Articles: trauma.
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Case Reports Comparative Study
Surgical versus nonsurgical treatment of subaxial cervical pedicle fractures.
Pedicle fractures in the cervical spine are common. They may occur in isolation or in combination with other concomitant fractures. Multiple classification systems have been introduced to provide a clinical framework when approaching these types of fractures; however, these systems do not provide guidelines for optimal treatment. Data regarding decision making are limited. Conservative treatment with orthoses may result in subluxation and instability requiring further treatment. Surgery may not be required in all instances because many of these injuries may heal without surgical intervention. ⋯ This study describes and classifies unique cervical pedicle fractures and associated injuries. Our findings suggest that surgical treatment results in definitive stability for these injuries compared with conservative therapy, particularly for pedicle fractures associated with comminuted lateral mass or initially displaced fractures. However, nondisplaced vertical split pedicle fractures and isolated single line horizontal fractures may be treated nonsurgically without occurrence of further instability. A larger prospective study is required to confirm these findings.
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Arch Gerontol Geriatr · Nov 2014
Gender differences in the clinical characteristics of traumatic spinal fractures among the elderly.
In order to illustrate the epidemiology of traumatic spinal fractures among the elderly, with an emphasis on exploring gender differences in clinical characteristics, we retrospectively reviewed hospital records on all elderly patients with traumatic spinal fractures who were 60 years of age or older at two university-affiliated hospitals between January 2001 and December 2010. A total of 642 elderly patients with traumatic spinal fractures were identified, of whom 249 were male and 393 were female. Accidental falls from low heights were the most common cause of traumatic spinal fractures among the elderly (50.8%). ⋯ Frequencies of cervical spinal fractures, spinal cord injuries, associated non-spinal injuries (ASOIs) and mean injury severity scores (ISSs) were significantly higher in males than in females (P<0.05). Frequencies of thoracic and thoracolumbar spinal fractures in females were significantly higher than in males (P<0.05). Clinicians should make their diagnoses and direct their injury prevention strategies according to gender differences in the clinical characteristics of traumatic spinal fractures among the elderly.
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Pediatric emergency care · Nov 2014
Observational StudyEvaluation of an After-Hours Call Center: Are Pediatric Patients Appropriately Referred to the Emergency Department?
There is concern that after-hours nurse telephone triage systems are overwhelming the emergency department (ED) with nonemergent pediatric referrals. ⋯ Our study identifies that a third of unnecessary pediatric visits to the ED occurred as a result of the nurse triage telephone system in question. We recommend review of the algorithms stated to reduce strain on local ED resources.
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Ulus Travma Acil Cer · Nov 2014
Treatment and results in pediatric traumatic hip dislocation: Case series and review of the literature.
Six acute traumatic hip dislocations in pediatric patients were retrospectively analyzed. Types of dislocations, associated lesions, treatment methods, complications, and clinical and radiological outcomes were reviewed. ⋯ Traumatic hip dislocation is a rare condition. It should be treated with preferably closed method as soon as possible. Repetitive reduction trials should be avoided. Open reduction should be performed to recognize accompanying lesions after advanced radiologic examinations such as computerized tomography and magnetic resonance imaging.