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Pelvic trauma

Jeremy S Juern, David Milia, Panna Codner, Marshall Beckman, Lewis Somberg, Travis Webb, John A Weigelt
INTRODUCTION: Blunt pelvic fractures can be associated with major pelvic bleeding. The significance of contrast extravasation (CE) on computed tomography (CT) is debated. We sought to update our experience with CE on CT scan for the years 2009-2014 to determine the accuracy of CE in predicting the need for angioembolization. METHODS: This is a retrospective review of the trauma registry and our electronic medical record from a Level I trauma center. Patients seen from July 1, 2009 to September 7, 2014 with blunt pelvic fractures and contrast enhanced CT were included...
October 25, 2016: Journal of Trauma and Acute Care Surgery
Michael V Friedman, J Derek Stensby, Jeremiah R Long, Stephen A Currie, Travis J Hillen
PURPOSE: Review the MRI appearance of different bursae located throughout the pelvis, including the pertinent osseous and musculotendinous anatomy. MATERIALS AND METHODS: Bursae are potential spaces that reduce friction between opposed moving components which can become inflamed, clinically mimicking internal derangement. RESULTS: This series illustrates the most common as well as lesser-known pelvic bursae. Common causes of bursitis including overuse, trauma, and infection are presented...
September 28, 2016: Clinical Imaging
P Michel, D Wähnert, M Freistühler, M G Laukoetter, S Rehberg, M J Raschke, P Garcia
BACKGROUND: Secondary abdominal compartment syndrome is well known as a life-threatening complication in critically ill patients in an intensive care unit. Massive crystalloid fluid resuscitation has been identified as the most important risk factor. The time interval from hospital admittance to the development of manifest abdominal compartment syndrome is usually greater than 24 hours. In the absence of any direct abdominal trauma, we observed a rapidly evolving secondary abdominal compartment syndrome shortly after hospital admittance associated with massive transfusion of blood products and only moderate crystalloid resuscitation...
October 19, 2016: Journal of Medical Case Reports
Kyle Lybrand, Anthony Bell, Deirdre Rodericks, David Templeman, Paul Tornetta
OBJECTIVE: To evaluate the influence of the symphyseal position at union, implant failure, and the type of posterior ring injury on validated outcome measures. DESIGN: Retrospective review with prospectively collected validated outcome data SETTING:: Two academic Level 1 trauma centersPatients/Participants: We evaluated 54 patients with operatively treated anterior-posterior compression (APC) type 2 and 3 injuries. INTERVENTION: Thirty-five APC type 2 and 19 APC type 3 injuries were reviewed at a minimum of 2 years after surgery...
October 7, 2016: Journal of Orthopaedic Trauma
Joel Wells, Jeffrey J Nepple, Karla Crook, James R Ross, Asheesh Bedi, Perry Schoenecker, John C Clohisy
BACKGROUND: Hip dysplasia represents a spectrum of complex deformities on both sides of the joint. Although many studies have described the acetabular side of the deformity, to our knowledge, little is known about the three-dimensional (3-D) head and neck offset differences of the femora of dysplastic hips. A thorough knowledge of proximal femoral anatomy is important to prevent potential impingement and improve results after acetabular reorientation. QUESTIONS/PURPOSES: (1) Are there common proximal femoral characteristics in patients with symptomatic hip dysplasia undergoing periacetabular osteotomy (PAO)? (2) Where is the location of maximal femoral head and neck offset deformity in hip dysplasia? (3) Do certain subgroups of dysplastic hips more commonly have cam-type femoral morphology? (4) Is there a relationship between hip ROM as well as impingement testing and 3-D head and neck offset deformity? METHODS: Using our hip preservation database, 153 hips (148 patients) underwent PAO from October 2013 to July 2015...
October 17, 2016: Clinical Orthopaedics and related Research
Ong-Art Phruetthiphat, Michael Willey, Matthew D Karam, Yubo Gao, Brian O Westerlind, J Lawrence Marsh
OBJECTIVE: To compare patients with acetabular fractures that are isolated (acetabular fracture alone) and acetabular fracture presenting with additional non-acetabular injury using functional outcomes, complications, and readmissions. DESIGN: Retrospective review SETTING:: Level 1 Trauma CenterPatients/Participants: 215 patients underwent open surgical treatment for acetabular fracture between 2003 and 2012 with age ≥18 years and minimum one year follow-up inclusive of functional scores and complications...
