital condyle or within the transverse foramen. However, vertebral artery dissection secondary to motion in the setting of anomalous anatomy has not been reported. CASE DESCRIPTION: To the authors' knowledge, rotational vertebral artery occlusion and dissection secondary to anomalous entrance into the transverse foramen has never been reported...
September 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28941503/management-of-high-velocity-injuries-of-the-head-and-neck
#19
REVIEW
Jacob S Majors, Joseph Brennan, G Richard Holt
Trauma centers must prepare to manage high-velocity injuries resulting from a mass casualty incidents as global terrorism becomes a greater concern and an increasing risk. The most recent conflicts in Iraq and Afghanistan have significantly improved understanding of battlefield trauma and how to appropriately address these injures. This article applies combat surgery experience to civilian situations, outlines the physiology and kinetics of high-velocity injuries, and reviews applicable triage and management strategies...
November 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28940048/validity-and-reliability-of-clinical-prediction-rules-used-to-screen-for-cervical-spine-injury-in-alert-low-risk-patients-with-blunt-trauma-to-the-neck-part-2-a-systematic-review-from-the-cervical-assessment-and-diagnosis-research-evaluation-cadre-collaboration
#20
REVIEW
N Moser, N Lemeunier, D Southerst, H Shearer, K Murnaghan, D Sutton, P Côté
PURPOSE: To update findings of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) on the validity and reliability of clinical prediction rules used to screen for cervical spine injury in alert low-risk adult patients with blunt trauma to the neck. METHODS: We searched four databases from 2005 to 2015. Pairs of independent reviewers critically appraised eligible studies using the modified QUADAS-2 and QAREL criteria...
September 22, 2017: European Spine Journal
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