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https://www.readbyqxmd.com/read/28544074/single-stage-aesthetic-and-functional-reconstruction-of-composite-facial-gunshot-wound-with-a-chimeric-functioning-muscle-and-fibular-osseous-flap-case-report-and-review-of-the-literature
#1
Andreas Gravvanis, Konstantinos Apostolou, Dimitrios Anterriotis, Dimosthenis Tsoutsos
The current concepts in the aesthetic and functional reconstruction of complex oromandibular defects are presented with a case of a patient with self-inflicted gunshot wound to the face. The patient presented with a 6 cm composite mandibular defect; the buccomandibular and suborbital aesthetic zones of the cheek along with the mucosa lining, and the ipsilateral facial musculature were missing. A rapid prototyping model of the facial skeleton was used to assist in preoperative planning. A single stage reconstruction with two free flaps was planned; a free fibula osseous flap to reconstruct the mandibular defect, and a free chimeric ALT/functioning vastus lateralis muscle...
May 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28538646/defining-the-ge-junction-in-trauma-epidemiology-and-management-of-a-challenging-injury
#2
Morgan Schellenberg, Kenji Inaba, James M Bardes, Daniel OʼBrien, Lydia Lam, Elizabeth Benjamin, Daniel Grabo, Demetrios Demetriades
INTRODUCTION: Injuries to the gastroesophageal (GE) junction are infrequently encountered because of the high mortality of associated injuries. Consequently, there is a paucity of literature on the patient demographics and treatment options. The aim of this study was to examine the epidemiology, surgical management, and outcomes of these rare injuries. METHODS: Patients presenting to LAC+USC Medical Center (01/2008-08/2016) with traumatic esophageal or gastric injury (ICD-9 and -10 codes) were extracted from the trauma registry...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28532914/penetrating-bihemispheric-traumatic-brain-injury-a-collective-review-of-gunshot-wounds-to-the-head
#3
REVIEW
L Turco, D L Cornell, B Phillips
BACKGROUND: Head injuries that cross midline structures of the brain are 'bihemispheric.' Other terms have been used to describe such injuries, but 'bihemispheric' is the most accurate and should be standard nomenclature. Bihemispheric head injuries are associated with higher mortality and morbidity than other penetrating traumatic brain injuries (TBI). Currently, there is a tendency to manage severe gunshot wounds (GSWs) to the head non-operatively, despite reports of improved outcome in military patients treated aggressively...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28531301/a-political-case-of-penetrating-cranial-trauma-the-injury-of-james-scott-brady
#4
Richard Menger, Piyush Kalakoti, Rimal Hanif, Osama Ahmed, Anil Nanda, Bharat Guthikonda
James Brady, the White House press secretary during President Ronald Reagan's first term in office, was 1 of 4 people (including the President) wounded during an attempted assassination attempt on President Reagan's life on March 30, 1981. John Hinckley, Jr. was found not guilty of this attempt by reason of insanity. The assassination attempt was a ploy by Hinckley, Jr. to impress the actress Jodie Foster. Brady was the most seriously injured of the 4 who were wounded. He suffered a gunshot wound to the left forehead that traveled through the left frontal lobe, corpus callosum, and then into the right frontal and temporal lobes...
May 22, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28523086/a-14-year-review-of-craniomaxillofacial-gunshot-wounds-in-a-resource-limited-setting
#5
Olushola Amole, Otasowie Osunde, Benjamin Akhiwu, Akinwale Efunkoya, Kelvin Omeje, Taiwo Amole, Zubairu Iliyasu
This study analyzed the prevalence, clinical characteristics, and management of civilian-type craniomaxillofacial gunshot wounds (CGSWs) seen over a 14-year period in a Northern Nigerian teaching hospital. A retrospective study of all hospital records relating to CGSWs from January 2000 to December 2013 was conducted to determine the prevalence of CGSWs. Information retrieved included site of injury, type of projectile, management protocol, as well as duration of hospitalization. A total of 46 admissions for CGSWs were recorded during the period under review from a total of 2,228 maxillofacial admissions...
June 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28513528/complete-upper-urinary-tract-obstruction-caused-by-penetrating-pellet-injury-of-the-ureterintroduction
#6
M T Gulpinar, S K Keskin, A Yildirim, T Caskurlu
Ureteral injuries due to gunshots are tend to be misdiagnosed because of concomitant vascular and intraabdominal organ wounds. Our case is a 23-year-old man who was admitted to the hospital with multiple abdominal gunshot wounds. Laboratory findings showed worsening anemia, and the computed tomography (CT) scan showed multiple lead bullets inside the abdomen and retroperitoneum. Patient was then taken to the operation room for laparatomy. There were many intestinal injuries and also a stable retroperitoneal hematoma...
