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Extremity trauma

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https://www.readbyqxmd.com/read/29040202/re-examination-of-a-battlefield-trauma-golden-hour-policy
#1
Jeffrey T Howard, Russ S Kotwal, Alexis R Santos, Matthew J Martin, Zsolt T Stockinger
BACKGROUND: Most combat casualties who die, do so in the prehospital setting. Efforts directed toward alleviating prehospital combat trauma death, known as killed in action (KIA) mortality, have the greatest opportunity for eliminating preventable death. METHODS: 4,542 military casualties injured in Afghanistan from September 11, 2001 to March 31, 2014 were included in this retrospective analysis to evaluate proposed explanations for observed KIA reduction following a mandate by Secretary of Defense Robert M...
October 16, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29035984/risk-factors-for-lower-extremity-injuries-among-contemporary-dance-students
#2
Christine van Seters, Rogier M van Rijn, Marienke van Middelkoop, Janine H Stubbe
OBJECTIVE: To determine whether student characteristics, lower-extremity kinematics, and strength are risk factors for sustaining lower-extremity injuries in preprofessional contemporary dancers. DESIGN: Prospective cohort study. SETTING: Codarts University of the Arts. PATIENTS: Forty-five first-year students of Bachelor Dance and Bachelor Dance Teacher. ASSESSMENT OF RISK FACTORS: At the beginning of the academic year, the injury history (only lower-extremity) and student characteristics (age, sex, educational program) were assessed using a questionnaire...
October 10, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29033772/intraparenchymal-hemorrhage-due-to-brain-metastasis-of-hepatocellular-carcinoma
#3
Rafael Sartori Balbinot, Ana Laura Facco Muscope, Mateus Dal Castel, Silvana Sartori Balbinot, Raul Angelo Balbinot, Jonathan Soldera
Although extrahepatic metastases from hepatocellular carcinoma (HCC) are present in only 5-15% of cases, they are certainly factors associated with poor prognosis. The main sites include lung, lymph nodes, bones, and adrenal glands, in descending order. Metastasis in the central nervous system is extremely rare, and the incidences vary from 0.6 to 1.7%. We report a case of a 54-year-old man previously diagnosed with alcohol-induced cirrhosis of the liver and HCC. The patient was admitted presenting progressive left hemiparesis and headache which started 2 days earlier, with no history of cranioencephalic trauma...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29033294/acetaminophen-or-nonsteroidal-anti-inflammatory-drugs-in-acute-musculoskeletal-trauma-a%C3%A2-multicenter-double-blind-randomized-clinical-trial
#4
Milan L Ridderikhof, Philipp Lirk, Helma Goddijn, Edwin Vandewalle, Erik Schinkel, Susan Van Dieren, E Marleen Kemper, Markus W Hollmann, J Carel Goslings
STUDY OBJECTIVE: We determine whether pain treatment with acetaminophen was not inferior to nonsteroidal anti-inflammatory drugs or the combination of both in minor musculoskeletal trauma. METHODS: The Paracetamol or NSAIDs in Acute Musculoskeletal Trauma Study was a double-blind, randomized, clinical trial conducted in 2 general practices and 2 emergency departments in the Netherlands. A total of 547 adults, aged 18 years and older, with acute blunt minor musculoskeletal extremity trauma were randomly assigned in a 1:1:1 ratio to acetaminophen 4,000 mg/day, diclofenac 150 mg/day, or acetaminophen 4,000 mg/day+diclofenac 150 mg/day during 3 consecutive days...
October 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29030619/unwavering-pathobiology-of-volumetric-muscle-loss-injury
#5
Sarah M Greising, Jessica C Rivera, Stephen M Goldman, Alain Watts, Carlos A Aguilar, Benjamin T Corona
Volumetric muscle loss (VML) resulting from extremity trauma presents chronic and persistent functional deficits which ultimately manifest disability. Acellular biological scaffolds, or decellularized extracellular matrices (ECMs), embody an ideal treatment platform due to their current clinical use for soft tissue repair, off-the-shelf availability, and zero autogenous donor tissue burden. ECMs have been reported to promote functional skeletal muscle tissue remodeling in small and large animal models of VML injury, and this conclusion was reached in a recent clinical trial that enrolled 13 patients...
