1
|
Adya KA, Inamadar A. Reactive perforating collagenosis: dermoscopic aspects and differential diagnosis. BMJ Case Rep 2024; 17:e259852. [PMID: 38594202 PMCID: PMC11015275 DOI: 10.1136/bcr-2024-259852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Affiliation(s)
- Keshavmurthy A Adya
- Dermatology Venereology and Leprosy, Shri B M Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur, Karnataka, India
| | - Arun Inamadar
- Dermatology Venereology and Leprosy, Shri B M Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapur, Karnataka, India
| |
Collapse
|
2
|
Osmani HT, Nicolaou N, Anand S, Gower J, Metcalfe A, McDonnell S, Siddiqui F, Carter H, Room J, Kirbyshire H, Hay L, Iqbal S, Gerleman S. Future research priorities for soft-tissue knee injuries. Bone Joint J 2024; 106-B:232-239. [PMID: 38423072 DOI: 10.1302/0301-620x.106b3.bjj-2023-0946.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Aims To identify unanswered questions about the prevention, diagnosis, treatment, and rehabilitation and delivery of care of first-time soft-tissue knee injuries (ligament injuries, patella dislocations, meniscal injuries, and articular cartilage) in children (aged 12 years and older) and adults. Methods The James Lind Alliance (JLA) methodology for Priority Setting Partnerships was followed. An initial survey invited patients and healthcare professionals from the UK to submit any uncertainties regarding soft-tissue knee injury prevention, diagnosis, treatment, and rehabilitation and delivery of care. Over 1,000 questions were received. From these, 74 questions (identifying common concerns) were formulated and checked against the best available evidence. An interim survey was then conducted and 27 questions were taken forward to the final workshop, held in January 2023, where they were discussed, ranked, and scored in multiple rounds of prioritization. This was conducted by healthcare professionals, patients, and carers. Results The top ten included questions regarding prevention, diagnosis, treatment, and rehabilitation. The number one question was, 'How urgently do soft-tissue knee injuries need to be treated for the best outcome?'. This reflects the concerns of patients, carers, and the wider multidisciplinary team. Conclusion This validated process has generated ten important priorities for future soft-tissue knee injury research. These have been submitted to the National Institute for Health and Care Research. All 27 questions in the final workshop have been published on the JLA website.
Collapse
Affiliation(s)
- Humza T Osmani
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Cambridge, UK
| | | | | | - Jonathan Gower
- James Lind Alliance, National Institute for Health and Care Research, School of Healthcare Enterprise and Innovation, University of Southampton, Southampton, UK
| | - Andrew Metcalfe
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Stephen McDonnell
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Cambridge, UK
| | | | | | | | | | | | | | | |
Collapse
|
3
|
Clark NW, Barrett DM, Kahmke RR, Powers DB, Woodard CR. Soft Tissue Trauma: Critical Recognition and Timing of Intervention in Emergency Presentations. Otolaryngol Clin North Am 2023; 56:1003-1012. [PMID: 37328319 DOI: 10.1016/j.otc.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The facial trauma surgeon will see a variety of facial injuries. Recognition of emergency cases and proper intervention is and this article aims to highlight those cases and the respective proper interventions.
Collapse
Affiliation(s)
- Nicholas W Clark
- Department of Head and Neck Surgery, Communication Sciences, Duke South Yellow Zone, 4000 DUMC Box 3805, Durham, NC 27710, USA
| | - Dane M Barrett
- Department of Head and Neck Surgery, Communication Sciences, Duke South Yellow Zone, 4000 DUMC Box 3805, Durham, NC 27710, USA
| | - Russel R Kahmke
- Department of Head and Neck Surgery, Communication Sciences, Duke South Yellow Zone, 4000 DUMC Box 3805, Durham, NC 27710, USA
| | - David B Powers
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, DUMC 2955, Durham, NC 27710, USA
| | - Charles R Woodard
- Department of Head and Neck Surgery, Communication Sciences, Duke South Yellow Zone, 4000 DUMC Box 3805, Durham, NC 27710, USA.
| |
Collapse
|
4
|
Hughes AJ, Joseph VM, Roy K, Lougher L. Cervico-thoracic Morel-Lavallée lesion. BMJ Case Rep 2023; 16:e253510. [PMID: 37977836 PMCID: PMC10660921 DOI: 10.1136/bcr-2022-253510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Morel-Lavallée lesions (MLLs) result from high-energy trauma causing separation of subcutaneous tissue from the underlying tissue, most commonly in the gluteal region or thigh.We report the case of a woman in her 40s with a fluctuant collection of the cervico-thoracic region following trauma. Further imaging identified an MLL. An orthoplastic approach resulted in non-operative management with a spinal brace. Three months from initial injury, the lesion completely resolved. She was symptom free at final follow-up and discharged.We present the only recorded case of MLL developing in the cervico-thoracic region. Management posed difficultly as no literature currently exists. We demonstrated conservative management for cervico-thoracic MLL can be effective.We have described the first documented case of cervico-thoracic MLL. MLL is not exclusive to pelvic injuries and can develop in the cervico-thoracic region. We have shown conservative management is a viable treatment of atypical MLL.
Collapse
Affiliation(s)
- Andrew James Hughes
- Trauma and Orthopaedics, Cwm Taf Morgannwg University Health Board, Abercynon, UK
| | - Vinay Mathew Joseph
- Trauma and Orthopaedics, Cwm Taf Morgannwg University Health Board, Abercynon, UK
| | - Kunal Roy
- Trauma and Orthopaedics, Cwm Taf Morgannwg University Health Board, Abercynon, UK
| | - Laura Lougher
- Trauma and Orthopaedics, Cwm Taf Morgannwg University Health Board, Abercynon, UK
| |
Collapse
|
5
|
Luisetto M, Legrand A, Vandromme E, Boulares S, Delahaut O. Morel-Lavallée lesion associated with atypical skin damage: a case report. Acta Orthop Belg 2021; 87:751-754. [PMID: 35172443 DOI: 10.52628/87.4.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A Morel-Lavallée lesion is a post-traumatic, soft tissue lesion that is little known and for which there is no standard treatment. This report describes the case of a 51-year-old man who presented with a large Morel-Lavallée lesion on the left calf that was not diagnosed on two visits to the emergency department. Given the deteriorating condition of the skin, we performed surgical drainage of the effusion because the skin was showing signs of major damage. Complications occurred following surgery, with cellulitis in the lower limb caused by Citrobacter Koseri, a gram-negative bacillus that is rarely implicated in soft tissue infections, and wound dehiscence. The purpose of our article is to present the difficulty involved in choosing the right treatment from among the many proposed in the literature, and to inform any practitioner working in an emergency setting about the existence of this often overlooked condition.
Collapse
|
6
|
Abstract
BACKGROUND Differential diagnosis of soft tissue swelling on exposed body parts in the young athlete is large and mostly includes benign self-limiting conditions, once underlying lesion to the bone, the cartilage, and the ligaments is excluded. Morel-Lavallée lesion represents a rare soft tissue injury requiring prompt intervention to ensure favorable outcome. CASES A 10-year-old boy presented with 2-week-old swelling of the medial side of the knee without recent traumatic event. Unawareness of Morel-Lavallée lesion in the differential diagnosis led to delayed diagnosis and treatment. A 16-year-old boy came to our pediatric tertiary care center with a similar presentation and history. Timely intervention allowed for favorable outcome and early return to play. CONCLUSIONS Morel-Lavallée lesion is a rare entity in the pediatric population, although underreporting due to unfamiliarity with the diagnosis is highly probable. Raising awareness among professionals in charge of young athletes should allow for better reporting as well as for elaboration of a standardized treatment plan, including rapid intervention and early return to play.
Collapse
Affiliation(s)
- Natalie Divjak
- From the Division of Surgery of the Child and the Adolescent, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | | | | |
Collapse
|
7
|
Brauns A, Lammens J. The challenge of the infected pilon tibial non-union: treatment with radical resection, bone transport and ankle arthrodesis. Acta Orthop Belg 2020; 86:335-341. [PMID: 33418626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A significant number of patients with pilon tibial fractures develop complications, the most devastating being a combination of infection and non-union with bone loss. The results of the Ilizarov bone transport technique were retrospectively evaluated in ten patients. All underwent an extensive resection and reconstruction aiming at an ankle arthrodesis. The outcome was registered by clinical and radiographic examination as proposed by Paley's functional and bone results classification. A good healing at the level of the docking site could be obtained in all patients but with a re- intervention in 8 of the 10. In 5 of these patients, re-intervention with a transcalcaneal nailing leaded to the final healing. Other options are debridement of the docking site (2 patients) and a new Ilizarov procedure (1 patient). If patients are prepared to participate in a long-term treatment with the risk of multiple interventions a reconstruction can be performed, resulting in a limb with an acceptable function, allowing all activities of daily life and even a professional occupation. To obtain this final result with a definite union at the docking site a secondary retrograde intramedullary nailing is considered a valuable and safe procedure.
