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Extremity trauma

Chelsea Boe, Sanjeev Kakar
BACKGROUND: We describe a modified string technique for ring removal from an edematous finger, a critical step in the initial treatment of a patient with upper-extremity trauma. TECHNIQUE: This technique involves multiple sutures looped around the ring to provide differential tension on the ring as it is advanced distally over a lubricated digit. With the use of an assistant, the ring can be advanced in caterpillar fashion without sliding back proximal when the direct pressure is released as a result of edema...
June 19, 2018: Journal of Emergency Medicine
Francky Teddy Endomba, Charlie Romain Mbega, Joel Noutakdie Tochie, Saint-Just N Petnga
BACKGROUND: Giant congenital melanocytic nevus is a very rare condition characterized by a large skin lesion and an increased risk of complications like neurocutaneous melanosis and malignant transformation. Reports of giant congenital melanocytic nevus are scarce in the sub-Saharan African literature and here we present a case of this disease in a Cameroonian adolescent. CASE PRESENTATION: A 12-year-old Cameroonian girl from the "Baka" ethnic group, with no relevant family and medical histories presented with a progressively extensive brownish-black nodular hypertrophic skin lesion of approximately 45 cm, which she had had since she was 2-days old...
June 23, 2018: Journal of Medical Case Reports
Hiroki Kano, Yohei Matsuo, Noriaki Kubo, Satoshi Fujimi, Takashi Nishiii
STUDY DESIGN: This was a retrospective case series at a single institution. OBJECTIVE: The study was performed to investigate the characteristics of spinal injuries in survivors of suicidal jumping. SUMMARY OF BACKGROUND DATA: Spinal fracture/dislocation is associated with high-energy trauma such as that induced by motor vehicle accidents. Survivors of suicidal jumping sometimes sustain spinal injuries. However, the characteristics of such spinal injuries are unclear...
June 21, 2018: Spine
Rachel M Nygaard, Frederick W Endorf
Frostbite is a form of thermal injury that can have devastating consequences for patients, including digit amputations and sometimes more proximal amputations. To the best of the authors' knowledge, no one has determined national characteristics of frostbite patients, nor the prevalence of these diagnostic and therapeutic modalities. This is the first look at nationwide trends in the treatment of frostbite in the United States. Patients with frostbite injury were identified in the National Trauma Data Bank (NTDB) and National Burn Repository (NBR)...
December 6, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Victoria Schlanser, Andrew Dennis, Katarina Ivkovic, Kimberly Joseph, Matthew Kaminsky, Thomas Messer, Stathis Poulakidas, Frederic Starr, Faran Bokhari
Reconstruction of skin and soft tissue wounds can pose a unique surgical challenge. This is especially true for cases of exposed bone and tendon where soft tissue loss is extensive and opportunities for tissue advancement or rotation are limited. A clinical case is presented describing an experience with dehydrated human amnion/chorion membrane (dHACM, EpiFix®/AmnioFix®, MiMedx Group, Marietta, GA) graft to obtain granulation over an open fracture with desiccated bone. The 22-year-old female trauma patient presented with high-grade bilateral lower extremity soft tissue loss after being run over and dragged by a semitruck...
December 5, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Tareq Maraqa, Mohamed A T Mohamed, Mina Salib, Stephen Morris, Leo Mercer, Gul R Sachwani-Daswani
The use of electronic cigarettes (ECs) has been on the rise with increased number of battery explosions causing burns. This study is a retrospective review of patients who presented with burns caused by EC explosions.Here, we present a case series of eight patients sustaining burns from EC explosions, within a year, to elucidate the pattern of such burns and to provide a treatment guideline.All of them were males. Five patients had partial-thickness burns and three had full-thickness burns. TBSA ranged from 4 to 16% (burns to lower extremity [n = 7], hand [n =3], scrotum/penis [n =2], chest [n = 1])...
December 4, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Júlio C Castro, Pedro S Coltro, Lincoln S Millan, Fernanda B Corrêa, Jayme A Farina Junior
Some groups have avoided early microsurgical flaps in electrical burns under the pretext of injury to the microvasculature, which could increase vascular thrombosis. However, this option frequently results in amputation of the extremity. This study aims to evaluate the early application of microsurgical flaps for the treatment of electrical burns of extremities. A case series was retrospectively evaluated including patients with electrical trauma in extremities undergoing early microsurgical reconstruction...
