Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Oct 2010
Putrid infectious pubic osteitis: case report and review of the literature on the differential diagnosis and treatment of infectious pubic osteitis and inflammatory pubic osteitis.
The differential diagnosis of osteolytic, destructive, and inflammatory processes around the symphysis, the os pubis, and the ramus ossis pubis includes infectious osteitis pubis, inflammatory osteitis pubis, posttraumatic benign pubic osteolyses in elderly women, and malignant neoplasia. Accurate diagnosis can be a challenge and requires a methodical approach and the use of a variety of diagnostic measures. ⋯ A case study of an 83-year-old female suffering from infectious pubis osteitis sheds light on the differential diagnosis of these conditions, particularly the distinction between infectious pubic osteitis and inflammatory pubis osteitis. In addition to the diagnostic indicators and methodologies, differential treatments are considered and a review of current literature on the topic is presented.
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Acute aortic valve insufficiency caused by laceration of the aortic valve cusp after blunt chest trauma is a rare condition. We report herein on a case of a 40-year-old patient who initially presented with cardiac tamponade and cardiac arrest after a traffic accident. The patient ultimately received aortic valve repair to treat acute aortic regurgitation due to multiple perforations on a single cusp, visualized on multidetector chest computed tomography scan (128 channels).
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The management of rib fractures and flail chest has changed considerably over the past century, and recently there has been a renewed interest in operative rib stabilization for these injuries. Despite numerous reports suggesting improved outcomes with rib stabilization, there are not well-defined indications and the approach remains somewhat controversial. ⋯ The authors offer their opinions on this operation with respect to rationale, indications, timing, technique, and postoperative care.
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Intestinal derotation (ID) is a rarely used surgical technique which allows elegant and effective surgical access to the superior mesenteric axis and third and fourth portion of the duodenum. ID proves an extremely useful technique especially in the emergency setting when access to the "surgical soul" is needed. To master this technique the surgeon has to become familiar with the anatomical landmarks of that area along with the embryological background.
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Hoffa fractures are uni- or bicondylar fractures of the distal femur in a coronal tangential plane. ⋯ Traditional methods of fixation for Hoffa fractures have led either to the application of complicated constructs attempting to achieve stability, or to large articular surface defects created whilst countersinking headed lag screws. Both have negative implications for the patient. We describe a novel method, not previously described in the literature, using screws in a posterior to anterior direction. This provides compression perpendicular to the fracture site whilst protecting against shear and torsional forces, thereby providing more stable fixation. Furthermore, our method allows for a minimally invasive approach and uses headless compression screws, which reduces the chance of damage to the articular surface and is, therefore, less physiologically invasive.