Articles: trauma.
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Fracture of the lateral process of the talus is a rare lesion commonly described in snowboarding injuries. Nevertheless, several conditions can lead to this injury, which is often misdiagnosed as a severe ankle sprain because of the difficulty in detecting it on standard radiographic views. Computed tomography is very helpful for the assessment of this injury. ⋯ In the 2 situations, we opted for an open reduction and internal fixation using 2.4-mm cannulated screws. Both patients were allowed walking with partial weightbearing with a walker boot (VACOped(®)) for 6 weeks. At 1 year, both showed a consolidated fracture and had regained their preinjury level of activity.
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Although the relationship between psychoactive substance use and injury is known, evidence remains conflicting on the impact of substance use on clinical outcomes after injury. We hypothesized that preinjury substance use would negatively impact clinical outcomes. ⋯ Females and those aged >45 y are less likely to receive BASs and UDSs. Differential screening that is biased may place patients at risk for receiving inadequate care.
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Pediatric emergency care · May 2014
Analysis of Infant Lumbar Puncture Success Rates: Sitting Flexed Versus Lateral Flexed Positions.
The primary objective was to determine whether the sitting flexed position yields higher success rates of obtaining cerebrospinal fluid (CSF) for culture. The secondary objectives were to determine whether the sitting flexed position yields higher success rates of obtaining the following: CSF for cell count, non-traumatic CSF, and CSF on the first attempt. ⋯ The sitting flexed position was as successful as the lateral flexed position in the primary objective of obtaining CSF for culture and the secondary objectives of obtaining CSF for cell count and non-traumatic CSF. For the secondary objective of obtaining CSF on the first attempt, the sitting flexed position was associated with a higher rate of obtaining CSF on the first attempt in infants younger than 12 months.
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The clinical outcome of patients with ankylosing spinal disorders (ASDs) sustaining a spinal fracture has been described to be worse compared with the general trauma population. ⋯ Many patients with AS and DISH showed unstable (hyperextension) fracture configurations and neurologic deficits. Complication and mortality rates were higher in patients with ASD compared with control patients. Increasing age and presence of DISH are predictors of mortality after a spinal fracture.