Ulus Travma Acil Cer
-
Ulus Travma Acil Cer · Jul 2021
Case ReportsUnusual airway obstruction due to thoracic duct injury after whiplash injury.
Traumatic chylothorax is a rare condition following blunt trauma. Although a chyle leak resulting from direct damage to the duct may occur at any level because of an anatomical variation, an airway obstruction due to thoracic duct injury after blunt trauma has never been described. Here, we report a very unusual case with airway obstruction due to thoracic duct injury after whiplash injury. ⋯ Seven days later, repeat CT showed an increased amount of mediastinal and prevertebral fluid collection extending to the upper neck level with airway compression. He underwent an operation to drain the fluid via a neck incision and a thoracic duct ligation via right thoracotomy and was discharged without complaint. The findings suggest that if hematoma and pneumomediastinum are found in the prevertebral space at the level of the cervical and upper thoracic spine, the patient should be closely observed to exclude the complication of airway obstruction caused by thoracic duct injury.
-
Ulus Travma Acil Cer · Jul 2021
Randomized Controlled TrialComparison of the C-MAC D-Blade videolaryngoscope and direct laryngoscope in pediatric patients: Randomized controlled trial.
Endotracheal intubation is a key skill for clinicians and may be challenging in some patients due to various reasons. Nowadays, various kinds of videolaryngoscopes are available and usually used as a rescue device when direct laryngoscopy failed. Pediatric airway has some differences when compared with adults and may be challenging. This study aims to compare and evaluate C Mac D-Blade and commonly used Macintosh laryngoscope in pediatric patients. ⋯ C Mac D-Blade videolaryngoscope shortened intubation time about twice when compared to Macintosh blade C Mac D-Blade videolaryngoscope, Videolaryngoscopes may be a good alternative for routine intubation, education and a rescue device for difficult intubation.
-
Ulus Travma Acil Cer · Jul 2021
Primary treatment of complex proximal humerus fractures using Humelock cementless reversible shoulder arthroplasty in the elderly.
Proximal humerus fractures are quite common, constituting 5% of all fractures. Plate osteosynthesis of comminuted fractures in the elderly with osteoporotic bones is prone to complications, including loss of reduction, intraarticular protrusion of screws, avascular necrosis and non-union. Hemiarthroplasty may be preferred to achieve a stable fixation, which permits early shoulder motion. Prerequisites for the successful functional outcome of this surgical technique are to have an intact rotator cuff, which is often torn, and achieve proper soft tissue balance, which is technically demanding. In RSA design, deltoid muscle replaces the function of the supraspinatus, compensating for a dysfunctional rotator cuff or a displaced tuberculum. We designed a retrospective study to evaluate the results of proximal humerus fractures treated with reverse shoulder arthroplasty using Humelock II reversible prosthesis in elderly patients. ⋯ RSA is a very reliable treatment for proximal humerus fractures in patients over 65 years old. Early active and passive shoulder exercises can be started postoperatively, and good functional outcome and wide ROM can be achieved with this age group. Although stable fixation of the tuberculum is not required for shoulder abduction, it facilitates external rotation and should be attempted in all cases. Clinical outcomes of patients who underwent RSA due to proximal humerus fracture are as good as the outcomes of patients with different etiologies.
-
Ulus Travma Acil Cer · Jul 2021
The relationship between changes in distal tibiofibular joint congruence and clinical and functional results in the short-term follow-up of patients operated on for ankle fracture.
The effects of changes in distal tibiofibular joint (DTFJ) congruence on clinical and functional outcomes are unclear in patients operated on for ankle fractures. The present study aims to evaluate the relationship between changes in DTFJ congruence and clinical and functional outcomes in the short-term follow-up of the patients operated on for ankle fractures. ⋯ Changes in dDA, dDP, and dDT values affect the clinical and functional outcomes. These parameters should be provided in accordance with the anatomy of the patient during the reduction of the DTFJ to achieve better outcomes.
-
Ulus Travma Acil Cer · Jul 2021
Case ReportsMisdiagnosis of appendiceal abscess with intestinal malrotation: A case report.
Here, we report the case of a 75-year-old male with abdominal pain who was admitted to our Emergency Department. Computed tomography (CT) scan revealed torsion of the mesenteric root with fluid surrounding the area. Emergency laparotomy, performed under general anesthesia, revealed appendiceal abscess with intestinal malrotation. ⋯ Intestinal malrotation is more common in neonates than in adults. The diagnosis of appendicitis could be further obscured by intestinal malrotation. Therefore, the rare situation of intestinal malrotation and ectopic appendicitis in the abdomen should be considered in cases with an absence of right lower abdominal pain, where preoperative abdominal CT shows mesenteric volvulus and the surrounding intestinal wall is thickened and demonstrating exudation.