Collapse
|
8
|
El-Rosasy MA, Ayoub MA. Traumatic Composite Bone and Soft Tissue Loss of the Leg: Region-Specific Classification and Treatment Algorithm. Injury 2020; 51:1352-1361. [PMID: 32327233 DOI: 10.1016/j.injury.2020.03.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The management of traumatic composite bone and soft tissue loss (TCBSTL) requires a classification system and decision-making algorithm for the purpose of description, prognosis and choice of treatment method. PATIENTS AND METHODS between the year 2000 and 2017 a series of 254 cases of TCBSTL were treated using distraction histogenesis and external fixation techniques. The tissue loss was due to either the initial injury or debridement of infection. Adjunctive procedures included split thickness skin grafting and ICBG when indicated. A classification system was designed by the author. The classification is based on factors that influence management and prognosis; (1) stability of the host bone (intact tibia or a well-fixed fracture), (2) presence or absence of infection in the fracture site, (3) size of bone defect, and (4) contamination (infection) of the medullary cavity. A flowchart and decision-making algorithm was subsequently developed. RESULTS Ilizarov external fixator was used in all cases. Ten cases (4%) had combined Masquelet - Ilizarov technique. One hundred seventy five cases (68.9%) had gradual distraction-compression (GDC) technique; while 79 cases (31.1%) had acute shortening and re-lengthening (ASRL) technique. Seventy-two cases (28.3%) had autogenous iliac crest bone graft (ICBG). All cases (100%) had complete clinical and radiological fracture union. All patients completed the follow up that ranged from 24 to 118 months (mean 43.3 ± 23). The results were satisfactory in 212 cases (83.5%) and unsatisfactory in 42 (16.5%) cases due to residual leg length discrepancy, joint stiffness, and persistent pain. DISCUSSION the proposed classification is simple, applicable, recallable and includes most scenarios of reconstructable TCBSTL. The classification provides a basis for communication, description and evaluation of such cases. The algorithm, based on our classification, provides a guideline for management without over/under treatment.
Collapse
Affiliation(s)
- Mahmoud A El-Rosasy
- Department of Orthopaedic Surgery & Traumatology, Tanta University, Faculty of Medicine, Tanta, Egypt.
| | - Mostafa A Ayoub
- Department of Orthopaedic Surgery & Traumatology, Tanta University, Faculty of Medicine, Tanta, Egypt
| |
Collapse
|
9
|
Kalaria SS, Boson A, Griffin LW. Liposuction Treatment of a Subacute Morel-Lavallée Lesion: A Case Report. Wounds 2020; 32:E23-E26. [PMID: 32335518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION A Morel-Lavallée lesion (MLL) is a rare and aesthetically concerning condition caused by a shearing force between subcutaneous fat and underlying fascia. Subsequent seroma formation occurs after the initial trauma of a crush injury, ligamentous sprain, or abdominal liposuction. Misdiagnosed lesions lead to inadequate treatment and are a source of chronic pain. CASE REPORT The case of a 33-year-old woman who presented with a large, painful subacute MLL of the left thigh after being run over by a truck 3 weeks prior is reported. Physical examination revealed severe hyperesthesia and fluctuance of the left thigh. After confirmation of the fluid collection by X-ray and computed tomography angiogram, the authors performed liposuction of the cavity and seroma wall to evacuate and treat the lesion. Postoperative care consisted of a temporary drain, thigh compression, and oral antibiotics. Immediate reduction in size was appreciated intraoperatively with no reaccumulation of fluid at postoperative visits on week 1 and week 6. The pathology report confirmed seroma etiology, and all cultures of the fluid returned negative. At the end of her postoperative course, the patient reported a reduction in pain and no recurrence of her symptoms. CONCLUSIONS This case of MLL was diagnosed early and successfully treated with liposuction, resulting in an acceptable cosmetic outcome. It is the authors' hope that this case report will lead to earlier diagnosis and proper treatment of MLLs.
Collapse
Affiliation(s)
- Shana S Kalaria
- Division of Plastic Surgery, University of Texas Medical Branch, Galveston, TX
| | - Alexis Boson
- School of Medicine, University of Texas Medical Branch, Galveston, TX
| | - Lance W Griffin
- Division of Trauma and Acute Care Surgery, Department of Surgery, University of Texas Medical Branch, Galveston, TX
| |
Collapse
|
10
|
Reid DBC, Daniels AH, Haque MU, Palumbo MA. Successful Treatment of Morel-Lavallée Lesion of the Back With Transcutaneous Transmyofascial Bolstered Progressive Tension Suturing. Orthopedics 2019; 42:e399-e401. [PMID: 31323112 DOI: 10.3928/01477447-20190624-08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/29/2018] [Indexed: 02/03/2023]
Abstract
The authors describe their experience in successfully treating an isolated Morel-Lavallée lesion of the lumbar spine after delayed presentation. In addition to thorough irrigation, debridement, and pseudo-capsulectomy, surgical management included transcutaneous transmyofascial bolstering with a progressive tension suturing technique to close the cavity over drains in a "quilting" fashion. This was followed by 6 days of incisional wound vacuum treatment and 13 days of drainage through 2 Jackson-Pratt drains. At 6-month follow-up, the patient noted resolution of pain and return to baseline level of functioning. No evidence of recurrence was noted. The Morel-Lavallée lesion of the low back represents a difficult soft tissue injury to treat with substantial risk of complications and recurrence. Diagnosing and treating physicians should be familiar with common injury mechanisms and clinical presentations, as well as a variety of nonoperative and operative treatment options. [Orthopedics. 2019; 42(4):e399-e401.].
Collapse
|
11
|
Hu D, Meng C, Hu J, Zhou Y, Lu S, Yu Y, Fang L, Sun Y. Ilioinguinal Flap Combined With Tensor Fascia Lata Muscle Flap to Repair Deep Electrical Burns in the Lower Abdomen: A Report of Two Cases. Wounds 2019; 31:E42-E45. [PMID: 31373558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Electrical burns are caused by the conversion of electrical energy flowing through the body into heat energy, which can cause coagulative necrosis of the skin and deep tissues. Deep tissue damage is often more serious than skin damage. Electrical burns have the characteristics of destructive and progressive damage and present the common symptoms of severe local tissue damage accompanied by a wide range of deep tissue necrosis, resulting in injury of nerves, blood vessels, bones, and internal organs. Autologous skin grafting alone cannot effectively cover deep tissues or repair electrical burn wounds. CASE REPORT This article describes 2 patients with deep electrical burns in the lower abdomen that showed extensive skin and soft tissue damage, partial necrosis of abdominal muscle tissue, and weak abdominal wall. As a single tissue flap was too small to effectively cover the defect wound, ilioinguinal flap and tensor fascia lata muscle flap were utilized in both cases with good outcomes. These flaps survived completely, and the wounds were effectively repaired. After repair, the shape was satisfactory, and the function of the lower abdomen was normal. CONCLUSIONS Transfer of flaps from a site near the wound for repairing electrical burns is convenient for transfer with minimal surgical trauma and a simpler operating procedure than the free flap.
Collapse
Affiliation(s)
- Delin Hu
- Department of Burn, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Chengying Meng
- Department of Burn, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jiayan Hu
- Department of Burn, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yan Zhou
- Department of Burn, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Shiping Lu
- Department of Burn, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Youxin Yu
- Department of Burn, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Linsen Fang
- Department of Burn, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yexiang Sun
- Department of Burn, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| |
Collapse
|
12
|
de Juan Marín M, García Martínez I, Milagros La Jara D, Pérez Arias Á. [Morel-Lavallée lesions the importance of early diagnosis]. Emergencias 2019; 29:433-434. [PMID: 29188926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Marta de Juan Marín
- Servicio de Cirugía Plástica y Reconstructiva, Hospital Universitario Central de Asturias, Oviedo, España
| | - Irene García Martínez
- Servicio de Cirugía Plástica y Reconstructiva, Hospital Universitario Central de Asturias, Oviedo, España
| | - Diana Milagros La Jara
- Servicio de Cirugía Plástica y Reconstructiva, Hospital Universitario Central de Asturias, Oviedo, España
| | - Ángel Pérez Arias
- Servicio de Cirugía Plástica y Reconstructiva, Hospital Universitario Central de Asturias, Oviedo, España
| |
Collapse
|
13
|
Müller C, Zippelius T, Strube P, Seeger JB, Brinkmann O, Matziolis G, Wagner A. Calcaneal Displacement Osteotomies - Less Soft Tissue Irritation in Lateral Compression Plate than Screws. Acta Chir Orthop Traumatol Cech 2018; 85:54-56. [PMID: 30257770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED PURPOSE OF THE STUDY With the concept of the lateral compression plate (LLCP) a technique has been available designed to combine the advantages of a fixed-angle fixation with a complete sinking of the implant into the proximal bone. The objective of the present study was to investigate the results of the LLCP compared with classical screw osteosynthesis (SO). MATERIAL AND METHODS 31 patients with pes planovalgus who received calcaneal displacement osteotomy and osteosyntheses with screws (n = 17) or LLCP (n = 14) between 2010 and 2015 were investigated retrospectively.The ankle-hindfoot scale, Kaikkonen score, VAS, and the SF-36 were determined preoperatively as well as at the last clinical follow-up. In addition, a radiological control of osseous integration was performed in all patients 12 weeks after surgery. RESULTS With regard to clinical scores both methods depicted significant improvement. In the overall cohort there were no pseudarthroses. In the SO group 5 cases (29%) showed hardware irritation, in the LLCP group there were none. Results in the LLCP group were significantly superior in the area of the physical section of the SF 36. CONCLUSIONS Based on the results of our study, surgical treatment of stage II pes planovalgus by means of calcaneal displacement osteotomy using the LLCP is equivalent to SO with a lower incidence of hardware irritation. Key words:pes planovalgus, lateral compression plate, osteosynthesis, screw, hardware irritation. LEVEL OF EVIDENCE Level IV, retrospective case serie.