October 5, 2016: Journal of Orthopaedic Trauma
Dae Wook Lee, Chang Hun Lim, Jae Young Han, Woong Mo Kim
Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report the case of a 54-year-old female patient with severe chronic pelvic pain after a transcutaneous electrical nerve stimulation (TENS) accident that was successfully managed with image-guided trigger point injections on several pelvic stabilizing muscles...
October 2016: Korean Journal of Pain
Zeynep Aslı Kartal, Nalan Kozacı, Bülent Çekiç, İnan Beydilli, Mehmet Akçimen, Dilek Soydam Güven, İclal Erdem Toslak
OBJECTIVE: In this study, emergency physicians and on-call radiologists were compared regarding identification of fatal injuries on computed tomographic (CT) scans in patients with trauma. MATERIALS AND METHODS: Multiply injured patients who were older than 18 years and underwent CT scanning were included in the study. The CT scans were interpreted by the responsible emergency physician. At the same time, these images were also evaluated by the on-call radiologist...
August 24, 2016: American Journal of Emergency Medicine
Sei Yano, Yasuchika Aoki, Atsuya Watanabe, Takayuki Nakajima, Makoto Takazawa, Hiroyuki Hirasawa, Kazuhisa Takahashi, Koichi Nakagawa, Arata Nakajima, Hiroshi Takahashi, Sumihisa Orita, Yawara Eguchi, Takane Suzuki, Seiji Ohtori
Pelvic ring fractures are defined as life-threatening injuries that can be treated surgically with external or internal fixation. The authors report on an 81-year-old woman with an unstable pelvic fracture accompanying multiple traumas that was successfully treated with a less invasive procedure. The patient was injured in a traffic accident and sustained a total of 20 fractures, including pelvic ring, bilateral rib, and lumbar transverse processes fractures, and multiple fractures of both upper and lower extremities...
October 7, 2016: Journal of Neurosurgery. Spine
Peng Yang, Di Du, Zhibin Zhou, Nan Lu, Qiang Fu, Jun Ma, Liangyu Zhao, Aimin Chen
INTRODUCTION: Osteotomy and internal fixation are usually the most effective way to treat the malunion of lateral tibial plateau fractures, and the accuracy of the osteotomy is still a challenge for surgeons. This is a report of a series of prospectively study of osteotomy treatment for the malunion of lateral plateau fractures with the aid of 3D printing technology. METHODS: A total of 7 patients with malunion of lateral tibial plateau fractures were enrolled in the study between September 2012 to September 2014 and completed follow up...
September 12, 2016: Injury
D Tchin, W Atsi, T Hodabalo Tchaa, Kpelao Essossinam, J Yaovii Edèm, K Koffi Amégbor, N-K Gado
We collected 190 forensic records from the only pathology laboratory in Lomé, over the period from January 2010 to December 2014. The sex ratio (M/F) was 4.4 and the decedents' average age 33.4 years. In 43.2% of cases, the accident resulted from a collision between a pedestrian and a motorcycle; excess speed noted in 56.8% of cases. Four principal groups of fatal injuries were observed: polytrauma (136 cases), isolated severe head injury (49 cases), isolated thoracic contusion (3 cases), and abdominal pelvic contusion with perinea trauma (2 cases)...
August 1, 2016: Médecine et Santé Tropicales
Charles A Karcutskie, Jonathan P Meizoso, Juliet J Ray, Davis Horkan, Xiomara D Ruiz, Carl I Schulman, Nicholas Namias, Kenneth G Proctor
Importance: To date, no study has assessed whether the risk of venous thromboembolism (VTE) varies with blunt or penetrating trauma. Objective: To test whether the mechanism of injury alters risk of VTE after trauma. Design, Setting, and Participants: A retrospective database review was conducted of adults admitted to the intensive care unit of an American College of Surgeons-verified level I trauma center between August 1, 2011, and January 1, 2015, with blunt or penetrating injuries...
September 28, 2016: JAMA Surgery
David Dreizin, Jason Nascone, Derik L Davis, Daniel Mascarenhas, Nikki Tirada, Haoxing Chen, Uttam K Bodanapally
OBJECTIVE: Pelvic binders may hinder radiologic assessment of pelvic instability after trauma, and avulsive injuries can potentially unmask instability in this setting. We compare the performance of MDCT for the detection of pelvic disruptions in patients with binders to a matched cohort without binders, and we assess the utility of avulsive injuries as signs of pelvic instability. MATERIALS AND METHODS: MDCT examinations of 56 patients with binders were compared with MDCT examinations of 54 patients without binders...
