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Trauma immobilisation

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https://www.readbyqxmd.com/read/29693313/routine-cervical-spine-immobilisation-is-unnecessary-in-patients-with-isolated-cerebral-gunshot-wounds-a-south-african-experience
#1
Victor Y Kong, Ross D Weale, Benn Sartorius, John L Bruce, Grant L Laing, Damian L Clarke
OBJECTIVE: Routine immobilisation of the cervical spine in trauma has been a long established practice. Very little is known in regard to its appropriateness in the specific setting of isolated traumatic brain injury secondary to gunshot wounds (GSWs). METHODS: A retrospective study was conducted over a 5 year period (January 2010 to December 2014) at the Pietermaritzburg Metropolitan Trauma Service, Pietermaritzburg, South Africa in order to determine the actual incidence of concomitant cervical spine injury (CSI) in the setting of isolated cerebral GSWs...
April 25, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29652779/is-the-current-management-of-patients-presenting-with-spinal-trauma-to-district-general-hospitals-fit-for-purpose-our-experience-of-delivering-a-spinal-service-using-an-electronic-referral-platform-in-a-large-district-general-teaching-hospital-without-onsite
#2
Daniel S Hill, Hans Marynissen
STUDY DESIGN: A retrospective cross-sectional analysis. OBJECTIVE: To describe the provision of a spinal service using an electronic platform to direct management from an external spinal unit, and quantify time taken to obtain definitive management plans whilst under prescribed spinal immobilization. SUMMARY OF BACKGROUND DATA: Most attending district general hospitals following spinal trauma will have stable injuries and normal neurology, with only a small proportion requiring urgent transfer to a specialist centre...
April 12, 2018: Spine
https://www.readbyqxmd.com/read/29602887/proximal-tibiofibular-joint-dislocation-treated-using-flexible-and-permanent-syndesmosis-fixation
#3
Antonio Carlos Moscon, Ana Luiza Cabrera Martimbianco, Aires Duarte Junior, Guilherme Conforto Gracitelli
We present the case of a 40-year-old man who suffered an isolated proximal tibiofibular dislocation of the left knee after a trauma during a soccer game. Physical examination and radiographic imaging revealed an anterolateral dislocation of the proximal fibula. The diagnosis was confirmed by MRI. The treatment choice was open reduction and internal fixation under direct visualisation using flexible and permanent internal fixation. Postoperative treatment includes knee immobilisation during the first week, and partial weight was allowed for 2 weeks progressing to full weight bearing over 4 weeks...
March 30, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29514819/diagnosis-treatment-and-prevention-of-ankle-sprains-update-of-an-evidence-based-clinical-guideline
#4
Gwendolyn Vuurberg, Alexander Hoorntje, Lauren M Wink, Brent F W van der Doelen, Michel P van den Bekerom, Rienk Dekker, C Niek van Dijk, Rover Krips, Masja C M Loogman, Milan L Ridderikhof, Frank F Smithuis, Sjoerd A S Stufkens, Evert A L M Verhagen, Rob A de Bie, Gino M M J Kerkhoffs
This guideline aimed to advance current understandings regarding the diagnosis, prevention and therapeutic interventions for ankle sprains by updating the existing guideline and incorporate new research. A secondary objective was to provide an update related to the cost-effectiveness of diagnostic procedures, therapeutic interventions and prevention strategies. It was posited that subsequent interaction of clinicians with this guideline could help reduce health impairments and patient burden associated with this prevalent musculoskeletal injury...
March 7, 2018: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/29229178/cervical-spine-clearance-in-adults-following-blunt-trauma-a-national-survey-across-major-trauma-centres-in-england
#5
G Chilvers, K Porter, S Choudhary
AIM: To assess current practice in cervical spine clearance across major trauma centres in England and review current guidelines. MATERIALS AND METHODS: An electronic survey was sent to lead trauma clinicians at 22 major trauma centres in England. This assessed the clinical decision tools used, the choice of initial imaging technique, and the methods used to clear the cervical spine in alert and obtunded patients without focal neurology, and where initial imaging was normal...
