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Pelvic trauma

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https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#1
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28412162/incidence-and-clinical-features-of-sacral-insufficiency-fracture-in-the-emergency-department
#2
Yasuaki Tamaki, Akihiro Nagamachi, Kazumasa Inoue, Makoto Takeuchi, Kosuke Sugiura, Yasuyuki Omichi, Shunsuke Tamaki, Takashi Chikawa, Koichi Sairyo, Keisuke Adachi
INTRODUCTION: A sacral insufficiency fracture (SIF) often manifests as low back pain or sciatica in the absence of any antecedent trauma. These fractures may be missed because of lack of appropriate imaging. The purpose of this study was to clarify the incidence and clinical features of SIF as well as the characteristic findings on magnetic resonance imaging (MRI) of the lumbar spine. MATERIALS AND METHODS: The study participants comprised 250 patients (132 male, 118 female; mean age 58...
March 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28409337/surgical-considerations-with-the-operative-fixation-of-unstable-paediatric-pelvic-ring-injuries
#3
Mohamed Kenawey
INTRODUCTION: The operative treatment of unstable pelvic injuries in paediatrics is not frequently indicated. The detailed modes of pelvic ring failure, surgical techniques, fixation choices, and peri-operative difficulties are not well reported. METHODS: From September 2010 to March 2016, 62 paediatric patients were admitted to an academic level I trauma center with the diagnosis of pelvic ring injury. Of them, 29 (17 males and 12 females) had operative fixation of unstable pelvic injuries...
April 13, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28409141/intrathoracic-fracture-dislocation-of-the-humerus-case-report-and-literature-review
#4
Wilson Carlos Sola Junior, Paulo Sérgio Dos Santos
Shoulder fracture-dislocations are uncommon. Those associated with intrathoracic dislocation are very rare conditions, resulting from high-energy trauma; usually, the affected limb is in an abduction position. In Brazil, there is only one report of a teenager with displacement of the epiphysis into the chest cavity; the present is the first adult patient report of intrathoracic dislocation of the humerus. The authors present the case of a patient female, aged 56 years, who was hit by motorcycle and thrown approximately 5 meters away...
March 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28406853/the-role-of-computed-tomography-in-the-classification-of-pediatric-pelvic-fractures-revisited
#5
Bent Ma, Hennrikus Wl, Latorre Je, Armstrong Dg, Shaw B, Jones Kc, Segal Ls
OBJECTIVES: To determine the need of CT scans in the assessment of pediatric pelvic fractures DESIGN:: Retrospective Chart Review SETTING:: Level-1 Pediatric Trauma CenterPatients/Participants: 30 pediatric trauma patients with pelvic fractures who have obtained both a radiograph and CT Scan MAIN OUTCOME MEASUREMENTS:: Fleiss Kappa coefficient to compare inter-reliability. RESULTS: The average age of the patients was 7 years (range 1-13 years). 17 were male and 13 were female...
April 10, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28403978/-pelvic-nodules-in-a-young-woman-all-is-not-endometriosis
#6
G Buisson, E Maissiat, G Dubernard, L Boussel
Splenosis is a pathology resulting from a rupture of the spleen due to a trauma or a surgery. We report the case of a patient presenting with a splenosis, initially diagnosed as endometriosis-related pelvic nodules, the most frequent cause of pelvic nodules in women. We will describe the imaging strategy that led to the final diagnosis of splenosis.
February 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28403918/trauma-and-endometriosis-a-review-may-we-explain-surgical-phenotypes-and-natural-history-of-the-disease
#7
M Canis, N Bourdel, C Houlle, A-S Gremeau, R Botchorishvili, S Matsuzaki
OBJECTIVE: The study was performed to evaluate whether trauma is an initial event of development of endometriosis. METHOD: Using Medline database from January 1960 up to December 2014, a systematic review was made of all published studies using the keywords trauma, healing, injury, infection, hyperperistaltism, stretch and endometriosis, adenomyosis and trauma. Studies and review articles written in French and/or in English related to the topic were included and reviewed independently by two authors...
March 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28403495/-diagnosis-and-therapeutic-management-in-kidney-ureter-and-bladder-trauma
#8
Karin Hirsch, Marco Heinz, Bernd Wullich
Trauma refers to the destruction of tissues or organs by external forces and it is the most common cause of mortality and morbidity in children (1, 2). Injuries of the genitourinary tract may be the result of blunt (falls, sport injuries, motor vehicle accidents and sexual abuse) or penetrating (stab wounds, gun shots, falling onto sharp objects) injuries. The genitourinary tract is significantly injured in 2.9% of paediatric trauma patients 4.In the paediatric population, the kidney is the most affected organ in the genitourinary tract (>60% of all genitourinary tract injuries) 4...