Collapse
Affiliation(s)
- C Müller
- Orthopaedic Department, University Hospital Jena, Campus Eisenberg,Germany
| | | | | | | | | | | | | |
Collapse
|
14
|
Suprun AS, Oleynik GA, Grigoryeva TG, Tsogoyev AA. [THE ELECTRICAL CONDUCTIVITY OF THE TISSUE IN THE EXPERIMENT AS A MODERN METHOD OF VIABILITY SCALPED LIMB INJURIES DIAGNOSTIC]. Klin Khir 2017:71-76. [PMID: 30273460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In experimental research the method for determining of viability of tissue and device for its realization were developed to improve treatment results degloving injuries of limbs.
Collapse
|
15
|
Manodh P, Prabhu Shankar D, Pradeep D, Santhosh R, Murugan A. Incidence and patterns of maxillofacial trauma-a retrospective analysis of 3611 patients-an update. Oral Maxillofac Surg 2016; 20:377-383. [PMID: 27663240 DOI: 10.1007/s10006-016-0576-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 09/08/2016] [Indexed: 06/06/2023]
Abstract
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. MATERIALS AND METHODS In this present retrospective study, we provide a comprehensive overview regarding cranio-maxillofacial trauma on 3611 patients to assist the clinician in assessment and management of this unique highly specialized area of traumatology. A preformed pro forma was used to analyze the medical records of patients treated for facial trauma in The Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai. The distribution according to age, gender, etiology, type of injury, time interval between accident and treatment, loss of consciousness, facial bones involved, pattern of fracture lines, treatment offered, and postoperative complications were recorded and evaluated. RESULTS We inferred male patients sustained more injuries mostly in the third decade of age. Road traffic accidents were the most common cause of injury. Mandible was the most commonly fractured bone in the facial skeleton. Soft tissue injuries occurred more in road traffic accidents and upper lip was the commonest site of injury. CONCLUSION Our study provides insights into the epidemiology of facial injuries and associated factors and can be useful not only in developing prevention strategies but also for grading the existing legal regulations and also for framing a more effective treatment protocol.
Collapse
Affiliation(s)
- P Manodh
- OMFS, Meenakhi Ammal Dental College, Alapakkam Road, Chennai, Tamil Nadu, 600095, India
| | - D Prabhu Shankar
- OMFS, Meenakhi Ammal Dental College, Alapakkam Road, Chennai, Tamil Nadu, 600095, India
| | - Devadoss Pradeep
- OMFS, Meenakhi Ammal Dental College, Alapakkam Road, Chennai, Tamil Nadu, 600095, India
| | - Rajan Santhosh
- OMFS, Meenakhi Ammal Dental College, Alapakkam Road, Chennai, Tamil Nadu, 600095, India
| | - Aparna Murugan
- OMFS, Meenakhi Ammal Dental College, Alapakkam Road, Chennai, Tamil Nadu, 600095, India.
| |
Collapse
|
16
|
Burtt KE, Rounds AD, Leland HA, Alluri RK, Patel KM, Carey JN. Patient and Surgical Factors Contributing to Perioperative Infection in Complex Lower Extremity Trauma. Am Surg 2016; 82:940-943. [PMID: 27779978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Infections in the traumatized lower extremity are a significant source of morbidity and expense. Outcomes after vascularized soft tissue reconstruction were analyzed to determine impact on infection rates. A retrospective review of a prospectively maintained database was performed, including 114 trauma patients requiring soft tissue reconstruction of lower extremity injuries at an urban Level I tertiary referral center from 2008 to 2015. Patient characteristics and perioperative outcomes were analyzed. After trauma, 39 (34.2%) patients developed wound infections, of which 74.4 per cent of infections occurred before soft tissue coverage. Isolated lower extremity injury yielded a 4-fold increase in the incidence of infection. Infection rates doubled in patients who smoked, sustained a fall, had a proximal third of the lower leg wound, or underwent external fixation. Comorbid diabetes, underlying fracture, and wound size were not predictive of infection. Overall, there was a 97.4 per cent rate of limb salvage after soft tissue reconstruction. In patients with infection before soft tissue reconstruction, a salvage rate of 96.6 per cent was achieved. Soft tissue reconstruction in the traumatized and infected lower extremity resulted in high limb salvage success rates, demonstrating vascularized tissue transfer in lower extremity injuries is effective in treating lower extremity infection.
Collapse
Affiliation(s)
- Karen E Burtt
- Keck School of Medicine of University of Southern California, Los Angeles, California, USA
| | | | | | | | | | | |
Collapse
|
17
|
Abstract
This article outlines adductor-related groin pain, pubic-related groin pain, inguinal-related groin pain, and iliopsoas-related groin pain, with a description of the corresponding functional anatomy and imaging findings. The imaging has been described mainly in terms of MR imaging findings as this is the principal imaging modality used to investigate groin pain, although plain radiographs and ultrasound can be very useful adjuncts in specific circumstances, especially if an alternative pathology needs to be excluded.
Collapse
Affiliation(s)
- Annu Chopra
- X-Ray department, Musculoskeletal Centre, Leeds Teaching Hospitals, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK
| | - Philip Robinson
- X-Ray department, Musculoskeletal Centre, Leeds Teaching Hospitals, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK; Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals, Chapel Allerton Hospital, Chapletown Road, Leeds LS7 4SA, UK.
| |
Collapse
|
18
|
Kim YW, Kim Y, Kim JM, Hong JS, Lim HS, Kim HS. Is poststroke complex regional pain syndrome the combination of shoulder pain and soft tissue injury of the wrist?: A prospective observational study: STROBE of ultrasonographic findings in complex regional pain syndrome. Medicine (Baltimore) 2016; 95:e4388. [PMID: 27495051 PMCID: PMC4979805 DOI: 10.1097/md.0000000000004388] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Patients with poststroke complex regional pain syndrome (CRPS) show different symptoms compared to other types of CRPS, as they usually complain of shoulder and wrist pain with the elbow relatively spared. It is thus also known by the term "shoulder-hand syndrome."The aim of this study is to present a possible pathophysiology of poststroke CRPS through ultrasonographic observation of the affected wrist before and after steroid injection at the extensor digitorum communis (EDC) tendon in patients suspected with poststroke CRPS.Prospective evaluation and observation, the STROBE guideline checklist was used.Twenty-three patients diagnosed as poststroke CRPS in accordance to clinical criteria were enrolled. They had a Three Phase Bone Scan (TPBS) done and the cross-sectional area (CSA) of EDC tendon was measured by using ultrasonography. They were then injected with steroid at the EDC tendon. The CSA of EDC tendon, visual analogue scale (VAS), and degree of swelling of the wrist were followed up 1 week after the injection.TPBS was interpreted as normal for 4 patients, suspected CRPS for 10 patients, and CRPS for 9 patients. Ultrasonographic findings of the affected wrist included swelling of the EDC tendon. After the injection of steroid to the wrist, CSA and swelling of the affected wrist compared to that before the treatment was significantly decreased (P < 0.001). The VAS score declined significantly after the injection (P < 0.001).Our results suggest that the pathophysiology of poststroke CRPS might be the combination of frozen shoulder or rotator cuff tear of shoulder and soft tissue injury of the wrist caused by the hemiplegic nature of patients with stroke.
