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Extremity trauma

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https://www.readbyqxmd.com/read/28650356/trending-fibrinolytic-dysregulation-fibrinolysis-shutdown-in-the-days-after-injury-is-associated-with-poor-outcome-in-severely-injured-children
#1
Christine M Leeper, Matthew D Neal, Christine J McKenna, Barbara A Gaines
OBJECTIVE: To trend fibrinolysis after injury and determine the influence of traumatic brain injury (TBI) and massive transfusion on fibrinolysis status. BACKGROUND: Admission fibrinolytic derangement is common in injured children and adults, and is associated with poor outcome. No studies examine fibrinolysis days after injury. METHODS: Prospective study of severely injured children at a level 1 pediatric trauma center. Rapid thromboelastography was obtained on admission and daily for up to 7 days...
July 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28648330/experience-with-patient-referrals-for-upper-extremity-transplantation-at-a-u-s-academic-medical-center
#2
Harriet Kiwanuka, Mario A Aycart, Ericka M Bueno, Bohdan Pomahac, Simon G Talbot
PURPOSE: To date, there have been over 100 upper extremity transplantations (UET) performed worldwide. However, little data are available regarding institutional screening practices or description of the population of patients that seek transplantation as a treatment modality for their upper extremity disabilities. We performed a review of our institutional experience in an attempt to better understand our referral patterns and identify factors that may be associated with successful screening...
June 22, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28647656/delayed-retroclival-and-cervical-spinal-subdural-hematoma-complicated-by-pre-existing-chiari-malformation-in-an-adult-trauma-patient
#3
Ha Nguyen, Hoon Choi, Shekar Kurpad, Hesham Soliman
INTRODUCTION: Traumatic spinal subdural hematoma involving the retroclival region and upper cervical spine is a rare pathology. To our knowledge, there have only been two prior cases in an adult trauma patient. We describe a patient with pre-existing Chiari 1 malformation, who recently sustained a unilateral Type 1 OCF (occipital condyle fracture) with associated disruption of the tectorial membrane and transverse ligament, that returned with a retroclival subdural hematoma extending down to C7, causing spinal cord compression and symptomatic obstructive hydrocephalus...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28647095/increased-detection-of-blunt-carotid-and-vertebral-artery-injury-after-implementation-of-diagnostic-imaging-pathway-in-level-1-trauma-centre-in-western-australia
#4
Manimaran Sinnathamby, Sudhakar V Rao, Dieter G Weber
BACKGROUND: The incidence of Blunt Carotid Artery and Vertebral Artery Injury (BCVI) is relatively low in modern trauma practice. However, these injuries may be associated with severe neurological consequences. Following the introduction of a Diagnostic Imaging Pathway in Department of Health of Western Australia, we hypothesized that this injury would be less likely to be missed, and accordingly diagnosed more frequently. METHOD: A review of all major trauma (Injury Severity Scale>15) admissions at the State Major Trauma Centre in Royal Perth Hospital was undertaken from 1995 until 2013...
June 13, 2017: Injury
https://www.readbyqxmd.com/read/28645215/upper-extremity-trauma-resulting-from-agricultural-accidents-mechanism-and-severity-for-patients-with-and-without-upper-extremity-injury
#5
Louis C Grandizio, Benjamin Wagner, Jove Graham, Joel C Klena
BACKGROUND: Farming remains the most dangerous occupation in the United States and upper extremity (UE) injuries occur frequently in agricultural accidents. The purpose of this study is to describe the injury mechanisms, severity, and health care costs of UE injuries resulting from agricultural accidents and to compare patients with and without injuries to the UE. METHODS: We performed a 6-year retrospective review of our level I trauma center registry from January 2006 to May 2013, identifying all patients injured in an agricultural accident...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28640775/prevalence-of-non-accidental-trauma-among-children-at-acs-verified-pediatric-trauma-centers
#6
David D A Bogumil, Natalie E Demeter, Karen Imagawa, Jeffrey S Upperman, Rita V Burke
BACKGROUND: Child abuse remains a national epidemic that has detrimental effects if unnoticed in the clinical setting. Extreme cases of child abuse, or non-accidental trauma (NAT), have large financial burdens associated with them due to treatment costs and long-term effects of abuse. Clinicians that have additional training and experience with pediatric trauma are better equipped to detect signs of NAT and have more experience reporting it. This additional training and experience can be measured by using the American College of Surgeons (ACS) Pediatric Trauma Verification...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28640081/-direct-vision-operation-of-posterior-atlantoaxial-transpedicular-screw-fixation-for-unstable-atlantoaxial-fractures-a-retrospective-study
#7
Liangliang Cao, Erzhu Yang, Jianguang Xu, Xiaofeng Lian, Bin Cai, Xiaokang Liu, Guowang Zhang
