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Pelvic trauma

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https://www.readbyqxmd.com/read/29221814/use-of-interventional-radiology-as-initial-hemorrhage-control-to-improve-outcomes-for-potentially-lethal-multiple-blunt-injuries
#1
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
INTRODUCTION: Recently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR...
December 6, 2017: Injury
https://www.readbyqxmd.com/read/29220065/clinical-profile-of-patients-with-psychogenic-non-epileptic-seizures-in-puerto-rico
#2
Joashlie M Méndez-Ruiz, Alfonso Martínez-Taboas, Yeira M Valdez-Pimentel, Miguel Torres-Narváez, Marianette Colón-Laboy, Gisela G Jiménez-Colón, José Rodríguez-Gómez, Christian J González-Jiménez
OBJECTIVE: Specialized epilepsy clinics receive many cases (20%-30% of total cases) in which the patients are diagnosed with psychogenic non-epileptic seizures (PNES). In Puerto Rico, there has been a lack of research on and data about patients with PNES. This study examined the clinical profile of 34 patients with a confirmed diagnosis of PNES. METHODS: A secondary analysis of 34 clinical records of patients with PNES was conducted. The resulting profile was based on clinical interviews, the behavioral presentation of seizures, the history of traumatic experiences or abuse, and the relationship between PNES events and life stressors...
December 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/29218648/pelvic-fracture-instability-associated-l5-transverse-process-fracture-fact-or-myth-a-systematic-review-and-meta-analysis
#3
REVIEW
Hazem Nasef, Ahmed Elhessy, Faris Abushaban, Abduljabbar Alhammoud
PURPOSE: Stable or unstable pelvic ring fractures are sometimes associated with L5 transverse process (TP) fractures. This review aimed to determine the effect of L5 TP fractures on pelvic ring fracture stability. METHODS: We searched electronic databases (including MEDLINE, Google Scholar, and SCOPUS) and performed hand searching of English orthopedics journals and conference abstracts until May 2017. We pooled data from five studies, with a total of 278 patients...
December 7, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29218390/gemelli-obturator-complex-in-the-deep-gluteal-space-an-anatomic-and-dynamic-study
#4
Ramon Balius, Antonio Susín, Carles Morros, Montse Pujol, Dolores Pérez-Cuenca, Xavier Sala-Blanch
OBJECTIVE: To investigate the behavior of the sciatic nerve during hip rotation at subgluteal space. MATERIALS AND METHODS: Sonographic examination (high-resolution ultrasound machine at 5.0-14 MHZ) of the gemelli-obturator internus complex following two approaches: (1) a study on cadavers and (2) a study on healthy volunteers. The cadavers were examined in pronation, pelvis-fixed position by forcing internal and external rotations of the hip with the knee in 90° flexion...
December 7, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29217906/liquid-paraffin-vs-hyaluronic-acid-in-preventing-intraperitoneal-adhesions
#5
Hanish Kataria, Vinod Prem Singh
Adhesion formation after abdominal and pelvic operations remains a challenging problem. Role of adjuvant barriers have been studied but there is no comparative study between liquid paraffin and hyaluronic acid as a barrier method. Hence, we planned to compare the effectiveness of 0.4 % hyaluronic acid and liquid paraffin in the prevention of postoperative intraperitoneal adhesions in rats. This prospective, randomized and controlled study was conducted in 60 adult Wistar albino rats. Surgical trauma by caecal abrasion and 1 g talcum powder was used in the rat model to induce adhesion formation...
December 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29212692/the-impact-of-age-on-major-orthopaedic-trauma-an-analysis-of-the-united-kingdom-trauma-audit-research-network-database
#6
J Herron, R Hutchinson, F Lecky, O Bouamra, A Edwards, M Woodford, W G P Eardley
AIMS: To compare the early management and mortality of older patients sustaining major orthopaedic trauma with that of a younger population with similar injuries. PATIENTS AND METHODS: The Trauma Audit Research Network database was reviewed to identify eligible patients admitted between April 2012 and June 2015. Distribution and severity of injury, interventions, comorbidity, critical care episodes and mortality were recorded. The population was divided into young (64 years or younger) and older (65 years and older) patients...
December 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29200474/personal-preference-of-mode-of-delivery-what-do-urogynaecologists-choose-preliminary-results-of-the-decision-study
#7
Julia Bihler, Ralf Tunn, Christl Reisenauer, Jan Pauluschke-Fröhlich, Philipp Wagner, Harald Abele, Katharina K Rall, Gert Naumann, Markus Wallwiener, Sara Y Brucker, Markus Hübner
Introduction: Currently, almost every third child in Germany is delivered by caesarean section. Apart from straightforward and clear indications for caesarean section which account for approx. 10%, the large proportion of relative indications in particular needs to be critically reviewed if the current C-section rate is to be effectively lowered. It is more than doubtful, however, whether this can be a realistic goal in Germany, especially in the context of international developments...