Collapse
Affiliation(s)
- Yong Wook Kim
- Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Severance Hospital
| | - Yoon Kim
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital
| | - Jong Moon Kim
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital
| | - Ji Seong Hong
- Departments of Physical Medicine and Rehabilitation, Hando Hospital
| | - Hyun Sun Lim
- Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Hyoung Seop Kim
- Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital
- Correspondence: Hyoung Seop Kim, National Health Insurance Service Ilsan Hospital, Ilsan-ro 100, ilsan-donggu, Goyang, Korea, 10444 (e-mail: )
| |
Collapse
|
19
|
Winsauer S, Gardetto A, Kompatscher P. Pedicled hypothenar perforator flap: Indications and clinical application. J Plast Reconstr Aesthet Surg 2016; 69:843-847. [PMID: 27068643 DOI: 10.1016/j.bjps.2016.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 03/01/2016] [Accepted: 03/06/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIM Soft-tissue defects of the palm and the palmar aspect of the fifth finger are a constant problem in reconstructive hand surgery. We present a possible approach to planning and harvesting pedicled hypothenar perforator flaps for the reconstruction of such defects. METHODS A hypothenar perforator flap was used to reconstruct a soft-tissue defect on the ulnar aspect of the palm and the palmar aspect of the fifth finger of 17 patients. The defects were located over the proximal phalanx of the fifth finger (n = 9), the palm (n = 5), and across both areas (n = 3). The size of the defects was up to 7.9 cm(2). RESULTS Eleven of the flaps healed primarily, out of which partial flap necrosis was observed in six. Four of these six flaps required operative revision, including debridement and delayed primary wound closure, while two healed secondarily. After an average of 26.6 days (range 21-45 days), all 17 patients achieved complete functional recovery. Despite the complications described, all the primary defects remained covered. CONCLUSION The pedicled hypothenar perforator flap is an option for reconstruction of ulnar-sided, soft-tissue defects of the palm and little finger. The flap is thin and the donor-site morbidity is low. Hand surgeons may wish to consider this flap when presented with soft-tissue defects in this area.
Collapse
Affiliation(s)
- S Winsauer
- Department for Plastic, Aesthetic and Reconstructive Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6807, Feldkirch, Austria.
| | - A Gardetto
- Department for Plastic, Aesthetic and Reconstructive Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6807, Feldkirch, Austria
| | - P Kompatscher
- Department for Plastic, Aesthetic and Reconstructive Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6807, Feldkirch, Austria
| |
Collapse
|
20
|
Nambi G, Salunke AA, Chung S, Kumar KR, Chaudhari VA, Dhanwate AD. Extended anterolateral thigh pedicled flap for reconstruction of trochanteric and gluteal defects: A new & innovative approach for reconstruction. Chin J Traumatol 2016; 19:113-5. [PMID: 27140220 PMCID: PMC4897841 DOI: 10.1016/j.cjtee.2015.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Descending branch of the lateral circumflex femoral artery (LCFA) is commonly used pedicle for ante- rolateral thigh (ALT) flap. Oblique branch of LCFA is an alternative pedicle that can be used in micro- vascular surgery. According to review of literature and to the best of our knowledge we could not find the use of oblique branch of LCFA as a pedicle of the ALT flap in regional soft tissue reconstruction. Here we presented a case of a 55-year-old man sustaining soft tissue injury and wound over the left trochanteric and gluteal region following a road traffic accident, who was treated by the use of extended ALT pedicle flap with oblique branch of LCFA as the pedicle for reconstruction of soft tissue defect in trochanteric and gluteal regions with successful outcome.
Collapse
Affiliation(s)
- G.I. Nambi
- Plastic & Reconstructive Microvascular Services, Kovai Medical Center & Hospital, Tamilnadu 641014, India
| | - Abhijeet Ashok Salunke
- Department of Orthopedics, Pramukswami Medical College, Gujrat, India
- Corresponding author.
| | - Szeryn Chung
- Department of Hand Surgery, Singapore General Hospital, Singapore
| | - K.S. Raj Kumar
- General & Laparoscopic Surgical Services, Kovai Medical Center & Hospital, Tamilnadu 641014, India
| | | | | |
Collapse
|
21
|
Leitsch S, Koban KC, Pototschnig A, Titze V, Giunta RE. Multimodal Therapy of Ulcers on the Dorsum of the Hand With Exposed Tendons Caused by Pyoderma Gangrenosum. Wounds 2016; 28:E10-E13. [PMID: 26992198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The authors present the case of a 54-year-old man with ulcers on the dorsal hand and forearm with exposed extensor tendons after he received misdiagnoses at 2 other hospitals, leading to deep soft tissue defects from multiple debridements. Due to the complicated nature of the wound, the ulcers did not heal under the systemic medication. After careful debridement, the defect was primarily closed with a collagen-glycosaminoglycan biodegradable matrix (Integra Matrix Wound Dressing, Integra LifeSciences, Plainsboro, NJ) on the dorsal hand and covered with a mesh graft 14 days later. Necrosis and superinfection over the index finger was treated again with systemic antibiotics and an unmeshed skin graft under a vacuum bandage with a mesh wound contact layer (Mepitel, Mölnlycke Health Care, Norcross, GA). The patient was satisfied with the functional and aesthetic outcome 1 month later when wounds were completely healed. The authors conclude that in cases where patients are living with pyoderma gangrenosum, even a challenging and complicated wound can be handled successfully with correct systemic immuno- suppression and appropriate soft tissue coverage.
Collapse
Affiliation(s)
- Sebastian Leitsch
- Department for Hand Surgery, Plastic Surgery and Aesthetic Surgery at the Ludwig Maximilian University of Munich, Munich, Germany
| | - Konstantin Christoph Koban
- Department for Hand Surgery, Plastic Surgery and Aesthetic Surgery at the Ludwig Maximilian University of Munich, Munich, Germany
| | - Adrian Pototschnig
- Department for Hand Surgery, Plastic Surgery and Aesthetic Surgery at the Ludwig Maximilian University of Munich, Munich, Germany
| | - Virginia Titze
- Department for Hand Surgery, Plastic Surgery and Aesthetic Surgery at the Ludwig Maximilian University of Munich, Munich, Germany
| | - Riccardo Enzo Giunta
- Department for Hand Surgery, Plastic Surgery and Aesthetic Surgery at the Ludwig Maximilian University of Munich, Munich, Germany
| |
Collapse
|
22
|
Callahan CL, Eisenman J. All That Swells Is Not A Bruise The Morel-Lavallée Lesion. J Spec Oper Med 2016; 16:109-111. [PMID: 27045507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Accepted: 03/01/2016] [Indexed: 06/05/2023]
Abstract
Frequently overlooked, Morel-Lavallée lesions are associated with a closed degloving or shearing mechanism causing a dehiscence of underlying soft tissue with formation of a potential space. This space fills with blood, lymph, and cellular debris, giving the lesion a fluctuant appearance on examination. The potential space associated with larger lesions can be a source for hemorrhage in the appropriate clinical context. However, these lesions are often diagnosed late in their clinical course or are misdiagnosed, leading to long-term complications. Management of this injury typically depends upon the size of the lesion. This article discusses a Morel-Lavallée lesion in an active-duty Servicemember requiring treatment by a plastic surgeon and includes the pathophysiology of Morel-Lavallée lesions, diagnostic strategies, and management pearls.
Collapse
|
23
|
Burkhart SS, Ricchetti ET, Levine WN, Galatz LM. Challenges and Controversies in Treating Massive Rotator Cuff Tears. Instr Course Lect 2016; 65:93-108. [PMID: 27049184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Massive rotator cuff tears present several challenges for orthopaedic surgeons. Many rotator cuff tears can be repaired; however, some chronic rotator cuff tears require advanced reconstructive techniques. Repair, if possible, is the optimal treatment for rotator cuff tears. In general, muscle transfers are an option for patients younger than 60 years who do not have pseudoparalysis. Arthroplasty is an option for older patients who have concomitant arthritis and for patients who have pseudoparalysis. Biologic augmentation in the setting of rotator cuff tears continues to evolve, and the application of biologic products should be guided by sound evidence and cost-benefit considerations.
Collapse
Affiliation(s)
- Stephen S Burkhart
- Orthopaedic Surgeon, The San Antonio Orthopaedic Group, San Antonio, Texas
| | | | | | | |
Collapse
|
24
|
Michaylusov RN, Negoduyko VV. [RESULTS OF SURGICAL MAGNETIC INSTRUMENTS APPLICATION FOR SURVEY OF WOUNDS AND REMOVAL OF FERROMAGNETIC FOREIGN BODIES]. Klin Khir 2016:58-60. [PMID: 30256600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The results of the developed set of magnetic surgical instruments for measuring parameters and testing wounds, diagnosis and removal of metallic ferromagnetic foreign bodies were analysed. Is a description of tools and devices, technologies used for the diagnosis and removal of metallic ferromagnetic foreign bodies. Using a magnetic surgical instruments for gunshot wounds has improved the quality of diagnosis and treatment outcomes.