April 2018: Clinical Radiology
https://www.readbyqxmd.com/read/29097604/complications-and-outcomes-associated-with-13-cases-of-triceps-tendon-disruption-in-dogs-and-cats-2003-2014
#6
Naomi Frances Earley, Gemma Ellse, Adrian M Wallace, Kevin J Parsons, Katja Voss, Lauren C Pugliese, Andy P Moores, Richard Whitelock, Christoph Stork, Sorrel J Langley-Hobbs, Heidi Radke
This study reports data from a larger number of cases of triceps tendon disruption. Records from 10 veterinary referral hospitals between 2003 and 2014 were searched for canine and feline cases diagnosed with triceps tendon disruption, based on orthopaedic examination confirmed during surgery. Long-term follow-up and owner satisfaction were assessed using a questionnaire. There were 13 cases of triceps tendon disruption diagnosed across seven hospitals (nine dogs, four cats). Trauma, history or presence of a wound, surgery in the region of tendon attachment or corticosteroid treatment preceded triceps tendon disruption...
January 27, 2018: Veterinary Record
https://www.readbyqxmd.com/read/28975397/traumatic-inferior-shoulder-dislocation-a-review-of-management-and-outcome
#7
REVIEW
Mithun Nambiar, David Owen, Peter Moore, Ashley Carr, Malcolm Thomas
INTRODUCTION: Traumatic inferior shoulder dislocation (ISD) is rare, estimated to occur in 0.5% of all shoulder dislocations. We describe the demographics, natural history and outcome of this injury. HYPOTHESIS/AIM: The aim of the study is to provide a summary of the demographics, clinical presentation, management and outcome of patients who suffer ISD METHODS: We conducted a systematic review of the English language literature on ISD using PubMed, Medline, CINHAL, Cochrane Database and Evidence-Based Medicine Reviews...
February 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28835284/maintaining-immobilisation-devices-on-trauma-patients-during-ct-a-feasibility-study
#8
Pål Johan Stokkeland, Erlend Andersen, Maria Myhre Bjørndal, Arne Morten Mikalsen, Sindre Aslaksen, Per Kristian Hyldmo
BACKGROUND: To reduce the possibility of secondary deterioration of spinal injuries, it is desirable to maintain the spinal immobilisation that is applied in the prehospital setting throughout computed tomography (CT) scanning. A previous study found that metallic components within the inflation valve of the vacuum mattresses caused CT artefacts. The aim of our study was to investigate the effect of vacuum mattresses with plastic valves on CT artefacts, the radiation dose, and noise compared to a trauma transfer board and the spine boards currently used in our trauma system...
August 23, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28803621/blunt-cervical-spine-injury-in-adult-polytrauma-incidence-injury-patterns-and-predictors-of-significant-ligament-injury-on-ct
#9
G Chilvers, U Janjua, S Choudhary
AIM: To describe the pattern of cervical spine fractures in adult major trauma and identify computed tomography (CT) parameters that can predict significant ligament injury when fractures are absent; to define the normal range for parameters used; and identify common variations due to position of cervical immobilisation in a trauma patient. MATERIALS AND METHODS: In this retrospective study all polytrauma patients imaged using multidetector CT over a period of 5 years were identified...
November 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28754750/postoperative-gluteal-compartment-syndrome-following-microsurgical-free-flap-hand-reconstruction-the-importance-of-early-recognition-and-treatment
#10
Umran Sarwar, Jason Ting
Compartment syndrome, a surgical emergency, is caused by an increase in pressure within a closed osseofascial space, often due to trauma. This causes a decrease in tissue perfusion and ultimately tissue necrosis and multiorgan failure if not treated in a timely fashion. Gluteal compartment syndrome is a rare variant and often caused by a period of immobilisation secondary to intoxication with alcohol or drugs or during long operations, typically in the supine position. We report on a case of gluteal compartment syndrome developing in a patient postoperatively following a long microsurgical procedure to a hand, which has not been documented before...
