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Ultrasound In Pelvic Fractures

Adel Elkbuli, John D Ehrhardt, Shaikh Hai, Mark McKenney, Dessy Boneva
INTRODUCTION: Urinary bladder ruptures are an uncommon injury, occurring in less than 1% of all blunt abdominal trauma. Extraperitoneal bladder ruptures are generally associated with pelvic fractures and usually managed nonoperatively. Conversely, intraperitoneal injuries are often caused by large compressive and shear forces produced during seatbelt injuries and almost invariably require surgical intervention. PRESENTATION OF CASE: A 29-year-old woman presented as a trauma alert after a motor vehicle collision with abdominal/flank pain and gross hematuria...
2019: International Journal of Surgery Case Reports
Bin-Fei Zhang, Jin-Lai Lei, Hong Zhang, Peng-Fei Wang, Hu Wang, Yu-Xuan Cong, Hai Huang, Yan Zhuang
BACKGROUND: Lateral compression type1 (LC-1) pelvic fractures represent a wide spectrum of heterogeneous injuries. These include both stable and unstable patterns; however, determining whether a LC-1 fracture is stable or unstable is a challenge, and the method used to evaluate fracture stability is complicated. METHODS: We prospectively collected and analyzed data from 22 patients with LC-1 pelvic fractures, who underwent ultrasonography and a pelvic compression and separation test, in order to evaluate the role of ultrasonography in determining fracture stability and assist decision-making for treatment strategy...
January 7, 2019: Journal of Orthopaedic Surgery and Research
Christopher A Becker, Christian Kammerlander, Adrian Cavalcanti Kußmaul, Fabian Dotzauer, Matthias Woiczinski, Bianka Rubenbauer, Fabian Sommer, Christoph Linhart, Simon Weidert, Christian Zeckey, Axel Greiner
INTRODUCTION: Operative treatments of T-type acetabular fractures are challenging surgical procedures. Open reduction and internal fixation is the standard method for the operative management of these fractures, however this is associated with high blood loss, long hospital stay and longer rehabilitation. Anterior subcutaneous pelvic fixation (internal fixation=INFIX) and retrograde pubic screw fixation have shown promising results in minimally invasive treatment of pelvic ring fractures...
November 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Vicente Mosquera Rey, Carlota Fernández, Amer Zanabili, Jose A Del Castro, Mónica G Pandavenes, Manuel Alonso
BACKGROUND: Iliac vein injury associated with pelvic fracture due to blunt trauma is an uncommon and difficult diagnosis but a life-threatening condition which often requires an emergent management. Although open repair has been traditionally used as the treatment of choice in unstable patients, it is controversial, given the difficulty due to injured vessel exposure in patients with significant retroperitoneal hematoma as well as tamponade effect loss associated with laparotomy. We present a challenging case of iliac vein laceration successfully treated by placement of a self-expanding covered stent...
January 2019: Annals of Vascular Surgery
Emilio Ríos, Luís Martínez-Piñeiro
Posterior urethral injuries typically arise in the context of a pelvic fracture. Retrograde urethrography is the preferred diagnostic test in trauma patients with pelvic fracture where a posterior urethral rupture is suspected. Pelvic fractures however preclude the adequate positioning of the patient on the X-ray table on admission and computed tomography scan with intravenous contrast and delayed films generally performed first. Suprapubic bladder catheter placement under ultrasound guidance should be performed whenever a posterior urethral disruption is suspected...
July 2018: Asian Journal of Urology
Christopher A Becker, Christian Kammerlander, Axel Greiner, Fabian Sommer, Christoph Linhart, Wolfgang Böcker, Bianka Rubenbauer, Simon Weidert
BACKGROUND: The Morel-Lavallée lesion is one of the concomitant soft tissue lesions of pelvic fractures. Its role in spine fractures and its treatment in combination with osteosynthesis of pelvic or spine fractures have not yet been determined. The aim of this study was to analyse the best diagnostic and treatment options of both spine and pelvic fractures combined with Morel-Lavallée lesions (MLL). METHODS: An analysis of the literature was performed via PubMed and Medline...