October 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29030045/the-potential-role-of-thermography-in-determining-the-efficacy-of-stroke-rehabilitation
#6
Béla Hegedűs
INTRODUCTION: Maintaining good physiological circulation in the extremities requires an optimally functioning muscle pump. Stroke symptoms indicate a change in venous circulation. In this study, changes were measured in joint function and microcirculation, and the correlation between them was examined. SETTING: Physiotherapy Center, Ss. Cosmas and Damian Rehabilitation Institute, Visegrád, Hungary. METHODOLOGY: Sixteen randomly selected poststroke patients with hemiparesis affecting mainly the upper extremities began undergoing rehabilitation 13 ± 4 days following stroke...
October 10, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29029772/inhibition-of-mammalian-target-of-rapamycin-signaling-with-rapamycin-prevents-trauma-induced-heterotopic-ossification
#7
Ammar T Qureshi, Devaveena Dey, Erin M Sanders, Jonathan G Seavey, Allison M Tomasino, Kaitlyn Moss, Benjamin Wheatley, David Cholok, Shawn Loder, John Li, Benjamin Levi, Thomas A Davis
A pressing clinical need exists for 63% to 65% of combat-wounded service members and 11% to 20% of civilians who develop heterotopic ossification (HO) after blast-related extremity injury and traumatic injuries, respectively. The mammalian target of rapamycin pathway is a central cellular sensor of injury. We evaluated the prophylactic effects of rapamycin, a selective inhibitor of mammalian target of rapamycin signaling, on HO formation in a rat model of blast-related, polytraumatic extremity injury. Rapamycin was administered intraperitoneally daily for 14 days at 0...
October 5, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/29029061/effects-of-access-to-radiology-in-out-of-hours-primary-care-in-the-netherlands-a-prospective-observational-study
#8
Martijn Hendrik Rutten, Marleen Smits, Yvonne Anthonia Sebastiana Peters, Willem Jan Jozef Assendelft, Gert Pieter Westert, Paul Hendrikus Josephus Giesen
Background: In the Netherlands, out-of-hours primary care is provided in general-practitioner-cooperatives (GPCs). These are increasingly located on site with emergency departments (ED), forming Emergency-Care-Access-Points (ECAP). A more efficient and economical organization of out-of-hours primary emergency care could be realized by increased collaboration at an ECAP. In this study, we compared the effects of different models with respect to access to (hospital) radiology by the GPC...
September 28, 2017: Family Practice
https://www.readbyqxmd.com/read/29026917/-fractures-of-the-lower-extremities-in-childhood-part-2-lower-leg-and-ankle-fractures
#9
M Voth, L Kremer, I Marzi
The treatment of pediatric patients in trauma surgery is a special situation in every aspect. For deciding on the correct treatment of fractures of the lower leg and ankle joint, various parameters, such as residual growth rate, skeletal age and height of the patient are decisive. The differences between fractures in children and adolescents are the open epiphyseal plate and the resulting residual growth. The bones of young children have a higher healing tendency and a greater potential for correction than in adolescents...
