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rib fracture management

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https://www.readbyqxmd.com/read/27913383/traumatic-haemopneumothorax-and-whole-body-subcutaneous-emphysema-successful-use-of-a-small-bore-chest-drain
#1
Benjamin Hardy, Nicholas Sunderland, Mevan Perera, Kathryn Channing
A 56-year-old man presented having had two falls at home. He had a background of multiple sclerosis. After his second fall, during which he had fallen onto the toilet injuring his right chest, he was brought into the emergency department reporting pleuritic chest discomfort. Immediately evident was extensive swelling from his forehead to his thighs, which on palpation was found to be subcutaneous emphysema. A chest X-ray showed a large right-sided pneumothorax for which a chest drain was inserted. A CT revealed extensive surgical emphysema, pneumomediastinum, pneumoperitoneum and gas within the spinal canal...
December 2, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27893505/rib-fracture-protocol-advancing-the-care-of-the-elderly-patient
#2
Susan Leininger
This article discusses unique factors associated with rib fractures in the elderly patient population and explains the process used in one facility to develop a revised protocol for the management of elderly patients with a rib fracture. The goals were to eliminate gaps in early trauma care management and employ a care routine that would improve outcomes for this vulnerable group of patients with fracture.
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27793168/physical-function-and-pain-after-surgical-or-conservative-management-of-multiple-rib-fractures-a-follow-up-study
#3
Monika Fagevik Olsén, Margareta Slobo, Lena Klarin, Eva-Corina Caragounis, David Pazooki, Hans Granhed
BACKGROUND: There is scarce knowledge of physical function and pain due to multiple rib fractures following trauma. The purpose of this follow-up was to assess respiratory and physical function, pain, range of movement and kinesiophobia in patients with multiple rib fractures who had undergone stabilizing surgery and compare with conservatively managed patients. METHODS: A consecutive series of 31 patients with multiple rib fractures who had undergone stabilizing surgery were assessed >1 year after the trauma concerning respiratory and physical function, pain, range of movement in the shoulders and thorax, shoulder function and kinesiophobia...
October 28, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27779590/management-of-rib-fractures-a-western-trauma-association-critical-decisions-algorithm
#4
Karen J Brasel, Ernest E Moore, Roxie A Albrecht, Marc deMoya, Riyad Karmy-Jones, Nicholas Namias, Susan Rowell, Martin Schreiber, Mitchell Cohen, David V Shatz, Walter L Biffl
No abstract text is available yet for this article.
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27770081/thoracic-outlet-syndrome-in-a-volleyball-player-due-to-nonunion-of-the-first-rib-fracture
#5
Kathleen T Puttmann, Bhagwan Satiani, Patrick Vaccaro
Fracture of the first rib with ensuing callus formation is a rare cause of thoracic outlet syndrome. We report a case of a 17-year-old female volleyball player who presented with months of chronic arm pain. Radiographic imaging demonstrated nonunion fracture of the first rib. Physical therapy had been unsuccessful in relieving the pain, and surgical management was performed with resection of the first rib through a transaxillary approach with complete resolution of symptoms. Inflammation surrounding such fractures may destroy tissue planes, making dissection more technically difficult...
October 20, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27716425/flank-pseudohernia-following-posterior-rib-fracture-a-case-report
#6
Adam M Butensky, Leah P Gruss, Zachary L Gleit
BACKGROUND: A pseudohernia is an abdominal wall bulge that may be mistaken for a hernia but that lacks the disruption of the abdominal wall that characterizes a hernia. Thus, the natural history and treatment of this condition differ from those of a hernia. This is the first report of a pseudohernia due to cough-associated rib fracture. CASE PRESENTATION: A case of pseudohernia due to fractures of the 10(th) and 11(th) ribs in a 68-year-old white woman is presented...
October 1, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27696695/blunt-chest-trauma-in-a-non-specialist-centre-right-treatment-right-place
#7
Lesley Maher, Sisira Jayathissa
OBJECTIVES: To compare patient characteristics, management and outcomes for patients admitted with isolated blunt chest trauma, managed by medical or surgical teams. METHODS: We reviewed adult patients admitted with blunt chest trauma between 1 September 2006 and 31 August 2011 to a secondary hospital in New Zealand. Inclusion criteria were: blunt chest trauma, with at least one radiologically demonstrated rib fracture. The primary outcome was in-hospital mortality, and secondary outcomes were development of pneumonia, and use of analgesia...
October 1, 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27624630/cough-augmentation-techniques-in-the-critically-ill-a-canadian-national-survey
#8
Louise Rose, Neill K Adhikari, Joseph Poon, David Leasa, Douglas A McKim
BACKGROUND: Critically ill mechanically ventilated patients experience impaired airway clearance due to ineffective cough and impaired secretion mobilization. Cough augmentation techniques, including mechanical insufflation-exsufflation (MI-E), manually assisted cough, and lung volume recruitment, improve cough efficiency. Our objective was to describe use, indications, contraindications, interfaces, settings, complications, and barriers to use across Canada. METHODS: An e-mail survey was sent to nominated local survey champions in eligible Canadian units (ICUs, weaning centers, and intermediate care units) with 4 telephone/e-mail reminders...