October 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Jalil Hosseini, Farzen Soleimanzadeh Ardebili, Behrouz Fadavi, Hamidreza Haghighatkhah
PURPOSE: Although improvements in urological function have been less challenged, concern about andrological problems following urethral stricture surgeries has been growing in recent years. The aim of this study is to evaluate the role of the anastomotic urethroplasty itself on erectile function in patients with posterior urethral injuries. MATERIALS AND METHODS: In this prospective cohort study, patients with urethral strictures referring to Tajrish Hospital during October 2013 to August 2016 for anastomotic urethroplasty, were included...
March 18, 2018: Urology Journal
Jonathan G Martin, Michael Kassin, Peter Park, R Mitchell Ermentrout, Sean Dariushnia
Trauma is a significant contributor to mortality, especially in the young. Pelvic trauma with pelvic ring fractures may result in associated arterial injury, necessitating endovascular intervention. As a result, interventional radiology plays a critical role in partnering with trauma providers in the care of these patients. Management is determined by the acuity of the patient's clinical status, radiographs, ultrasound, and the results of computed tomography imaging when available. Numerous embolic agents are available for treatment of arterial hemorrhage...
December 2017: Techniques in Vascular and Interventional Radiology
Francisco Chana-Rodríguez, Manuel Cuervas-Mons, José Rojo-Manaute, Félix Mora, Juan Arnal, Javier Vaquero-Martín
INTRODUCTION: Pelvic fracture in trauma patients can lead to hemodynamic instability. External fixation is a treatment capable of stabilizing these injuries in the context of damage control surgery. Supra-acetabular pin offers the greater biomechanical stability but requires the use of intraoperative fluoroscopy. The aim of this study was to analyze our results for an ultrasound-guided supra-acetabular pinning. MATERIAL AND METHODS: Cross-sectional study with cadaveric specimens...
November 2017: Injury
Antonio Lazzari, Roberto Bini, Roberto Bertucci, Antonio Coletti, Paolo Voghera
INTRODUCTION: Central venous catheterizations are common intraoperative procedures.Central venous catheter (CVC) placements are usually performed with patients lying in the supine position using real-time ultrasound (US) guidance. CASE DESCRIPTION: A 43-year-old man underwent open right popliteal artery reconstruction in the prone position for a limb-threatening injury. Excessive continuous intraoperative bleeding, increased by a coexisting pelvic fracture, was temporarily stabilized by a T POD device, but with the need of external fixation, required the placement of CVC, which was not feasible whilst in the prone position without US help...
November 17, 2017: Journal of Vascular Access
Roy Miler, Eric K Shang, Woosup Michael Park
BACKGROUND: Nutcracker syndrome, caused by mesoaortic compression of the left renal vein leading to symptoms related to venous hypertension, is an uncommon entity that may require operative intervention. Traditional open transposition of the left renal vein to the vena cava has been shown to have a reintervention rate of up to 30%, while also having additional morbidity associated with laparotomy. More recently, endovascular stenting has been described in several small series but have reported stent fracture, thrombosis, and migration...
January 2018: Annals of Vascular Surgery
Paolo Monticelli, Luis Campoy, Chiara Adami
Locoregional anesthetic techniques may be a very useful tool for the anesthetic management of wallabies with injuries of the pelvic limbs and may help to prevent capture myopathies resulting from stress and systemic opioids' administration. This report describes the use of ultrasound-guided femoral and sciatic nerve blocks in Bennett's wallaby (Macropus rufogriseus) referred for orthopaedic surgery. Ultrasound-guided femoral and sciatic nerve blocks were attempted at the femoral triangle and proximal thigh level, respectively...
2016: Case Reports in Anesthesiology
Daniel Howard Wiznia, Mike Wang, Chang Yeon-Kim, Paul Tomaszewski, Michael P Leslie
We report a case of a unilateral testicular dislocation to the superficial inguinal region associated with a lateral compression type pelvic ring injury (OTA classification 61-C3.3a2, b2, c3) and left T-shaped acetabulum fracture (OTA classification 62-B2) in a 44-year-old male who was in a motorcycle accident. The testicular dislocation was noted during the emergency department primary survey, and its location and viability were verified with ultrasound. The testicle was isolated during surgical stabilization of the left acetabulum through a Pfannenstiel incision and modified-Stoppa approach and returned through the inguinal canal to the scrotum...
