Pub Date : 2016-06-30DOI: 10.4172/2167-1222.1000313
C. Hazif‐Thomas, P. Thomas
The persistence of compulsory hospitalization in psychiatry is still a topical question within the atmosphere of violence and even of barbarism which comes to light in our society. Given opinions get more radical and demand zero risk in psychiatry, it becomes a lack of political ambition to carry on speaking of medical approach on the one side and of liberty one the other side.
{"title":"Psychiatric Care: \"The Free Choice: Still a Topical Issue?\"","authors":"C. Hazif‐Thomas, P. Thomas","doi":"10.4172/2167-1222.1000313","DOIUrl":"https://doi.org/10.4172/2167-1222.1000313","url":null,"abstract":"The persistence of compulsory hospitalization in psychiatry is still a topical question within the atmosphere of violence and even of barbarism which comes to light in our society. Given opinions get more radical and demand zero risk in psychiatry, it becomes a lack of political ambition to carry on speaking of medical approach on the one side and of liberty one the other side.","PeriodicalId":90636,"journal":{"name":"Journal of trauma & treatment","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-1222.1000313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70826815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-30DOI: 10.4172/2167-1222.1000314
C. Lutter, D. Popp, J. Dickschas, V. Schöffl
Atypical fractures are challenging for surgeons, as standard procedures are not applicable [1,2]. An interesting alternative for avulsion fractures of the tibial tubercle is the Bamberg Plate, a selfadjusted calcaneus titanium plate [3,4]. This simple and inexpensive implant was originally developed for displaced fractures of the greater humerus-tuberosity, but has already proved its advantage in various other locations, such as the tibial head or the posterior collum of the acetabulum [3,4].
{"title":"The Bamberg Plate: An Alternative Procedure for Tibial Tubercle Fractures","authors":"C. Lutter, D. Popp, J. Dickschas, V. Schöffl","doi":"10.4172/2167-1222.1000314","DOIUrl":"https://doi.org/10.4172/2167-1222.1000314","url":null,"abstract":"Atypical fractures are challenging for surgeons, as standard procedures are not applicable [1,2]. An interesting alternative for avulsion fractures of the tibial tubercle is the Bamberg Plate, a selfadjusted calcaneus titanium plate [3,4]. This simple and inexpensive implant was originally developed for displaced fractures of the greater humerus-tuberosity, but has already proved its advantage in various other locations, such as the tibial head or the posterior collum of the acetabulum [3,4].","PeriodicalId":90636,"journal":{"name":"Journal of trauma & treatment","volume":"5 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-1222.1000314","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70826803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-30DOI: 10.4172/2167-1222.1000312
Startzman As, T. Hawkes, Beter
Clinicians must be aware of this rare but devastating diagnosis, as early diagnosis may improve prognosis. Case presentation: An 11-year-old African American female presented to a pediatric orthopedic clinic with a 6- month history of insidious onset left hip pain. Over 6-months her pain became more severe, and limited her ability to walk. The left hip was fixed in 40-degrees flexion, 20-degrees abduction, and 30-degrees of external rotation. New x-ray findings consistent with idiopathic juvenile chondrolysis of the hip were present. Discussion: First described in the early 1900s, chondrolysis of the hip was initially identified in patients following slipped capital femoral epiphysis. Later, patients with no clear etiology were diagnosed. Associations with trauma, burns, infection, and prolonged immobilization have also been described. The course is variable, with an acute phase lasting 6-16 months followed by a chronic stage of 3-5 years. Conclusion: Idiopathic chondrolysis of the hip is a challenging diagnosis with devastating complications. Ultimately, most patients experience a spontaneous resolution of pain, develop early arthritis, and often arthrodesis
