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Fracture management in emergency department

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https://www.readbyqxmd.com/read/28330802/orofacial-trauma-in-rural-india-a-clinical-study
#1
Sunita Malik, Gurdarshan Singh, Gagandeep Kaur, Sunil Yadav, Hitesh C Mittal
PURPOSE: Orofacial trauma is becoming a leading medical problem worldwide. Most of the studies pertaining to orofacial trauma have been done in urban areas but very little scientific literature is available for rural areas. METHODS: A prospective medical institute-based study of orofacial injury patients was carried out from May 2013 to April 2016 (36 Months). Data regarding incidence, age and sex distribution, causes, types and site of injury, treatment modalities and trauma associated complications were collected and analysed...
February 24, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28330420/arthroplasty-treatment-of-proximal-humerus-fractures-14-year-trends-in-the-united-states
#2
William W Schairer, Benedict U Nwachukwu, Stephen Lyman, Lawrence V Gulotta
OBJECTIVES: Proximal humerus fractures are a common injury in the elderly population that can usually be managed non-operatively. However, arthroplasty has become increasingly utilized for complex fractures and poor bone quality. We evaluated national trends in treatment, specifically looking at the adoption of reverse total shoulder arthroplasty. METHODS: The incidence of proximal humerus fractures was calculated from the Nationwide Emergency Department Database (NEDD) from 2006-2012...
March 22, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28288080/management-of-pediatric-type-i-open-fractures-in-the-emergency-department-or-operating-room-a-multicenter-perspective
#3
Jenna Godfrey, Paul D Choi, Lior Shabtai, Sarah B Nossov, Amy Williams, Antoinette W Lindberg, Selina Silva, Michelle S Caird, Mathew D Schur, Alexandre Arkader
BACKGROUND: The management of pediatric type I open fractures remains controversial. The aim of this study is to compare outcomes in type I open fractures managed with superficial wound debridement and antibiotics in the emergency department (ED) (nonoperative management) to patients managed with operative debridement and antibiotics (operative management). METHODS: A multicenter retrospective review was performed of all pediatric type I open forearm, wrist, and tibia fractures treated at 4 high volume pediatric centers between 2000 and 2015...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28286861/nerve-stimulator-versus-ultrasound-guided-femoral-nerve-block-a-randomized-clinical-trial
#4
Arash Forouzan, Kambiz Masoumi, Hasan Motamed, Mohammad Reza Gousheh, Akram Rohani
INTRODUCTION: Pain control is the most important issue in emergency department management of patients with femoral bone fractures. The present study aimed to compare the procedural features of ultrasonography and nerve stimulator guided femoral nerve block in this regard. METHOD: In this randomized clinical trial, patients with proximal femoral fractures presenting to emergency department were randomly divided into two groups of ultrasonography or nerve stimulator guided femoral block and compared regarding success rate, procedural time, block time, and need for rescue doses of morphine sulfate, using SPSS 20...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28284470/virtual-fracture-clinic-management-of-fifth-metatarsal-including-jones-fractures-is-safe-and-cost-effective
#5
Kit Brogan, Simon Bellringer, Harold Akehurst, Christopher Gee, Nada Ibrahim, Lucy Cassidy, Ben Rogers, James Gibbs
Virtual clinics have been shown to be safe and cost-effective in many specialties, yet barriers exist to their implementation in orthopaedics. The aims of this study were to look at whether the management of 5th metatarsal fractures using a virtual fracture clinic model is safe, cost effective and avoids adverse outcomes whilst being acceptable to patients using the service. All patients with a fifth metatarsal fracture between September 2013 and September 2015 had a standardised management plan initiated (blackboot, full weightbearing) in the emergency department (ED)...