October 12, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29026667/lumbar-chronic-subdural-hematoma-mimicking-an-intradural-extramedullary-tumor-a-case-report
#10
Hyeun Sung Kim, Nitin Adsul, Yoon Seok Ju, Ki Joon Kim, Sung Ho Choi, Jeong Hoon Kim, Sung Kyun Chung, Jeong-Hoon Choi, Jee-Soo Jang, Il-Tae Jang, Seong-Hoon Oh, Jae Eun Park, Sol Lee
BACKGROUND: Chronic spinal subdural hematomas are extremely rare with only 28 cases reported in the literature. Nevertheless, they should be considered among the differential diagnoses for spinal intradural/extramedullary lesions. CASE REPORT: A 65-year-old male presented with progressive back pain and right S1 radiculopathy. Magnetic resonance imaging scan revealed a right-sided posterolateral intradural/extramedullary lesion at the L5-S1 level. It was hyperintense on T1 and hypointense on T2-weighted images; on the short TI inversion recovery sequence it was hyperintense...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29025455/the-burden-of-gunshot-injuries-on-orthopaedic-healthcare-resources-in-south-africa
#11
Case Martin, Gerhard Thiart, Graham McCollum, Stephen Roche, Sithombo Maqungo
BACKGROUND: Injuries inflicted by gunshot wounds (GSWs) are an immense burden on the South African (SA) healthcare system. In 2005, Allard and Burch estimated SA state hospitals treated approximately 127 000 firearm victims annually and concluded that the cost of treating an abdominal GSW was approximately USD1 467 per patient. While the annual number of GSW injuries has decreased over the past decade, an estimated 54 870 firearm-related injuries occurred in SA in 2012. No study has estimated the burden of these GSWs from an orthopaedic perspective...
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29023275/proximal-radial-head-fractures-in-young-gymnasts-a-case-series-of-newly-described-overuse-injuries
#12
Jaron Santelli, Teri M McCambridge, Amy E Valasek, Kathleen Standiford
We report a case series of unilateral Salter-Harris IV fractures of the proximal radial heads in young female gymnasts. To date, there are no previous reports of such injuries in gymnastics. In all 3 athletes, no significant injury preceded presentation or diagnosis. Radiographs and magnetic resonance imaging showed fractures and associated bone marrow edema of the proximal radial head, respectively. All but 1 was treated nonoperatively with success. Given the lack of acute trauma, lack of large effusion, and good range of motion at presentation, these injuries are believed to be chronic in nature and related to overuse...
October 11, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29019874/injury-patterns-among-various-age-and-gender-groups-of-trauma-patients-in-southern-iran-a-cross-sectional-study
#13
Shahram Bolandparvaz, Mahnaz Yadollahi, Hamid Reza Abbasi, Mehrdad Anvar
Administrative data from trauma referral centers are useful sources while studying epidemiologic aspects of injuries. We aimed to provide a hospital-based view of injuries in Shiraz considering victims' age and gender, using administrative data from trauma research center.A cross-sectional registry-based study of adult trauma patients (age ≥15 years) sustaining injury through traffic accidents, violence, and unintentional incidents was conducted. Information was retrieved from 3 hospital administrative databases...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29019536/trauma-mechanism-predicts-the-frequency-and-the-severity-of-injuries-in-blunt-trauma-patients
#14
José Gustavo Parreira, Giovanna Zucchini Rondini, Cristiano Below, Giuliana Olivi Tanaka, Julia Nunes Pelluchi, Jacqueline Arantes-Perlingeiro, Silvia Cristine Soldá, José César Assef
OBJECTIVE: to study the correlation of trauma mechanism with frequency and severity of injuries in blunt trauma patients. METHODS: retrospective analysis of trauma registry in a 15-month period was carried out. Trauma mechanism was classified into six types: occupants of four-wheeled vehicles involved in road traffic accidents (AUTO), pedestrians struck by road vehicles (PED), motorcyclists involved in road traffic accidents (MOTO), falls from height (FALL), physical assault with blunt instruments (ASSA) and falls on same level (FSL)...
July 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29018173/a-pilot-study-of-surgical-telementoring-for-leg-fasciotomy
#15
Max Talbot, E J Harvey, G K Berry, R Reindl, H Tien, D J Stinner, G Slobogean
INTRODUCTION: Acute extremity compartment syndrome requires rapid decompression. In remote locations, distance, weather and logistics may delay the evacuation of patients with extremity trauma beyond the desired timeline for compartment release. The aim of this study was to establish the feasibility of performing telementored surgery for leg compartment release and to identify methodological issues relevant for future research. METHODS: Three anaethetists and one critical care physician were recruited as operators...
