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Pelvic trauma

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https://www.readbyqxmd.com/read/27911067/-vascular-interventional-radiology-a-fundamental-procedure-for-the-management-of-paediatric-trauma
#1
E Bordón Cabrera, A Laín, R Gander, M Pérez Lafuente, I Díez Miranda, C G Fontecha, L Seidler, I Delgado, S Cañadas Palazón, J Lloret
INTRODUCTION: The management of active bleeding with haemodinamic lability in the paediatric trauma patient is difficult and generally leads to damage control surgery. Vascular Interventional Radiology (VIR) techniques are useful for the diagnosis as for the definitive treatment. AIM: The aim of our study was to describe our experience and evaluate effectiveness of VIR in the management of the paediatric trauma patient with active bleeding signs. METHODS: Retrospective analysis (2003-2014) of politraumatic patients who showed contrast blush on computed tomography and then treated by VIR techniques...
January 25, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27908816/blunt-traumatic-occlusion-of-the-common-iliac-artery-repaired-with-segmental-excision-and-internal-iliac-artery-patch-angioplasty
#2
Abid C Mogannam, Robert F Cubas, Ivan M Gutierrez, Juan A Astudillo, Ahmed M Abou-Zamzam
Common iliac artery (CIA) occlusion as a result of blunt trauma is rare and seldom reported. This has been associated with pelvic fractures and other great vessel lesions. Management options include endovascular covered stent placement, open anatomic repair with autogenous conduit, or open extra-anatomic repair with prosthetic material. We report the case of a middle-aged male with a right CIA injury secondary to blunt trauma who underwent a successful repair using an internal iliac artery (IIA) patch for injury to a 2 cm segment of CIA with peritoneal contamination...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27905350/evaluation-of-severity-score-in-patients-with-lower-limb-and-pelvic-fractures-injured-in-motor-vehicle-front-impact-collisions
#3
Mehmet Ata Gokalp, Yavuz Hekimoglu, Abdurrahim Gozen, Savas Guner, Mahmut Asirdizer
BACKGROUND Lower limb and pelvic injuries and fractures occur at a very high incidence in motor vehicle accidents. In this study, the characteristics (e.g., body side, bone location, and fracture severity) of lower limb and pelvic fractures that occurred during front-impact collisions were correlated with the injured patients' sex, age, and position in the vehicle. MATERIAL AND METHODS We retrospectively evaluated 191 patients (136 males, 55 females) who were injured in motor vehicle accidents, specifically in frontal collisions...
December 1, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27905184/lower-urinary-tract-imaging-in-pelvic-fracture-an-11-year-review-of-genitourinary-complications-and-clinical-outcomes
#4
Wilson Choi, Handoo Rhee, Eric Chung
BACKGROUND: Diagnostic cysto-urethrogram (CUG) is accepted as the standard of imaging for lower urinary tract (LUT) injuries in patients with pelvic fracture. This study evaluates the prevalence of LUT trauma and adequacy of diagnostic CUG in the initial assessment of patients with pelvic fractures. METHODS: A retrospective review on all patients admitted with pelvic trauma between 2002 and 2012 was undertaken following ethics approval. Patient demographics such as pelvic fracture pattern, genitourinary injury, diagnostic imaging tests and clinical outcomes were reviewed...
December 1, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27904220/pfna-ii-protrusion-over-the-greater-trochanter-in-the-asian-population-used-in-proximal-femoral-fractures
#5
Sun-Jun Hu, Shi-Min Chang, Zhuo Ma, Shou-Chao Du, Liang-Ping Xiong, Xin Wang
BACKGROUND: The treatment of proximal femoral fractures in geriatric osteoporotic patients continues to be a challenge in orthopaedic trauma. Various kinds of cephalomedullary nails, such as gamma nail, InterTan and PFNA were used clinically. The latest generation PFNA II, specially designed for Asian population, is commonly used for geriatric per-/intertrochanteric fractures. The aim of this study was to determine whether the current PFNA-II proximal segment length is suitable for the greater trochanter height, as assessed by postoperative radiograph measurements...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27899124/outcomes-after-helicopter-versus-ground-emergency-medical-services-for-major-trauma-propensity-score-and-instrumental-variable-analyses-a-retrospective-nationwide-cohort-study
#6
Asuka Tsuchiya, Yusuke Tsutsumi, Hideo Yasunaga
BACKGROUND: Because of a lack of randomized controlled trials and the methodological weakness of currently available observational studies, the benefits of helicopter emergency medical services (HEMS) over ground emergency medical services (GEMS) for major trauma patients remain uncertain. The aim of this retrospective nationwide cohort study was to compare the mortality of adults with serious traumatic injuries who were transported by HEMS and GEMS, and to analyze the effects of HEMS in various subpopulations...
