J Trauma
-
Review Case Reports
Brachial artery rupture associated with closed posterior elbow dislocation: a case report and review of the literature.
A case report of a closed posterior elbow dislocation with brachial artery rupture treated with a reversed saphenous vein graft, fasciotomy, and medical collateral ligament (anterior oblique component) repair is presented. A literature review of 21 other similar cases is discussed. ⋯ At final follow-up, 12 patients (55%) had a motor and/or sensory deficit, and 11 patients (50%) had restriction of elbow extension. Seven of these 11 patients had a loss of elbow extension of 5 to 15 degrees; the other four patients had a loss of 20 to 35 degrees.
-
Review Case Reports
Extracorporeal membrane oxygenation in the successful treatment of traumatic adult respiratory distress syndrome: case report and review.
We present the case of a 25-year-old, 28-week pregnant woman with two gunshot wounds to the chest. Extracorporeal membrane oxygenation (ECMO) was begun within 12 hours, despite poor results in prior studies and the need for anticoagulation postoperatively, since oxygenation was rapidly deteriorating despite aggressive treatment. The patient ultimately made a full recovery.
-
Lumbar hernia is an uncommon abdominal wall hernia. Acute abdominal wall hernias, particularly lumbar hernias, are a rare complication of trauma. ⋯ Double-contrast CT scan detected herniation of bowel through an 8-cm right flank defect, which was surgically repaired with a prosthetic patch and omentopexy. In cases of acute traumatic lumbar hernia, immediate exploratory laparotomy with primary repair (when feasible) is recommended.
-
Recent years have seen a renewed interest in the use of hypertonic-hyperoncotic solutions as plasma volume expanders for the treatment of hemorrhagic hypotension. In particular, a number of studies in experimental animals have addressed the efficacy and safety of small-volume infusions of 7.5% NaCl/6% dextran 70 (HSD). ⋯ In the few human field trials completed to date, HSD has been shown to be potentially beneficial in hypotensive trauma patients who require surgery or have concomitant head injury. Extensive toxicologic evaluations and lack of reports of adverse effects in the human trials indicate that, at the proposed therapeutic dose of 4 mL/kg, HSD should present little risk.
-
Review Case Reports
Baluster entrapment avulsion of the little finger: a new clinical entity--case reports.
Five cases of avulsion injuries of the little finger are described. The mechanism of injury was identical in all cases. The little finger was entrapped by a baluster when the patient frantically attempted to grasp the handrail to avoid falling down stairs. To our knowledge, this type of injury has not been reported previously.