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Extremity trauma

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https://www.readbyqxmd.com/read/29453979/toward-a-meaningful-definition-of-recovery-after-hip-fracture-comparing-two-definitions-for-community-dwelling-older-adults
#1
Mohammad Auais, Suzanne N Morin, Lois Finch, Sara Ahmed, Nancy Mayo
OBJECTIVES: To examine the course of recovery and resulting health-related quality of life (HRQL) after low-trauma hip fracture using two different definitions of recovery. DESIGN: Inception cohort with eight assessments over one year. SETTING: Participants were recruited from a tertiary-care hospital and followed in the community. INTERVENTION: Not applicable PARTICIPANTS: 47 (75% of all eligible) community-dwelling hip fracture patients (≥65 years)...
February 14, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29451657/malignant-fibrous-histiocytoma-in-a-patient-presenting-with-urinary-system-symptoms
#2
Mustafa Resorlu, Ozan Karatag, Fatma Uysal, Muhsin Ozturk
Malignant fibrous histiocytoma is a rare tumor. It is most commonly seen in individuals between the fifth and seventh decades of life, in extremities, and less frequently in the retroperitoneum. Although its etiology is not clearly known, radiotherapy, chemical agents, previous history of surgery, trauma and fracture, and Hodgkin lymphoma have been blamed. Leiomyosarcoma, liposarcoma and rhabdomyosarcoma should be taken into account in differential diagnosis. It is seen on computed tomography as a mass lesion with irregular borders and density similar to that of the surrounding muscle tissue...
November 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/29447384/antimicrobial-prophylaxis-with-combat-related-open-soft-tissue-injuries
#3
Bradley A Lloyd, Clinton K Murray, Faraz Shaikh, M Leigh Carson, Dana M Blyth, Elizabeth R Schnaubelt, Timothy J Whitman, David R Tribble
Introduction: All Department of Defense (DoD) guidance documents recommend cefazolin or clindamycin as post-trauma antibiotic prophylaxis for open soft-tissue injuries. Although not advocated, some patients with open soft-tissue injuries also received expanded Gram-negative coverage (EGN) prophylaxis based on the judgment of front-line trauma providers. During the study period, revised guidelines in 2011/2012 re-emphasized recommendations for using cefazolin or clindamycin, and stewardship efforts in the DoD trauma community aimed to reduce the practice of adding EGN to guideline-recommended antibiotic prophylaxis...
February 13, 2018: Military Medicine
https://www.readbyqxmd.com/read/29443860/a-novel-rat-model-of-extremity-trauma-for-pre-hospital-pain-management-research
#4
Lusha Xiang, Harold G Klemcke, Nathan A Wienandt, Kathy L Ryan, Carmen Hinojosa-Laborde
BACKGROUND: Pain management is important in pre-hospital care of patients with extremity trauma (ET). The goal of this study was to establish a rat model of ET for pre-hospital pain research, and validate it using pain behaviors and analgesics. METHODS: Rats were anesthetized using isoflurane and ET was induced in one hindlimb via clamping retrofemoral tissues for 30 sec, followed by closed fibula fracture. Rats regained consciousness after ET. Pain responses in the injured hindlimb to thermal hyperalgesia (paw withdrawal latency, PWL), mechanical allodynia (paw withdrawal pressure, PWP), and weight bearing (WB) were determined before and 90 minutes after ET...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29443814/danger-signals-in-the-icu
#5
Edward J Schenck, Kevin C Ma, Santosh B Murthy, Augustine M K Choi
OBJECTIVES: Sterile and infectious critical illnesses often result in vasoplegic shock and a robust systemic inflammatory response that are similar in presentation. The innate immune system is at the center of the response to both infectious and traumatic insults. Damage-associated molecular patterns are small molecules that are released from stressed or dying cells. Damage-associated molecular patterns activate pattern recognition receptors and coordinate the leading edge of the innate immune response...
February 13, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29440243/spontaneous-pneumomediastinum
#6
Shilpa Ojha, Julian Gaskin
Spontaneous pneumomediastinum is the presence of free air within the mediastinum that is not associated with trauma. It is a rare, self-limiting condition that can cause widespread subcutaneous surgical emphysema. We present the case of a 12-year-old boy who presented with widespread spontaneous surgical emphysema and pneumomediastinum, with no history of trauma or respiratory tract disease. We discuss our assessment of him and management with our multidisciplinary team (MDT), and whether radiological investigations including CT are helpful in such cases...
February 11, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29435220/after-a-punch-recurrence-of-compartment-syndrome-following-minor-trauma
#7
Stanislav Ryndin, Andrew Delozier, Michael Stanley
Acute compartment syndrome (ACS) is a diagnosis that requires high-clinical suspicion especially in cases when the initial causal event could be considered insignificant. We present a novel case presentation of ACS associated with minor trauma in a patient with a previous history of compartment syndrome in the same extremity from a motor vehicle accident 10 years prior to presentation. To the best of our knowledge, this is the first reported case of recurrent ACS. Due to the possibility of significant morbidity, including loss of limb, it is imperative to recognize the presentation quickly so proper surgical intervention can occur...