November 29, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27894498/noncompressible-torso-hemorrhage
#7
REVIEW
Jonathan J Morrison
Noncompressible torso hemorrhage (NCTH) constitutes a leading cause of potentially preventable trauma mortality. NCTH is defined by high-grade injury present in one or more of the following anatomic domains: pulmonary, solid abdominal organ, major vascular or pelvic trauma; plus hemodynamic instability or the need for immediate hemorrhage control. Rapid operative management, as part of a damage control resuscitation strategy, remains the mainstay of treatment. However, endovascular techniques are evolving and may become more mainstream with the advent of hybrid rooms that can deliver concurrent open and radiologic/endovascular management of traumatic hemorrhage...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27891547/severe-pelvic-injury-vascular-lesions-detected-by-ante-and-post-mortem-contrast-medium-enhanced-ct-and-associations-with-pelvic-fractures
#8
Mahmoud Hussami, Silke Grabherr, Reto A Meuli, Sabine Schmidt
OBJECTIVES: The objectives of this study were to compare arterial and venous contrast medium extravasation in severe pelvic injury detected by ante- and post-mortem multi-detector CT (MDCT) and determine whether vascular injury is associated with certain types of pelvic fracture. METHODS: We retrospectively included two different cohorts of blunt pelvic trauma with contrast medium extravasation shown by MDCT. The first group comprised 49 polytrauma patients; the second included 45 dead bodies undergoing multi-phase post-mortem CT-angiography (MPMCTA)...
November 28, 2016: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/27891285/complex-perineal-trauma-with-anorectal-avulsion
#9
Adelina Maria Cruceru, Ionut Negoi, Sorin Paun, Sorin Hostiuc, Ruxandra Irina Negoi, Mircea Beuran
Introduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock. Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture and massive perineal soft tissue destruction and anorectal avulsion. On arrival, the systolic blood pressure was 85 mm Hg and the hemoglobin was 7.1 g/dL. The patient was transported to the operating room, and perineal lavage, hemostasis, and repacking were performed...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27878132/ruptured-cystic-mesothelioma-diagnosed-after-blunt-trauma-case-report-and-literature-review
#10
Francisco Igor B Macedo, Alice J Race, Laszlo M Hoesel
The majority of blunt trauma is secondary to motor vehicle crashes,especially in those wearing seatbelts or sitting in the front or passenger seat location.Hollow viscus gastrointestinal injuries occur more frequently in small bowel, followed by colorectal, duodenum, stomach and appendix. A 25-year-old male presents after being involved in a motor vehicle accident. Initialworkup was significant for moderate amount of pelvic free fluid and curvilinear,cysticlike structures in the pelvis. He subsequently developed peritonitis and underwentdiagnostic laparoscopy, which revealed multiple cystic nodules arising from theperitoneum...
October 2016: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/27875491/assessing-the-efficacy-of-prothrombin-complex-concentrate-in-multiply-injured-patients-with-high-energy-pelvic-and-extremity-fractures
#11
Bellal Joseph, Mazhar Khalil, Caitlyn Harrison, Tianyi Swartz, Narong Kulvatunyou, Ansab A Haider, Tahereh O Jokar, David Burk, Ali Mahmoud, Rifat Latifi, Peter Rhee
OBJECTIVES: Prothrombin complex concentrate (PCC) is being increasingly used for reversing induced coagulopathy of trauma. However, the use of PCC for reversing coagulopathy in multiply injured patients with pelvic and/or lower extremity fractures remains unclear. The aim of our study was to assess the efficacy of PCC for reversing coagulopathy in this group of patients. DESIGN: Two-year retrospective analysis. SETTING: Our level I trauma center...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27865518/impact-of-surgical-correction-of-a-u-shaped-sacral-fracture-on-sagittal-spino-pelvic-alignment-regarding-one-case
#12
N Mansouri, T Graillon, K Farah, S Pesenti, B Blondel, S Fuentes
U-shaped sacral fractures are uncommon and are mostly the consequence of a high-energy kinetic trauma. The sacrum is a crucial element for sagittal alignment in a standing position as it determines the value of the pelvic incidence, which is a fixed and unchanging parameter for a given individual. We report the case of a 21-year-old man who underwent corrective surgery for a type II U-shaped fracture of the sacrum (according to the Roy-Camille classification), associated with a S1-S2 dislocation and sacral kyphosis that modified the patient's pelvic incidence...
December 2016: Neuro-Chirurgie
https://www.readbyqxmd.com/read/27863917/pelvic-fracture-in-multiple-trauma-a-67-case-series
#13
M Caillot, E Hammad, M Le Baron, V Villes, M Leone, X Flecher
INTRODUCTION: Severe pelvic trauma remains associated with elevated mortality, largely due to hemorrhagic shock. OBJECTIVE: The main study objective was to test for correlation between fracture type and mortality. The secondary objective was to assess the efficacy in terms of mortality of multidisciplinary management following a decision-tree in multiple trauma victims admitted to a level 1 trauma center. MATERIAL AND METHODS: Between July 2011 and July 2013, 534 severe trauma patients were included in a single-center continuous prospective observational study...