BACKGROUND: The posterior screw fixation in atlas via posterior arch and lateral mass, also called C1 "pedicle" screw, combined with C2 pedicle screw fixiation has shown better biomechanical stability in unstable atlantoaxial fractures. However, its popularization has to fulfill the limitation imposed by anatomical characteristics. The aim of this study was to explore the manipulation, effect, and safety of the atlantoaxial transpedicular screw fixation under "direct vision" for the treatment of unstable atlantoaxial fracture...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639529/circular-external-fixation-and-cemented-pmma-spacers-for-the-treatment-of-complex-tibial-fractures-and-infected-nonunions-with-segmental-bone-loss
#8
Andries H van Niekerk, Franz F Birkholtz, Phillip de Lange, Kevin Tetsworth, Erik Hohmann
PURPOSE: The purpose of this study was to compare the outcome of combined circular external fixation and cemented polymethylmethacrylate (PMMA) spacer application between a cohort of patients with grade 3 open fractures and infected tibial nonunions and concomitant segmental bone loss. METHODS: The study was designed as a retrospective cohort study. All patients who were treated for complex tibial fractures or infected nonunions with segmental bone loss between 2009 and 2013 were included if they were aged between 16 years and 60 years, sustained acute traumatic grade 3 open tibial fractures, presented with infected nonunion, and were followed up for a minimum of 12 months...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28638493/tibialis-anterior-muscle-hernia-a-case-of-chronic-dull-pain-and-swelling-in-leg-diagnosed-by-dynamic-ultrasonography
#9
Navneet Sharma, Neeraj Kumar, Richa Verma, Anupam Jhobta
BACKGROUND: Symptomatic muscle hernias are not uncommon in the lower extremities and are a rare cause of chronic leg pain. They are most commonly seen in the tibialis anterior muscle, occurring through fascial defects, usually after trauma. There are about 200 cases of muscle hernias described in the literature. The diagnosis is challenging as most of the patients present with non-specific chronic leg pain. Dynamic muscle ultrasonography at rest and at stress is often used for the diagnosis...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28636733/idiopathic-pretracheal-deep-neck-space-infection-with-mediastinal-extension-a-series-of-3-cases-and-review-of-the-literature
#10
Samuel Roberts, Lyndon Chan, Robert Eisenberg
Idiopathic pretracheal deep neck space infection is an extremely rare condition with potentially devastating complications. We present a series of 3 cases of pretracheal deep neck space infection that arose in the absence of trauma or a congenital lesion and that exhibited mediastinal spread. To the best of our knowledge, these cases represent the first reported series of this rare condition to be published in the English-language literature. All cultures grew Streptococcus milleri, and all patients had a favorable outcome...
June 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28633796/cotton-osteotomy-in-flatfoot-reconstruction-a-case-report-highlighting-surgical-technique-and-modified-incision-to-protect-the%C3%A2-medial-dorsal-cutaneous-nerve
#11
Troy J Boffeli, Katherine R Schnell
The Cotton osteotomy or opening wedge medial cuneiform osteotomy is a useful adjunctive flatfoot reconstructive procedure that is rarely performed in isolation. The Cotton procedure is relatively quick to perform and effectively corrects forefoot varus deformity after rearfoot fusion or osteotomy to achieve a rectus forefoot to rearfoot relationship. Proper patient selection is critical, because preoperative findings of medial column joint instability, concomitant hallux valgus deformity, or degenerative joint disease of the medial column might be better treated with arthrodesis of the naviculocuneiform or first tarsometatarsal joints...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28632948/nodular-cutaneous-amyloidoma-of-the-extremity-secondary-to-chronic-granulomatous-inflammation-in-setting-of-sarcoidosis
#12
Victoria Billero, Audrey A Jacobsen, Mariya I Miteva, Adam J Wulkan, Claudio Marasca, Roanelli Paolo
Soft tissue amyloidoma is a rare condition that presents primarily in the abdomen and/or mediastinum and more uncommonly on the extremities(1) . Soft tissue amyloidomas on the extremities have been associated with chronic inflammation, particularly when accompanied by AA-type amyloid deposition as seen in local trauma, surgery, hypertension, and diabetes(2) . To our knowledge, this is the first reported case of nodular cutaneous amyloidoma in the setting of systemic and cutaneous sarcoidosis. A 65-year-old woman presented with an asymptomatic subcutaneous nodule above her left lateral malleolus...
June 20, 2017: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/28631272/a-unique-fatal-moose-attack-mimicking-homicide
#13
Petur Gudmannsson, Johan Berge, Henrik Druid, Göran Ericsson, Anders Eriksson
Fatalities caused by animal attacks are rare, but have the potential to mimic homicide. We present a case in which a moose attacked and killed a woman who was walking her dog in a forest. Autopsy showed widespread blunt trauma with a large laceration on one leg in which blades of grass were embedded. Flail chest was the cause of death. The case was initially conceived as homicide by means of a riding lawn mower. A review of the case by moose experts and analyses of biological trace material that proved to originate from moose, established the true source of injury...