May 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28513518/firearm-injuries-received-in-emergency-room-of-a-nigerian-teaching-hospital-aanalysis-of-pattern-morbidity-and-mortality
#7
N I Omoke
BACKGROUND: The morbidity and mortality associated with civilian firearm injury in developing countries is appreciable. The increasing incidence of gunshot casualties received in hospital emergency rooms is an emerging concern. The aim of this study was to determine the pattern and outcome of firearm injuries in a civilian setting of a developing country. MATERIALS AND METHOD: This was a retrospective analysis of data on the entire patients with firearm injury received in the emergency room of Federal Teaching Hospital Abakaliki from January 2005 to December 2014...
May 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28512618/incomplete-isolated-c7-root-injury-caused-by-gunshot-wound-a-case-report
#8
Ulvi Çiftçi, Ahmet Tolgay Akıncı, Emre Delen, Doğan Güçlühan
Gunshot wounds to the spine cause severe neurological and/or internal organs damages. Although most of publications in the literature are realized on military injuries, increased civilian arming which raises civilian gunshot injuries is a new social danger causing serious health problems. In gunshot injuries to the spine; vertebral column, spinal cord and nerve roots are damaged with direct, indirect and transient cavitation related mechanisms. In this case report, we present 24 years old male patient who had severe pain and monoparesis in left upper extremity followed by gunshot injury to the spine with clinical, radiological and postoperative follow-up findings...
April 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/28498136/gunshot-wound-in-an-18-year-old-woman-inflicted-with-a-hunting-weapon-through-an-obstacle-mobile-phone-reconstruction-of-events
#9
Anna Smędra, Przemysław Sidelnik, Wojciech Goryca, Jarosław Berent
The article presents a case of an 18-year-old woman wounded by a shot fired from a distance with a hunting weapon. Because the location of the entrance and exit wounds initially seemed inconsistent with the reports (both wounds were described as "large and irregular in shape") and no photographs documenting the inflicted injuries were taken, the case was referred for an opinion to the Department of Forensic Medicine in Lodz. After a review of the medical records, radiology, the victim's clothing, and performance of an experiment using the gun and ammunition, it was established that the entrance wound was located on the abdomen, and the exit wound was located on the buttock...
May 12, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28492406/routine-computed-tomography-after-recent-operative-exploration-for-penetrating-trauma-what-injuries-do-we-miss
#10
April E Mendoza, Christopher A Wybourn, Anthony G Charles, Andre Campbell, Bruce A Cairns, Margaret M Knudson
BACKGROUND: Patients with penetrating trauma who cannot be stabilized undergo operative intervention without preoperative imaging. In such cases, post-operative imaging may reveal additional injuries not identified during the initial operative exploration. The purpose of this study is to explore the utility of post-operative CT imaging in the setting of penetrating trauma. METHODS: This was a retrospective analysis of patients with penetrating trauma treated at an urban level 1 trauma center between 2010-2015...
May 11, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28488619/peripheral-nerve-injuries-a-retrospective-survey-of-1124-cases
#11
João A Kouyoumdjian, Carla R Graça, Vanessa F M Ferreira
BACKGROUND: Peripheral nerve injuries (PNIs) remain an important health problem often leading to severe motor disabilities predominantly in the younger population. OBJECTIVE: To analyze our experience of clinical and electrodiagnostic evaluation (EDX) of PNIs over a 26-year period. MATERIALS AND METHODS: Between 1989 and 2014, 1124 consecutive patients with 1418 PNIs were referred for clinical as well as EDX evaluation. These PNIs involved upper and lower limbs as well as the facial nerves...
May 2017: Neurology India
https://www.readbyqxmd.com/read/28488041/malunion-of-long-bone-fractures-in-a-conflict-zone-in-the-democratic-republic-of-congo
#12
Grace Bauhahn, Harald Veen, Rigo Hoencamp, Nelson Olim, Edward C T H Tan
INTRODUCTION: Malunion is a well-recognized complication of long-bone fractures which accounts for more than 25% of injuries in conflict zones. The aim of this study was to investigate the rate of malunion sustained by casualties with penetrating gunshot wounds in an International Committee of the Red Cross (ICRC) surgical substitution project in the Democratic Republic of Congo (DRC) and compare these results with current literature. METHODS: A retrospective cohort study was performed...
May 9, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28486324/case-report-and-review-of-management-of-penetrating-trauma-and-cardiac-pericarditis
#13
Elizabeth Thomas, Pamela Golden, Vicki Moran
Acute pericarditis is the most common form of pericardial disease worldwide and it has many potential etiologies. This case study examines a patient admitted for multiple gunshot wounds who developed acute pericarditis postpericardial drain removal. The initial penetrating abdominal trauma, along with facial injuries and a suspected myocardial infarction, led to confusion in which the initial etiology of pericarditis was missed, creating a delay in overall patient care and extended length of stay.
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28462659/prevalence-management-and-outcome-of-traumatic-diaphragm-injuries-managed-by-the-pietermaritzburg-metropolitan-trauma-service
#14
N D'Souza, D Clarke, G Laing
INTRODUCTION This audit of traumatic diaphram injury (TDI) from a busy South African trauma service reviews the spectrum of disease and highlights current approaches to these injuries. METHODS The Pietermaritzburg Metropolitan Trauma Service (PMTS) has maintained an Electronic Surgical Registry (ESR) and a Hybrid Electronic Medical Record (HEMR) system since January 1(st) 2012. RESULTS A total of 105 TDIs were identified and repaired during the study period. The mean patient age was 30 years (range 15-68 years - SD 9...