October 10, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29017862/emergency-repair-of-upper-extremity-large-soft-tissue-and-vascular-injuries-with-flow-through-anterolateral-thigh-free-flaps
#16
Yi Zhan, Guo Fu, Xiang Zhou, Bo He, Li-Wei Yan, Qing-Tang Zhu, Li-Qiang Gu, Xiao-Lin Liu, Jian Qi
BACKGROUND/OBJECTIVES: Complex extremity trauma commonly involves both soft tissue and vascular injuries. Traditional two-stage surgical repair may delay rehabilitation and functional recovery, as well as increase the risk of infections. We report a single-stage reconstructive surgical method that repairs soft tissue defects and vascular injuries with flow-through free flaps to improve functional outcomes. METHODS: Between March 2010 and December 2016 in our hospital, 5 patients with severe upper extremity trauma received single-stage reconstructive surgery, in which a flow-through anterolateral thigh free flap was applied to repair soft tissue defects and vascular injuries simultaneously...
October 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28994317/isolated-cervical-anterior-spinal-artery-aneurysm-case-report
#17
Yam Bahadur Roka
Isolated cervical anterior spinal artery (CASA) aneurysms are extremely rare with most of them mostly associated with arteriovenous malformation. The underlying pathology is not known but some factors leading to the aneurysm are inflammatory, infection and connective tissue disorders. Trauma with formation of pseudoaneurysm has also been reported. We report a case which presented with fourth ventricle bleed and was managed successfully with conservative treatment.
October 10, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28990694/suprafascial-versus-traditional-harvesting-technique-for-free-antero-lateral-thigh-flap-a-case-control-study-to-assess-the-best-functional-and-aesthetic-result-in-extremity-reconstruction
#18
Michele Maruccia, Nefer Fallico, Emanuele Cigna, Pedro Ciudad, Fabio Nicoli, Emilio Trignano, Eleonora Nacchiero, Giuseppe Giudice, Diego Ribuffo, Hung-Chi Chen
Clinical applications of ALT flap have currently extended to extremity (hand and foot) as well as oral cavity reconstruction. In these anatomical areas, the traditional harvesting technique presents a few disadvantages such as bulkiness of the recipient site and potential donor site morbidity including damage to the deep fascia and skin graft adhesions. The purpose of the present study was to compare the functional and aesthetic outcomes of upper and lower extremity reconstruction with either suprafascial or subfascial harvested anterolateral (ALT) flaps...
October 9, 2017: Microsurgery
https://www.readbyqxmd.com/read/28987901/quality-of-relationships-with-caregivers-depression-and-life-satisfaction-after-dysvascular-lower-extremity-amputation
#19
Moriah J Brier, Rhonda M Williams, Aaron P Turner, Alison W Henderson, Ann Marie Roepke, Daniel C Norvell, Helene Henson, Joseph M Czerniecki
OBJECTIVE: To describe the relationship between caregiver-specific support and conflict, and psychosocial outcomes among individuals experiencing their first lower extremity amputation (LEA). We hypothesized that caregiver-specific support would be associated with lower levels of depressive symptoms and higher levels of life satisfaction, and that caregiver-specific conflict would be associated with higher levels of depressive symptoms and lower levels of life satisfaction. DESIGN: Cross-sectional cohort study using self-report surveys...
October 5, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28985633/role-of-negative-pressure-therapy-as-damage-control-in-soft-tissue-reconstruction-for-open-tibial-fractures
#20
Mario Cherubino, Luigi Valdatta, Pierluigi Tos, Salvatore D'Arpa, Luigi Troisi, Pellegatta Igor, Federica Corradi, Umraz Khan
The concept of damage control orthopaedics (DCO) is a strategy that focuses on managing orthopaedic injuries in polytrauma patients who are in an unstable physiological state. The concept of DCO is an extension of damage control surgery or damage limitation surgery (DCS/DLS). Recently, it has become clear that certain patients, following extensive soft tissue trauma, could benefit from the idea of DCS. In the management of severe lower extremity trauma with exposed fracture sites, aggressive early wound excision debridement, early internal fixation, and vascularized wound coverage within a few days after trauma were proposed...
October 2017: Journal of Reconstructive Microsurgery
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