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Fracture management in emergency department

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https://www.readbyqxmd.com/read/27906845/an-algorithmic-approach-using-ultrasonography-in-the-diagnosis-of-pediatric-nasal-bone-fracture
#1
Ikkei Tamada, Takaaki Mori, Nobuaki Inoue, Hirokazu Shido, Marie Aoki, Yukie Nakamura, Ruri Kamogawa
BACKGROUND: Ultrasonography (US) was recently reported as a reliable modality for diagnosing nasal bone fractures. However, whether US is reliable as a screening tool in the pediatric emergency department (ED) remains unknown. This prospective cohort study had a 2-fold aim: to assess the utility of US in the diagnosis of pediatric nasal bone fracture, and to evaluate the validity of our protocol for managing pediatric nasal bone fractures (Fuchu-Kids algorithm). PATIENTS AND METHODS: Among the patients who presented at the ED with facial trauma, those with a suspected nasal bone fracture were enrolled in the study...
November 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27900328/blunt-traumatic-tension-chylothorax-case-report-and-mini-review-of-the-literature
#2
Kamal Idris, Michael Sebastian, Ashraf F Hefny, Navidul Haq Khan, Fikri M Abu-Zidan
Tension chylothorax following blunt thoracic trauma is an extremely rare condition. Here we report such a case and review its management. A 31-year-old man was involved in a road traffic collision. The car rolled over and the patient was ejected from the vehicle. On arrival at the Emergency Department the patient was conscious and haemodynamically stable. Clinical examination of the chest and abdomen was normal. The patient had sustained fractures of the sixth cervical vertebra and the tenth thoracic vertebra, left pleural effusion, haematoma around the descending aorta and fracture of the right clavicle...
November 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/27898626/dental-trauma-in-a-pediatric-emergency-department-referral-center
#3
Emily Hall, Patricia Hickey, Thuy Nguyen-Tran, Jeff Louie
OBJECTIVE: The purpose of this study was to describe dental and associated oral injuries in a pediatric population that presents to an emergency department. METHODS: We performed a retrospective study and identified children from January 2007 to September 2011. Charts were reviewed for any subject, age from newborn to younger than 19 years, based on International Classification of Diseases, Ninth Revision codes for any dental or oral injury. Data abstraction included demographics, time of day of presentation, location and identification of tooth (s) injured, management, and disposition...
December 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27865726/-falls-in-less-than-one-year-old-infants-management-in-the-emergency-department
#4
Elena Rubio García, Ana Jiménez de Domingo, Rafael Marañon Pardillo, Miriam Triviño Rodríguez, Luis Alberto Frontado Haiek, Nuria Gilabert Iriondo, Francesc Ripoll Oliveras, Cristina Remón García, Gloria Estopiña Ferrer, Cristina Muñoz López
OBJECTIVES: A study was performed in order to describe injuries associated with falls in children aged <1 year who attended the emergency department. The approaches used were examined, as well as the factors associated with the greater use of these approaches, and the management of the patient. PATIENTS AND METHODS: This was a multicentre, descriptive and analytical study that included all patients aged <1 year who had experienced a fall for which they attended the emergency departments of one of 8 Spanish Hospitals belonging to the "Unintentional Paediatric Injury Working Group" of the Spanish Paediatric Society...
November 16, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/27854071/staged-laparotomies-based-on-the-damage-control-principle-to-treat-hemodynamically-unstable-grade-iv-blunt-hepatic-injury-in-an-eight-year-old-girl
#5
Takashi Kobayashi, Masayuki Kubota, Yuhki Arai, Toshiyuki Ohyama, Naoki Yokota, Kohei Miura, Hirosuke Ishikawa, Daiki Soma, Kazuyasu Takizawa, Jun Sakata, Masayuki Nagahashi, Hitoshi Kameyama, Toshifumi Wakai
BACKGROUND: Severe blunt hepatic injury is a major cause of morbidity and mortality in pediatric patients. Damage control (DC) surgery has been reported to be useful in severely compromised children with hepatic injury. We applied such a technique in the treatment of a case of hemodynamically unstable grade IV blunt hepatic injury in an eight-year-old girl. This case is the first to use multimodal approaches including perihepatic packing, temporary closure of the abdominal wall with a plastic sheet, transarterial embolization (TAE), and planned delayed anatomical hepatic resection in a child...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27836784/-clinical-observation-a-safe-alternative-to-radiology-in-infants-with-mild-traumatic-brain-injury
#6
David Muñoz-Santanach, Victoria Trenchs Sainz de la Maza, Sara Maya Gallego, Adriana Cuaresma González, Carles Luaces Cubells
OBJECTIVE: The protocol for the management of mild cranioencephalic trauma in the emergency department was changed in July 2013. The principal innovation was the replacement of systematic X-ray in infants with clinical observation. The aims of this study were to determine whether there was, 1) a reduction in the ability to detect traumatic brain injury (TBI) in the initial visit to Emergency, and 2) a change in the number of requests for imaging tests and hospital admissions. METHODOLOGY: This was a retrospective, descriptive, observational study...
