Paolo Titolo, Andrea Lavorato, Gianluca Isoardo, Francesca Vincitorio, Diego Garbossa, Bruno Battiston
Closed brachial plexus lesions (BPLs) are generally associated with a traumatic mechanism of forced traction between the neck and the shoulder-arm complex. For brachial plexus reconstruction different techniques have been proposed with donor motor nerves like intercostal nerves, or the ipsilateral cervical plexus, the phrenic nerve, the contralateral C7 root, and many others. Despite all these surgical possibilities, the overall recovery is generally poor and not satisfactory. The principal drawback is linked to the loss of upper limb proprioception, in a way that dramatically influences even a good motor recovery, so in complete BPLs the sensory loss still represents a debilitating problem...
March 19, 2020: Injury
Ferdinand C Wagner, Mirjam V Neumann, Steffen Wolf, Alexander Jonaszik, Kaywan Izadpanah, Stefan Piatek, Norbert P Südkamp
PURPOSE: To date, surgically treated multifragmentary patellar fractures are still associated with high rates of complications, such as i.e. secondary fracture displacement. Osteosynthesis is most frequently performed with screws and cerclages. To increase primary stability, locking plates have been introduced. However, there is still a lack of biomechanical data supporting the superiority of plate fixation compared to screw fixation with cerclages in these cases. The goal of the present study was to conduct biomechanical comparison of these two techniques under dynamic loading conditions...
March 17, 2020: Injury
T Tolppa, A M Vangu, H C Balu, P Matondo, E Tissingh
No abstract text is available yet for this article.
March 17, 2020: Injury
Efterpi Demiri, Antonios Tsimponis, Leonidas Pavlidis, Georgia-Alexandra Spyropoulou, Periclis Foroglou, Dimitrios Dionyssiou
Introduction Reverse neurocutaneous and propeller perforator flaps are both used to reconstruct diabetic distal lower limb defects. Our study aims to compare outcomes between these two groups of flaps with an emphasis on indications and complication rates. Method A retrospective analysis was conducted, reviewing data from 54 diabetic patients who underwent reconstruction of acute or chronic wounds of the foot and ankle between 2005-2018. Thirty-four patients (Group A) had a reverse neurocutaneous flap (NCF): nineteen sural and fifteen lateral supramalleolar flaps...
March 14, 2020: Injury
J Carney, A Ton, R K Alluri, P Grisdela, G S Marecek
INTRODUCTION: There are few published studies that investigate the surgical treatment of supination-adduction (SAD, AO/OTA 44A2.3) ankle fractures. The purpose of this study was to describe the complications and outcomes following operative fixation of SAD type 2 ankle fractures. MATERIALS AND METHODS: We identified all SAD-2 ankle fractures that presented at our institution's two hospitals from 2006-2018. Demographics, operative data, and complications (deep infection, superficial infection, delayed union, failure of fixation, and unplanned reoperation) were recorded for all patients...
March 13, 2020: Injury
Lauri M Halonen, Henri Vasara, Antti Stenroos, Jussi Kosola
BACKGROUND AND PURPOSE: Approximately 2000 trochanteric fractures are operated in Finland annually. These fractures make a major burden to health care system and affected individuals. The role of routine follow-up has been questioned in multiple fracture types. PATIENTS AND METHODS: We analyzed routine follow-up visits after intramedullary fixation of trochanteric fractures (n = 995). Patients were followed up from patient registries until 2 years or death. Planned and unplanned follow-up visits were analyzed...
March 10, 2020: Injury
Korhonen Linda, Lutz Nicolas, Sinikumpu Juha-Jaakko
INTRODUCTION: The gold-standard surgical procedure of both-bone forearm shaft fracture repair is elastic stable intramedullary nailing (ESIN). Disadvantages effects of ESIN have suggested to be a consequence of inappropriate surgical techniques, while recommendations are not always followed. The purpose of the study was to analyze the effect of inadequate metal frame construct on impaired fracture healing, refracture and changing alignment. MATERIALS AND METHODS: It is a population-based study including all consecutive patients, aged less than 16 years, who had been treated for forearm shaft fracture by ESIN during the ten-year period 2009-2018...