July 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28721003/patient-compliance-with-venous-thromboembolism-prophylaxis-vte
#11
John Ross Blackwell, Parag Raval, John-Patrick Quigley, Amit Patel, Donald McBride
Venous thromboembolic disease (VTE) comprises pulmonary embolism (PE) and deep vein thrombosis (DVT), and causes morbidity and mortality, particularly in trauma and orthopaedic patients. Prevalence of 0.9% and 1.2% respectively are reported, with mortality rates up to 13.8%. Chemical thromboprophylactic agents including low molecular weight heparin (LMWH) are considered cost effective in reducing VTE risk. Evidence for anti-platelets including Aspirin for VTE prophylaxis is less compelling and is not supported as monotherapy...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28704681/cytokine-il1%C3%AE-and-lactate-as-markers-for-tissue-damage-in-spineboard-immobilisation-a-prospective-randomised-open-label-crossover-trial
#12
Baukje Hemmes, Luuk A de Wert, Peter R G Brink, Cees W J Oomens, Dan L Bader, Martijn Poeze
BACKGROUND: Spinal immobilisation using a rigid long spineboard is a well-established procedure in trauma care. During immobilisation, the body is exposed to high tissue-interface pressures. This may lead to a localised inflammatory response of the skin, which may be used to monitor the body's response to different types of immobilisation device. AIM: In this study we compared the standard rigid spineboard with a new soft-layered spineboard regarding tissue-interface pressures, skin redness as an indicator of reactive hyperaemia and cutaneous IL1α and lactate release...
June 23, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28526902/retroclival-epidural-haematoma-a-diagnosis-to-suspect-report-of-three-cases-and-review-of-the-literature
#13
REVIEW
Gorka Zabalo, Rodrigo Ortega, Jorge Díaz, Alfonso Vázquez, Daniel de Frutos, Juan Carlos García, Idoya Zazpe
Retroclival epidural haematoma (REDH) has been reported infrequently. It is a rare entity which is probably underdiagnosed. It is most commonly seen in the paediatric population and is generally associated with high-velocity injuries. We report three cases of paediatric patients diagnosed with REDHs: two of them secondary to high-energy trauma related to a motor-vehicle accident and the other a low-energy trauma after a slip while playing football. All three patients were managed conservatively by cervical immobilisation with favourable outcome...
August 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28463474/the-height-of-the-cricothyroid-membrane-on-computed-tomography-scans-in-trauma-patients
#14
T Nutbeam, R Clarke, T Luff, D Enki, D Gay
Emergency cricothyrotomy is a common feature in all difficult airway algorithms. It is the final step following a 'can't intubate, can't oxygenate' scenario. It is rarely performed and has a significant failure rate. There is variation in the reported size of the cricothyroid membrane, especially across population groups. Procedural failure may result from attempting to pass a device with too large an external diameter through the cricothyroid membrane. We aimed to determine the maximum height of the cricothyroid membrane in a UK trauma population...
August 2017: Anaesthesia
https://www.readbyqxmd.com/read/28428037/non-operative-treatment-of-displaced-distal-radius-fractures-leads-to-acceptable-functional-outcomes-however-at-the-expense-of-40-subsequent-surgeries
#15
M A M Mulders, P V van Eerten, J C Goslings, N W L Schep
BACKGROUND: Although secondary displacement following closed reduction and plaster immobilisation is high, several guidelines still recommend non-operative treatment for displaced distal radius fractures with an adequate closed reduction. PURPOSE: The purpose of this study was to evaluate functional outcomes, measured with the Disability of the Arm, Shoulder and Hand (DASH) questionnaire, in non-operative treated patients with displaced distal radius fractures and an adequate closed reduction confirmed on radiograph...