2016: Case Reports in Orthopedics
L Cogorno Wasylkowski, E Ríos González, L Martínez-Piñeiro Lorenzo
This article presents a review of the different tests used for the evaluation and follow-up of urethral strictures. Because there is no consensus on how to assess urethral pathology, we reviewed each of the next follow-up tests: questionnaires, uroflowmetry, ultrasound, urethroscopy, urethrogram, CT scan and MRI, outlining their benefits and limitations in the diagnosis and follow-up of urethral stricture. Urethrogram and urethroscopy are the most commonly used tests, as they are those that give us more information on the evaluation of stenosis and for surgery planning...
September 2016: Archivos Españoles de Urología
Zhongcheng Xin, Guiting Lin, Hongen Lei, Tom F Lue, Yinglu Guo
Low-intensity pulsed ultrasound (LIPUS) is a form of ultrasound that delivered at a much lower intensity (<3 W/cm(2)) than traditional ultrasound energy and output in the mode of pulse wave, and it is typically used for therapeutic purpose in rehabilitation medicine. LIPUS has minimal thermal effects due to its low intensity and pulsed output mode, and its non-thermal effects which is normally claimed to induce therapeutic changes in tissues attract most researchers' attentions. LIPUS have been demonstrated to have a rage of biological effects on tissues, including promoting bone-fracture healing, accelerating soft-tissue regeneration, inhibiting inflammatory responses and so on...
April 2016: Translational Andrology and Urology
J Peng, Z Zhang, B Gao, Y Yuan, W Cui, Y Tang, W Song, Z Xin
Erectile dysfunction (ED) is a common sequel of pelvic fracture urethral disruption. Those patients with nocturnal erections may respond favourably to sildenafil; however, little is known about the response to sildenafil in patients with absent nocturnal erections. The aim was to evaluate the response to the treatment of sildenafil 50 mg taken once daily in the patients with absent nocturnal erections. From January 2008 to December 2011, a total of 28 patients with absent nocturnal erections were evaluated...
December 2016: Andrologia
Filippo Randelli, Paolo Capitani, Fabrizio Pace, Sara Favilla, Claudio Galante, Pietro Randelli
A 25-year-old man was admitted to our hospital because of pulmonary embolism and suspected fat embolism after sustaining bilateral femoral shaft fracture. A left arm weakness, tachycardia and sudden hemoglobin drop delayed his definitive fixation with intramedullary nailing. His clinical course was further complicated by bleeding from the pin sites of the external fixators which had initially been used to temporarily stabilize his femoral fractures (clotting disturbances). A lower leg Doppler ultrasound and a new pelvic-chest CT angiography excluded any remaining thrombus, meanwhile the embolus had broken in smaller pieces, more distally...
December 2015: Injury
Yong Guan, Sun Wendong, Shengtian Zhao, Tongyan Liu, Yuqiang Liu, Xiulin Zhang, Mingzhen Yuan
Erectile dysfunction (ED) is a common complication of pelvic fractures. To identify the vascular and neurogenic factors associated with ED, 120 patients admitted with ED after traumatic pelvic fracture between January 2009 and June 2013 were enrolled in this study. All patients answered the International Index of Erectile Function (IIEF-5) questionnaire. Nocturnal penile tumescence (NPT) testing confirmed the occurrence of ED in 96 (80%) patients on whom penile duplex ultrasound and neurophysiological testing were further performed...
September 2015: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Reynaldo G Gomez, Rodrigo A Campos, Laura G Velarde
OBJECTIVE: To present a novel reconstruction technique for patients with pelvic fracture urethral injuries (PFUI) with bulbar artery sparing. MATERIALS AND METHODS: We modified the traditional technique for PFUI reconstruction to preserve the proximal arterial inflow to the bulb. Since 2008, 26 consecutive patients have undergone this technique at our institution. The bulbar arteries are located using a Doppler ultrasound stethoscope and then the bulb is mobilized from one side only, without detachment from the perineum...
February 2016: Urology
Zachary C Dietch, Robin T Petroze, Matthew Thames, Rhett Willis, Robert G Sawyer, Michael D Williams
BACKGROUND: Many centers advocate aggressive lower extremity deep venous thrombosis (DVT) screening using ultrasound (LUS) for patients meeting high-risk criteria. We hypothesized that a high-risk screening protocol is impractical and costly to implement. METHODS: The University of Virginia's trauma database was queried to identify 6,656 patients admitted between 2009 and 2013. Patient characteristics and outcomes were recorded. Multivariate analyses were performed on patients who underwent LUS to assess the association between patient characteristics and the development of DVT...
December 2015: Journal of Trauma and Acute Care Surgery
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