Rebecca Howett, Alida M Gertz, Tiroyaone Kgaswanyane, Gregory Petro, Chelsea Morroni
The etonogestrel (ENG) subdermal contraceptive implant (Implanon NXT®) is a safe and highly effective method of contraception which is increasing in popularity globally. This case report describes a 26-year-old woman who requested removal of the Implanon NXT® contraceptive implant. She reported that her implant had bent following direct trauma. The implant was removed in accordance with her request and without complication, but was noted to be incompletely fractured. We compare this case with a summary of the existing literature on fractured or damaged contraceptive implants...
December 2019: African Journal of Reproductive Health
Quan Lin, Xingyu Hong, Duo Zhang, Hongjuan Jin
BACKGROUND: To evaluate the orbital involvement epidemiology in facial fractures, the clinical distribution and effects of orbital involvement in these patients, the frequency and nature of treatment procedures performed for these involvements, and the immediate- and intermediate-term effects of these treatment procedures. METHODS: Two hundred patients with hard tissue maxillofacial injuries were included in this study. Clinical examination was performed in-depth...
March 30, 2020: Journal of Cosmetic Dermatology
Andreas Voss, Stefan Greiner
Posterolateral elbow instability with an insufficiency of the lateral ulnar collateral ligament commonly results from elbow trauma. However, other etiologies such as iatrogenic injuries after primary surgical treatment for lateral epicondylitis or repetitive corticosteroid injections also may lead to a lateral ulnar collateral ligament insufficiency. In these cases, surgical treatment can help to restore posterolateral stability of the elbow. Besides the stabilizing effect of the ligamentous structures, the anconeus muscle is the most import active stabilizer against posterolateral elbow instability...
March 2020: Arthroscopy Techniques
Kyle W Scott, Jonathan Arias, Kourosh Tavanaiepour, Daryoush Tavanaiepour, Gazanfar Rahmathulla
Traumatic lumbosacral dissociation is a unique, but well-documented, phenomenon that generally stems from high-energy impact injuries to the lower lumbar spine. Patients typically present with complicated and multisystem injuries with wide-ranging neurological deficits below the level of trauma. This presents stark challenges regarding the diagnosis, management, and surgical correction technique utilized. In this study, we present the case of a 21-year-old, morbidly obese, male patient that presented after a traumatic motor vehicle accident with L5-S1 lumbosacroiliac dissociation, cauda equina syndrome, and left lower extremity monoplegia...
February 24, 2020: Curēus
Jorge Valencia, Alejandro Alvaro-Meca, Jesús Troya, Jorge Gutiérrez, Cristina Ramón, Antonio Rodríguez, Sonia Vázquez-Morón, Salvador Resino, Santiago Moreno, Pablo Ryan
BACKGROUND AND AIMS: In comparison with men, women who use drugs (WWUD) have considerably more frequent and intense experiences with interpersonal violence, sexual abuse and trauma. The aim of this study was to identify issues related to gender-based vulnerability in a group of WWUD attended in a harm reduction facility in Madrid, Spain. MATERIAL AND METHODS: A cross-sectional study was conducted during a screening of blood borne infections. We included WWUD (smoked or injected heroin/cocaine) who were actively screened for HIV, HBV and HCV in a harm reduction setting in Madrid (Spain) from January to December 2017...
2020: PloS One
Jaime Leonel Quiroz-Mendoza, Diego Alejandro Valera-Cornejo, Marlon García-Roa, Paulina Ramírez-Neria, Yolanda Villalpando-Gómez, Verónica Romero-Morales, Renata García-Franco
Introduction: Macular hemorrhages result in a sudden and profound loss of vision. The primary treatment modalities include observation, intravitreal injection of antiangiogenic drugs, neodymium-doped yttrium aluminum garnet hialoidotomy, intravitreal injection of gas with or without tissue plasminogen activator, as monotherapy or combined with surgery. In this paper, we report four cases of macular hemorrhages of different causes treated with different approaches, and we review the literature in this regard...