May 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28457327/an-epidemiologic-overview-of-13%C3%A2-years-of-firearm-hospitalizations-in-pennsylvania
#15
Brian W Gross, Alan D Cook, Cole D Rinehart, Caitlin A Lynch, Eric H Bradburn, Katherine A Bupp, Chet A Morrison, Frederick B Rogers
BACKGROUND: Gun violence is a controversial public health issue plagued by a lack of recent research. We sought to provide a 13-y overview of firearm hospitalizations in Pennsylvania, analyzing trends in mode, intent, and outcome. We hypothesized that no adjusted change in mortality or functional status at discharge (FSD) would be observed for gunshot wound (GSW) victims over the study period. METHODS: All admissions to the Pennsylvania Trauma Outcome Study database from 2003 to 2015 were queried...
April 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28446350/the-first-aid-and-hospital-treatment-of-gunshot-and-blast-injuries
#16
Axel Franke, Dan Bieler, Benedikt Friemert, Robert Schwab, Erwin Kollig, Christoph Güsgen
BACKGROUND: When gunshot and blast injuries affect only a single person, first aid can always be delivered in conformity with the relevant guidelines. In contrast, when there is a dynamic casualty situation affecting many persons, such as after a terrorist attack, treatment may need to be focused on immediately life-threatening complications. METHODS: This review is based on pertinent publications retrieved by a selective search in Medline and on the authors' clinical experience...
April 7, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28444618/rna-dna-co-analysis-on-aged-bloodstains-from-adhesive-tapes-used-for-gunshot-residue-collection-from-hands
#17
Melanie Grabmüller, Christian Schyma, Burkhard Madea, Tim Eichhorst, Cornelius Courts
In cases of firearm related fatalities a systematic investigation at the scene of death is indispensable to differentiate between self-inflicted and homicidal gunshot injuries. A common method to preserve gunshot residues (GSR) is their collection using adhesive tapes. However, the biological material gathered at the same time by the tapes would be of special interest if backspatter, ejected from the entrance wound against the direction of fire, could be detected. In the present study we examined the success rate of co-analysis of RNA and DNA recovered from biological traces sampled with adhesive tapes...
April 25, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28442204/out-of-hospital-thoracotomy-for-cardiac-arrest-after-penetrating-thoracic-trauma
#18
Mark G Van Vledder, Oscar J F Van Waes, Fabian O Kooij, Joost H Peters, Esther M M Van Lieshout, Michael H J Verhofstad
INTRODUCTION: Emergency department thoracotomy is an established procedure for cardiac arrest in patients suffering from penetrating thoracic trauma and yields relatively high survival rates (up to 21%) in patients with cardiac tamponade. To minimize the delay between arrest and thoracotomy, some have advocated thoracotomy on the accident scene. The aim of this study was to determine the proportion of patients with return of spontaneous circulation and subsequent survival after out of hospital thoracotomy in the Netherlands...
April 15, 2017: Injury
https://www.readbyqxmd.com/read/28431721/intra-aortic-missile-after-gunshot-wound-to-chest-an-interesting-case-of-traumatic-cardiac-injury
#19
Charles D Fraser, Lee Goeddel, Nishant D Patel, Said C Azoury, Joshua C Grimm, Rosanne B Sheinberg, Christopher M Sciortino
Missile embolus to the heart, although uncommon, is one of the most challenging scenarios in trauma. We describe a 36-year-old man who presented with a gunshot wound to the left chest and a chest x-ray revealing a foreign body in the mediastinum. A median sternotomy was performed and an injury to the left ventricle was identified. After intraoperative echocardiography and fluoroscopy confirmed a foreign body in the aortic root, cardiopulmonary bypass was implemented. A bullet was retrieved from the noncoronary sinus of the aortic valve...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28424127/analysis-of-mortality-in-traumatically-injured-patients-based-on-body-mass-index-and-mechanism-reveals-highest-mortality-among-the-underweight-in-comparison-with-the-ideal-weight-patients
#20
COMPARATIVE STUDY
Kevin Treto, Karen Safcsak, David Chesire, Indermeet S Bhullar
The purpose of this study was to evaluate the effect of body mass index (BMI) on mortality after traumatic injury. The records of patients from 2012 to 2015 were retrospectively reviewed. The patients were stratified into the following groups based on admission BMI (kg/m2): underweight (UW) (BMI <19), ideal weight (IW) (BMI = 19-24.9), overweight (OW) (BMI = 25-29.9), obese (OB) (BMI = 30-39.9), and morbid obese (MO) (BMI >40). The groups were well matched with no significant differences in demographics and Injury Severity Score...
April 1, 2017: American Surgeon
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