{"title":"Juvenile Idiopathic Chondrolysis of the Hip","authors":"Startzman As, T. Hawkes, Beter","doi":"10.4172/2167-1222.1000312","DOIUrl":"https://doi.org/10.4172/2167-1222.1000312","url":null,"abstract":"Clinicians must be aware of this rare but devastating diagnosis, as early diagnosis may improve prognosis. Case presentation: An 11-year-old African American female presented to a pediatric orthopedic clinic with a 6- month history of insidious onset left hip pain. Over 6-months her pain became more severe, and limited her ability to walk. The left hip was fixed in 40-degrees flexion, 20-degrees abduction, and 30-degrees of external rotation. New x-ray findings consistent with idiopathic juvenile chondrolysis of the hip were present. Discussion: First described in the early 1900s, chondrolysis of the hip was initially identified in patients following slipped capital femoral epiphysis. Later, patients with no clear etiology were diagnosed. Associations with trauma, burns, infection, and prolonged immobilization have also been described. The course is variable, with an acute phase lasting 6-16 months followed by a chronic stage of 3-5 years. Conclusion: Idiopathic chondrolysis of the hip is a challenging diagnosis with devastating complications. Ultimately, most patients experience a spontaneous resolution of pain, develop early arthritis, and often arthrodesis","PeriodicalId":90636,"journal":{"name":"Journal of trauma & treatment","volume":"5 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70826579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-30DOI: 10.4172/2167-1222.1000311
D. Saragaglia, Morin, R. Pailhé
Postero-medial tibial plateau fracture (Moore type 1) is challenging. Since several years a posterior approach has been described in order to use a butteress plate. In our opinion, it is possible to fix accurately this kind of fracture with 2 to 5 antero-posterior 6.5 mm cancellous screws through an anterior approach. The aim of this work was to present anatomical results and return to sport of 15 patients operated on for Moore type 1 tibial plateau fracture. We observed no pseudarthrosis or secondary varus displacement. 87% of patients resumed back to their sporting activities. The anteromedial incision has a dual advantage of anatomical postero-medial fragment reduction and tibial spine fixation (in 80% of our cases).
{"title":"Surgical Management of Postero-Medial Tibial Plateau Fracture: Is PlateOsteosynthesis Mandatory?","authors":"D. Saragaglia, Morin, R. Pailhé","doi":"10.4172/2167-1222.1000311","DOIUrl":"https://doi.org/10.4172/2167-1222.1000311","url":null,"abstract":"Postero-medial tibial plateau fracture (Moore type 1) is challenging. Since several years a posterior approach has been described in order to use a butteress plate. In our opinion, it is possible to fix accurately this kind of fracture with 2 to 5 antero-posterior 6.5 mm cancellous screws through an anterior approach. The aim of this work was to present anatomical results and return to sport of 15 patients operated on for Moore type 1 tibial plateau fracture. We observed no pseudarthrosis or secondary varus displacement. 87% of patients resumed back to their sporting activities. The anteromedial incision has a dual advantage of anatomical postero-medial fragment reduction and tibial spine fixation (in 80% of our cases).","PeriodicalId":90636,"journal":{"name":"Journal of trauma & treatment","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-1222.1000311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70826392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-30DOI: 10.4172/2167-1222.1000315
David Fuchs
The hospital in which I have worked in the Galilee for over twenty years is close to the borders of Lebanon and Syria with Israel. I am an Israeli Emergency Room nurse in my sixties. I am also the Trauma Co-ordinator of the hospital. Galilee is a spectacularly beautiful and tranquil part of Israel. Arabs and Jews have lived together here for generations. I have raised my children and grandchildren here. Together we have lived through years of peace and apprehension, and also years of bitter conflict with our neighbor’s. As a father and grandfather I have worried for my family, and, as a nurse, I have always had to make sure that my department is ready to respond immediately to medical emergencies in conflict and mass casualty scenarios.