Collapse
|
25
|
Tripathi R, Sharma N, Dwivedi AN, Kumar S. Severity of Soft Tissue Injury Within the Temporomandibular Joint Following Condylar Fracture as Seen on Magnetic Resonance Imaging and Its Impact on Outcome of Functional Management. J Oral Maxillofac Surg 2015; 73:2379.e1-7. [PMID: 26428614 DOI: 10.1016/j.joms.2015.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 09/15/2015] [Accepted: 09/15/2015] [Indexed: 02/05/2023]
Affiliation(s)
- Richik Tripathi
- Service Senior Resident, Oral Maxillofacial Surgery Division, Faculty of Dental Sciences, Institute of Medical Science, Banaras Hindu University, Varanasi, India.
| | - Naresh Sharma
- Professor, Oral Maxillofacial Surgery Division, Faculty of Dental Sciences, Institute of Medical Science, Banaras Hindu University, Varanasi, India
| | - Amit Nandan Dwivedi
- Associate Professor, Radiodiagnosis, Institute of Medical Science, Banaras Hindu University, Varanasi, India
| | - Sanjeev Kumar
- Professor and Department Head, Oral Maxillofacial Surgery Division, ITS Dental College, Muradnagar, India
| |
Collapse
|
26
|
Ligonenko OV, Borysenko MM, Digtyar II, Ivashchenko DM, Zubakha AB, Chorna IO, Shumeyko IA, Storozhenko OV, Gorb LI, Ligonenko OO. [PROGNOSIS OF INFECTIVE COMPLICATIONS OF THE GUN-SHOT WOUNDS OF SOFT TISSUES]. Klin Khir 2015:51-53. [PMID: 27025034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The method of prognostication of infectious complications in a gun-shot wound was elaborated, using the methods of logistic regression analysis.
Collapse
|
27
|
Öksüz S, Alagöz MŞ, Ülkür E. Changing the Donor Site Selection Concept of Facial Skin Expansion from Pure Healthy Tissue to Defect and Healthy Tissue Combination. Aesthetic Plast Surg 2015; 39:745-51. [PMID: 26296638 DOI: 10.1007/s00266-015-0547-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 07/31/2015] [Indexed: 11/25/2022]
Abstract
UNLABELLED Facial defect reconstruction is a challenge for plastic surgeons due to unique esthetic and functional properties of the region. Facial tissue expansion provides an ideal reconstruction resource. However, the donor site is limited in the facial region. Thus, a cost-effective expansion management is crucial for an efficient reconstruction. In this article, the evolution of our donor site preference for tissue expansion from pure healthy tissue to a defect-healthy tissue combination is presented. Fifteen patients underwent skin reconstruction with local tissue expansion for facial and cervical defects. The full facial or cervical region including the defect and healthy tissue combination was determined as the donor expansion site. The donor site was not limited only to pure healthy tissue. The largest size rectangular expander suitable for the combined expandable donor site size was placed under the defect and healthy tissue border, paying attention to carry the expander far beneath the defect site. The defect site and most adjacent healthy tissue were expanded simultaneously. Major complications such as infection, hematoma, rupture, or flap necrosis were not observed. The expansion of defect-healthy tissue border presented successful reconstruction results with acceptable scars. In the traditional tissue expansion concept, using a large size expander to provide more abundant flap gain does not comply with the limited size of healthy donor site in the face. Expanding the whole facial region, without restriction of the defect, supplies excess donor tissue area for larger size expander use. Eventually, defect-healthy tissue border expansion with large expanders results in minimum final scar and less tissue loss in flap relocation and enables optimal flap gain. This method can easily be adapted to any tissue expansion site of the body. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Collapse
Affiliation(s)
- Sinan Öksüz
- Department of Plastic Reconstructive and Aesthetic Surgery, Burn Center, Gulhane Military Medical Academy School of Medicine, Ankara, Turkey,
| | | | | |
Collapse
|
28
|
Havrda JB. Emergency Chest Imaging. Radiol Technol 2015; 87:39-59. [PMID: 26377267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article presents the anatomy of the chest, heart, and upper airway and describes types of traumatic pathology and injuries of the chest. Chest imaging in a variety of settings is described. Radiography, computed tomography, and ultrasonography are discussed, along with the benefits and limitations of each modality. Finally, promising technological developments that could aid chest imaging in emergent situations are reviewed.
Collapse
|
29
|
Kumar Y, Hooda K, Lo L, Karol I. Morel-Lavallée Lesion: A Case of an American Football Injury. Conn Med 2015; 79:477-478. [PMID: 26506679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Morel-Lavallée Lesion (MLL) is a posttraumatic, closed degloving injury where the skin and superficial fascia get separated from deep fascia (fascialata) in the trochanteric region and upper thigh, hence creating a potential space. Similar lesions at other locations (e.g., abdominal wall and lumbar regions) have been described as Morel-Lavallée effusion, hematoma, or extravasation. Injury to an area with rich vascular and lymphatic supply leads to filling of this space with blood, lymph, fat, and necrotic debris. MLL usually presents as painful fluctuant swelling in the anterolateral portion o fthe upper thigh. Many of these maybe missed at initial evaluation and present weeks to months after the initial trauma.
Collapse
|
30
|
Abstract
Osteochondral fractures are traumatic shearing injuries to the cartilage and the subchondral bone which lead to defects in the articular surface and potentially lead to further degeneration and arthritis. Early diagnosis and therapy are therefore very important. As the resolving power of conventional X-rays is limited for this situation, magnetic resonance imaging (MRI) is regarded as the gold standard for diagnostics. Concomitant injuries often occur, such as tearing of the anterior cruciate ligament (ACL) or patellar dislocation resulting in instability of the patella. Concerning treatment options for osteochondral fractures, there are two potential strategies that can be applied: the first is removal of small osteochondral fragments with subsequent formation of regeneration tissue and the second is refixation of the dislocated fragment and therefore a 1-stage reconstruction of the joint surface. It is important to also address concomitant injuries. Even though there is no consensus for a standardized or evidence-based therapy in literature, this article gives an overview of the diagnostics and available therapeutic options.
Collapse
Affiliation(s)
- J Kühle
- Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg, Hugstetter Str. 55, 79098, Freiburg, Deutschland,
| | | | | |
Collapse
|
31
|
Yoshimatsu H, Yamamoto T, Iwamoto T, Haragi M, Narushima M, Iida T, Koshima I. Pedicle-in-a-trench technique for lower extremity reconstruction. J Plast Reconstr Aesthet Surg 2015; 68:1318-9. [PMID: 26037221 DOI: 10.1016/j.bjps.2015.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 04/29/2015] [Accepted: 05/03/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Hidehiko Yoshimatsu
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Takumi Yamamoto
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Taku Iwamoto
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Makiko Haragi
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Mitsunaga Narushima
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Takuya Iida
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Isao Koshima
- Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| |
Collapse
|
32
|
Kovalenko AO. [THERMOMETRY APPLICATION FOR ESTIMATION OF THE SKIN BURNS DEPTH]. Klin Khir 2015:66-68. [PMID: 26263650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Determination of the burn wound depth, using noncontact infrared thermometry, permits to predict the burn affection severity, basing on the revealed difference between local, perifocal temperature and temperature in certain nonaffected areas of the body surface. The temperature difference (ΔT) over 1 °C constitutes a strict criterion of the skin burn presence. The temperature 34 °C have been considered a border one for the skin burns. If the burn wound temperature in 24 h after trauma was lower 34 °C and ΔT 2 °C and more, it have witnessed the presence of deep burn of the skin. High sensitivity (87%) and specificity (96%) of thermometric test in 24 h after trauma were established. In epidermal burns the temperature of the burn wounds have constituted (35.9 ± 0.3) °C at average, in superficial burns of the skin--(35.1 ± 0.6) °C, and in the deep burns--(33.6 ± 0.8) °C.