February 12, 2017: Injury
https://www.readbyqxmd.com/read/28274010/radiological-outcomes-of-distal-radius-fractures-managed-with-2-7mm-volar-locking-plate-fixation-a-retrospective-analysis
#6
Prem Kotian, Srikanth Mudiganty, Rajendra Annappa, Jose Austine
INTRODUCTION: Distal radius fractures accounts for around 15% of all fractures diagnosed and treated in the emergency rooms. These fractures usually result secondary to high velocity injury such as a motor vehicle accident or fall on an out stretched hand. In the elderly, it is a common fragility fracture. Volar Locking Compression Plates (LCP) is effective devices for fixation of the distal radius fractures. There is a lacuna with regard to literature on the 2.7 mm volar LCP and the current study retrospectively assesses the postoperative radiological outcomes...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28255505/odontoid-fracture-in-a-patient-with-diffuse-idiopathic-skeletal-hyperostosis
#7
Adan Omar, Addisu Mesfin
Nonoperative management of fractures in the setting of diffuse idiopathic skeletal hyperostosis (DISH) or ankylosing spondylitis is often unsuccessful. The subaxial spine is a common site of hyperextension fractures in the setting of DISH. Fractures of the upper cervical spine are uncommon in DISH. We report, to our knowledge, the first case describing successful nonoperative management of a type 2 odontoid fracture in a patient with DISH. We discuss the patient's initial presentation, physical examination, imaging findings, and management...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28214061/open-physeal-fracture-of-the-distal-phalanx-of-the-hallux-case-study-diagnosis-and-management
#8
Brandon Morris, Scott Mullen, Paul Schroeppel, Bryan Vopat
Open physeal fractures of the distal phalanx of the hallux are the lesser described counterpart to the same fracture of the finger, known by its eponym as a "Seymour fracture". Displaced Salter-Harris phalangeal fractures present with a concomitant nailbed or soft tissue injury. Often these fractures occur in the summer months when open-toe footwear can be worn, however, they may occur indoors as well. Frequently, the injury results from direct axial load of the toe, or "stubbing", which causes the fracture and associated soft tissue injury...
February 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28192567/development-and-internal-validation-of-a-clinical-risk-score-for-treating-children-with-mild-head-trauma-and-intracranial-injury
#9
Jacob K Greenberg, Yan Yan, Christopher R Carpenter, Angela Lumba-Brown, Martin S Keller, Jose A Pineda, Ross C Brownson, David D Limbrick
Importance: The appropriate treatment of children with mild traumatic brain injury (mTBI) and intracranial injury (ICI) on computed tomographic imaging remains unclear. Evidence-based risk assessments may improve patient safety and reduce resource use. Objective: To derive a risk score predicting the need for intensive care unit observation in children with mTBI and ICI. Design, Setting, and Participants: This retrospective analysis of the prospective Pediatric Emergency Care Applied Research Network (PECARN) head injury cohort study included patients enrolled in 25 North American emergency departments from 2004 to 2006...
February 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28187874/falling-while-walking-a-hidden-contributor-to-pedestrian-injury
#10
Jennifer Oxley, Steve O'Hern, Duane Burtt, Ben Rossiter
Walking is a sustainable mode of transportation which is beneficial to both individuals and to the broader community, however, there are risks and it is essential that road design and operation provides safe conditions for walking. In Victoria, pedestrians represent one of the most vulnerable road user groups, accounting for approximately 12% of all road fatalities and serious injuries. These figures largely represent injuries where the pedestrian has been struck by a vehicle with the extent of pedestrian-only injuries largely un-reported...
February 7, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/28186860/traumatic-rib-injury-patterns-imaging-pitfalls-complications-and-treatment
#11
Brett S Talbot, Christopher P Gange, Apeksha Chaturvedi, Nina Klionsky, Susan K Hobbs, Abhishek Chaturvedi
The ribs are frequently affected by blunt or penetrating injury to the thorax. In the emergency department setting, it is vital for the interpreting radiologist to not only identify the presence of rib injuries but also alert the clinician about organ-specific injury, specific traumatic patterns, and acute rib trauma complications that require emergent attention. Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic fractures...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28168971/the-virtual-fracture-clinic-reducing-unnecessary-review-of-clavicle-fractures
#12
Rahul Bhattacharyya, Prem Ruben Jayaram, Robin Holliday, Paul Jenkins, Iain Anthony, Lech Rymaszewski
INTRODUCTION: We re-designed the outpatient management of trauma at our institution to eliminate appointments if there would be no change in management or information provision. All cases referred by the Emergency Department (ED) were reviewed at a Virtual Fracture Clinic (VFC) by an orthopaedic consultant and telephoned afterwards by a senior nurse. If face-to-face review was required, it was arranged at a specialist shoulder clinic. AIMS: The primary aim of this study was to evaluate the proportion of clavicle fractures that could be discharged without physical review...
January 27, 2017: Injury
https://www.readbyqxmd.com/read/28164049/a-case-report-of-bisphosphonate-induced-bilateral-osteoporotic-subtrochanteric-fracture-femurii-review-of-literature
#13
Rajendra Uppin, Srinath Gupta, Shivank Prakash
INTRODUCTION: Osteoporosis is a significant health-care problem characterized by excessive skeletal fragility, susceptibility to low-trauma fractures in men as well as women. Any abnormality of the bone that reduces the strength of the bone predisposes it to mechanical failure during normal activity or with minimum trauma. The mechanical failure manifests itself as a fracture, and this fracture must be recognized as a pathological fracture if the patient is to be treated properly. Osteoporosis is one of the leading causes of such pathological fractures and accounts for 1...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28134091/irrigation-solutions-in-open-fractures-of-the-lower-extremities-evaluation-of-isotonic-saline-and-distilled-water
#14
Olukemi Temiloluwa Olufemi, Adeolu Ikechukwu Adeyeye
INTRODUCTION: Open fractures are widely considered as orthopaedic emergencies requiring immediate intervention. The initial management of these injuries usually affects the ultimate outcome because open fractures may be associated with significant morbidity. Wound irrigation forms one of the pivotal principles in the treatment of open fractures. The choice of irrigation fluid has since been a source of debate. This study aimed to evaluate and compare the effects of isotonic saline and distilled water as irrigation solutions in the management of open fractures of the lower extremities...