February 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/28391147/influence-of-a-pelvic-floor-training-programme-to-prevent-perineal-trauma-a-quasi-randomised-controlled-trial
#9
Fatima Leon-Larios, Isabel Corrales-Gutierrez, Rosa Casado-Mejía, Carmen Suarez-Serrano
BACKGROUND: perineal injury is common after birth and may be caused by tears or episiotomy or both. Perineal massage has been shown to prevent episiotomies in primiparous women. On the other hand, pelvic floor exercises might have an influence by shortening the first and second stages of labour in the primigravida. AIM: the aim of this study was to investigate the effects of a pelvic floor training following a birth programme on perineal trauma. DESIGN: a single-blind quasi-randomized controlled trial with two groups: standard care and intervention...
March 27, 2017: Midwifery
https://www.readbyqxmd.com/read/28385787/a-rare-case-of-a-non-traumatic-neck-of-femur-fracture-in-a-17-year-old-boy-associated-with-vitamin-d-deficiency
#10
Maliha Moten, Mohamed Mussa, Syeda Naqvi, Shrikant Kulkarni
Hip fractures in the young, healthy population are rare and often the result of high-energy trauma. A previously healthy 17-year-old patient presented to our institution with a 5-week history of left hip and knee pain in the absence of any trauma. Pelvic radiograph revealed a subacute left femoral neck fracture. He subsequently underwent surgical fixation and made an uneventful recovery. Further endocrine evaluation revealed isolated vitamin D deficiency to be the likely underlying cause for this fracture. Multiple previous opportunities were missed to identify the cause for this patient's symptoms...
April 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28384504/pelvic-ring-fractures-in-the-elderly-now-and-then-a-pelvic-registry-study
#11
Mika F Rollmann, Steven C Herath, Florian Kirchhoff, Benedikt J Braun, Joerg H Holstein, Tim Pohlemann, Michael D Menger, Tina Histing
OBJECTIVES: To analyze the changes in demographic data stratified for age, sex and type of injury of elderly patients suffering from pelvic ring fractures over a 22-year observation period. DESIGN/SETTING: Data has been collected prospectively, multi-centrically in hospitals participating in the German Pelvic Trauma Registry. PATIENTS: We analyzed the data of 5665 patients with an age ≥60years included in the German Pelvic Trauma Registry from 1991 to 2013...
March 19, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28382255/angioembolization-is-necessary-with-any-volume-of-contrast-extravasation-in-blunt-trauma
#12
Ankur Bhakta, David S Magee, Matthew S Peterson, Michael Shay O'Mara
INTRODUCTION: Reduction of nonessential angiogram and embolization for patients sustaining blunt abdominal and pelvic trauma would allow improved utilization and decreased morbidity related to nontherapeutic embolization. We hypothesized that the nature of intravenous contrast extravasation (IVCE) on computed tomography (CT) would be directly related to the finding of extravasation on angiogram and need for embolization. METHODS: A 5-year retrospective evaluation of trauma patients with IVCE on CT...
January 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28379911/treatment-of-pregnant-patients-with-orthopaedic-trauma
#13
Nirmal Tejwani, Kevin Klifto, Christopher Looze, Christopher Scott Klifto
Fracture management in pregnant patients is challenging. Anatomic and physiologic changes in pregnancy increase the complexity of treatment. Maternal trauma increases the risk of fetal loss, preterm birth, placental abruption, cesarean delivery, and maternal death. Initial resuscitation and treatment in a facility equipped to handle the orthopaedic injury and preterm births are paramount. Pelvic and acetabular injuries are potentially life threatening. The benefits and risks of surgical treatment must be carefully considered...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28379869/resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-the-anesthesiologist-a-case-report-and-literature-review
#14
Bianca M Conti, Justin E Richards, Rishi Kundi, Jason Nascone, Thomas M Scalea, Maureen McCunn
The most common preventable cause of death after trauma is exsanguination due to uncontrolled hemorrhage. Traditionally, anterolateral emergency department thoracotomy is used for temporary control of noncompressible torso hemorrhage and to increase preload after trauma. Resuscitative endovascular balloon occlusion of the aorta is a minimally invasive technique that achieves similar goals. It is therefore imperative for the anesthesiologist to understand physiologic implications during resuscitative endovascular aortic occlusion and after balloon deflation...