Collapse
|
33
|
Tzortzis S, Tzifa K, Tikka T, Worrollo S, Williams J, Reid AP, Proops D. A ten-year review of soft tissue reactions around percutaneous titanium implants for auricular prosthesis. Laryngoscope 2015; 125:1934-9. [PMID: 25703159 DOI: 10.1002/lary.25211] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 12/11/2014] [Accepted: 01/20/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS Soft tissue reactions around abutments are the most common complications of percutaneous osseointegrated implants. The main objective of this study was to review our series of osseointegrated implants, evaluate the degree of adverse skin reactions around the auricular abutments, and compare with skin reactions in the pediatric bone-anchored hearing aid (BAHA) population. The reason for comparing these two groups was the difference in abutment shape and position in skin with different characteristics. STUDY DESIGN A retrospective case analysis of 131 patient notes. METHODS We retrospectively studied 131 pediatric and adult patients who underwent an osseointegrated auricular prosthesis over a 10-year period (1997-2007). RESULTS There were 95 adults and 36 children who had been implanted and fitted with an auricular prosthesis during the 10-year study period. All patients were followed up postoperatively for a 2-year minimum up to a 14-year maximum follow-up. Thirteen (13/36, 36%) children and seven adults (7/95, 7%) had a skin reaction around the ear prosthesis. CONCLUSIONS The literature review has supported our study results and has shown that children have higher skin reactions in both BAHA and auricular prostheses than adults. Adverse skin reactions in the pediatric auricular group were significantly lower that the pediatric BAHA group. LEVEL OF EVIDENCE 4
Collapse
Affiliation(s)
- Sevasti Tzortzis
- Department of Otolaryngology, University Hospital Birmingham, Birmingham, United Kingdom
| | - Konstantina Tzifa
- Department of Paediatric ENT, Birmingham Children's Hospital, University Hospital Birmingham, Birmingham, United Kingdom
| | - Theofano Tikka
- Ear, Nose, and Throat Department, University Hospital Birmingham, Birmingham, United Kingdom
| | - Steve Worrollo
- Prosthetics Department, University Hospital Birmingham, Birmingham, United Kingdom
| | - Joanne Williams
- Ear, Nose, and Throat Department, University Hospital Birmingham, Birmingham, United Kingdom
| | - Andrew P Reid
- Department of Paediatric ENT, Birmingham Children's Hospital, University Hospital Birmingham, Birmingham, United Kingdom
| | - David Proops
- Department of Otolaryngology, University Hospital Birmingham, Birmingham, United Kingdom
| |
Collapse
|
34
|
Abstract
Free flaps are still the gold standard for large defects of the lower limb, but propeller perforator flaps have become a simpler and faster alternative to free flaps because of some advantages such as reliable vascular pedicle, wide mobilization and rotation, great freedom in design, low donor site morbidity, and easy harvest with no requirement for anastomosis. But when the vessels show insufficient findings in preoperative evaluation using a Doppler probe or the vessel is injured, the surgeon should avoid performing free flap surgery to prevent flap failure and should select a propeller perforator flap as an alternative method on the condition that more than one perforator is intact. In this study, we report reconstruction of soft tissue defects of the heel with a pedicled propeller flap in postfasciotomy and popliteal artery revascularization state by making an incision on the central portion above the Achilles tendon, which can be covered by the posterior tibial artery perforator or the peroneal artery perforator based flaps. In conclusion, we showed that although the popliteal artery was injured, the soft tissue defect can be reconstructed using a perforator propeller flap if intact distal flow in the anastomosis site was confirmed.
Collapse
Affiliation(s)
- Jin Seok Kang
- Department of Plastic & Reconstructive Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Hwan Jun Choi
- Department of Plastic & Reconstructive Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Min Sung Tak
- Department of Plastic & Reconstructive Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
| |
Collapse
|
35
|
Buisman FE, de Meijer VE. [A woman with a blast injury]. Ned Tijdschr Geneeskd 2015; 159:A8853. [PMID: 26043255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A 39-year-old woman presented with extensive soft tissue injury involving her upper legs and her left hand caused by the explosion of her cell phone. She suffered second and third-degree burns. She underwent surgery. She underwent surgical removal of metal slivers, wound debridement and repair of the soft tissue injury.
Collapse
|
36
|
Almuzara M, Traglia GM, Krizova L, Barberis C, Montaña S, Bakai R, Tuduri A, Vay C, Nemec A, Ramírez MS. A taxonomically unique Acinetobacter strain with proteolytic and hemolytic activities recovered from a patient with a soft tissue injury. J Clin Microbiol 2015; 53:349-51. [PMID: 25392359 PMCID: PMC4290954 DOI: 10.1128/jcm.02625-14] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 10/29/2014] [Indexed: 11/20/2022] Open
Abstract
A taxonomically unique bacterial strain, Acinetobacter sp. A47, has been recovered from several soft tissue samples from a patient undergoing reconstructive surgery owing to a traumatic amputation. The results of 16S rRNA, rpoB, and gyrB gene comparative sequence analyses showed that A47 does not belong to any of the hitherto-known taxa and may represent an as-yet-unknown Acinetobacter species. The recognition of this novel organism contributes to our knowledge of the taxonomic complexity underlying infections caused by Acinetobacter.
Collapse
Affiliation(s)
- Marisa Almuzara
- Laboratorio de Bacteriología Clínica, Departamento de Bioquímica Clínica, Hospital de Clínicas José de San Martín, Facultad de Farmacia y Bioquímica, Buenos Aires, Argentina Laboratorio de Bacteriología, Hospital Interzonal de Agudos Eva Perón, San Martín, Buenos Aires, Argentina
| | - German Matías Traglia
- Instituto de Microbiología y Parasitología Médica (IMPaM, UBA-CONICET), Buenos Aires, Argentina
| | - Lenka Krizova
- Laboratory of Bacterial Genetics, National Institute of Public Health, Šrobárova, Prague, Czech Republic
| | - Claudia Barberis
- Laboratorio de Bacteriología Clínica, Departamento de Bioquímica Clínica, Hospital de Clínicas José de San Martín, Facultad de Farmacia y Bioquímica, Buenos Aires, Argentina
| | - Sabrina Montaña
- Instituto de Microbiología y Parasitología Médica (IMPaM, UBA-CONICET), Buenos Aires, Argentina
| | - Romina Bakai
- Laboratorio de Bacteriología, Hospital Interzonal de Agudos Eva Perón, San Martín, Buenos Aires, Argentina
| | - Alicia Tuduri
- Laboratorio de Bacteriología, Hospital Interzonal de Agudos Eva Perón, San Martín, Buenos Aires, Argentina
| | - Carlos Vay
- Laboratorio de Bacteriología Clínica, Departamento de Bioquímica Clínica, Hospital de Clínicas José de San Martín, Facultad de Farmacia y Bioquímica, Buenos Aires, Argentina
| | - Alexandr Nemec
- Laboratory of Bacterial Genetics, National Institute of Public Health, Šrobárova, Prague, Czech Republic
| | - María Soledad Ramírez
- Instituto de Microbiología y Parasitología Médica (IMPaM, UBA-CONICET), Buenos Aires, Argentina Center for Applied Biotechnology Studies, Department of Biological Science, California State University, Fullerton, Fullerton, California, USA
| |
Collapse
|
37
|
Abstract
Examination of the oral cavity can provide significant diagnostic information regarding the general health of the patient. The oral cavity is affected by a multitude of pathologic conditions of variable cause and significance; however, there are numerous normal variations of oral soft tissue structures that may resemble a pathologic state. Understanding these variations assists practitioners to discriminate between normal versus abnormal findings and determine the appropriate course of management, if necessary.
Collapse
Affiliation(s)
- Farideh M Madani
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
| | - Arthur S Kuperstein
- Oral Medicine Clinical Services, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
| |
Collapse
|
38
|
Abstract
Intra-articular fractures of the tibial plafond are typically the result of rotational or axial loading forces, and both mechanisms of injuries can result in an associated fibula fracture. Rotational distal tibial plafond fractures are typically of lower energy and are associated with less articular injury and chondral impaction, whereas axial load injuries of the distal tibial plafond are associated with a higher incidence of intra-articular and soft tissue injury. The goal of this article is to review the mechanisms of injury, fracture patterns, and potential complications associated with the most common presentations of tibial plafond fractures.
Collapse
Affiliation(s)
- John J Stapleton
- Foot and Ankle Surgery, VSAS Orthopaedics, Lehigh Valley Hospital, 1250 South Cedar Crest Boulevard, Suite # 110, Allentown, PA 18103, USA; Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
| | - Thomas Zgonis
- Reconstructive Foot and Ankle Surgery, Division of Podiatric Medicine and Surgery, Department of Orthopaedic Surgery, University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive MSC 7776, San Antonio, TX 78229, USA
| |
Collapse
|
39
|
Sanchis-Sánchez E, Vergara-Hernández C, Cibrián RM, Salvador R, Sanchis E, Codoñer-Franch P. Infrared thermal imaging in the diagnosis of musculoskeletal injuries: a systematic review and meta-analysis. AJR Am J Roentgenol 2014; 203:875-882. [PMID: 25247955 DOI: 10.2214/ajr.13.11716] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
OBJECTIVE Musculoskeletal injuries occur frequently. Diagnostic tests using ionizing radiation can lead to problems for patients, and infrared thermal imaging could be useful when diagnosing these injuries. CONCLUSION A systematic review was performed to determine the diagnostic accuracy of infrared thermal imaging in patients with musculoskeletal injuries. A meta-analysis of three studies evaluating stress fractures was performed and found a lack of support for the usefulness of infrared thermal imaging in musculoskeletal injuries diagnosis.