October 2016: Respiratory Care
https://www.readbyqxmd.com/read/27582999/primum-non-nocere-a-case-of-a-humeral-fracture-in-a-patient-with-fibrodysplasia-progressiva-ossificans
#9
Alun Yewlett, Jeff Kitson, Andrew Redfern, Chris Smith
Fibrodysplasia progressiva ossificans (FPO) is an extremely rare condition characterized by abnormal heterotopic bone formation. The condition is eponymously known as 'stoneman' disease because patients can become effectively entombed within abnormal heterotopic bone. We present the first known case of a diaphyseal humeral fracture managed conservatively in an adult patient with this condition. This patient already had a pre-existing bony bar from a fusion mass involving the thoracic spine, scapula and ribs to her proximal humerus splinting the arm in a position of adduction with the palm of her hand facing towards her groin...
January 2016: Shoulder & Elbow
https://www.readbyqxmd.com/read/27572897/operative-management-versus-non-operative-management-of-rib-fractures-in-flail-chest-injuries-a-systematic-review
#10
Jaap Schuurmans, J C Goslings, T Schepers
PURPOSE: Flail chest is a life-threatening complication of severe chest trauma with a mortality rate of up to 15 %. The standard non-operative management has high comorbidities with pneumonia and often leads to extended Intensive Care Unit (ICU) stay, due to insufficient respiratory function and complications. The aim of this literature study was to investigate how operative management improves patient care for adults with flail chest. METHODS: Randomized-controlled trials comparing operative management versus non-operative management of flail chest were included in this systematic review and meta-analysis...
August 29, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27552936/-management-of-blunt-renal-trauma-in-paediatric-patients
#11
L Brouwers, M Bemelman, W L M Kramer, F H W M van der Heijden
- In 90% of children, blunt abdominal trauma is the cause of renal, splenic or hepatic injury or an injury affecting a combination of these organs.- Because children's kidneys are anatomically less protected than those of adults, potential renal injury following direct trauma affecting the child's flank, for example by a handlebar or knee should be considered.- Symptoms of renal trauma include excoriations or haematoma on the flank, a 'seatbelt-sign', macroscopic haematuria and fractures of the ribs and vertebra...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27550958/improved-outcomes-associated-with-the-liberal-use-of-thoracic-epidural-analgesia-in-patients-with-rib-fractures
#12
Courtney D Jensen, Jamie T Stark, Lewis L Jacobson, Jan M Powers, Michael F Joseph, Jeffrey M Kinsella-Shaw, Craig R Denegar
OBJECTIVE: Each year, more than 150,000 patients with rib fractures are admitted to US trauma centers; as many as 10% die. Effective pain control is critical to survival. One way to manage pain is thoracic epidural analgesia. If this treatment reduces mortality, more frequent use may be indicated. METHODS: We analyzed the patient registry of a level II trauma center. All patients admitted with one or more rib fractures (N = 1,347) were considered. Patients who were not candidates for epidural analgesia (N = 382) were eliminated...
August 22, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27540552/ketamine-infusion-therapy-as-an-alternative-pain-control-strategy-in-patients-with-multi-trauma-including-rib-fracture-case-report-and-literature-review
#13
Ashley K Losing, Justin M Jones, Adis Keric, Steven E Briggs, David D Leedahl
Ketamine is a promising alternative agent for pain control that offers benefit to traditional strategies, particularly in the setting of rib fracture. Current pharmacologic therapies have clear adverse effects, and other options may be invasive, cost prohibitive, or marginally effective. We describe three consecutive patients with traumatic injuries including rib fracture for which a ketamine infusion was utilized as part of their pain control strategy.  For each patient, use of a ketamine infusion trended toward reduced opioid requirements with stable pain scores...
July 2016: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/27495253/an-assessment-of-outcomes-with-intramedullary-fixation-of-fractured-ribs
#14
Silvana Marasco, Margaret Quayle, Robyn Summerhayes, Ilija D Šutalo, Petar Liovic
BACKGROUND: Surgical management of fractured ribs with internal fixation is an increasingly accepted therapy. Concurrently, specific rib fixation prostheses are being developed which should improve results and minimise hardware and rib/splint construct failures. The Synthes titanium intramedullary splint lends itself to difficult to access areas such as posterior rib fractures and fractures under the scapula. We analyse a case series of patients in whom this rib fixation prosthesis has been used...