June 20, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28630831/unusual-presentation-of-mycetoma-of-the-foot-a-rare-case-report
#14
Amit Grover, Prashanth Nagaraj, Vinay M Joseph, Daksh Gadi
INTRODUCTION: Mycetoma is a chronic granulomatous infection. It is caused by actinomycetes or fungi. It is common in tropical countries and males. Predisposing conditions include malnutrition, poor hygiene, history of trauma, wounds on barefeet, and systemic infections. Eumycotic mycetoma commonly involves lower extremities whereas actinomycosis affects the cervicofacial, thoracic, and abdominal regions. Mycetoma presents with a chronic indurated ulcerated plague with swelling and yellowish discharge of sulfur granules...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630829/are-we-justified-doing-salvage-or-amputation-procedure-based-on-mangled-extremity-severity-score-in-mangled-upper-extremity-injury
#15
R Siva Kumar, Prahalad Kumar Singhi, M Chidambaram
INTRODUCTION: Mangled upper limb injuries are at surge because of industrialization, modernization, and severe motor vehicle accidents. The utility of various scoring systems are meant for decision making in mangled lower limb injuries, and the same have been extrapolated for mangled upper limb injuries to make a decision of salvage or amputation for the lack of separate scoring system. MATERIALS AND METHODS: We applied mangled extremity severity score (MESS) and mangled extremity syndrome index (MESI) scoring systems to 10 cases of mangled upper limb injuries during the period of November 2010 to September 2012 presented at our tertiary trauma care center...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28621630/evaluation-of-surgical-treatment-for-neuropathic-pain-from-neuroma-in-patients-with-injured-peripheral-nerves
#16
Valérie Decrouy-Duruz, Thierry Christen, Wassim Raffoul
OBJECTIVE Chronic neuropathic pain after peripheral nerve injury is a major clinical problem. Its management is difficult, and therapeutic approaches vary and include oral medication, neurostimulation, and surgery. The aim of this study was to assess the adequacy of surgical nerve revision in a large series of patients with long-term follow-up. METHODS The authors reviewed the charts of 231 patients (335 nerve injuries) who experienced neuropathic pain after peripheral nerve injury and underwent surgery for nerve revision at the authors' institution between 1997 and 2012...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28619303/effect-of-light-pressure-stroking-massage-with-sesame-sesamum-indicum-l-oil-on-alleviating-acute-traumatic-limbs-pain-a-triple-blind-controlled-trial-in-emergency-department
#17
Morteza Nasiri, Zahra Farsi
OBJECTIVES: Due to adverse effects of common medications used for traumatic pain management, it is crucial to use complementary methods to alleviate this pain. Present study aimed to assess the effect of light pressure stroking massage with topical sesame oil on pain severity of patients with limbs trauma. METHODS: This triple-blinded randomized trial was conducted on 40 patients with upper or lower extremities trauma in emergency department of Busheher Amir Al-Momenian Hospital, Busheher, Iran, in 2015-2016...
June 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28615044/comparison-of-transportation-related-injury-mechanisms-and-outcome-of-young-road-users-and-adult-road-users-a-retrospective-analysis-on-24-373-patients-derived-from-the-traumaregister-dgu-%C3%A2
#18
Thomas Brockamp, Uli Schmucker, Rolf Lefering, Manuel Mutschler, Arne Driessen, Christian Probst, Bertil Bouillon, Paola Koenen
BACKGROUND: Most young people killed in road crashes are known as vulnerable road users. A combination of physical and developmental immaturity as well as inexperience increases the risk of road traffic accidents with a high injury severity rate. Understanding injury mechanism and pattern in a group of young road users may reduce morbidity and mortality. This study analyzes injury patterns and outcomes of young road users compared to adult road users. The comparison takes into account different transportation related injury mechanisms...
June 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28614146/the-effect-of-concomitant-elbow-injuries-on-the-outcomes-of-radial-head-arthroplasty-a-cohort-comparison
#19
Jason A Strelzow, George S Athwal, Joy C MacDermid, Ruby Grewal, Kenneth J Faber, Darren Drosdowech, Graham J W King
OBJECTIVES: To compare physical impairments and patient reported outcomes in patients following simple and complex elbow injuries who were treated with a radial head arthroplasty. DESIGN: Patients with isolated elbow trauma and no prior injury to the elbow were prospectively enrolled following radial head arthroplasty for an acute unreconstructable fracture. Injury patterns were classified as simple or complex based on the presence or absence of associated elbow fractures and/or dislocation...
May 31, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28611170/go-karting-injury-a-case-of-laryngeal-trauma
#20
Marina Brimioulle, Matthew King, Philippe Bowles, Nicholas Saunders
We report a case of accidental strangulation and crush injury to the anterior neck resulting in laryngeal trauma. This extremely uncommon mechanism of injury provides a safety warning regarding precautions with neck wear, and the unusual resulting injury represents an opportunity to review best practice in management of laryngeal trauma.
June 13, 2017: BMJ Case Reports
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