J Trauma
-
Comparative Study
Blunt pulmonary contusion: admission computed tomography scan predicts mechanical ventilation.
Blunt pulmonary contusion (BPC) evolves over 12 to 24 hours, and the initial plain radiographs fail to reliably identify patients at risk of clinical deterioration. Admission computed tomography (CT) may offer accurate characterization of BPC and early prediction of the need for mechanical ventilation (MV). ⋯ A simple score derived by the initial chest CT, in combination with GCS and the number of fractured ribs, can predict the need for MV early. In the presence of these predictors, patients should be admitted to a high level of monitoring.
-
Comparative Study
The association between anemia and the mortality of severe traumatic brain injury in emergency department.
Anemia is a common medical problem for critically ill patients. Blood transfusion to augment oxygen delivery for these patients has been a traditional therapy. However, few studies have identified the impact of anemia on individuals suffering from severe traumatic brain injury (TBI). Hence, this study aims to evaluate the effects of initial anemia on patients with severe TBI admitted to the Emergency Unit. ⋯ This study shows that initial anemia is not a mortality risk factor for patients with isolated severe blunt TBI.
-
Comparative Study
Facial nerve decompression surgery in patients with temporal bone trauma: analysis of 66 cases.
In the treatment of facial nerve paralysis after temporal bone trauma, it is important to appropriately determine whether nerve decompression surgery is indicated. The aim of this study was to examine the efficacy of facial nerve decompression surgery according to fracture location and the ideal time for surgery after trauma by analyzing the therapeutic outcome of traumatic facial nerve paralysis. ⋯ The results of this study demonstrated that the ideal time for decompression surgery for facial nerve paralysis after temporal bone fracture was the first 2 weeks after trauma in patients with severe, immediate-onset paralysis. Our study also showed that surgery should be performed within 2 months at the latest. These findings provide useful information for patients and help to determine the priority of treatment when concomitant disease exists.
-
Traumatic sternal fractures occur in approximately 3% to 8% of all blunt trauma patients. Most of these fractures are treated conservatively, but a small number require operative intervention. Only a few studies have reported operative fixation of sternal fractures, and no investigation to our knowledge has systematically reviewed the literature on this intervention. ⋯ Although the outcomes were generally positive, only one-half of the articles documented patient follow-up. In future studies, focus needs to be placed on long-term results and specific indications for surgery. The first step toward a standardized sternal fracture operative trial must be a prospective study of incidence and nonoperative long-term outcomes. It is likely that as the interest and demand for plate fixation increases, the demand for orthopedic involvement with sternal fractures will also increase.
-
The treatment of interprosthetic femoral fractures is challenging because of several factors. Poor bone stock, advanced age, potential prosthetic instability, and limited fracture fixation options both proximally and distally can complicate standard femur fracture treatment procedures. The purpose of this report was to describe our experience treating interprosthetic femoral fractures, providing an emphasis on treatment principles and specific intraoperative management. ⋯ The principles for treatment of isolated periprosthetic fractures are useful to guide the fixation of interprosthetic fractures. Locked plating is an effective method for the treatment of interprosthetic femoral fractures. Bypassing the adjacent prosthesis by a minimum of two femoral diameters is a necessary technique to prevent a stress riser.