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https://www.readbyqxmd.com/read/28633779/differences-in-classification-between-mono-and-polytrauma-and-low-%C3%A2-and-high-energy-trauma-patients-with-an-ankle-fracture-a%C3%A2-retrospective-cohort-study
#1
Jan Paul Briet, Roderick Marijn Houwert, Diederik P J Smeeing, Marcel G W Dijkgraaf, Egbert Jan Verleisdonk, Luke P H Leenen, Falco Hietbrink
Although fracture type and treatment options for ankle fractures are well defined, the differences between mono- and polytrauma patients and low- and high-energy trauma have not been addressed. The aim of the present study was to compare the fracture type and trauma mechanism between mono- and polytrauma and low- and high-energy trauma patients with an ankle fracture. We performed a single-center retrospective cohort study. Fractures were classified according to the Lauge-Hansen classification and a descriptive classification...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28631272/a-unique-fatal-moose-attack-mimicking-homicide
#2
Petur Gudmannsson, Johan Berge, Henrik Druid, Göran Ericsson, Anders Eriksson
Fatalities caused by animal attacks are rare, but have the potential to mimic homicide. We present a case in which a moose attacked and killed a woman who was walking her dog in a forest. Autopsy showed widespread blunt trauma with a large laceration on one leg in which blades of grass were embedded. Flail chest was the cause of death. The case was initially conceived as homicide by means of a riding lawn mower. A review of the case by moose experts and analyses of biological trace material that proved to originate from moose, established the true source of injury...
June 20, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28624920/interobserver-agreement-in-perineal-ultrasound-measurement-of-the-anovaginal-distance-a-methodological-study
#3
Sofia Pihl, Eva Uustal, Linda Hjertberg, Marie Blomberg
INTRODUCTION AND HYPOTHESIS: Objective outcome measures of the extent of laceration at delivery are needed. In this study we evaluated and describe here a method for learning perineal ultrasound measurement of the anovaginal distance (AVD). The learning period needed for examiners proficient in vaginal ultrasound examination and the interobserver agreement after reaching proficiency in AVD measurement were determined. The hypothesis was that the method is feasible to learn and reproducible for use in further research...
June 17, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28616605/splenic-laceration-after-routine-colonoscopy-a-case-report-of-a-rare-iatrogenic-complication
#4
Shuo Li, Nishant Gupta, Yogesh Kumar, Frank Mele
Colonoscopy is a common and routine procedure performed in the United States, most commonly performed for screening of colorectal cancer. Although colonoscopy is considered a safe procedure, it is associated with complications including intestinal hemorrhage and perforation. Splenic trauma, such as laceration or even complete rupture is a rarely reported, but potentially fatal complication if undetected. We present a case of splenic laceration with subcapsular hematoma status post routine colonoscopy. Fortunately, patient was able to be managed medically, without further operative intervention...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28614864/-the-patient-with-chest-trauma-surgical-management
#5
Patrick Zardo, Henning Busk, Stefan Piatek, Norman Zinne, Irina Kropivnitskaya, Ingo Kutschka
Even though isolated cases of penetrating chest wounds are exceptionally rare in Germany, chest trauma accounts for major morbidity and mortality in over 18 0000 multitrauma patients encountered every year. Injuries range from immediately fatal cardiac wounds and major vessel lacerations to intercostal bleeding, parenchymal damage, chronic haematothorax and secondary empyema. Placement of large-bore chest tubes constitutes a sufficient treatment for most of these pathologies. In select cases further treatment either by minimally invasive techniques (VATS) or conventional thoracotomy is warranted...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28610452/outcomes-of-flexor-tendon-repairs-in-zone-2-subzones-with-early-active-mobilization
#6
K Moriya, T Yoshizu, N Tsubokawa, H Narisawa, S Matsuzawa, Y Maki
We report on the outcomes of flexor tendon repair in zone 2 subzones with early active mobilization in 102 fingers in 88 consecutive patients. There were 28, 53, 15, and six fingers with repairs in zones 2A to 2D, respectively. Rupture of the repair occurred in four fingers, all in zone 2B. Excluding those with repair ruptures, the mean total active motion was 230° (range 143°-286°). Evaluated with Tang's criteria, the outcomes were ranked excellent in 39 fingers, good in 46, fair in ten, poor in three, and failure in four...