April 4, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28374792/cell-based-secondary-prevention-of-childbirth-induced-pelvic-floor-trauma
#15
REVIEW
Geertje Callewaert, Marina Monteiro Carvalho Mori Da Cunha, Nikhil Sindhwani, Maurilio Sampaolesi, Maarten Albersen, Jan Deprest
With advancing population age, pelvic-floor dysfunction (PFD) will affect an increasing number of women. Many of these women wish to maintain active lifestyles, indicating an urgent need for effective strategies to treat or, preferably, prevent the occurrence of PFD. Childbirth and pregnancy have both long been recognized as crucial contributing factors in the pathophysiology of PFD. Vaginal delivery of a child is a serious traumatic event, causing anatomical and functional changes in the pelvic floor. Similar changes to those experienced during childbirth can be found in symptomatic women, often many years after delivery...
April 4, 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28365496/optimum-pelvic-incidence-minus-lumbar-lordosis-value-after-operation-for-patients-with-adult-degenerative-scoliosis
#16
Xiang-Yao Sun, Xi-Nuo Zhang, Yong Hai
BACKGROUND CONTEXT: Schwab classification for adult degenerative scoliosis (ADS) concluded that health-related quality of life (HRQOL) was closely related to curve type and three sagittal modifiers. It was suggested that pelvic incidence minus lumbar lordosis value (PI-LL) should be corrected within -10°~+10°. However, recent studies also indicated that ideal clinical outcomes could also be achieved in patients without ideal PI-LL mentioned above. PURPOSE: This study evaluated the relation between the clinical outcomes and the pelvic incidence minus lumbar lordosis value (PI-LL) of Chinese patients with ADS who received long posterior internal fixation and fusion...
March 29, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28363753/the-use-of-external-fixators-in-the-definitive-stabilisation-of-the-pelvis-in-polytrauma-patients-safety-efficacy-and-clinical-outcomes
#17
Theodoros H Tosounidis, Hassaan Qaiser Sheikh, Nikolaos K Kanakaris, Peter V Giannoudis
OBJECTIVES: To analyse the complications and outcomes (functional/radiographic) of Pelvic External Fixators applied as part of the definitive fixation in polytrauma patients. DESIGN: A single center retrospective chart review. SETTING: A level-1 trauma center. PATIENTS AND METHODS: We reviewed all the polytrauma patients (ISS>16) between 2007 and 2012 that had a PEF applied more than 30days. Complications including infection, aseptic loosening, neurological injury, loss of reduction, non-union and mal-union were recorded...
March 24, 2017: Injury
https://www.readbyqxmd.com/read/28360950/management-of-pelvic-fracture-associated-urethral-injuries-a-survey-of-canadian-urologists
#18
Nathan Colin Wong, Christopher B Allard, Shawn Dason, Patricia Farrugia, Mohit Bhandari, Timothy O Davies
INTRODUCTION: The management of pelvic fracture-associated urethral injuries (PFUI) is not standardized and optimal management is controversial. We surveyed Canadian urologists about their experiences and opinions regarding optimal management of PFUI. METHODS: Canadian urologists were surveyed via an anonymous, bilingual, web-based, 12-item questionnaire. A total of 735 Canadian urologists were invited to participate via email distributed by the Canadian Urological Association...
March 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28358976/analysis-of-bony-and-internal-organ-injuries-associated-with-26-357-adult-femoral-shaft-fractures-and-their-impact-on-mortality
#19
Nidharshan S Anandasivam, Glenn S Russo, Jennifer M Fischer, Andre M Samuel, Nathaniel T Ondeck, Matthew S Swallow, Sophie H Chung, Daniel D Bohl, Jonathan N Grauer
The spectrum of injuries associated with femoral shaft fractures and those injuries' association with mortality have not been well delineated previously. Patients in the National Trauma Data Bank who presented with femoral shaft fractures from 2011 to 2012 were analyzed in 3 age groups (18-39, 40-64, and 65+ years). For each group, modified Charlson Comorbidity Index (CCI), mechanism of injury (MOI), injury severity score (ISS), and associated injuries were reported. Multivariate logistic regression was used to identify predictors of mortality...
March 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28357493/intra-operative-multi-dimensional-fluoroscopy-of-guidepin-placement-prior-to-iliosacral-screw-fixation-for-posterior-pelvic-ring-injuries-and-sacroiliac-dislocation-an-early-case-series
#20
James C Shaw, Milton L Chip Routt, Joshua L Gary
PURPOSE: Traditional fluoroscopic techniques during percutaneous fixation of the posterior pelvic ring at times cannot adequately visualize errant or malpositioned iliosacral screws. Intra-operative fluoroscopic techniques have been advanced using multi-dimensional fluoroscopy to generate computed tomography-like images. This provides the surgeon not only the ability to assess iliosacral screw placement, but also the opportunity to assess reduction. We present a case series of four patients in which the Ziehm RFD multi-dimensional fluoroscopy was used to assess reduction and guidepin placement prior to definitive iliosacral screw fixation...
March 29, 2017: International Orthopaedics
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