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Nicholas Brandmeir, Russell Payne, Elias Rizk, R Shane Tubbs, Juan Luis Arsuaga, Antonis Bartsiokas
Objective King Philip II, the father of Alexander the Great, suffered a penetrating wound to the leg from a spear that left him severely handicapped. His skeletal remains represent the first and only case of an injury from ancient Greece that can be directly compared to its historical record. The objective of the study was to confirm the identity of the male occupant of Royal Tomb I in Vergina, Greece as Philip II of Macedonia by providing new evidence based on anatomical dissection and correlation with the historical description of the wounds...
April 18, 2018: Curēus
Michael Williamson, Felice Vanacore, Caroline Hing
Pubic symphysis diastasis injuries typically occur following a high velocity force such as road traffic accidents, horse riding, crush injuries and falls from a height. There are reports of a range of injuries caused by waterslides including spinal fractures, head injuries and vaginal injuries. Here we report the case of a 50-year-old female who suffered a pelvic diastasis injury during the use of a waterslide.
June 2018: Journal of Clinical Orthopaedics and Trauma
M Maruf, J Jayman, M Kasprenski, K Benz, Z Feng, D Friedlander, T Baumgartner, B J Trock, H Di Carlo, P D Sponseller, J P Gearhart
BACKGROUND: Primary bladder closure of classic bladder exstrophy (CBE) is a major operation that occasionally requires intraoperative or postoperative (within 72 h) blood transfusions. OBJECTIVE: This study reported perioperative transfusion rates, risk factors for transfusion, and outcomes from a high-volume exstrophy center in primary bladder closure of CBE patients. STUDY DESIGN: A prospectively maintained, institutional exstrophy-epispadias complex database of 1305 patients was reviewed for primary CBE closures performed at the authors' institution (Johns Hopkins Hospital) between 1993 and 2017...
June 7, 2018: Journal of Pediatric Urology
Rosa Maria Blotta, Sirlei Dos Santos Costa, Eduardo Neubarth Trindade, Luise Meurer, Manoel Roberto Maciel-Trindade
OBJECTIVES: Interest in elucidating the etiology of hernias has encouraged countless studies of musculoaponeurotic structures in individuals with and without hernias. Studies of hernia patients have firmly demonstrated a correlation between hernias and collagen alterations in their fascia. Diastasis recti is an increased width of the abdominal midline that is exclusively composed of interlacing aponeurotic expansions of the anterolateral abdominal muscles. The condition is common among women undergoing abdominoplasty, and many factors, not only mechanical, play a role...
June 7, 2018: Clinics
S Sipahioglu, S Zehir, U E Isikan
Background: In chronic instability of syndesmosis, osteoarthritis and poor functional outcome were seen more prevalently. To avoid diastasis of ankle joint, the affected distal tibiofibular syndesmosis should be restored. We evaluated the clinical and radiological results of operative treatment of ankle fractures in patients who required syndesmotic stabilization. Materials and Methods: Twenty-one patients operated for ankle fracture were evaluated. Patients were followed up for 12 to 81 months, with a mean value of 49 months...
June 2018: Nigerian Journal of Clinical Practice
C Giné, S Arévalo, N Maíz, C Rodó, S Manrique, A Poca, J A Molino, E Carreras, M López
PURPOSE: Fetoscopic technique for closure of open neural tube defects (NTD) remains controversial as the use of patches or the single layer closure are believed to stay far from the standards of a good neurosurgical reconstruction. We describe hereby a fetoscopic two-layer closure technique (myofascial and skin) for the treatment of NTD in 5 patients and our preliminary anatomical outcome at birth. MATERIAL AND METHODS: With the exteriorized uterus and three 10Fr ports, the placode is dissected from the surrounding tissue and de-tethered, removing the cystic tissue...
June 6, 2018: Ultrasound in Obstetrics & Gynecology
C K Spies, M Langer, L P Müller, J Oppermann, S Löw, F Unglaub
BACKGROUND: The functionality of the upper extremity is decisively based on rotation of the forearm. The rotation depends on the extent of motion of the distal radioulnar joint. Rotation enables complete and focused usability of the hand in order to cope with daily activities. The configuration of the distal radioulnar joint has developed over millions of years of evolution. ANATOMIC CONDITIONS: The triangular fibrocartilage complex is the crucial stabiliser of the latter joint since osseous structures are limited...
