Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Aug 2008
Popliteal A-V Fistula with Pseudo-aneurysm: A Complication Following Total Knee Arthroplasty.
Arthroscopy and total knee replacement (TKR) are the two orthopedic procedures in which instruments are routinely placed near the posterior capsule of the knee. A review of the literature demonstrated that the four commonest reported problems following TKR are thrombosis, arterial transection, A-V fistula, and aneurysm formation. ⋯ Despite the uncommon occurrence of these injuries, the outcome can be devastating, leading to further surgery, including vascular repair or possibly even amputation of the affected limb. We present a rare case of popliteal A-V fistula following TKR and discuss the probable etiology and the management.
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Hepatic injuries are one of the most common abdominal injuries following either blunt or penetrating trauma. CT scanning has revolutionized the treatment algorithm for these patients. The majority of patients are successfully treated with nonoperative management, but surgeons should have a clear understanding of the indications for operative intervention. An array of techniques including operative, interventional, and endoscopic, are often required for management of advanced grade hepatic injuries.
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Eur J Trauma Emerg S · Aug 2008
Traumatic First Metatarsal Bone Loss Treated with a Staged Method Using an Antibiotic Cement Spacer and Subsequent Autografting: A Case Report.
Fractures with bone loss are rare. A staged method of using bone cement as a spacer and subsequent autografting has been used successfully to treat traumatic bone loss of long bones. We report a case of traumatic bone loss of the 1st metatarsal bone that was treated successively with a staged method of using antibiotic-impregnated bone cement as a spacer in the primary phase and cancellous autografting in second-stage surgery.
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Eur J Trauma Emerg S · Aug 2008
The use of Hypertonic Saline in the Treatment of Post-Traumatic Cerebral Edema: A Review.
Effective methods for treating cerebral edema have recently become a matter of both extensive research and significant debate within the neurosurgery and trauma surgery communities. The pathophysiologic progression and outcome of different forms of cerebral edema associated with traumatic brain injury have yet to be fully elucidated. There are heterogeneous factors influencing the onset and progress of post-traumatic cerebral edema, including the magnitude and type of head injury, age, co-morbid conditions of the patient, the critical window for therapeutic intervention and the presence of secondary insults including hypoxia, hypotension, hypo/hyperthermia, degree of raised intracranial pressure (ICP), and disruption of blood brain barrier (BBB) integrity. ⋯ More recently, fluid resuscitation strategies using hyperosmolar agents such as pentastarch and hypertonic saline (HS) have achieved some success. HS treatment is of particular interest due to its apparent advantageous action over other types of hyper-osmotic solutions in both clinical and laboratory studies. In this review, we provide a summary of recent literature concerning the pathogenesis and mechanisms involved in the various types of cerebral edema, and the possible mechanisms of action of HS for the treatment cerebral edema.
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Eur J Trauma Emerg S · Aug 2008
Midfacial Fractures: A Scoring Method and Validation on 117 Patients.
The midfacial region (MR) is located in the middle-third of the face, composed of several bones and surrounded by complex anatomical structures so that MR fractures (MRFs) often involve other parts of the face. A staging system for classifying MRFs is of paramount importance in order to exchange information among trauma centers. Le Fort described three lines of fractures but still there is no scoring method to stage MRFs. ⋯ In conclusion, the proposed classification is a simple and precise method of staging MRFs. It can summarize MRFs and be used in daily practice. It is our understanding, however, that a multi-centers study should be performed before the effectiveness of the proposed classification can be clearly stated.