December 4, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Hsu-Min Tseng, Whei-Mei Shih, Yung-Chao Shen, Lun-Hui Ho, Chu-Fang Wu
A Dust explosion that injured 499 patients occurred on June 27, 2015 in Taiwan. This tragedy inundated hospitals across northern Taiwan with an unprecedented number of burn patients. It caused extreme pressure and challenges for nurses. The purpose of this study is to investigate factors associated with nurses' work stress, resilience, and professional quality of life in caring for dust exposure patients. A cross-sectional survey data was collected from nurses in caring for dust explosion patients. A total of 83 nurses in burn unit, plastic surgery ward, and reconstructive microsurgery unit returned valid data for analysis...
December 6, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Nicholas R Pettit
CLINICAL INTRODUCTION: A 45-year-old man with no past medical history presents with bilateral lower extremity pain and perineal numbness after walking 10-15 min. The pain starts in his bilateral buttocks and radiates down into his thigh and into his toes. He has no back pain, fever, difficulty urinating or stooling, incontinence or trauma. Social history is positive for smoking. Physical examination was only remarkable for non-dopplerable lower extremity pulses, and he was unable to ambulate down the ED hallway without becoming symptomatic...
July 2018: Emergency Medicine Journal: EMJ
Mahnaz Yadollahi, Ali Kashkooe, Monireh Feyzi, Saman Bornapour
PURPOSE: Trauma-related injuries are the leading cause of death worldwide. Some risk factors make traumatic patients susceptible to infection. Furthermore, some mortality risk factors, including length of hospitalization and increasing age, were detected in non-traumatic infected patients. This study aimed to assess mortality risk factors among nosocomial infected traumatic patients in Rajaee trauma center, Shiraz, Iran. METHODS: This prospective cohort study was conducted during a period of 2 years since April 2015 to March 2017 in Rajaee hospital, which is the center of emergency medical services for traumatic injuries in Shiraz, Iran...
May 19, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Philip Ashley, Shawn R Gilbert
Obese children with high-energy injuries present with more severe injuries, more extremity injuries, and higher Injury Severity Scores. They are at increased risk for complications, prolonged ventilation, and ICU stay and have increased mortality. Obesity is associated with altered bone mass accrual and higher fracture rates. Obese patients have a higher risk of loss of reduction of forearm fractures, more severe supracondylar fractures, and a higher likelihood of lateral condyle fractures. Obese patients are more likely to have complications with femur fractures and have higher rates of foot and ankle fracture...
July 2018: Orthopedic Clinics of North America
Ravi Kumar Mahajan, Krishnan Srinivasan, Abhiskek Bhamre, Mahipal Singh, Prakash Kumar, Ankush Tambotra
Background: Many flaps have been described for reconstruction of lower extremity defects, including, Latissimus Dorsi, Rectus abdominis, Anterolateral thigh perforator flaps, each having advantages and disadvantages. The defect location, size and specific geometric pattern of defect influences the type of flap that can be used. In this case series, we describe the specific situations where the use of chimeric latissimus dorsi-serratus anterior (LD + SA) free flaps are of advantage in providing complete wound cover...
January 2018: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Christopher J Lehiy, Lindsey M Reister-Hendricks, Mark G Ruder, D Scott McVey, Barbara S Drolet
BACKGROUND: Hematophagous Culicoides spp. biting midges are of great agricultural importance as livestock, equine, and wildlife pests and as vectors of the orbiviruses bluetongue, epizootic hemorrhagic disease and African horse sickness. To obtain a blood meal, midges deposit saliva containing allergens, proteases, and anti-hemostatic factors, into the dermis to facilitate feeding. Infected midges deposit virus along with the myriad of salivary proteins during feeding. The extreme efficiency with which midges are able to transmit orbiviruses is not clearly understood, as much is still unknown about the physiological trauma of the bite and immune responses to saliva deposited during feeding...
June 20, 2018: Parasites & Vectors
M L Sun, X H Wang, J Huang, J Wang, Y Wang
Objective: To improve the understanding of deep venous thrombosis (DVT), the present study was conducted to investigate the difference of DVT onset in hospitalized patients with different underlying diseases. Methods: This is a single-center retrospective study from Beijing Shijitan Hospital. Clinical data from hospital onset DVT patients from 2007 to 2016 were collected. DVT was confirmed with compression ultrasonography (CUS), color Doppler flow imaging (CDFI), CT venography (CTV), magnetic resonance venography (MRV), lower extremities radionuclide venography(RDV) or conventional venography (CV)...