March 3, 2020: Medwave
Robyne M Le Brocque, Belinda L Dow, Hayley McMahon, Anna L Crothers, Justin A Kenardy, Tara J Williams, Debbie A Long
OBJECTIVES: This study investigated trauma symptom trajectories of children 2-16 years old following admission to pediatric intensive care and identified factors that predicted a child's trauma symptom trajectory. DESIGN: Prospective longitudinal design. SETTING: Two tertiary care PICUs in Brisbane, Qld, Australia. PATIENTS: Children 2-16 years old admitted to PICU for longer than 8 hours. MEASUREMENTS MAIN RESULTS: Maternal reported child posttraumatic stress symptoms (n = 272) on the Trauma Symptom Checklist for Young Children were used to assess posttraumatic stress symptoms up to 12 months post admission...
March 12, 2020: Pediatric Critical Care Medicine
Lauren E Birmingham, Gwendolyn Richner, Mary Moran, Kindra M Hatridge, Richard L George
BACKGROUND: The impact of freestanding emergency departments (FSEDs) on timeliness of care for trauma patients is not well understood. This quality improvement project had 2 objectives: (1) to determine whether significant delays in definitive care existed among trauma patients initially seen at FSEDs compared with those initially seen at other outlying sites prior to transfer to a level I trauma center; and (2) to determine the feasibility of identifying differences in time-to-definitive care and emergency department length of stay (ED LOS) based on initial treatment location...
April 2020: Quality Management in Health Care
Lee Gammon, Erik Hansen, Seth Cheatham
CASE: A 25-year-old man sustained a right femur Hoffa fracture with an ipsilateral patella dislocation from a twisting injury to his right knee. He underwent open reduction and internal fixation of the right femur with medial patellofemoral ligament (MPFL) reconstruction with allograft. One year postoperatively, he had returned to full activity and painless range of motion. CONCLUSION: Hoffa fracture associated with ipsilateral patella dislocation is a rare injury in young men and warrants judicious clinician awareness...
January 2020: JBJS Case Connector
Benjamin C Taylor, Thomas Zink, Sean McGowan
CASE: A 33-year-old man with recurrent intrathoracic scapular dislocation due to previous trauma-related chest wall resection successfully underwent the 2-stage induced membrane technique commonly known as the Masquelet technique; this procedure effectively created 2 new ribs that resolved his symptoms. CONCLUSIONS: Techniques for chest wall reconstruction for bone loss are quite limited, and these often consist of filling defects with a layered patch; this often cannot withstand the cyclical respiratory motion...
January 2020: JBJS Case Connector
Alice Faure, Romain Boissier
INTRODUCTION: To the best of our knowledge, no pediatric paper has been published regarding specifically how to set the Holmium:YAG laser for multiple urologic applications. OBJECTIVE: To provide insight into the laser parameters for pediatric applications. STUDY DESIGN: We describe the principle and the settings of the laser. RESULTS: The Holmium:YAG laser can produce four different biological effects: (1) fragmentation of stones in small fragments that can be retrieved with grasping instruments, thereby increasing the immediate stone-free outcome...
March 13, 2020: Journal of Pediatric Urology
Colin F Mackenzie, Eric A Elster, Mark W Bowyer, Nick Sevdalis
OBJECTIVE: Scope evidence on technical performance metrics for open emergency surgery. Identify surgical performance metrics and procedures used in trauma training courses. DESIGN: Structured literature searches of electronic databases were conducted from January 2010 to December 2019 to identify systematic reviews of tools to measure surgical skills employed in vascular or trauma surgery evaluation and training. SETTING AND PARTICIPANTS: Faculty of Shock Trauma Anesthesiology Research Center, University of Maryland School of Medicine, Uniformed Services University of Health Sciences, Bethesda, Maryland and Implementation Science, King's College, London...
March 26, 2020: Journal of Surgical Education
S Sreedharan, V Veeramuthu, F Hariri, N Hamzah, N Ramli, V Narayanan
Isolated traumatic maxillofacial injury without concomitant brain injury may cause delayed post-concussive symptoms. Early identification allows optimal diagnosis, prognostication, and therapeutic intervention. The aim of this prospective observational study was to investigate longitudinal microstructural changes of the white matter (WM) tracts based on diffusion tensor imaging (DTI) indices in patients with isolated maxillofacial injuries, immediately and 6 months post-trauma, and to correlate these DTI indices with neuropsychological changes observed...