September 28, 2016: AJR. American Journal of Roentgenology
Flávia L Osório, Ana Carolina F Carvalho, Mariana F Donadon, André L Moreno, Omero Polli-Neto
AIM: To compare the prevalence of psychiatric disorders and early emotional traumas between women with chronic pelvic pain (CPP) and healthy women. METHODS: One hundred women in reproductive age, 50 of them had CPP (according to the criteria set by the International Association for Study of Pain), and 50 were considered healthy after the gynecological evaluation. The eligibility criteria were defined as follows: chronic or persistent pain perceived in the pelvis-related structures (digestive, urinary, genital, myofascial or neurological systems)...
September 22, 2016: World Journal of Psychiatry
Jacob D Gire, Michael J Gardner, Alex H S Harris, Julius A Bishop
PURPOSE: There has recently been an increase in the number of fellowship trained orthopaedic trauma surgeons, raising concerns that the surgical experience of early career surgeons may be diluted. We sought to evaluate the change in complex trauma case volume of orthopaedic trauma surgeons sitting for Part II of the American Board of Orthopaedic Surgeons certification examination. METHODS: The case log data from all surgeons taking Part II of the American Board of Orthopaedic Surgeons examination over a 13-year period (2003-2015) was evaluated...
October 2016: Journal of Orthopaedic Trauma
Michael J Beltran, Tyson E Becker, Richard K Hurley, Jennifer M Gurney, Roman A Hayda
Hemorrhage continues to be the most common cause of death among service members wounded in combat. Injuries that were previously nonsurvivable in previous wars are now routinely seen by combat surgeons in forward surgical units, the result of improvements in body armor, the universal use of field tourniquets to control extremity hemorrhage at the point of injury, and rapid air evacuation strategies. Combat orthopaedic surgeons remain a vital aspect of the forward surgical unit, tasked with assisting general surgical colleagues in the resuscitation of patients in hemorrhagic shock while also addressing traumatic amputations, open and closed long bone fractures, and mechanically unstable pelvic trauma...
October 2016: Journal of Orthopaedic Trauma
Scott M Sandilands, Brandon L Raudenbush, Dominic S Carreira, Brian J Cross
Femoroacetabular impingements (FAIs), specifically cam type and pincer type, continue to be accepted as causes of intra-articular hip pathology and sources of hip pain. Reports of other causes of hip impingement including extra-articular causes have surfaced recently. One structure of importance is the anterior inferior iliac spine (AIIS) due to its inconsistent bony morphology and the pull of the rectus femoris muscle putting it at risk for an avulsion fracture. Under certain circumstances, open surgical excision of exostosis formation after an avulsion fracture of the AIIS has been used...
2016: BMJ Case Reports
James E Leone, Steve Middleton
OBJECTIVE:  To discuss the case of a 49-year-old man who presented to the sports medicine staff with pelvic pain of 10 years' duration consistent with pudendal neuralgia. BACKGROUND:  Testicular pain in men is often provoked by direct trauma or may indicate an oncologic process. DIFFERENTIAL DIAGNOSIS:  Epididymitis, athletic pubalgia, testicular tumor, sacroiliac joint dysfunction, lumbar radiculopathy. TREATMENT:  The patient responded positively to treatment and rehabilitation to restore normal mechanics to the lumbo-pelvic-hip complex...
September 14, 2016: Journal of Athletic Training
Alessio Comai, Marianna Zatelli, Thomas Haglmuller, Giampietro Bonatti
PURPOSE: The most common life-threatening complication of pelvic trauma is bleeding. Arterial bleedings frequently require active management, preferably with transcatheter arterial embolization (TAE). Hemodynamic instability and/or contrast extravasation at computer tomography (CT) examination are reliable indicators of arterial injury. Unstable pelvic fractures are much more hemorrhagic than stable fractures. Nevertheless, an absent or isolated pelvic fracture does not exclude pelvic hemorrhage...
2016: Curēus
S E van Oostendorp, E C T H Tan, L M G Geeraedts
INTRODUCTION: Exsanguination following trauma is potentially preventable. Extremity tourniquets have been successfully implemented in military and civilian prehospital care. Prehospital control of bleeding from the torso and junctional area's remains challenging but offers a great potential to improve survival rates. This review aims to provide an overview of potential treatment options in both clinical as preclinical state of research on truncal and junctional bleeding. Since many options have been developed for application in the military primarily, translation to the civilian situation is discussed...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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