August 5, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27490985/mechanisms-patterns-and-outcomes-of-paediatric-polytrauma-in-a-uk-major-trauma-centre
#15
G Naqvi, G Johansson, G Yip, A Rehm, A Carrothers, K Stöhr
Introduction Paediatric trauma is a significant burden to healthcare worldwide and accounts for a large proportion of deaths in the UK. Methods This retrospective study examined the epidemiological data from a major trauma centre in the UK between January 2012 and December 2014, reviewing all cases of moderate to severe trauma in children. Patients were included if aged ≤16 years and if they had an abbreviated injury scale score of ≥2 in one or more body region. Results A total of 213 patients were included in the study, with a mean age of 7...
August 4, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27438051/no-benefit-to-surgical-fixation-of-flail-chest-injuries-compared-with-modern-comprehensive-management-results-of-a-retrospective-cohort-study
#16
Jaclyn Farquhar, Yahya Almahrabi, Gerard Slobogean, Bronwyn Slobogean, Naisan Garraway, Richard K Simons, S Morad Hameed
BACKGROUND: Chest wall trauma is a common cause of morbidity and mortality. Recent technological advances and scientific publications have created a renewed interest in surgical fixation of flail chest. However, definitive data supporting surgical fixation are lacking, and its virtues have not been evaluated against modern, comprehensive management protocols. METHODS: Consecutive patients undergoing rib fracture fixation with rib-specific locking plates at 2 regional trauma centres between July 2010 and August 2012 were matched to historical controls with similar injury patterns and severity who were managed nonoperatively with modern, multidisciplinary protocols...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/27427761/stereotactic-body-radiation-therapy-for-stage-i-non-small-cell-lung-cancer-a-retrospective-single-center-study-of-55-patients
#17
Rahul P Bhandari, Jason D Stanford, Satya Packianathan, William N Duggar, Madhava R Kanakamedala, Xu Zhang, Shankar P Giri, Pullatikurthi P Kumar, Leslie M Harrell, Sophy H Mangana, Chunli Yang, Srinivasan Vijayakumar
PURPOSE/OBJECTIVE(S): Stereotactic body radiation therapy (SBRT) is an effective treatment for patients with early-stage non-small cell lung cancer (NSCLC) who are not surgical candidates or who refuse surgical management. In this study, we report on our clinical outcomes and toxicity in the treatment of early-stage NSCLC with SBRT. METHODS AND MATERIALS: Fifty-five patients with 59 T1-2N0M0 NSCLC lesions were treated at our institution between December 2009 and August 2014...
July 19, 2016: Oncology
https://www.readbyqxmd.com/read/27389132/magnitude-of-rib-fracture-displacement-predicts-opioid-requirements
#18
Nikolay Bugaev, Janis L Breeze, Majid Alhazmi, Hassan S Anbari, Sandra S Arabian, Sharon Holewinski, Reuven Rabinovici
INTRODUCTION: It is unknown whether the magnitude of rib fracture (RF) displacement predicts pain medication requirements in blunt chest trauma patients. METHODS: Adult blunt RF patients undergoing computed tomography (CT) of the chest admitted to an urban Level 1 trauma center (2007-2012) were retrospectively reviewed. Pain management in those with displaced RF (DRF), nondisplaced RF (NDRF), or combined DRF and NDRF (CRF) was compared by univariate analysis. Linear regression models were developed to determine whether total opioid requirements [expressed as log morphine equianalgesic dose (MED)] could be predicted by the magnitude of RF displacement (expressed as the sum of the Euclidean distance of all displaced RF) or number of RF, after adjusting for patient and injury characteristics...
October 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27364299/left-diaphragm-laceration-due-to-cardiopulmonary-resuscitation
#19
Vincent Dupont, Clotilde Rougé-Maillart, Arnaud Gaudin, Audrey Jeanneteau, Nathalie Jousset, Stéphane Malbranque
External cardiac massage is the essential life-saving gesture for the management of any cardiac arrest. Since the 1960s, many recommendations have been published to improve the effectiveness of chest compressions alongside the development of automated systems intended to maximize the chances of survival. The use of these manual and/or instrumental techniques can cause secondary injuries, of which rib fractures are the most commonly observed by forensic pathologists. However, a comprehensive review of the literature seldom highlights reports of injuries to the abdomen, even less so to the diaphragm...
July 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27359278/factors-associated-with-narcotic-use-after-clavicle-fractures
#20
Douglas S Weinberg, Joshua K Napora, William H West, Dominic C Grimberg, Heather A Vallier
Clavicle fractures are common in adults. Recent studies have shown that operative treatment of clavicle fractures has benefits in many situations. However, there is controversy about the indications. Data on social outcomes are limited. A total of 434 patients with 436 clavicle fractures treated both operatively and nonoperatively at a level 1 trauma center were identified. Narcotic use was recorded 2, 4, 6, 8, 10, 12, 14, and 16 weeks after injury for both treatment groups. Other descriptive data included age, sex, laterality, hand dominance, rib fractures, smoking, alcohol use, employment, long bone or spine fracture, open clavicle fracture, and mechanism of injury...
September 1, 2016: Orthopedics
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