June 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28606903/estimating-the-incidence-and-the-economic-burden-of-third-and-fourth-degree-obstetric-tears-in-the-english-nhs-an-observational-study-using-propensity-score-matching
#7
Martina Orlovic, Alexander William Carter, Joachim Marti, Elias Mossialos
OBJECTIVE: Obstetric care is a high-risk area in healthcare delivery, so it is essential to have up-to-date quantitative evidence in this area to inform policy decisions regarding these services. In light of this, the objective of this study is to investigate the incidence and economic burden of third and fourth-degree lacerations in the English National Health Service (NHS) using recent national data. METHODS: We used coded inpatient data from Hospital Episode Statistics (HES) for the financial years from 2010/2011 to 2013/2014 for all females that gave birth during that period in the English NHS...
June 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28604156/outcomes-of-repair-of-the-lacerated-a2-pulley-with-extensor-retinaculum-during-primary-flexor-tendon-repair
#8
A El-Shebly, M El Fahar, H Mohammed, A Bahaa Eldin
We report outcomes of repairing the lacerated A2 pulley with extensor retinaculum graft in ten patients (ten fingers) during primary flexor tendon repair in zone 2. Complete A2 pulley lacerations were found in eight fingers and partial A2 pulley laceration in two. We extended the laceration in the sheath to the middle of the A4 or A1 pulley to allow tendon repair with a four-strand core suture. The A2 pulley was reconstructed with an extensor retinaculum graft. All patients followed the early controlled active mobilization protocol and recovered active range of motion at the interphalangeal joints without major extension deficits...
June 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28602180/evaluation-of-monaldi-s-approach-with-regard-to-needle-decompression-of-the-tension-pneumothorax-a-cadaver-study
#9
G M Hohenberger, A Schwarz, F Hohenberger, T Niernberger, R Krassnig, N Hörlesberger, A H Weiglein, V Matzi
BACKGROUND: Although needle decompression of tension pneumothorax through the second intercostal space in the midclavicular line (Monaldi's approach) is a life-saving procedure, severe complications have been reported after its implementation. We evaluated the procedure by comparing how it was performed on cadavers by study participants with different training levels. METHODS: Six participants including one thoracic surgeon performed bilateral thoracic drainage after Monaldi on 82 torsos...
June 3, 2017: Injury
https://www.readbyqxmd.com/read/28600670/management-of-blunt-splenic-injury-in-a-uk-major-trauma-centre-and-predicting-the-failure-of-non-operative-management-a-retrospective-cross-sectional-study
#10
Stella R Smith, Louise Morris, Stephen Spreadborough, Waleed Al-Obaydi, Marta D'Auria, Hilary White, Adam J Brooks
PURPOSE: To review the management of patients >16 years with blunt splenic injury in a single, UK, major trauma centre and identify whether the following are associated with success or failure of non-operative management with selective use of arterial embolization (NOM ± AE): age, Injury Severity Score (ISS), head injury, haemodynamic instability, massive transfusion, radiological hard signs [contrast extravasation or pseudoaneurysm on the initial computed tomography (CT) scan], grade, and presence of intraparenchymal haematoma or splenic laceration...