{"title":"Caring for the Children of our Neighbours: A Nurses Perspective","authors":"David Fuchs","doi":"10.4172/2167-1222.1000315","DOIUrl":"https://doi.org/10.4172/2167-1222.1000315","url":null,"abstract":"The hospital in which I have worked in the Galilee for over twenty years is close to the borders of Lebanon and Syria with Israel. I am an Israeli Emergency Room nurse in my sixties. I am also the Trauma Co-ordinator of the hospital. Galilee is a spectacularly beautiful and tranquil part of Israel. Arabs and Jews have lived together here for generations. I have raised my children and grandchildren here. Together we have lived through years of peace and apprehension, and also years of bitter conflict with our neighbor’s. As a father and grandfather I have worried for my family, and, as a nurse, I have always had to make sure that my department is ready to respond immediately to medical emergencies in conflict and mass casualty scenarios.","PeriodicalId":90636,"journal":{"name":"Journal of trauma & treatment","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70826454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-25DOI: 10.4172/2167-1222.1000309
Sheng Huang, Yan Zhou
Traumatic brain injury (TBI) is the leading cause of death and disability in children and young adults around the world because it has been the most misunderstood and misdiagnosed problem among the central nervous system (CNS) disorders. Around 90% of TBIs are classified as mild (mTBI). The current detection of mTBI relies heavily on an assessment of behavioral symptoms, often with delay and subject to motivation. Despite notable advances in diagnostic magnetic resonance imaging (MRI), it remains a challenging issue to precisely make early evaluation of the severity of TBI and to predict the long-term outcomes. Currently there are no molecular biomarker-based blood tests that can accurately determine the presence and the severity of TBI because at present no clinical tools are available for measuring glymphatic-derived convective bulk flow in humans. There is an urgent need to call for a concerted effort to search for sensitive and reliable biomarkers of TBI, especially mTBI. There is a growing consensus that TBI, no matter what the cause, leads to dysfunction of the blood-brain barrier (BBB), which is mainly constituted by brain microvascular endothelial cells (BMEC). Our recent preclinical studies have shown that circulating BMEC in the peripheral blood, which are independent of the glymphatic system, could be used as cellbased biomarkers for quantitative assessment of BBB injury caused by various pathogenic insults, including trauma. The vimentin-α7 nAChR pathway significantly contributes to cBMEC shedding during the pathogenesis of BBB/CNS disorders. The cell-based biomarkers cBMEC along with the single cell technology will overcome the limitations of molecular biomarkers mentioned above and make the early diagnosis of TBI.
{"title":"Why Molecular Biomarkers of Traumatic Brain Injury May Never Work:Effects of Glymphatic Pathway Dysfunction","authors":"Sheng Huang, Yan Zhou","doi":"10.4172/2167-1222.1000309","DOIUrl":"https://doi.org/10.4172/2167-1222.1000309","url":null,"abstract":"Traumatic brain injury (TBI) is the leading cause of death and disability in children and young adults around the world because it has been the most misunderstood and misdiagnosed problem among the central nervous system (CNS) disorders. Around 90% of TBIs are classified as mild (mTBI). The current detection of mTBI relies heavily on an assessment of behavioral symptoms, often with delay and subject to motivation. Despite notable advances in diagnostic magnetic resonance imaging (MRI), it remains a challenging issue to precisely make early evaluation of the severity of TBI and to predict the long-term outcomes. Currently there are no molecular biomarker-based blood tests that can accurately determine the presence and the severity of TBI because at present no clinical tools are available for measuring glymphatic-derived convective bulk flow in humans. There is an urgent need to call for a concerted effort to search for sensitive and reliable biomarkers of TBI, especially mTBI. There is a growing consensus that TBI, no matter what the cause, leads to dysfunction of the blood-brain barrier (BBB), which is mainly constituted by brain microvascular endothelial cells (BMEC). Our recent preclinical studies have shown that circulating BMEC in the peripheral blood, which are independent of the glymphatic system, could be used as cellbased biomarkers for quantitative assessment of BBB injury caused by various pathogenic insults, including trauma. The vimentin-α7 nAChR pathway significantly contributes to cBMEC shedding during the pathogenesis of BBB/CNS disorders. The cell-based biomarkers cBMEC along with the single cell technology will overcome the limitations of molecular biomarkers mentioned above and make the early diagnosis of TBI.","PeriodicalId":90636,"journal":{"name":"Journal of trauma & treatment","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70826268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-17DOI: 10.4172/2167-1222.1000308
C. McCamley, P. Tamblyn, C. Kimber, Steve Quinn, A. Watts, R. Jaarsma
For intra-articular and extra-articular distal radius fractures do volar locking plates (VLP) provide patients with functionally, clinically and radiologically superior results compared to fixation methods before their introduction; Kirschner wires, non-locking plates and external fixators? In this prospective, randomized controlled trial 180 participants with a median age of 65 (range 18-96) were followed up for 1 year. Outcome measures included Disability of Arm Shoulder and Hand (DASH) score, range of motion (ROM) and grip strength, radiological measurements (radial length, angle, tilt, ulnar variance and articular step) and complications. There was no statistical difference of DASH scores between groups at any time point. ROM differed at one and six weeks post operatively, favoring the VLP fixation. However these results were not sustained at 12 and 52 weeks. The results have confirmed VLP’s ability to maintain fracture reduction over 12 weeks compared to alternative fixation methods.
