J Trauma
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Comparative Study
A comparative study of the patients with bilateral or unilateral chronic subdural hematoma: precipitating factors and postoperative outcomes.
: Chronic subdural hematoma (CSDH) is a relatively frequent problem in neurologic or neurosurgical practice. Although CSDH is a well-known disease, data on bilateral CSDH are scarce compared with data on unilateral CSDH. The purpose of this study was to compare the clinical presentations, precipitating factors, computed tomography (CT) scan findings, postoperative complications, and outcomes between patients with bilateral and unilateral CSDH. ⋯ : Bilateral CSDH tended to occur more in patients with anticoagulant or antiplatelet therapy. Compared with patients with unilateral CSDH, patients with bilateral CSDH had more symptoms of increased intracranial pressure and lower incidences of midline shift on CT scans. Most patients with either bilateral or unilateral CSDH had a good postoperative outcome.
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: The objective was to evaluate the newly developed Radiographic Union Score for Tibial fractures (RUST). Because there is no "gold standard," it was hypothesized that the RUST score would provide substantial improvements compared with previous scores presented in the literature. ⋯ : The RUST score exhibits substantial improvements in reliability from previously published scores and produces equally reproducible results among a variety of orthopedic specialties and experience levels. Because no "gold standards" currently exist against which RUST can be compared, this study provides only the initial step in the score's full validation for use in a clinical context.
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: The fluoroscopic imaging technique that has been used in the dorsal percutaneous screw fixation of scaphoid fracture was modified for more consistent central screw placement according to the different fracture locations. ⋯ : The fluoroscopic images should be individualized according to the fracture planes for more consistent and accurate central guide wire placement in the dorsal percutaneous screw fixation of scaphoid fracture.
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: Current abdominal compartment syndrome (ACS) models rely on intraperitoneal instillation of fluid, air, and other space-occupying substances. Although this allows for the study of the effects of increased abdominal pressure, it poorly mimics its pathogenesis. We have developed the first reported large animal model of ACS incorporating hemorrhagic shock/resuscitation. ⋯ : We have created the first reported physiologic animal ACS model incorporating hemorrhagic shock/resuscitation and the effects of damage control surgery.
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: We report microvascular free tissue transfers in pediatric patients in a retrospective series. ⋯ : In cases of severe tissue defects in pediatric patients, microvascular free flap reconstruction is a treatment of choice. A multicenter study for guidelines on preoperative assessment and antitrombotic therapy in pediatric microsurgery is warranted.