February 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29433408/blunt-injury-of-the-innominate-artery-what-surprises-to-expect-a-case-report
#8
Marina Dias-Neto, José F Ramos, José F Teixeira
Injuries of the supra-aortic trunk after blunt chest trauma are rare. This is a case report of a blunt traumatic lesion of the innominate artery (IA) origin that exhibited aortic arch involvement with a focus on imaging and treatment. A 41-year-old fisherman presented an IA injury secondary to a high-impact blunt chest trauma. Upon physical examination, vital signs were stable and upper extremity pulses were present. In addition to several bone fractures (costal ribs, clavicle, scapula, temporal, maxillary, and sphenoid), computed tomography angiography revealed dissection/pseudoaneurysm of the IA sparing the bifurcation...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29432043/prehospital-application-of-hemostatic-agents-in-iraq-and-afghanistan
#9
Steven G Schauer, Michael D April, Jason F Naylor, Joseph K Maddry, Allyson A Arana, Michael A Dubick, Andrew D Fisher, Cord W Cunningham, Anthony E Pusateri
INTRODUCTION: Hemorrhage is the leading cause of death on the battlefield. Development of chitosan- and kaolin-based hemostatic agents has improved hemorrhage control options. Sparse data exists on the use of these agents in the prehospital, combat setting. We describe recent use of these agents and compare patients receiving hemostatic to the baseline population. METHODS: We used a series of emergency department (ED) procedure codes to identify patients within the Department of Defense Trauma Registry (DODTR) from January 2007 to August 2016...
February 12, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29430148/prosthetic-rehabilitation-of-a-partially-amputated-finger-using-a-customized-ring-wire-substructure
#10
Siddharth Mehta, B Leela, Abha Karanjkar, Arpit J Halani
Defects of fingers or hands due to congenital reasons or trauma can be a catastrophic setback to an individual physically, emotionally, and psychologically. An artificial finger prosthesis is a lucrative option to camouflage such defects. The anatomy of the residual stump of the defect is of extreme importance and will dictate the mode of retention to be used, and the level of esthetics one can expect. Despite the availability of the advanced skills, best of materials, and laboratory support, sometimes, the anatomy of the defect may be a hindrance in furnishing a better prosthesis...
January 2018: Journal of Indian Prosthodontic Society
https://www.readbyqxmd.com/read/29429577/epidemiology-of-distal-radius-fractures-in-polytrauma-patients-and-the-influence-of-high-traumatic-energy-transfer
#11
Steven Ferree, Quirine M J van der Vliet, Femke Nawijn, Abhiram R Bhashyam, Roderick M Houwert, Luke P H Leenen, Falco Hietbrink
INTRODUCTION: For several extremity fractures differences in morphology, incidence rate and functional outcome were found when polytrauma patients were compared to patients with an isolated injury. This is not proven for distal radius fractures (DRF). Therefore, this study aimed to analyse fracture morphology in relation to energy transfer in both poly- and mono-trauma patients with a DRF. METHODS: This was a retrospective cohort study. All patients aged 16 years and older with a DRF were included...
February 5, 2018: Injury
https://www.readbyqxmd.com/read/29429478/-femur-shaft-fractures-in-infants-should-be-considered-despite-no-known-trauma
#12
Ahmed Abdul-Hussein Abood, Jens Svendsson, Søren Harvig
Femur shaft fractures in infants are rare and associated with abuse or fall from heights. The fracture is often easy to recognize on X-ray, however, the determination of the indication can be difficult. It is important to pay attention to pain signals from the extremity and the objective findings, such as a swollen and tight thigh. Early recognition of the fracture is of importance to the prognosis and to detection of possible violence resulting in battered child syndrome. Exploration for injuries of the extremities is of utmost necessity in these cases, despite the absence of trauma in the anamnesis...
February 5, 2018: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29428539/vascular-trauma-in-children-review-from-a-major-paediatric-centre
#13
REVIEW
Sofia Morão, Rita S Ferreira, Nelson Camacho, Vanda Pratas Vital, J Pascoal, M Emília Ferreira, L Mota Capitão, Frederico B Gonçalves
INTRODUCTION: Traumatic non-iatrogenic vascular injuries in children are rare and rarely discussed in literature. Paediatric vascular injuries pose a set of challenges mainly because of continued growth and development in a child or adolescent. The purpose of the study is to characterize management strategies and outcomes in these cases. PATIENTS AND METHODS: Single-centre retrospective review of patients less than age 18 years (paediatric age) with acute, non-iatrogenic traumatic vascular injuries between January 2009 and December 2015...