November 2017: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/29200143/the-predictors-for-positive-yield-abdominal-computed-tomography-in-pediatric-abdominal-trauma
#8
Abdulrahman M Alzahem, Soundappan S V Soundappan, Daniel T Cass
OBJECTIVES: Abdominal computed tomography (ACT) use in the initial evaluation of pediatric abdominal trauma is liberal in most instances. The aim of this study was to identify the predictors for a positive yield ACT scan in this population. METHODS: A prospective, cohort, single-center observational study was conducted at Children's Hospital at Westmead, New South Wales, from January 2008 to June 2015 on 240 pediatric abdominal trauma patients who had abdominal computed tomography...
December 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29198896/computed-tomographic-imaging-in-the-pediatric-patient-with-a-seatbelt-sign-still-not-good-enough
#9
Tammy R Kopelman, Ramin Jamshidi, Paola G Pieri, Karole Davis, James Bogert, Sydney J Vail, Daniel Gridley, Melissa A Singer Pressman
PURPOSE: Considering the improvements in CT over the past decade, this study aimed to determine whether CT can diagnose HVI in pediatric trauma patients with seatbelt signs (SBS). METHODS: We retrospectively identified pediatric patients with SBS who had abdominopelvic CT performed on initial evaluation over 5 1/2years. Abnormal CT was defined by identification of any intra-abdominal abnormality possibly related to trauma. RESULTS: One hundred twenty patients met inclusion criteria...
October 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29198375/the-value-of-binder-off-imaging-to-identify-occult-and-unexpected-pelvic-ring-injuries
#10
James A C Fagg, Mehool R Acharya, Tim J S Chesser, Anthony J Ward
AIMS: To determine the effectiveness of 'binder-off' plain pelvic radiographs in the assessment of pelvic ring injuries. PATIENTS AND METHODS: All patients requiring operative intervention at our tertiary referral pelvic unit/major trauma centre for high-energy pelvic injuries between April 2012 and December 2014 were retrospectively identified. Pre-operative pelvic imaging with and without pelvic binder was reviewed with respect to fracture pattern and pelvic stability...
November 21, 2017: Injury
https://www.readbyqxmd.com/read/29191643/incidence-of-stress-urinary-incontinence-following-posterior-urethroplasty-for-radiation-induced-urethral-strictures
#11
Paul H Chung, Paige Esposito, Hunter Wessells, Bryan B Voelzke
OBJECTIVES: To identify the frequency of de novo SUI after posterior excision and primary anastomotic (EPA) urethroplasty in patients with radiation-induced urethral strictures (RIUS) and compare to patients with pelvic fracture urethral injuries (PFUI). METHODS: A retrospective review was conducted among patients who underwent successful posterior EPA urethroplasty between 2008 and 2016 for RIUS from prostate cancer or PFUI from blunt trauma. Only patients with an intact bladder neck on imaging were included...
November 27, 2017: Urology
https://www.readbyqxmd.com/read/29191213/modified-pedicle-screw-rod-fixation-versus-anterior-pelvic-external-fixation-for-the-management-of-anterior-pelvic-ring-fractures-a-comparative-study
#12
Chun Bi, Qiugen Wang, Jianhong Wu, Feng Zhou, Fei Zhang, Haipeng Liang, Fei Lyu, Jiandong Wang
BACKGROUND: Anterior pelvic ring fracture, as high-energy trauma, needs to be effectively treated. The purpose of the current study was to evaluate the clinical applications of modified pedicle screw-rod fixation and anterior pelvic external fixation for the treatment of anterior pelvic ring fracture. METHODS: Either modified pedicle screw-rod fixation (modified PSRF group, N = 21) or anterior pelvic external fixation (APEF group, N = 22) was performed to 43 patients, with or without fixation of posterior ring...
December 1, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29184798/successful-management-of-cavernosal-artery-pseudoaneurysm-using-microcoil-embolization
#13
John M Masterson, Luis F Savio, Kenneth Softness, Thomas A Masterson, Jesus Beltran Perez, Shivank Bhatia, Ranjith Ramasamy
Erectile dysfunction (ED) is a common condition among men and has several causes. Among men under the age of 40, pelvic or perineal trauma is the most common cause of ED. Pelvic or perineal trauma often results in arterial injury as the likely mechanism of ED. We present the case of a 14-year-old male diagnosed with a pseudoaneurysm causing arteriogenic ED secondary to blunt force trauma to the perineum. We successfully managed arteriogenic ED with superselective embolization using microcoils. We also conclude through a review of the literature that microcoil and Gelfoam yield similar outcomes...
October 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/29184791/comprehensive-pelvic-floor-physical-therapy-program-for-men-with-idiopathic-chronic-pelvic-pain-syndrome-a-prospective-study
#14
Thomas A Masterson, John M Masterson, Jessica Azzinaro, Lattoya Manderson, Sanjaya Swain, Ranjith Ramasamy
Background: Male chronic pelvic pain syndrome (CPPS) is a heterogeneous constellation of symptoms that causes significant impairment and is often challenging to treat. In this prospective study, we evaluated men with CPPS who underwent comprehensive pelvic floor physical therapy (PFPT) program. We used the previously validated Genitourinary Pain Index (GUPI) to measure outcomes. Methods: We included 14 men who underwent physical therapy for idiopathic CPPS from October 2015 to October 2016...