June 5, 2018: Der Orthopäde
N Habib, G Filardo, M Delcogliano, M Arigoni, C Candrian
OBJECTIVE: In polytrauma patients, to limit the pelvic space favouring internal bleeding, the use of pelvic binders is now a standard practice. In case of external pelvic binder placement with anatomic reduction of the symphyseal and sacroiliac joints, delayed diagnosis and missed injuries could occur. The aim of this study is to document the risk of missed diagnosis, as well as to identify a possible algorithm for optimal management of traumatized patients with pelvic binders, in order to reach an early diagnosis of pelvic fractures without additional risks...
May 2018: European Review for Medical and Pharmacological Sciences
S Rammelt, E Manke
BACKGROUND: Injuries to the distal tibiofibular syndesmosis are frequent and continue to generate controversy due to an extensive range of diagnostic techniques and therapeutic options. OBJECTIVE: The aim of this review is to summarize the current knowledge on syndesmotic instability and to present some recommendations for the clinical practice for acute an chronic injuries. MATERIAL AND METHODS: Analysis of the current literature concerning the anatomy, etiology, diagnostics and treatment of syndesmosis injuries...
May 29, 2018: Der Unfallchirurg
Hong-Yun Li, Ru-Shou Zhou, Zi-Ying Wu, Yutong Zhao, Shi-Yi Chen, Ying-Hui Hua
PURPOSE: To compare the biomechanical characteristics of suture-button fixation versus ligament reconstruction using semitendinosus tendon autograft in treatment of syndesmotic injury in cadaver biomechanical study. METHODS: Eight matched pairs of human cadaveric lower-extremities were measured intact, then following simulated syndesmosis injury by cutting the anterior tibiofibular ligament (AITFL), the distal 15 cm of the interosseous membrane (IO), and the deltoid ligament...
May 24, 2018: International Orthopaedics
Samantha Lawson, Ashley Sacks
Pelvic floor dysfunction is defined as abnormal function of the pelvic floor and includes conditions that can have significant adverse impacts on a woman's quality of life, including urinary incontinence (stress, urge, and mixed), fecal incontinence, pelvic organ prolapse, sexual dysfunction, diastasis recti abdominis, pelvic girdle pain, and chronic pain syndromes. Women's health care providers can screen for, identify, and treat pelvic floor dysfunction. This article examines the case of a woman with multiple pelvic-floor-related problems and presents the evidence for the use of pelvic floor physical therapy (PFPT) for pregnancy-related pelvic floor dysfunction...
May 19, 2018: Journal of Midwifery & Women's Health
Stefan E van Oostendorp, Rene Buijsman, Wietse P Zuidema
We present the case of a 57-year-old man who had suffered pain in the left hemithorax for a year, which started after a period of severe coughing during pneumonia. The pain was triggered by lying down. A computed tomography scan revealed two nonunion costal fractures. In the operating room, intercostal diastasis with pulmonary herniation was encountered in addition to the costal fractures. This report describes the technique used to reconstruct the thoracic wall with mesh and plate-osteosynthesis.
January 1, 2018: Asian Cardiovascular & Thoracic Annals
Amir H Faraji, Pawel G Ochalski, Alp Ozpinar, Jason E Blatt, Ian F Pollack
Traumatic clival fractures in the pediatric population are associated with high mortality rates. In our previously reported series, a subset of clival fractures were associated with traumatic diastasis of the surrounding clival synchondroses. Herein, we describe a pediatric case of an isolated traumatic diastasis of the clival synchondroses without clival fracture with significant injury to neurovascular structures. To our knowledge this is the first report to describe this entity. Careful radiological attention should be made towards the clival synchondroses in crushing head injuries to best tailor screening for cerebrovascular injury even in the absence of clival fractures...
April 19, 2018: Pediatric Neurosurgery
Vijay Govindarajan, John Mousel, H S Udaykumar, Sarah C Vigmostad, David D McPherson, Hyunggun Kim, Krishnan B Chandran
Highly resolved three-dimensional (3D) fluid structure interaction (FSI) simulation using patient-specific echocardiographic data can be a powerful tool for accurately and thoroughly elucidating the biomechanics of mitral valve (MV) function and left ventricular (LV) fluid dynamics. We developed and validated a strongly coupled FSI algorithm to fully characterize the LV flow field during diastolic MV opening under physiologic conditions. Our model revealed that distinct MV deformation and LV flow patterns developed during different diastolic stages...