June 9, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28597975/domestic-predation-of-an-elder-a-fatal-dog-attack-case
#11
Erwan Le Garff, Vadim Mesli, Yann Delannoy, Jocelyn Pollard, Anne Becart, Valéry Hedouin
We present the case of a 91-year-old woman lived alone at her home with two domestic dogs, that is,, a Labrador Retriever and a Staffordshire Bull Terrier and found dead. The investigation of the scene revealed that the Bull Terrier's jawbone and chest were covered with blood. The autopsy revealed multiple, histologically confirmed, life-threatening skin and bone lacerations without scavenging marks. The punctures and tearing of each of the wounds on the skin were compatible with bites. A left humeral fracture and multiple fractures of the right facial bones were observed...
June 9, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28597665/-injuries-associated-with-cardiopulmonary-resuscitation-in-non-survivors-after-out-of-hospital-cardiac-arrest-autopsy-study
#12
Lucia Ihnát Rudinská, Petr Hejna, Margita Smatanová, Peter Ihnát, Igor Dvořáček
The aim of the present study is to investigate incidence and seriousness of CPR-associated injuries on a cohort of CPR non-survivors after out-of-hospital cardiac arrest in the Moravian-Silesian region. In total, 80 persons were included in the study within the study period (2012 - 2015). CPR-associated injuries were identified in 75 (93.7 %) persons, multiple injuries were found in 73 persons. Spectrum of identified injuries covered skin injuries of the upper half of the body, head and neck injuries, rare abdominal injuries and very frequent thorax injuries...
2017: Soudní Lékarství
https://www.readbyqxmd.com/read/28594760/an-initiative-to-reduce-the-episiotomy-rate-association-of-feedback-and-the-hawthorne-effect-with-leapfrog-goals
#13
Kathy Zhang-Rutledge, Steven L Clark, Stacie Denning, Audra Timmins, Gary A Dildy, Manisha Gandhi
OBJECTIVE: To assess the association of education, performance feedback, and the Hawthorne effect with a reduction in the episiotomy rate in a large academic institution. METHODS: We describe a prospective observational study of a project conducted between March 2012 and February 2017 to assist clinicians in meeting the Leapfrog Group (www.leapfroggroup.org) target rates for episiotomy. Phases of this project included preintervention (phase 1, March 2012 to April 2014), education and provision of collective department episiotomy rates (phase 2, May 2014 to December 2014), ongoing education with emphasis on a revised Leapfrog target rate (phase 3, January 2015 to February 2016), and provision of individual episiotomy rates to practitioners on a monthly basis (phase 4, March 2016 to February 2017)...
June 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28594518/pediatric-phalanx-fractures
#14
Joshua M Abzug, Karan Dua, Andrea Sesko Bauer, Roger Cornwall, Theresa O Wyrick
Phalangeal fractures are the most common type of hand fracture that occurs in the pediatric population and account for the second highest number of emergency department visits in the United States for fractures. The incidence of phalangeal fractures is the highest in children aged 10 to 14 years, which coincides with the time that most children begin playing contact sports. Younger children are more likely to sustain a phalangeal fracture in the home setting as a result of crush and laceration injuries. Salter-Harris type II fractures of the proximal phalanx are the most common type of finger fracture...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28594303/self-inflicted-enucleations-clinical-features-of-seven-cases
#15
Mamta Shah, Lucy Sun, Solly Elmann, Ivan Vrcek, Ronald Mancini, Hee Joon Kim, Jacqueline Carrasco, Roman Shinder
We report the clinical presentation, radiography, and management outcomes of autoenucleations (AE). Charts of 7 patients evaluated at 4 institutions with AE were reviewed. Four males and three females had a mean age of 50 years (range 26-72 years). The etiologies were psychosis secondary to underlying mental illness (6, 88%) and substance use (1, 12%), and the mechanism was largely blunt digital injury (6, 88%). Three (43%) AE patients suffered bilateral enucleations. Common concomitant injuries included eyelid lacerations (5, 71%) and optic nerve avulsion (3, 43%)...
