Chinese journal of traumatology = Zhonghua chuang shang za zhi / Chinese Medical Association
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Chin. J. Traumatol. · Apr 2014
Case ReportsInadvertent advancement of guide wire across the knee caused by incarcerated bone fragment at the nail tip during femoral nailing.
Fracture of femoral shaft in adults is common and mostly managed with intramedullary interlocking nails. Complications during closed intramedullary femoral nailing are uncommon, and mostly of them are caused by technical reasons. We describe a case of closed nailing for a femoral shaft fracture in which a jammed intramedullary guide wire, due to an incarcerated bone fragment at the nail tip, was inadvertently advanced across the knee. Forceful attempt of nail insertion caused this complication, which was probably attributed to nail design.
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Chin. J. Traumatol. · Apr 2014
Internal fixation with headless compression screws and back buttress plate for treatment of old Hoffa fracture.
To analyze the early clinical and radiographic outcomes of Hoffa fractures treated by a standard protocol of open reduction and internal fixation using headless compression screws combined with back buttress plate in a consecutive series of 8 Chinese patients. ⋯ Headless compression screws combined with back buttress plate and/or autologous bone grafting to treat old Hoffa fracture is one of effective measures. It would be conducive to not only fracture healing but also early exercise and functional recovery.
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Hemorrhage is the second most common cause of death among trauma patients and almost half of the deaths occur within 24 hours after arrival. Damage control resuscitation is a new paradigm for patients with massive bleeding. It consists of permissive hypotension, hemostatic resuscitation and transfusion strategies, and damage control surgery. ⋯ The strategy of fluid resuscitation is minimizing crystalloid infusion and increasing early transfusion with a high ratio of fresh frozen plasma to packed red cells. Damage control surgery is done when the patient's condition is unfit for definitive surgery. Hemorrhage and contamination control with temporary abdominal closure is performed before transferring the patients to intensive care unit and the operating room for a permanent laparotomy.
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Chin. J. Traumatol. · Apr 2014
Randomized Controlled Trial Comparative StudyComparison between traction-countertraction and modified scapular manipulation for reduction of shoulder dislocation.
One of the most common joint dislocations presented to the emergency department (ED) is anterior shoulder dislocation (ASD). Various techniques for the treatment of this abnormality have been suggested. In this study, we evaluated the efficacy and success rate of modified scapular manipulation (MSM) as a painless procedure compared to traction-countertraction (TCT) for reduction of ASD. ⋯ It seems that the manipulation technique can be more successful than the TCT method at the first effort whilst the second effort has the opposite results. Also MSM can be safer, cheaper and more acceptable for patients than TCT as a standard traditional method.
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Chin. J. Traumatol. · Jan 2014
Comparative StudyCerebral state index versus Glasgow coma scale as a predictor for in-hospital mortality in brain-injured patients.
To compare the value of Glasgow coma scale (GCS) and cerebral state index (CSI) on predicting hospital discharge status of acute brain-injured patients. ⋯ GCS score at ICU admission is a good predictor of in-hospital mortality. GCS<4.5 and CSI<64.5 at the time of admission is associated with higher mortality risk in traumatic brain injury patients and GCS is more sensitive than CSI in predicting death in these patients.