2017: SICOT-J
https://www.readbyqxmd.com/read/28118993/soft-tissue-evidence-of-head-injury-in-infants-and-young-children-is-ct-head-examination-justified
#15
S Zaman, P H Logan, C Landes, S Harave
AIM: To determine whether it is justified to undertake a computed tomography (CT) examination of the head in children under 1 year of age who present with a bruise, swelling, or laceration of >5 cm following head injury in children presenting to a paediatric accident and emergency (A&E) department in the northwest of England. Further aims were to determine whether there was any justification for performing a CT head examination for children with soft-tissue injuries measuring <5 cm, or for children >1 year with evidence of soft-tissue injury, but without any other concerning feature...
April 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28106673/outcomes-of-pediatric-fractures-managed-with-closed-reduction-by-orthopaedic-residents-in-the-emergency-department
#16
Vivek Natarajan, Ermias Abebe, James Dunlap, Patrick Bosch, Ozgur Dede, W Timothy Ward, James Roach
BACKGROUND: Closed reduction of pediatric fractures is commonly performed by orthopaedic residents using conscious sedation in the emergency department (ED). The purpose of this study was to determine the rate of satisfactory reductions as performed by residents, and to determine the outcomes of these procedures. METHODS: A retrospective review was performed of all fractures that underwent closed reduction under conscious sedation in the ED of a level 1 pediatric trauma center between January 1, 2010 and November 30, 2014...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28072666/outcomes-from-referrals-and-unscheduled-visits-from-community-emergency-departments-to-a-regional-pediatric-emergency-department-in-canada
#17
Ethan Reiner, Ardalan Ahmadi, Eric Grafstein, Quynh Doan
OBJECTIVES: Existing pediatric literature describing repeat visits to the emergency department (ED) for the same medical complaint has yet to report on patient flow patterns from general EDs (GEDs) to a pediatric ED (PED). We sought to characterize the population of patients who are treated in a GED and subsequently present to a PED for further care. METHODS: We conducted a retrospective cohort study reviewing all pediatric visits (age < 17 y) at 5 GEDs in Vancouver...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28050700/when-is-it-safe-to-reduce-fracture-dislocation-of-shoulder-under-sedation-proposed-treatment-algorithm
#18
Konrad Sebastian Wronka, Abhimanyu Ved, Khitish Mohanty
INTRODUCTION: Shoulder dislocations are common. It is known that incongruent shoulder should be promptly reduced. However, when associated with fracture of the proximal humerus, there is a clinical dilemma if reduction under sedation is a safe option. We wanted to establish when it is safe to attempt reduction of a shoulder fracture dislocation under sedation in emergency room. METHODS: This is a retrospective cohort study assessing consecutive patients presenting with a dislocation of a gleno-humeral joint with an associated fracture of the humerus between 2007 and 2015...
January 3, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28050441/blunt-cardiac-rupture-a-diagnostic-challenge
#19
Suraj Pinni, Vineet Kumar, Satish Balkrishna Dharap
Blunt Cardiac Rupture (BCR) is a life threatening injury. Majority of patients do not reach the hospital and in those who reach the emergency department, timely diagnosis and treatment is a challenge. The case is about a patient with multiple blunt injuries who presented in shock. Cardiac tamponade was suspected on clinical grounds and on evidence of mediastinal widening on radiograph. In the absence of songography, the diagnosis was confirmed by subxiphoid pericardial window. Emergency thoracotomy revealed a right atrial appendage rupture which was surgically corrected...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28003917/frontal-mucocele-following-previous-facial-trauma-with-hardware-reconstruction
#20
Megan EuDaly, Chadd K Kraus
Mucoceles are cysts that can develop after facial bone fractures, especially those involving the frontal sinuses. Despite being rare, mucoceles can result in serious delayed sequelae. We present a case of a frontal mucocele that developed two years after extensive facial trauma following a motor vehicle crash (MVC) and review the emergency department (ED) evaluation and treatment of mucocele. Early recognition, appropriate imaging, and an interdisciplinary approach are essential for managing these rare sequelae of facial trauma...
2016: Case Reports in Emergency Medicine
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