Collapse
Affiliation(s)
- Enrique Sanchis-Sánchez
- 1 Department of Physical Therapy, University of Valencia, C. Gasco Oliag 5, Valencia E-46010, Spain
| | | | | | | | | | | |
Collapse
|
40
|
Edwards DS, Davis I, Jones NA, Simon DW. Rapid tracheal deviation and airway compromise due to fluid extravasation during shoulder arthroscopy. J Shoulder Elbow Surg 2014; 23:e163-5. [PMID: 24929747 DOI: 10.1016/j.jse.2014.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 03/19/2014] [Accepted: 03/20/2014] [Indexed: 02/01/2023]
Affiliation(s)
- Dafydd S Edwards
- Department of Trauma and Orthopaedics, Basingstoke Hospitals, Hampshire Hospitals NHS Foundation Trust, Basingstoke, Hampshire, UK.
| | - Ian Davis
- Department of Trauma and Orthopaedics, Basingstoke Hospitals, Hampshire Hospitals NHS Foundation Trust, Basingstoke, Hampshire, UK
| | - Nick A Jones
- Department of Trauma and Orthopaedics, Basingstoke Hospitals, Hampshire Hospitals NHS Foundation Trust, Basingstoke, Hampshire, UK
| | - Dominic W Simon
- Department of Trauma and Orthopaedics, Basingstoke Hospitals, Hampshire Hospitals NHS Foundation Trust, Basingstoke, Hampshire, UK
| |
Collapse
|
41
|
Martínez-Pérez R, Paredes I, Cepeda S, Ramos A, Castaño-León AM, García-Fuentes C, Lobato RD, Gómez PA, Lagares A. Spinal cord injury after blunt cervical spine trauma: correlation of soft-tissue damage and extension of lesion. AJNR Am J Neuroradiol 2014; 35:1029-34. [PMID: 24335539 DOI: 10.3174/ajnr.a3812] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE In patients with spinal cord injury after blunt trauma, several studies have observed a correlation between neurologic impairment and radiologic findings. Few studies have been performed to correlate spinal cord injury with ligamentous injury. The purpose of this study was to retrospectively evaluate whether ligamentous injury or disk disruption after spinal cord injury correlates with lesion length. MATERIALS AND METHODS We retrospectively reviewed 108 patients diagnosed with traumatic spinal cord injury after cervical trauma between 1990-2011. Plain films, CT, and MR imaging were performed on patients and then reviewed for this study. MR imaging was performed within 96 hours after cervical trauma for all patients. Data regarding ligamentous injury, disk injury, and the extent of the spinal cord injury were collected from an adequate number of MR images. We evaluated anterior longitudinal ligaments, posterior longitudinal ligaments, and the ligamentum flavum. Length of lesion, disk disruption, and ligamentous injury association, as well as the extent of the spinal cord injury were statistically assessed by means of univariate analysis, with the use of nonparametric tests and multivariate analysis along with linear regression. RESULTS There were significant differences in lesion length on T2-weighted images for anterior longitudinal ligaments, posterior longitudinal ligaments, and ligamentum flavum in the univariate analysis; however, when this was adjusted by age, level of injury, sex, and disruption of the soft tissue evaluated (disk, anterior longitudinal ligaments, posterior longitudinal ligaments, and ligamentum flavum) in a multivariable analysis, only ligamentum flavum showed a statistically significant association with lesion length. Furthermore, the number of ligaments affected had a positive correlation with the extension of the lesion. CONCLUSIONS In cervical spine trauma, a specific pattern of ligamentous injury correlates with the length of the spinal cord lesion in MR imaging studies. Ligamentous injury detected by MR imaging is not a dynamic finding; thus it proved to be useful in predicting neurologic outcome in patients for whom the MR imaging examination was delayed.
Collapse
Affiliation(s)
- R Martínez-Pérez
- From the Departments of Neurosurgery (R.M.-P., I.P., S.C., AM.C.-L., R.D.L., P.A.G., A.L.)
| | - I Paredes
- From the Departments of Neurosurgery (R.M.-P., I.P., S.C., AM.C.-L., R.D.L., P.A.G., A.L.)
| | - S Cepeda
- From the Departments of Neurosurgery (R.M.-P., I.P., S.C., AM.C.-L., R.D.L., P.A.G., A.L.)
| | | | - A M Castaño-León
- From the Departments of Neurosurgery (R.M.-P., I.P., S.C., AM.C.-L., R.D.L., P.A.G., A.L.)
| | - C García-Fuentes
- Intensive Care Unit (C.G.-F.), Hospital 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
| | - R D Lobato
- From the Departments of Neurosurgery (R.M.-P., I.P., S.C., AM.C.-L., R.D.L., P.A.G., A.L.)
| | - P A Gómez
- From the Departments of Neurosurgery (R.M.-P., I.P., S.C., AM.C.-L., R.D.L., P.A.G., A.L.)
| | - A Lagares
- From the Departments of Neurosurgery (R.M.-P., I.P., S.C., AM.C.-L., R.D.L., P.A.G., A.L.)
| |
Collapse
|
42
|
Moon JG, Kwon HN, Biraris S, Shon WY. Minimally invasive plate osteosynthesis using a helical plate for metadiaphyseal complex fractures of the proximal humerus. Orthopedics 2014; 37:e237-43. [PMID: 24762150 DOI: 10.3928/01477447-20140225-55] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 09/26/2013] [Indexed: 02/03/2023]
Abstract
Minimally invasive plate osteosynthesis (MIPO) has been used for humeral shaft fractures, but concerns exist about soft tissue injuries. The purpose of this study was to report the surgical technique and clinical outcomes of MIPO using a helical plate for metadiaphyseal complex humeral shaft fractures. Twelve patients with acute displacement involving proximal and middle third humeral shaft fractures (AO type C) were treated using the MIPO technique with a helical plate. Fracture union, complications, and functional outcomes were evaluated using the Constant-Murley score and Mayo Elbow Performance Score (MEPS) at final follow-up. All fractures united at an average of 17.9 weeks. No major complications, such as neurovascular injury, infection, and nonunion, were observed. Mean Constant-Murley and MEPS scores at final follow-up were 88.6 and 97.9, respectively. A MIPO technique using a helical plate can be a useful surgical option for metadiaphyseal complex fractures of the humeral shaft.
Collapse
|
43
|
Vuletić M, Škaričić J, Batinjan G, Trampuš Z, Bagić IČ, Jurić H. A retrospective study on traumatic dental and soft-tissue injuries in preschool children in Zagreb, Croatia. Bosn J Basic Med Sci 2014; 14:12-5. [PMID: 24579964 PMCID: PMC4333948 DOI: 10.17305/bjbms.2014.2283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 12/05/2013] [Indexed: 03/13/2024] Open
Abstract
The purpose of this study was to analyze data according to gender, age, cause, number of traumatized teeth, time elapsed before treatment and type of tooth from the records of traumatized children. A retrospective study was conducted in the Department of Paediatric Dentistry at the University Dental Clinic in Zagreb, Croatia using the documentation of 128 patients (61 males and 67 females) aged 1 month to 6 years with injuries of primary teeth between February 2009 and January 2013. Trauma was seen in 217 primary teeth, which implies that the number of injured primary teeth was 1.69 per child. The maxillary central incisors were the most frequently affected teeth (81.1%), they were followed by maxillary lateral incisors, while the least affected were mandibular central incisors. Traumatic dental injuries involved periodontal tissue 2.82 times more frequently than hard dental and pulp tissue. The main cause of teeth injury was fall (67.2%) and the majority of injuries occurred at home (51.6%) (p<0.05). Of 128 patients who received treatment 71 (55.5%) also had soft-tissue injuries. The distribution of soft-tissue injuries by gender (35 males, 36 females) was not statistically significant. Comparing children with soft-tissue injuries and those without them, a statistically significant difference was found in the time of arrival (p<0.01). The results of this study showed the need of informing about preventive measures against falls at home and the methods of providing first aid in dental trauma injuries.
Collapse
Affiliation(s)
- Marko Vuletić
- Private practice, Specialized practice of dental prosthodontics I. Sušnik Vuletić, Žitna 8, 44000, Sisak, Croatia
| | - Josip Škaričić
- Private practice, Dental practice with dental laboratory B. Tot, Bana Berislavica 6a, 21000, Split, Croatia
| | - Goran Batinjan
- Private practice, Dental practice I. Mršić, Hrvatskog sokola 59, 10000, Zagreb; Ortoimplant dental spa, Ilica 283, 10000, Zagreb, Croatia
| | - Zdenko Trampuš
- Private practice, Dental practice I. Mršić, Hrvatskog sokola 59, 10000, Zagreb; Ortoimplant dental spa, Ilica 283, 10000, Zagreb, Croatia
| | - Ivana Čuković Bagić
- Department of Paediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000, Zagreb, Croatia
| | - Hrvoje Jurić
- Department of Paediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000, Zagreb, Croatia
| |
Collapse
|
44
|
[Research and application of multipoint centralization method in removal of small foreign body]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2014; 28:241-3. [PMID: 24796202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To introduce a new method to remove the small foreign body in the hand or foot, and to discuss its feasibility and effectiveness. METHODS Between May 2007 and March 2012, 78 patients with small foreign bodies embedded in the soft tissue of the hand or foot were treated with the method. There were 51 males and 27 females, aged from 7 to 69 years with an average of 32.5 years. The hand, wrist, and foot were involved in 48, 6, and 24 cases respectively. Foreign body type included fiberglass (57 cases), thorn (11 cases), iron (5 cases), bamboo thorn (2 cases), fishbone (2 cases), and metal needles (1 case). The time between injury and operation was 30 minutes to 16 days (mean, 2.6 days). The position and range of the foreign body were defined using the multipoint centralization method before removal surgery. The skin was cut according multipoint connection for finding small foreign body under a microscope. RESULTS All foreign bodies were successfully removed. The mean operation time was 6 minutes (range, 3-22 minutes). Healing of incision by first intention was obtained in all cases; no blood circulation disorders or infection occurred. All the patients were followed up 3 months-3 years (mean, 9 months). The distal limb had no feeling or movement disorders. CONCLUSION Removal of small foreign body in soft-tissue using multipoint centralization method is safe and effective.