June 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Chul-Hyun Kim, Jong Moon Hwang, Jin-Sung Park, Seungwoo Han, Donghwi Park
The aim of this study is to investigate the usefulness of flexion-extension (dynamic) radiographs in evaluating the severity of disc degeneration and disc protrusion in cervical magnetic resonance image (MRI). Patients complaining of neck or arm pain with no prior surgical history and who had undergone both cervical MRI and dynamic radiographs were included in this study. The following patients were excluded: those who had any history of trauma, autoimmune disease such as rheumatoid arthritis or ankylosing spondylitis, prior cervical fracture or prior cervical spine surgery...
June 2018: Medicine (Baltimore)
Jana K Denkinger, Petra Windthorst, Caroline Rometsch-Ogioun El Sount, Michael Blume, Hes Sedik, Jan I Kizilhan, Niamh Gibbons, Phuong Pham, Jennifer Hillebrecht, Nora Ateia, Christoph Nikendei, Stephan Zipfel, Florian Junne
Introduction: Refugees fleeing persecution, torture, or sexual violence are at high risk of developing both acute and chronic psychological disorders. Systematic violence, as committed against the Yazidi minority in Northern Iraq by the terror organization known as the Islamic State (IS), can be seen as a particularly traumatic burden to the victims, but also to caregivers providing treatments and assistance to them. The intense exposure to traumatic content may cause secondary traumatization in respective caregivers...
2018: Frontiers in Psychiatry
Pooya Hosseinzadeh, Clarabelle A DeVries, Ena Nielsen, Lindsay A Andras, Megan Mignemi, Jeffrey R Sawyer, John M Flynn, Stephen A Albanese
BACKGROUND: There has been an increase in the number of the graduates of pediatric orthopaedic fellowship programs over the past decade creating the potential for increased competition in the field. The purpose of this study was to analyze the effect of increased number of pediatric orthopaedic fellowship graduates on case volume as well as the type of procedures performed by recent graduates of pediatric orthopaedic fellowship programs from 2004 to 2014. METHODS: Case logs submitted for the American Board of Orthopaedic Surgery Part II examination by applicants with the self-declared subspecialty of pediatric orthopaedics from 2004 to 2014 were analyzed...
June 18, 2018: Journal of Pediatric Orthopedics
James C Iannuzzi, Sahael M Stapleton, Yanik J Bababekov, David Chang, Robert T Lancaster, Mark F Conrad, Richard P Cambria, Virendra I Patel
BACKGROUND: In uncomplicated type B aortic dissection (UTBAD), the "gold standard" has been nonoperative treatment with medical therapy, although this has been questioned by studies demonstrating improved outcomes in those treated with thoracic endovascular aortic repair (TEVAR). This study assessed long-term survival after acute UTBAD comparing medical therapy, open repair, and TEVAR. METHODS: The California Office of Statewide Hospital Planning Development database was analyzed from 2000 to 2010 for adult patients with acute UTBAD...
June 15, 2018: Journal of Vascular Surgery
N Stensson, N Ghafouri, B Gerdle, B Ghafouri
Aims Since the insertion of MD probes causes an acute tissue trauma, analyses of microdialysates during this period has previously been disregarded in favour of waiting until stable baselines are achieved. The aim of this study is to compare the levels of NAEs in women with chronic widespread pain (CWP) to the healthy controls (CON) during the tissue trauma period. Methods 18 women with CWP were included in this study. Inclusion criteria were female sex, age range 20-65 years, and widespread pain according to the American College of Rheumatology (ACR) classification...
December 29, 2017: Scandinavian Journal of Pain
Wenche Iglebekk, Carsten Tjell, Peter Borenstein
Background and aim A diagnosis of chronic benign paroxysmal positional vertigo (BPPV) is based on brief attacks of rotatory vertigo and concomitant nystagmus elicited by rapid changes in head position relative to gravity. However, the clinical course of BPPV may vary considerably from a self-limiting to a persisting and/or recurrent disabling problem. The authors' experience is that the most common complaints of patients with chronic BPPV are nautical vertigo or dizziness with other symptoms including neck pain, headache, widespread musculoskeletal pain, fatigue, and visual disturbances...
December 29, 2017: Scandinavian Journal of Pain
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