Injury
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Comparative Study
"Comparison of the diagnostic accuracy of X-ray and computed tomography in patients with wrist injury".
This study aimed to compare CT and XR images of patients admitted to the emergency department due to wrist injuries and to evaluate the accuracy of XR in the diagnosis of fractures. ⋯ XR is the first-choice imaging modality in the evaluation of wrist injuries, but CT imaging should be preferred when fractures extending to the joint space, adjacent bone fracture and carpal bone fracture are being considered.
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To introduce a classification for medial wall fragments in pertrochanteric femur fractures and investigate potential preoperative predictors of implant failure following fixation. ⋯ Type III fractures had a significantly increased failure rate. It is important for orthopedists to identify Type III fractures presurgically, reduction of the medial wall fragment and fixation should be considered during surgery using intramedullary nails.
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Scapular neck and body fractures are typically treated nonoperatively, with operative treatment traditionally focused on intraarticular fractures or double disruptions of the shoulder suspensory complex. The objective of this study was to systematically examine and compile the existing literature in regard to operative and conservative treatment of extraarticular fractures of the scapula. ⋯ Patients with extraarticular fractures of the scapula have excellent outcomes following either nonoperative or operative management. There is a need for high quality comparative studies to determine the optimal treatment strategy for these injuries.
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Distal Salter-Harris (SH) II fractures of the tibia are common injuries in the pediatric population. The purpose of this study is to evaluate our treatment and outcomes of SH II fractures of the distal tibia. ⋯ Most SH II fractures of the distal tibia are minimally displaced and do not need a reduction. 6/51 cases (12%) in the current study were displaced and were indicated for a reduction. Displacement greater than or equal to 3 mm can be treated with closed reduction followed by a cast; if closed reduction fails, open reduction is indicated. Displaced fractures have a small risk of growth arrest.
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Duodenopancreatic trauma is rare and presents high morbidity and mortality rates. Pancreaticoduodenectomy (PD) is the only possible treatment indicated for the most complex injuries (grades IV and V). Although, it is commonly a one-stage procedure, damage control surgery corroborates with a two-stage PD performed on unstable trauma victims. ⋯ There were no differences in mortality rates when comparing two and one-stage PD in hemodynamic unstable patients, who had duodenopancreatic lesions (grades IV or V).