October 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28163926/rapid-analgesia-for-prehospital-hip-disruption-rapid-protocol-for-feasibility-study-of-randomised-controlled-trial
#16
Jenna K Bulger, Alan Brown, Bridie A Evans, Greg Fegan, Simon Ford, Katy Guy, Sian Jones, Leigh Keen, Ashrafunnesa Khanom, Ian Pallister, Nigel Rees, Ian T Russell, Anne C Seagrove, Helen A Snooks
BACKGROUND: Adequate pain relief at the point of injury and during transport to hospital is a major challenge in all acute traumas, especially for those with hip fractures, whose injuries are difficult to immobilise and whose long-term outcomes may be adversely affected by administration of opiate analgesics. Fascia iliaca compartment block (FICB) is a procedure routinely undertaken by doctors and nurses in the emergency department for patients with hip fracture but not yet evaluated for use by paramedics at the scene of emergency calls...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28157082/venous-thromboembolism-prophylaxis-in-outpatient-lower-limb-fractures-and-injuries
#17
COMPARATIVE STUDY
Sanil H Ajwani, Alex Shaw, Osamah Naiz, Deepu Bhaskar, Charalambos P Charalambous
BACKGROUND: The risk of venous thromboembolism (VTE) is a preventable complication of trauma in ambulatory patients requiring temporary lower limb immobilisation. We introduced a VTE risk assessment and management tool in fracture clinics, to help improve appropriate VTE management of trauma patients that do not require hospitalisation. This was based on guidelines published by the College of Emergency Medicine (UK). Clinicians were asked to follow the screening tool and manage patients as per the pathway...
May 5, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28104707/improving-care-standards-for-patients-with-spinal-trauma-combining-a-modified-e-delphi-process-and-stakeholder-interviews-a-study-protocol
#18
Lisa N Sharwood, Ralph Stanford, James W Middleton, Brian Burns, Anthony Joseph, Oliver Flower, Oran Rigby, Jonathon Ball, Shelly Dhaliwal
INTRODUCTION: Around 300 people sustain a new traumatic spinal cord injury (TSCI) in Australia each year; a relatively low incidence injury with extremely high long-term associated costs. Care standards are inconsistent nationally, lacking in consensus across important components of care such as prehospital spinal immobilisation, timing of surgery and timeliness of transfer to specialist services. This study aims to develop 'expertly defined' and agreed standards of care across the majority of disciplines involved for these patients...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28052526/effectiveness-of-a-multi-layer-foam-dressing-in-preventing-sacral-pressure-ulcers-for-the-early-acute-care-of-patients-with-a-traumatic-spinal-cord-injury-comparison-with-the-use-of-a-gel-mattress
#19
Andréane Richard-Denis, Cynthia Thompson, Jean-Marc Mac-Thiong
Individuals with spinal cord injury are at risk of sacral pressure ulcers due to, among other reasons, prolonged immobilisation. The effectiveness of a multi-layer foam dressing installed pre-operatively in reducing sacral pressure ulcer occurrence in spinal cord injured patients was compared to that of using a gel mattress, and stratified analyses were performed on patients with complete tetraplegia and paraplegia. Socio-demographic and clinical data were collected from 315 patients admitted in a level-I trauma centre following a spinal cord injury between April 2010 and March 2016...
January 4, 2017: International Wound Journal
https://www.readbyqxmd.com/read/27747560/the-epidemiology-of-pre-hospital-potential-spinal-cord-injuries-in-victoria-australia-a-six-year-retrospective-cohort-study
#20
Ala'a O Oteir, Karen Smith, Johannes U Stoelwinder, Shelley Cox, James W Middleton, Paul A Jennings
BACKGROUND: Traumatic Spinal Cord Injury (TSCI) is relatively uncommon, yet a devastating and costly condition. Despite the human and social impacts, studies describing patients with potential TSCI in the pre-hospital setting are scarce. This paper aims to describe the epidemiology of patients potentially at risk of or suspected to have a TSCI by paramedics, with a view to providing a better understanding of factors associated with potential TSCI. METHODS: This is a retrospective cohort study of all adult patients managed and transported by Ambulance Victoria (AV) between 01 January 2007 and 31 December 2012 who, based on meeting pre-hospital triage protocols and criteria for spinal clearance, paramedic suspicion or spinal immobilisation, were classified to be at risk of or suspected to have a TSCI...
December 2016: Injury Epidemiology
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