June 2017: Orbit
https://www.readbyqxmd.com/read/28593788/a-complication-following-a-biopsy-sample-in-eosinophilic-esophagitis
#16
Antonio Cerezo Ruiz, Encarnación Parras Mejías, José María Martos Becerra
We present a case of a young 16 year old patient that had an esophageal perforation in the context of eosinophilic esophagitis. The esophagus showed vertical lacerations and mucosal thickness on endoscopy, thus a biopsy was performed in the proximal section which resulted in profuse bleeding due to a deep mucosal tear. A subsequent computed tomography scan revealed a perforation. Due to the absence of symptoms the patient was managed conservatively. The patient was discharged within 48 hours after admission...
June 8, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28591509/-double-pneumotorax-secondary-to-single-proyectile-weapon-one-case-report-and-review-of-literature
#17
Mario Quintero-Amaya, Francisco Flores-Orozco, José Herrera-Maldonado, Jorge Miño-Bernal, Edna López-Morales, Abigail Juárez-Ugalde, Marisol Flores-Gonzaga, Débora Aguilar-Sánchez
BACKGROUND: The 25% of traumatic deaths are due to chest trauma with a mortality of 28%, and closed trauma is the most common mechanism of injury. The use of firearms increases the relative risk of death. The five more frequent specific chest injuries are lung contusion (31.8%), hemothorax/pneumothorax (19.4%), rib fractures (13.2%), and diaphragmatic injury (7.5%). CLINICAL CASE: Patient of 25 years with a single firearm projectile wound in the chest who assisted to the emergency room (ER) with significant respiratory distress and meriting surgical emergency airway, documenting double pneumothorax, aortic laceration and rupture of the trachea, which required management in the ER with bilateral chest tube placement and subsequent surgical repair...
July 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28587949/usefulness-of-direct-w-plasty-application-to-wound-debridement-for-minimizing-scar-formation-in-the-emergency-department
#18
Jin Hong Min, Kyung Hye Park, Hong Lak Choi, Jung Soo Park, Ji Han Lee, Hoon Kim, Byung Kook Lee, Dong Hun Lee, Taek Gu Lee
PURPOSE: A suture line placed with the same direction as the relaxed skin tension line leads to good healing, but a suture line with over 30 degrees of angle from the relaxed skin tension line leads to longer healing time and more prominent scarring. W-plasty is widely used to change the direction of the scar or to divide it into several split scars. In this study, we applied W-plasty to patients with facial lacerations in the emergency room. METHODS: From June 2012 to December 2014, 35 patients underwent simple repair or W-plasty for facial lacerations...
May 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28578171/nonmedically-indicated-induction-in-morbidly-obese-women%C3%A2-is-not-associated-with-an-increased-risk-of-cesarean%C3%A2-delivery
#19
Tetsuya Kawakita, Sara N Iqbal, Chun-Chih Huang, Uma M Reddy
BACKGROUND: The prevalence of morbid obesity (body mass index ≥40 kg/m(2)) in women aged 20-39 years was 7.5% in 2009 through 2010. Morbid obesity is associated with an increased risk of stillbirth compared with normal body mass index, especially >39 weeks' gestation. The data regarding increased risk of cesarean delivery associated with nonmedically indicated induction of labor compared to expectant management in morbidly obese women are limited. OBJECTIVE: We sought to compare the cesarean delivery rate of nonmedically indicated induction of labor with expectant management in morbidly obese women without other comorbidity...
May 31, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28577618/hysteroscopic-management-of-a-stenotic-cervix
#20
Michael W H Suen, Olga Bougie, Sukhbir S Singh
OBJECTIVE: To demonstrate an approach to the hysteroscopic management of a stenotic cervix. DESIGN: Step-by-step explanation of the techniques using video and animation (educational video). SETTING: Academic tertiary level referral center. PATIENT(S): Patients with cervical stenosis, inclusive of both reproductive age and postmenopausal women. Gynecologists require intrauterine access for many procedures, but a stenotic cervix can obstruct surgery...
June 2017: Fertility and Sterility
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