April 18, 2018: Scientific Reports
J D Luck, Joseph Lopez, Muhammad Faateh, Alexandra Macmillan, Robin Yang, Edward H Davidson, Arthur Nam, Michael Grant, Anthony P Tufaro, Richard Redett, Paul N Manson, Amir H Dorafshar
BACKGROUND: Currently, there is a relative paucity of data investigating the operative management of displaced pediatric zygomaticomaxillary complex (ZMC) fractures. The purpose of this study was to assess ZMC fracture management and associated complications in the pediatric population, and potentially describe a standard treatment paradigm for pediatric ZMC fractures. METHODS: A retrospective cohort review was performed of all patients younger than 15 years-of-age presenting to a single institution with ZMC fractures from 1990-2010...
April 5, 2018: Plastic and Reconstructive Surgery
Gernot Köhler, Ines Fischer, Richard Kaltenböck, Rudolf Schrittwieser
INTRODUCTION: Patients with umbilical or epigastric hernias benefit from mesh- based repairs, and even more so if a concomitant rectus diastasis (RD) is present. The ideal technique is, however, still under debate. In this study we introduce the minimal invasive linea alba reconstruction (MILAR) with the supraaponeurotic placement of a fully absorbable synthetic mesh. MATERIALS AND METHODS: Midline reconstruction with anterior rectus sheath repair and mesh augmentation by an open approach is a well-known surgical technique for ventral hernia repair...
April 5, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Laura Valentini, Francesca Chiaffarino, Nicoletta Bonfanti, Marilou Pannacci, Paolo Cortellazzi, Caterina Uberti-Foppa, Marika Furlanetto, Francesco DI Meco, Luca Massimi
OBJECTIVES: Neurosurgical surgical site infections (SSI) are life-threatening complications, requiring medical treatment and additional surgeries and remain a substantial cause of morbidity. In order to identify the incidence and the main risk factors for SSI, we developed the Prophylaxis with Antibiotic protocol for neuroSurgical Site Infections Study (PASSIS), a prospective observational multicenter cohort study for examining a large number of neurosurgical procedures. METHODS: The study PASSIS involved four Italian Neurosurgical Departments applying the same antibiotic prophylaxis (ABP) protocol on 6359 consecutive neurosurgical procedures...
March 26, 2018: Journal of Neurosurgical Sciences
Isaac Fernandez, William M Weiss, Vinod K Panchbhavi
BACKGROUND: A cannulated screw is currently the standard fixation method to reduce and stabilize diastasis at the lisfranc joint following injury. Currently, there is no literature examining the area of the lisfranc ligament damaged by screw placement. The objective of this investigation is to define the area of the ligament damaged by fixation with a 3.5-mm cannulated screw. MATERIALS AND METHODS: Twelve cadaveric feet were dissected to identify the Lisfranc ligament metatarsal insertion site and origin on the medial cuneiform...
March 1, 2018: Foot & Ankle Specialist
Anil Akoon, Louis C Grandizio, Gaurav G Mookerjee, Jove Graham, Joel C Klena
BACKGROUND: The purpose of this investigation is to compare the radiographic and intraoperative assessment of scaphotrapezoid (ST) joint arthritis in patients with end-stage carpometacarpal (CMC) arthritis of the thumb base. We aim to define the incidence of ST arthritis in this population and determine whether radiographic features such as lunate morphology, dorsal intercalated segment instability (DISI), and scapholunate (SL) diastasis are associated with the incidence of ST arthritis...
March 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
David Dreizin, Uttam Bodanapally, Daniel Mascarenhas, Robert V O'Toole, Nikki Tirada, Ghada Issa, Jason Nascone
OBJECTIVE: To assess effects of pelvic binders for different instability grades using quantitative multidetector computed tomography (MDCT) parameters including segmented pelvic haematoma volumes and multiplanar caliper measurements. METHODS: CT examinations of 49 patients with binders and 49 controls performed from January 2008-June 2016, and matched 1:1 for Tile instability grade and Pennal/Young-Burgess force vector, were compared for differences in pubic symphysis and sacroiliac displacement using caliper measurements in three orthogonal planes...
March 13, 2018: European Radiology
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