February 8, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29428042/extremity-vascular-injury-management-good-outcomes-using-selective-referral-to-vascular-surgeons
#14
Shabnam Hafiz, Elizabeth A Zubowicz, Chadi Abouassaly, John J Ricotta, Jack A Sava
Revascularization after extremity vascular injury has long been considered an important skill among trauma surgeons. Increasingly, some trauma surgeons defer vascular repair in response to training or practice patterns. This study was designed to document results of extremity revascularization surgery to evaluate trauma surgeon outcomes and judicious referral of more complex injuries to vascular surgeons (VAS). The trauma registry of an urban level I trauma center was used to identify all patients from 2003 to 2013 who underwent an early (<24 hours) procedure for urgent management of acute injury to extremity vessels...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29427094/hemicorporectomy-as-a-life-saving-strategy-for-severe-pelvic-ring-crush-injury-a-case-report
#15
REVIEW
Salin Pereira Warr, Paula M Jaramillo, Sebastian Tobon Franco, Carlos Oliver Valderrama-Molina, Alfredo Constain Franco
Hemicorporectomy is an ultra-radical surgery used only in extreme circumstances. Initially used for advanced pelvic neoplastic diseases and intractable pelvic infection, it may also be the only treatment option in patients with crushed pelvic trauma, in cases there are no reconstruction options. This procedure has a high mortality, and its success depends on the multidisciplinary approach, both in the initial phase and in the rehabilitation process. We present the case of a young patient with severe pelvic trauma that required a hemicorporectomy as the only treatment option and review of the literature...
February 10, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29420771/genitourinary-injuries-among-female-u-s-service-members-during-operation-iraqi-freedom-and-operation-enduring-freedom-findings-from-the-trauma-outcomes-and-urogenital-health-tough-project
#16
Amy M Reed, Judson C Janak, Jean A Orman, Steven J Hudak
Introduction: Until recently, female U.S. service members (SMs) have not been permitted to serve in direct combat roles. However, during Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), a large number of female SMs have been wounded while serving in combat support roles. This included an unprecedented number of women with genitourinary (GU) injuries. No previous studies have reported either the incidence or clinical picture of these injuries. The objective of this study is to describe the epidemiology of GU injuries among female U...
February 6, 2018: Military Medicine
https://www.readbyqxmd.com/read/29417348/perioperative-management-of-external-fixation-in-staged-protocols-an-international-survey
#17
Sandro Hodel, Björn-Christian Link, Reto Babst, W H Mallee, Philippe Posso, Frank J P Beeres
INTRODUCTION: Despite the frequent use of external fixation, various regimes of antibiotic prophylaxis, surgical technique and postoperative pin care exist and underline the lack of current evidence. The aim of the study was to assess the variability or consensus in perioperative protocols to prevent implant-associated infections for temporary external fixation in closed fractures of the extremities. MATERIALS AND METHODS: A 26-question survey was sent to 170 members of the Traumaplatform...
February 7, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29417181/analysis-of-quality-of-life-after-major-trauma-a-spanish-follow-up-cohort-study
#18
Heura Llaquet Bayo, Sandra Montmany, Pere Rebasa, Miriam Secanella, Marta Alberich, Salvador Navarro
PURPOSE: Study objectives are to determine whether quality of life is recovered completely after major injury and to identify determinants associated with a worse quality of life. METHODS: Prospective 12-month follow-up of injured patients admitted to the intensive care unit in a Spanish level 1 trauma centre. The main outcome (quality of life) was measured using the EQ-5D-5L. The relationships between sociodemographic factors, injury severity and location, and quality of life scores were evaluated...
February 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29415912/idiopathic-and-chronic-epidural-hematoma-in-the-lumbar-spine-a-case-report-and-review-of-literatures
#19
Toshiyuki Okazaki, Hiroshi Nakagawa, Hitoshi Hayase, Shinsuke Irie, Toru Inagaki, Osamu Saito, Motoshige Yamashina, Shinji Nagahiro, Koji Saito
Spontaneous and chronic epidural hematoma (SSEH) in the lumbar spine is rare, and idiopathic and chronic SSEH in the lumbar spine is extremely rare disease. Most of lumbar SSEH were acute and secondary with trauma, hematologic disorders, drug, and surgical procedure. Only 20 cases of chronic SSEH in the lumbar spine have been reported and 14 cases among them were considered to be idiopathic. Definitive guidelines for management of this condition are not clear and surgical total evacuation was performed in most of the cases...
February 7, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29414502/intraorbital-hemorrhage-following-a-secondary-intervention-at-integrated-zygomatic-implants-a-case-report
#20
Philippe Van Camp, Luc Vrielinck, Bert Gemels, Constantinus Politis
INTRODUCTION: Zygomatic implant placement can be the best option for restoring masticatory function of an extremely atrophic upper jaw, but the procedure is more invasive than conventional implant placement and can be associated with complications. PRESENTATION OF CASE: We report a complication that occurred during a secondary corrective surgical procedure four years after zygomatic implant placement. The patient was a 54-year-old female who had been edentulous for 25 years...
January 29, 2018: International Journal of Surgery Case Reports
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