Collapse
|
45
|
Li H, Zhang F, Lei G. Morel-Lavallee lesion. Chin Med J (Engl) 2014; 127:1351-1356. [PMID: 24709193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE To review current knowledge of the Morel-Lavallee lesion (MLL) to help clinicians become familiar with this entity. Familiarization may decrease missed diagnoses and misdiagnoses. It could also help steer the clinician to the proper treatment choice. DATA SOURCES A search was performed via PubMed and EMBASE from 1966 to July 2013 using the following keywords: Morel-Lavallee lesion, closed degloving injury, concealed degloving injury, Morel-Lavallee effusion, Morel-Lavallee hematoma, posttraumatic pseudocyst, posttraumatic soft tissue cyst. STUDY SELECTION Chinese and English language literatures relevant to the subject were collected. Their references were also reviewed. RESULTS Morel-Lavallee lesion is a relatively rare condition involving a closed degloving injury. It is characterized by a filled cystic cavity created by separation of the subcutaneous tissue from the underlying fascia. Apart from the classic location over the region of the greater trochanter, MLLs have been described in other parts of the body. The natural history of MLL has not yet been established. The lesion may decrease in volume, remain stable, enlarge progressively or show a recurrent pattern. Diagnosis of MLL was often missed or delayed. Ultrasonography, computed tomography, and magnetic resonance imaging have great value in the diagnosis of MLL. Treatment of MLL has included compression, local aspiration, open debridement, and sclerodesis. No standard treatment has been established. CONCLUSIONS A diagnosis of MLL should be suspected when a soft, fluctuant area of skin or chronic recurrent fluid collection is found in a region exposed to a previous shear injury. Clinicians and radiologists should be aware of both the acute and chronic appearances to make the correct diagnosis. Treatment decisions should base on association with fractures, the condition of the lesion, symptom and desire of the patient.
Collapse
Affiliation(s)
- Hui Li
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Fangjie Zhang
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Guanghua Lei
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
| |
Collapse
|
46
|
X-rays and MRI--what's the difference? Duke Med Health News 2013; 19:8. [PMID: 24616937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
47
|
Oral A, Ilieva EM, Küçükdeveci AA, Varela E, Valero R, Berteanu M, Christodoulou N. Local soft tissue musculoskeletal disorders and injuries. The role of physical and rehabilitation medicine physicians. The European perspective based on the best evidence. A paper by the UEMS-PRM Section Professional Practice Committee. Eur J Phys Rehabil Med 2013; 49:727-742. [PMID: 24145231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
One of the objectives of the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the Union of European Medical Specialists (UEMS) is the development of the field of competence of PRM physicians in Europe. To achieve this objective, UEMS PRM Section PPC has adopted a systematic action plan of preparing a series of papers describing the role of PRM physicians in a number of disabling health conditions, based on the evidence of effectiveness of PRM interventions. Soft tissue musculoskeletal disorders (MSDs) and injuries are associated with significant pain and loss of function that may lead to significant disability. The aim of this paper is to define the role of PRM physician in the management of local soft tissue MSDs and injuries with their specific focus on assessing and improving function as well as participation in the community. The training of PRM specialists make them well equipped to successfully treat MSDs including soft tissue MSDs and injuries. PRM specialists may well meet the needs of patients with soft tissue MSDs and injuries using PRM approaches including 1) assessment based on the comprehensive model of functioning, the International Classification of Functioning, Disability and Health (ICF), that enable them to identify the areas of impaired functioning in order to apply necessary measures; 2) accurate diagnosis using instrumental diagnostic procedures in addition to clinical examination; 3) outcome measurements available to them; 4) evidence-based pharmacological and nonpharmacological treatments; and finally 5) maintenance of social involvement including "return to work" based on restoration of function, all of which will eventually result in improved quality of life for patients with soft tissue MSDs and injuries.
Collapse
Affiliation(s)
- A Oral
- Member, Board Committee, UEMS Board of PRM, Department of Physical Medicine and RehabilitationIstanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey -
| | | | | | | | | | | | | |
Collapse
|
48
|
Narang S. Progressive hematoma in an older adult: closed internal degloving injury of the knee. Am J Orthop (Belle Mead NJ) 2013; 42:376-378. [PMID: 24078957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Closed internal degloving injury of soft-tissues has been reported in the pelvic-acetabular area after high-velocity trauma. More recently, this lesion has been reported in the knees of young athletes involved in contact sports. The injury is often brought late to the notice of the clinician, and sometimes the diagnosis is missed. Effective treatment relies heavily on clinical examination, and magnetic resonance imaging is helpful as a diagnostic tool. Treatment may depend on time between injury and presentation, patient age, collection severity, and the effects of previous treatment. Lesions that threaten skin vascularity and show rapid progression require emergency management. Minimally invasive techniques are preferred over extensive procedures. Elderly patients need to be observed for progression of the initial lesion and development of late complications, which may require emergency intervention. Clinicians should tailor the rehabilitation protocol to the patient's age and the severity of the lesion. This case report of a 55-year-old female patient covers the nature, diagnosis, and management of a progressively dissecting hematoma that evolved into a massive closed internal degloving lesion.
Collapse
Affiliation(s)
- Sagar Narang
- Associate Professor, Department of Orthopaedic Surgery, Lumbini Medical College Teaching Hospital and Research Centre, Palpa, Nepal.
| |
Collapse
|
49
|
Jagodzinski M, Ettinger M, Liodakis E, Hawi N, Petri M, Krettek C. [Trauma sequalae after complex knee ligament injuries]. Unfallchirurg 2013; 116:404-12. [PMID: 23604338 DOI: 10.1007/s00113-013-2376-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Complex ligament injuries can compromise a knee joint and residual conditions comprise stiffness (arthrofibrosis), instability, cartilage damage leading to osteoarthritis and bone deformity. Accurate diagnosis must address the direction and extent of the instability, the severity of any cartilage lesion and an analysis of the axis and bone deformity as well as important cofactors. Therapeutic options are adhesiolysis, ligament reconstruction, cartilage regeneration and axis correction. As a consequence patients mostly profit from the procedure but there is never a return to the functional level that existed before injury.
Collapse
Affiliation(s)
- M Jagodzinski
- Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30161, Hannover, Deutschland.
| | | | | | | | | | | |
Collapse
|
50
|
Dwivedi AND, Tripathi R, Gupta PK, Tripathi S, Garg S. Magnetic resonance imaging evaluation of temporomandibular joint and associated soft tissue changes following acute condylar injury. J Oral Maxillofac Surg 2013; 70:2829-34. [PMID: 23141983 DOI: 10.1016/j.joms.2012.08.026] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 08/24/2012] [Accepted: 08/27/2012] [Indexed: 02/05/2023]
Abstract
PURPOSE This study evaluated the role of magnetic resonance imaging (MRI) in cases of acute condylar injury and assessed soft tissue damage such as disc displacement, capsular tear, and hemarthrosis within the temporomandibular joint (TMJ). PATIENTS AND METHODS This prospective study was conducted in 15 patients who presented with unilateral or bilateral condylar fracture or contusion with a unilateral or bilateral diagnosis of TMJ sprain/strain. Patients with trauma of less than 7 days previously with a unilateral or bilateral condylar fracture or contusion with a diagnosis of TMJ sprain/strain were included in the present study. The clinical diagnosis of TMJ sprain was made and further classified and graded according to the severity and type of injury. On confirmation of the diagnosis of condylar injury, patients underwent evaluation by MRI. All patients were treated by closed reduction of the condylar fracture and intermaxillary fixation for 14 to 21 days. RESULTS Of the 15 patients, 5 were children and 10 were adults. Of all 17 TMJ cases (2 bilateral, 13 unilateral), 2 condylar fractures were of the high variety and 13 were of the low variety. MRI diagnosis of disc displacement was established in 8 of 17 TMJ cases. There was a significant association between degrees of condylar injury and the MRI diagnosis of displaced disc and hemarthrosis. However, an MRI finding of capsular tear was not significantly associated with the degree of condylar injury. CONCLUSIONS Soft tissue changes of the TMJ can be predicted accurately by MRI and are in direct proportion to the severity of the condylar injury of the mandible. Among the soft tissue changes, disc displacement and hemarthrosis seem to affect the outcome of functional treatment.
Collapse
Affiliation(s)
- Amit Nandan Dhar Dwivedi
- Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
| | | | | | | | | |
Collapse
|