November 8, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/27833708/surgical-treatment-of-orbital-blowout-fractures-complications-and-postoperative-care-patterns
#7
Matthew Shew, Michael P Carlisle, Guanning Nina Lu, Clinton Humphrey, J David Kriet
Orbital fractures are a common result of facial trauma. Sequelae and indications for repair include enophthalmos and/or diplopia from extraocular muscle entrapment. Alloplastic implant placement with careful release of periorbital fat and extraocular muscles can effectively restore extraocular movements, orbital integrity, and anatomic volume. However, rare but devastating complications such as retrobulbar hematoma (RBH) can occur after repair, which pose a risk of permanent vision loss if not addressed emergently...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27823937/orbital-blowout-fractures-a-novel-computed-tomographic-measurement-that-can-predict-the-likelihood-of-surgical-management
#8
Tamer N Mansour, Megan Rudolph, Derek Brown, Natalie Mansour, M Reza Taheri
OBJECTIVE: The purpose of this study is to identify an accurate and reliable computed tomographic (CT) measurement that can identify those patients presenting to the emergency department (ED) with orbital floor fracture (BOF) who require surgical repair to prevent ensuing visually debilitating diplopia and/or enophthalmos. METHODS: In this retrospective institutional review board-approved study, we reviewed 99 patients older than 18 years with orbital fractures treated in a level I trauma center from 2011 through 2015...
October 14, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27822361/serious-bicycle-crash-injury-in-chiropractic-practice-a-case-report-of-delayed-diagnosis
#9
Lars Uhrenholt
BACKGROUND: Bicyclists are vulnerable road users and are at risk of serious spinal injury if involved in traffic crashes. In Denmark approximately 25 bicyclists are killed each year and some 20.000 bicycle related casualties are registered in the National Patient Registry each year. In addition to these figures, a large number of casualties remain unregistered despite injury. Many of the casualties will consult chiropractors in primary practice with or without preceding evaluation in the established emergency care facilities...
2016: Chiropractic & Manual Therapies
https://www.readbyqxmd.com/read/27818032/laryngeal-injury-and-pneumomediastinum-due-to-minor-blunt-neck-trauma-case-report
#10
Yasutaka Kuniyoshi, Azusa Kamura, Sumie Yasuda, Makoto Tashiro, Yoichiro Toriyabe
BACKGROUND: Serious isolated laryngeal injuries are uncommon in children. CASE REPORT: We describe the case of an 8-year-old boy with laryngeal injury and pneumomediastinum due to minor blunt neck trauma. He presented to the emergency department complaining of odynophagia and hoarseness, but without respiratory distress. Emphysema was seen between the trachea and vertebral body on initial cervical spine x-ray study, and flexible laryngoscopy revealed erythema and mild edema of both the right vocal cord and the arytenoid region...
November 3, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27800460/metacarpal-neck-fractures-a-review-of-surgical-indications-and-techniques
#11
REVIEW
Eric M Padegimas, William J Warrender, Christopher M Jones, Asif M Ilyas
CONTEXT: Hand injuries are a common emergency department presentation. Metacarpal fractures account for 40% of all hand fractures and can be seen in the setting of low or high energy trauma. The most common injury pattern is a metacarpal neck fracture. In this study, the authors aim to review the surgical indications for metacarpal neck fractures, the fixation options available along with the risk and benefits of each. EVIDENCE ACQUISITION: Literature review of the different treatment modalities for metacarpal neck fractures...
September 2016: Archives of Trauma Research
https://www.readbyqxmd.com/read/27799653/-reboa-is-it-really-safe-a-case-with-massive-intracranial-hemorrhage-possibly-due-to-endovascular-balloon-occlusion-of-the-aorta-reboa
#12
Hayaki Uchino, Nobuichiro Tamura, Ryosuke Echigoya, Tetsunori Ikegami, Toshio Fukuoka
BACKGROUND Non-compressible torso hemorrhage continues to be the leading cause of preventable death in trauma patients. Recent case series report that resuscitative endovascular balloon occlusion of the aorta (REBOA) in the trauma population is a technically feasible method to manage the patients with exsanguinating hemorrhage. On the other hand, it seems that REBOA is being widely promoted prematurely. Complications due to REBOA haven't been reported much in the literature, and they could have been underestimated...
November 1, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27792069/management-of-hand-injuries-part-ii
#13
Elda G Ramirez, K Sue Hoyt
Hand injuries are a frequent emergency department occurrence and account for most upper extremity injuries. Proper assessment and management of hand injuries can reduce morbidity and prevent long-term disability. "Assessment of Acute Hand Injuries" Part I was discussed in the Advanced Emergency Nursing Journal (). Part II herein discusses the epidemiology, radiographs, and the management of hand lacerations, fingertip injuries, and fractures. Part III will discuss the management of tendon, ligamentous, neurovascular, and other special hand injuries along with the management of selected chronic hand conditions...