March 26, 2020: International Journal of Oral and Maxillofacial Surgery
Chiara Benzoni, Domenico Aquino, Daniela Di Bella, Elisa Sarto, Marco Moscatelli, Davide Pareyson, Franco Taroni, Ettore Salsano
Alexander disease (ALXDRD) is a rare astrocytic leukodystrophy caused by GFAP mutations. The adult-onset (AO) variant is usually characterized by gradual onset of spastic ataxia and bulbar symptoms with slowly progressive course. We report two AO-ALXDRD cases with rapid worsening after minor head trauma. In one of them, the only post-traumatic neuroimaging change was revealed by diffusion tensor imaging study. Our observations support the link between head trauma and ALXDRD progression, and suggest that this progression may be ascribed to microstructural changes...
March 26, 2020: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Arthur McDowell, Andrew Jeong, Rolanda Willacy, Robert Wilson
Carpal coalition is an uncommon and rarely reported anomaly, characterized by the union of two or more carpal bones. It is usually found incidentally during radiographic evaluation for trauma or other unassociated pathology. While lunotriquetral and capitohamate coalitions are the most common forms of carpal coalition, there are very few reports of scaphotrapezial coalitions described in the literature. This a novel case report, in which we present a case of bilateral scaphotrapezial coalition in a patient with radiocarpal arthritis and persistent wrist pain...
2020: Journal of Surgical Orthopaedic Advances
John D Adams, Michael R Koerner, Catherine Long Williams, Stephanie L Tanner, Michael S Sridhar, Thomas M Schaller, Kyle J Jeray
This study evaluated the frequency in which a hip dislocation is first diagnosed by computed tomography (CT) scan. A retrospective review was conducted of orthopaedic trauma patients presenting with hip dislocation to a Level 1 trauma center over three years. We recorded whether the patient first received pelvic radiograph (PXR) or CT scan of the pelvis, if the patient underwent closed reduction of the hip prior to CT scan, and if repeat pelvis CT scan was done. Of 83 hip dislocations, 64 patients were sent to CT scanner dislocated; 19 patients first had PXR and underwent closed reduction of the hip prior to CT scan...
2020: Journal of Surgical Orthopaedic Advances
Jennifer Wentzel, Ryan Taylor, Christen Zino, Michael Avery, Keely Muertos, Jason D Sciarretta
No abstract text is available yet for this article.
March 1, 2020: American Surgeon
Adel Elkbuli, Sarah Zajd, Raed Ismail Narvel, Brianna Dowd, Shaikh Hai, Mark McKenney, Dessy Boneva
This study aimed to identify factors that promote and impede research participation and productivity by Eastern Association for the Surgery of Trauma (EAST) surgeons. In addition, the study aimed to determine what changes can be implemented by surgical departments to improve this research productivity and granting. A 25-question anonymous research survey tool was offered to EAST surgeons. The questions analyzed factors including demographics, career accomplishments, current institution type, educational/research background, perceived barriers to research, and current research productivity, including grants...
March 1, 2020: American Surgeon
Alberto Aiolfi, Kenji Inaba, Matthew Martin, Kazuhide Matsushima, Gianluca Bonitta, Davide Bona, Demetrios Demetriades
The resection of lung parenchyma for thoracic trauma is uncommon. Different surgical procedures with a wide range of complexities have been described depending on the severity of trauma and the presence of associated injuries. The aim of this study was to analyze outcomes of wedge resection, lobectomy, and pneumonectomy. Data for this study were obtained from an eight-year retrospective National Trauma Data Bank study (2007-2015). Adult patients who sustained severe chest trauma (Abbreviated Injury Scale > 3) that required any type of lung resection were included...
March 1, 2020: American Surgeon
Brianna Dowd, Irfan Khan, Dessy Boneva, Mark McKenney, Adel Elkbuli
Gun-related injuries are a hotly debated sociopolitical topic in the United States. Annually, more than 33 million Americans seek heathcare services for mental health issues. These conditions are the leading cause of combined disability and death among women and the second highest among men. Our study's main objective was to identify cases of self-inflicted penetrating firearm injuries with reported pre-existing psychiatric conditions as defined in the 2013-2016 National Trauma Data Standard. The 2013-2016 Research Data Sets (RDSs) were reviewed...
March 1, 2020: American Surgeon
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