November 15, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27856389/mini-laparoscopy-of-removal-partial-adnexae-at-the-time-of-hysterectomy
#14
António Gutierrez Setúbal, João Sequeira Alves, Olga Lavado, Joana Faria
STUDY OBJECTIVE: To describe our technique of mini laparoscopic adnexectomy or salpingectomy at the time of total laparoscopic hysterectomy DESIGN: Step-by-step video explanation of our technique SETTING: The advantages of laparoscopic surgery have been widely recognised in the past two decades: improved vision, exposure, reduction in operative trauma because of smaller incisions and more gentle tissue´s handling, that result in a faster postoperative recovery. The technology development has allowed the use of smaller caliber instruments while maintaining the high standard surgical performance...
November 14, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27849481/brief-report-systemic-vascular-access-and-resuscitation-via-corpus-cavernosum
#15
Melville Bradley
BACKGROUND: Pre-hospital systemic vascular access with early resuscitation in the hypovolemic trauma patient can be problematic and is attempted through venous cut-downs, peripheral IV lines, and/or interosseous routes. This brief report examines an alternative for males via the corpus cavernosum (CC). METHODS: A systematic literature review using certain inclusion criteria including, but not limited to, corpus cavernosum access and resuscitation was conducted and a summary table created...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849473/high-fidelity-simulation-model-of-pelvic-hemorrhagic-trauma-the-future-for-military-surgical-skills-training
#16
David N Naumann, Douglas M Bowley, Mark J Midwinter, Alasdair Walker, Ian Pallister
No abstract text is available yet for this article.
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27836253/bi-manual-proximal-external-aortic-compression-after-major-abdominal-pelvic-trauma-and-during-ambulance-transfer-a-simulation-study
#17
M J Douma, D O'Dochartaigh, P G Brindley
BACKGROUND: Applying manual pressure after hemorrhage is intuitive, cost-free, and logistically-simple. When direct abdominal-pelvic compression fails, clinicians can attempt indirect proximal-external-aortic-compression (PEAC), while expediting transfer and definitive rescue. This study quantifies the sustainability of simulated bi-manual PEAC both immediately on scene and during subsequent ambulance transfer. The goal is to understand when bi-manual PEAC might be clinically-useful, and when to prioritize compression-devices or endovascular-occlusion...
November 5, 2016: Injury
https://www.readbyqxmd.com/read/27833687/application-of-circumferential-compression-device-binder-in-pelvic-injuries-room-for-improvement
#18
Rahul Vaidya, Matthew Roth, Bradley Zarling, Sarah Zhang, Christopher Walsh, Jessica Macsuga, John Swartz
INTRODUCTION: The use of a noninvasive pelvic circumferential compression device (PCCD) to achieve pelvic stabilization by both decreasing pelvic volume and limiting inter-fragmentary motion has become commonplace, and is a well-established component of Advanced Trauma Life Support (ATLS) protocol in the treatment of pelvic ring injuries. The purpose of this study was to evaluate the following: 1) how consistently a PCCD was placed on patients who arrived at our hospital with unstable pelvic ring injuries; 2) if they were placed in a timely manner; and 3) if hemodynamic instability influenced their use...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27830486/three-patterns-of-acetabular-deficiency-are-common-in-young-adult-patients-with-acetabular-dysplasia
#19
Jeffrey J Nepple, Joel Wells, James R Ross, Asheesh Bedi, Perry L Schoenecker, John C Clohisy
BACKGROUND: Detailed recognition of the three-dimensional (3-D) deformity in acetabular dysplasia is important to help guide correction at the time of reorientation during periacetabular osteotomy (PAO). Common plain radiographic parameters of acetabular dysplasia are limited in their ability to characterize acetabular deficiency precisely. The 3-D characterization of such deficiencies with low-dose CT may allow for more precise characterization. QUESTIONS/PURPOSES: The purposes of this study were (1) to determine the variability in 3-D acetabular deficiency in acetabular dysplasia; (2) to define subtypes of acetabular dysplasia based on 3-D morphology; (3) to determine the correlation of plain radiographic parameters with 3-D morphology; and (4) to determine the association of acetabular dysplasia subtype with patient clinical characteristics including sex, range of motion, and femoral version...
November 9, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27820707/resuscitative-endovascular-balloon-occlusion-of-the-aorta-promise-practice-and-progress
#20
Zane B Perkins, Robbie A Lendrum, Karim Brohi
PURPOSE OF REVIEW: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive damage control procedure for life-threatening abdominal or pelvic haemorrhage. The purpose of this review is to summarize the current understanding and experience with REBOA, outline potential future applications of this technology, and highlight priority areas for further research. RECENT FINDINGS: REBOA is a feasible method of achieving temporary aortic occlusion and can be performed rapidly, with a high degree of success, in the emergency setting (including at the scene of injury) by appropriately trained clinicians...
November 4, 2016: Current Opinion in Critical Care
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