October 2016: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/27767903/neurosurgical-sequelae-of-domestic-dog-attacks-in-children
#14
Ramesh Kumar, Frederic W B Deleyiannis, Corbett Wilkinson, Brent R O'Neill
OBJECTIVE The authors' goals in this study were to describe a series of dog attacks on children that required neurosurgical consultation and to better understand the pattern of injuries inflicted, the circumstances that place children at risk for attack, and the dog breeds involved. In addition, the authors review the surgical and medical management of these patients. METHODS The authors performed a retrospective review of all children requiring neurosurgical consultation for dog bite at a regional Level 1 pediatric trauma center over a 15-year period...
October 21, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27755266/pediatric-phalanx-fractures
#15
Joshua M Abzug, Karan Dua, Andrea Sesko Bauer, Roger Cornwall, Theresa O Wyrick
Phalangeal fractures are the most common type of hand fracture that occurs in the pediatric population and account for the second highest number of emergency department visits for fractures in the United States. The incidence of phalangeal fractures is the highest in children aged 10 to 14 years, which coincides with the time that most children begin playing contact sports. Younger children are more likely to sustain a phalangeal fracture in the home setting as a result of crush and laceration injuries. Salter-Harris type II fractures of the proximal phalanx are the most common type of finger fracture...
November 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27693868/ilizarov-bone-transport-after-massive-tibial-trauma-case-report
#16
Nader S Alkenani, Mariam A Alosfoor, Abdulaziz K Al-Araifi, Hala A Alnuaim
INTRODUCTION: This is a case report of extreme lengthening of the tibia of about 14.5cm using bone transport technique following road traffic accident trauma to the lower limbs. The management of the subsequent massive skeletal defects was challenging to orthopedic surgeons. Based on reported cases, the highest tibial lengthening was 22cm using bifocal transport, while the highest unifocal tibial lengthening reached 14.5cm. CASE PRESENTATION: A 20-year-old male driver was brought to the emergency department after a road traffic accident...
September 3, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27663240/incidence-and-patterns-of-maxillofacial-trauma-a-retrospective-analysis-of-3611-patients-an-update
#17
P Manodh, D Prabhu Shankar, Devadoss Pradeep, Rajan Santhosh, Aparna Murugan
BACKGROUND: Maxillofacial fractures occur in a significant proportion worldwide and can occur as an isolated injury or in combination with other severe injuries including cranial, spinal, and upper and lower body injuries requiring prompt diagnosis with possible emergency interventions. The epidemiology of facial fractures varies with regard to injury type, severity, and cause and depends on the population studied. Hence, understanding of these factors can aid in establishing clinical and research priorities for effective treatment and prevention of these injuries...
September 23, 2016: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27659369/the-construction-and-implementation-of-a-clinical-decision-making-algorithm-reduces-the-cost-of-adult-fracture-clinic-visits-by-up-to-%C3%A2-104-800-per-year-a-quality-improvement-study
#18
P Legg, D Ramoutar, F Shivji, B Choudry, S Milner
INTRODUCTION Inappropriate referrals to the new patient fracture clinic unnecessarily consume hospital resources and many hospitals lack clear guidelines as to what should be referred. Many of these injuries can be definitively managed by the emergency department. Our aim was to construct and disseminate a clinical decision-making algorithm to reduce the frequency of inappropriate referrals to fracture clinics at our institution, to improve the management of patients with minor injuries and save the hospital and the patient the cost of unnecessary visits...
September 23, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27658550/calcaneus-fractures-a-possible-musculoskeletal-emergency
#19
Tyler Snoap, Matthew Jaykel, Cayla Williams, Jason Roberts
BACKGROUND: Calcaneal fractures are commonly seen and treated in the emergency department. There are subsets of calcaneal fractures that pose a high risk to the adjacent soft tissue of the heel and can result in full-thickness tissue necrosis. OBJECTIVE: To identify which calcaneal fractures need to be managed within hours and triaged to the orthopedic team and which can be temporized in a neutral or plantarflexed ankle splint and seen in an outpatient setting. DISCUSSION: Tongue-type calcaneal fractures and tuberosity fractures must be triaged appropriately within the first few hours of presentation to prevent skin compromise...
September 19, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27640877/associations-of-emergency-department-length-of-stay-with-publicly-reported-quality-of-care-measures
#20
Anna Marie Chang, Amber Lin, Rongwei Fu, K John McConnell, Benjamin Sun
OBJECTIVE: The Institute of Medicine identified emergency department (ED) crowding as a critical threat to patient safety. We assess the association between changes in publicly reported ED length-of-stay (LOS) and changes in quality-of-care measures in a national cohort of hospitals. METHODS: Longitudinal analysis of 2012 and 2013 data from the American Hospital Association (AHA) Survey, Center for Medicare and Medicaid Services (CMS) Cost Reports, and CMS Hospital Compare...
September 19, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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