March 10, 2020: Injury
Myrto Bami, Thomas Sarlikiotis, Mandy Milonaki, Myrofora Vikentiou, Evgenia Konsta, Violetta Kapsimali, Vasiliki Pappa, Dimitrios Koulalis, Elizabeth O Johnson, Panayotis N Soucacos
Engineering complex tissues is perhaps the most ambitious goal of all tissue engineers. Despite significant advances in tissue engineering, which have resulted in successful engineering of simple tissues such as skin and cartilage, there are a number of challenges that remain in engineering of complex, hybrid tissue structures, such as osteochondral tissue. Mesenchymal stem cells (MSCs) have the capacity to highly proliferate in an undifferentiated state and the potential to differentiate into a variety of different lineages, providing a promising single cell source to produce multiple cell types...
March 9, 2020: Injury
Iuliu Alpar Kadar, Timea Helga Virág, Ileana Rodica Matei, Alexandru Valentin Georgescu
BACKGROUND: Median nerve (MN) variation in the carpal tunnel has been well documented by Lanz. Encountering rarely documented variants, that do not fit into existing classifications, increases the risk of iatrogenic injury. METHODS: The random occurrence of two unclassifiable anatomical variants of the MN in the carpal tunnel gives motivation to search the literature for similar and identical cases. CASE REPORTS: This article presents two cases of very rare anatomical variants of high division of the MN...
March 9, 2020: Injury
Gkotsi Antonia, Schuind Frédéric
Diaphyseal fractures of the clavicle had until recently the reputation to always heal with abundant callus formation, except if operated, due to a reported high rate of nonunion after plate fixation by older series. The reason would be that the bone has only periosteal vascularization, easily destroyed by periosteal stripping for implant apposition. Bone autograft and external fixation has been reported as the best technique to heal a nonunited clavicle nonunion. Are these classical considerations still valid nowadays? The purposes of this article focusing only on diaphyseal clavicular fractures are to review the vascularization of the bone, the rate of nonunion after nonoperative treatment, the indications and techniques of osteosynthesis, and the treatment possibilities of an established nonunion...
March 9, 2020: Injury
Pierluigi Tos, Simona Odella, Alessandro Crosio, Davide Ciclamini, Raimondo Piana, Stefano Bastoni, Primo Andrea Daolio
Fibulo-scapho-lunate fusion is a technique that allows residual movement in the wrist in case of wide bone resection replacing the distal radius by a vascularised fibular transfer. Some authors have used this technique with favourable results but the distal synthesis seems to not be standardised at all, many different osteosynthesis methods have been proposed. This paper reports a complete review of the present day literature about this subject and, evaluating the different proposed osteosynthesis techniques referred in literature, suggests a standardization of the synthesis methods with dorsal plating...
March 9, 2020: Injury
Alessandro Crosio, Erika Albo, Ignazio Marcoccio, Roberto Adani, Maddalena Bertolini, Michele Rosario Colonna, Nicola Felici, Matteo Guzzini, Andrea Atzei, Michele Riccio, Paolo Titolo, Pierluigi Tos
INTRODUCTION: The appearance of a symptomatic neuroma following finger amputation is a devastating consequence for patient's quality of life. It could be cause of chronic neuropathic pain. The prevention of neuroma formation is a challenging effort for hand surgeons. The biological mechanisms leading to neuroma formation are mostly unknown and different preventing procedures have been tried without certain results. In this paper, a panel of Italian hand surgeons have been asked to express appropriateness about potentially preventive techniques of neuroma formation following the RAND/UCLA appropriateness protocol...
March 9, 2020: Injury
Alexandros Beris, Ioannis Kostas-Agnantis, Ioannis Gkiatas, Dimitrios Gatsios, Dimitrios Fotiadis, Anastasios Korompilias
A proposed microsurgical training program is presented that includes all the existing training methods, such as simulation in nonliving models, virtual reality simulation system and exercise in living models. Our experience in microsurgery training over the last decades indicates the need of evolution in training programs. This can be achieved with the introduction of new technologies into education and training. The first primary results of the described training program are promising, however this system needs to be assessed by training greater number of microsurgeons...