October 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/29177179/endovascular-management-of-a-penetrating-zone-iii-retroperitoneal-gunshot-wound-injury-a-case-report
#15
Saptarshi Biswas, Boris Hristov
Traumatic iliac vessels injuries secondary to gunshot wound can often be fatal at the scene. One of the intriguing complications of vascular injuries is arteriovenous fistula. If the patient survives, these lesions may often not be diagnosed on first evaluation and patients may present with clinical signs and symptoms years later. Open surgical repair can have prohibitive morbidity and mortality and endovascular techniques, an effective treatment alternative, can interrupt the abnormal vascular communication and preserve artery vein patency...
October 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29169094/evaluation-of-full-pelvic-ring-stresses-using-a-bilateral-static-gait-phase-finite-element-modeling-method
#16
Bridget Volinski, Anil Kalra, King Yang
Trauma to the pelvis is debilitating and often needs fixation intervention. In 58% of patients with this trauma, the injuries can lead to permanent disability, preventing the return to jobs. Of all unsuccessful fixation procedures, 42% are caused by failures of the method, sometimes due to mobilization during healing. Patients would benefit by havibridgetv@comcast.netng fixation hardware in place that enabled ambulation. During walking the bilateral hip joint plus leg and trunk muscle forces, including those from hip motion, can induce torsion into the pelvic ring and across the joint cartilages, and affect the internal stresses of the pelvis...
November 4, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29162245/ultrasound-guided-supra-acetabular-pin-placement-in-pelvic-external-fixation-description-of-a-surgical-technique-and-results
#17
Francisco Chana-Rodríguez, Manuel Cuervas-Mons, José Rojo-Manaute, Félix Mora, Juan Arnal, Javier Vaquero-Martín
INTRODUCTION: Pelvic fracture in trauma patients can lead to hemodynamic instability. External fixation is a treatment capable of stabilizing these injuries in the context of damage control surgery. Supra-acetabular pin offers the greater biomechanical stability but requires the use of intraoperative fluoroscopy. The aim of this study was to analyze our results for an ultrasound-guided supra-acetabular pinning. MATERIAL AND METHODS: Cross-sectional study with cadaveric specimens...
November 2017: Injury
https://www.readbyqxmd.com/read/29162242/current-concepts-in-spondylopelvic-dissociation
#18
REVIEW
André Luiz Loyelo Barcellos, Vinícius M da Rocha, João Antonio Matheus Guimarães
INTRODUCTION: Spondylopelvic dissociation is an uncommon and complex injury that results from high-energy trauma with axial overloading through the sacrum. Due to the life-threatening nature of these injuries, standard Advanced Trauma Life Support® (ATLS) protocol must be used in the trauma setting as part of the initial management of these patients. The key to diagnosis is a good physical exam coupled with high level of suspicion. Radicular neurological deficits commonly are present in spondylopelvic dissociation (L5's roots) and should be documented for future evaluations...
November 2017: Injury
https://www.readbyqxmd.com/read/29143074/-additional-emergency-medical-measures-in-trauma-associated-cardiac-arrest
#19
B Ondruschka, C Baier, J Dreßler, A Höch, M Bernhard, C Kleber, C Buschmann
INTRODUCTION: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The present cohort study evaluated forensic autopsy reports of trauma deaths occurring at the scene with respect to additive actions in preclinical tCPR as well as the potentially preventable nature of the individual death cases...
November 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29140953/contemporary-management-of-rectal-injuries-at-level-i-trauma-centers-the-results-of-an-american-association-for-the-surgery-of-trauma-multi-institutional-study
#20
Carlos V R Brown, Pedro G Teixeira, Elisa Furay, John P Sharpe, Tashinga Musonza, John Holcomb, Eric Bui, Brandon Bruns, H Andrew Hopper, Michael S Truitt, Clay C Burlew, Morgan Schellenberg, Jack Sava, John VanHorn, Brian Eastridge, Alicia M Cross, Richard Vasak, Gary Vercruysse, Eleanor E Curtis, James Haan, Raul Coimbra, Phillip Bohan, Stephen Gale, Peter G Bendix
INTRODUCTION: Rectal injuries have been historically treated with a combination of modalities including direct repair, resection, proximal diversion, presacral drainage, and distal rectal washout. We hypothesized that intraperitoneal rectal injuries may be selectively managed without diversion and the addition of distal rectal washout and pre-sacral drainage in the management of extraperitoneal injuries are not beneficial. METHODS: This is an American Association for the Surgery of Trauma multi-institutional retrospective study from 2004-2015 of all patients who sustained a traumatic rectal injury and were admitted to one of the 22 participating centers...
November 14, 2017: Journal of Trauma and Acute Care Surgery
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