Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
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Ulus Travma Acil Cerrahi Derg · Nov 2024
Reliability of ankle clonus evaluation for monitoring neural-tract integrity in pediatric spinal deformity surgery under different anesthetics protocols.
Although the ankle clonus test is a pathological finding in neurological examination, it may temporarily occur in neurologically intact individuals during awakening from anesthesia. Some studies suggest it as a marker indicating neural tract integrity in pediatric spinal deformity surgery. This study aims to investigate the consistency of the ankle clonus test under different anesthesia protocols in pediatric patients with spinal deformities. ⋯ The ankle clonus test is not a reliable method for monitoring neurological deficits during spinal surgery. It is not exactly known how such myoclonic contractions occur or how the pathway is inhibited or activated.
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Ulus Travma Acil Cerrahi Derg · Nov 2024
Case ReportsShoulder disarticulation after clavicle fracture: a case report.
In this case report, we presented to a 90-year-old female with multiple comorbidities presented to the emergency department of our hospital three weeks following a fall from standing height. Upon arrival, the patient exhibited a Glasgow Coma Scale (GCS) 12, blood pressure of 100/60 mmHg, heart rate of 117 beats/min, respiratory rate of 24 breaths/min. Examination revealed atrophy, skin color change, sensory disturbance, or motor palsy in the left upper extremity. ⋯ No other symptoms of circulatory dysfunction were observed at the 3 months follow-up. This case report emphasizes that delayed clavicle fracture can lead to catastrophic consequences. Trauma surgeons should also consider surgical treatment of clavicle fractures, depending on the patient's condition.
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Ulus Travma Acil Cerrahi Derg · Nov 2024
The evaluation of secondary pneumomediastinum in children: the experience of a pediatric surgery clinic.
Pneumomediastinum, defined as mediastinal emphysema, is the term coined for the presence of air in the mediastinum. It is a rare condition that can occur in children due to various etiologies, especially trauma, and may appear without any underlying injury. We investigated the causes of secondary pneumomediastinum and the treatment approaches in children treated at our clinic. ⋯ Although pneumomediastinum is a self-limiting pathology, ventilation difficulties alongside pneumomediastinum should raise suspicion of esophageal and tracheal injuries, necessitating further investigations. Since the etiologies are very different, each patient should be evaluated separately. In most patients, pneumomediastinum regresses on its own. However, patients with complications should be carefully evaluated for accompanying diseases and injuries.
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Ulus Travma Acil Cerrahi Derg · Nov 2024
Case ReportsCompression-induced reversible brachial plexopathy: Urgent neurological approach.
Brachial plexus injuries are the second most common perioperative peripheral nerve injuries. Malposition is a significant predisposing factor to these injuries. ⋯ Herein, we present the electroneuromyography (EMG) findings within the first 48 hours for a patient who has been under tacrolimus treatment for five years due to liver transplantation and developed compression-induced reversible brachial plexopathy. Through this case, we highlighted that brachial plexus injury may not always result in axonal involvement and discussed the findings that may be encountered in early neurophysiological examinations.
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Ulus Travma Acil Cerrahi Derg · Oct 2024
Comparative Study Observational StudyComparative study of imaging features in uncomplicated and complicated acute appendicitis.
Acute appendicitis is a common cause of acute abdominal pain necessitating surgical intervention. While the traditional treatment has been urgent appendectomy, recent studies suggest that an antibiotics-first approach can be safe for uncomplicated cases. Classifying appendicitis into uncomplicated and complicated categories is crucial for guiding treatment decisions and predicting patient outcomes. This study aims to evaluate the distinct imaging findings associated with uncomplicated appendicitis and its complicated subtypes-phlegmonous, gangrenous, and perforated appendicitis-to aid in differential diagnosis. ⋯ This study provides a detailed analysis of distinct imaging findings associated with uncomplicated and complicated appendicitis. Key differentiators such as appendiceal diameter, periappendiceal air, effusion, and intraluminal appendicolith are crucial for accurate diagnosis. The findings highlight the importance of these parameters in distinguishing various types of appendicitis, offering valuable insights for clinical practice. Future prospective studies and advanced imaging techniques are needed to validate these findings and enhance the diagnosis and management of acute appendicitis and its complications.