March 9, 2020: Injury
Dimitrios Dionyssiou, Anastasios Pagkalos, Athanasios Papas, Leonidas Pavlidis, Alexandra Georgia Spyropoulou, Efterpi Demiri
BACKGROUND: Soft tissue defects to the dorsum of fingers are quite demanding for the reconstructive surgeon especially in the cases that bone and extensor tendons are exposed. The purpose of our study was to describe a new adipofascial island flap by a single dorsal digital perforator (dorsal adipofascial digital artery perforator, DADAP). MATERIALS: Methods: In 8 patients (7 male, 1 female), 12 soft tissue defects to the dorsum of the fingers (3 index, 6 middle, 2 ring, 1 little finger), ranging from 1 × 2 cm to 2 × 4 cm, were reconstructed using the DADAP flap...
March 9, 2020: Injury
Cristina Nicoleta Marina, Laura Raducu, Valeriu Ardeleanu, Ioan Petre Florescu, Cristian Radu Jecan
Traumatic lacerations, burns and ulcerations are a common cause of admission in the plastic surgery wards. Clinical evaluation alone sometimes provides insufficient or even inaccurate information. Thermographic camera is a new tool that could provide additional information regarding skin vascularization, presence of inflammation or involvement of deep tissue. A prospective study was realized for assessing pre and postoperative status of patients with lacerations, trauma, burn and diabetic foot. Preoperative evaluation helped in assessing bone involvement, inflammation and infection in order to decide the necessity of surgery...
March 9, 2020: Injury
Timea Helga Virág, Iuliu Alpar Kadar, Ileana Rodica Matei, Alexandru Valentin Georgescu
INTRODUCTION: Hidradenitis suppurativa is a chronic, relapsing disease of the skin, characterized by apocrine gland and pilosebaceous complex infections, causing recurrent superficial nodules and abscesses, fistula formation, scarring and fibrosis. It is accepted that wide local excision and local coverage is the crucial treatment to prevent recurrence of the disease. MATERIALS AND METHODS: All patients presenting for surgical treatment of hidradenitis suppurativa between 2014 and 2019 were identified from the hospital database...
March 9, 2020: Injury
E Yilmaz, A von Glinski, T A Schildhauer, J Iwanaga, B Ishak, A Abdul-Jabbar, M Moisi, R J Oskouian, R S Tubbs, J R Chapman
No abstract text is available yet for this article.
March 7, 2020: Injury
Han Thi Ngoc Doan, Michelle B Hobday, Justine Leavy, Jonine Jancey
OBJECTIVE: This study aimed to determine changes in functional status, pain, and return to work/study (RTW/study) over 12 months post-injury in motorcyclists admitted to a large hospital in Ho Chi Minh City (HCMC), Vietnam. METHODS: A prospective study was undertaken with adult motorcyclists who were injured due to a crash and were admitted to hospital for more than 24 h. Pain and functional status data were collected at baseline (time of injury), and follow-up at 6 and 12 months post-injury...
March 5, 2020: Injury
John Capo, Frank Liporace, John Michael Yingling, Sergio Glait, Ferris Pfeiffer, Adam C Crawford, David Volgas, Brett D Crist, Tyler Dailey, Gregory J Della Rocca
BACKGROUND: Multiple small relaxing skin incisions oriented parallel to the longitudinal axis (so-called "pie-crusting") near traumatic lacerations or surgical incisions in edematous tissue beds have been utilized to achieve primary closure when edema or skin loss would otherwise have made this difficult. Our study hopes to demonstrate (1) biomechanical evidence that pie-crusting decreases wound closure tension and (2) provide a case series with data showing clinical results...
March 4, 2020: Injury
Martin Müller, Julia M Münster, Wolf E Hautz, Joël L Gerber, Joerg C Schefold, Aristomenis K Exadaktylos, Carmen A Pfortmueller
BACKGROUND: S-100 B protein was identified as a biomarker for traumatic brain injury, but studies suggest that extracranial injuries may also lead to increased S-100 B serum levels. In this study, we aim to quantify the impact of injury patterns on S-100 B levels in patients with suspected multiple trauma. METHODS: Patients with suspected multiple trauma treated at a Level 1 Trauma centre in Switzerland were included in this retrospective patient chart review. Extent of injuries and severity was assessed and S-100 B levels on admission measured...
March 4, 2020: Injury
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