{"title":"Fractures of the Distal Radius: A Randomized Controlled Trial of 180 Patients Comparing Volar Locking Plates and Alternative Fixation Methods","authors":"C. McCamley, P. Tamblyn, C. Kimber, Steve Quinn, A. Watts, R. Jaarsma","doi":"10.4172/2167-1222.1000308","DOIUrl":"https://doi.org/10.4172/2167-1222.1000308","url":null,"abstract":"For intra-articular and extra-articular distal radius fractures do volar locking plates (VLP) provide patients with functionally, clinically and radiologically superior results compared to fixation methods before their introduction; Kirschner wires, non-locking plates and external fixators? In this prospective, randomized controlled trial 180 participants with a median age of 65 (range 18-96) were followed up for 1 year. Outcome measures included Disability of Arm Shoulder and Hand (DASH) score, range of motion (ROM) and grip strength, radiological measurements (radial length, angle, tilt, ulnar variance and articular step) and complications. There was no statistical difference of DASH scores between groups at any time point. ROM differed at one and six weeks post operatively, favoring the VLP fixation. However these results were not sustained at 12 and 52 weeks. The results have confirmed VLP’s ability to maintain fracture reduction over 12 weeks compared to alternative fixation methods.","PeriodicalId":90636,"journal":{"name":"Journal of trauma & treatment","volume":"5 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2016-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-1222.1000308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70826206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-05-28DOI: 10.4172/2167-1222.1000310
Joy S. Kaufman, M. Whitson, Cindy A. Crusto
The environment in which children grow and develop is vital to the trajectory of their development [1]. Risk and protective factors increase or decrease the likelihood of developmental disruptions and the onset of psychopathology [1,2]. Risk factors such as poverty, maternal depression maternal substance use, parenting stress and exposure to potentially traumatic events such as family and community violence have been shown to impact on development and place children at risk for the onset of psychopathology [3-10].
{"title":"Parenting Stress as a Mediator of Exposure to Potentially Traumatic Events and Behavioral Health Outcomes in Children and Youth","authors":"Joy S. Kaufman, M. Whitson, Cindy A. Crusto","doi":"10.4172/2167-1222.1000310","DOIUrl":"https://doi.org/10.4172/2167-1222.1000310","url":null,"abstract":"The environment in which children grow and develop is vital to the trajectory of their development [1]. Risk and protective factors increase or decrease the likelihood of developmental disruptions and the onset of psychopathology [1,2]. Risk factors such as poverty, maternal depression maternal substance use, parenting stress and exposure to potentially traumatic events such as family and community violence have been shown to impact on development and place children at risk for the onset of psychopathology [3-10].","PeriodicalId":90636,"journal":{"name":"Journal of trauma & treatment","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70826277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-05-20DOI: 10.4172/2167-1222.1000306
S. Bhat, K. Kangoo, A. Baba, A. Zahoor, Sami Jan
Purpose: Pediatric hip fractures are very uncommon and the complications of these fractures are very serious. With this purpose in mind we evaluated retrospectively the treatment of pediatric femur neck fractures admitted during proceeding five years in our hospital. The Aim of study was to evaluate the outcome of our treatment and know preventable complications of pediatric neck fractures in comparison with literature. Method: We evaluated 19 pediatric femur neck fractures with age from 3-12 years including 12 males 7 females. Treatment was by closed reduction and internal fixation at average of 4.5 days after hospital admission. Spica cast was applied for all patients up to age 10. Clinical and radiological evaluation was done by RATLIFF CRITERIA Results: We enrolled 23 cases in study 4 lost to follow up and thus excluded from final study. We had 10 cases of Delbet type II, 7 cases type III and 2 cases of type IV. Patients were treated by closed reduction and internal fixation at average of 4.5 days after admission. Our results were 12 good, 3 fair and 4 poor. Complications encountered included avascular necrosis in 5 patients, 1 coxa vara, 2 cases of superficial infection and 1 septic sequel of sab acute septic arthritis. Conclusion: Fluoroscopic aided reduction and internal fixation is a very good method of treatment for pediatric neck femur fractures. Emphasis should be on measures to reduce avascular necrosis and infection and give maximum smile to the children and their parents. In our under eloped and far-flung area complications are unavoidable but preventable once infrastructure and facilities of emergency and postoperative care are improved. Education regarding prevention of pediatric fractures in general and neck femur in particular and active participation of parents will help in minimizing complication of these fracture thus limiting diability and morbidity of these fractures.
{"title":"Is Urgent Treatment of Pediatric Neck Femur Always Needed","authors":"S. Bhat, K. Kangoo, A. Baba, A. Zahoor, Sami Jan","doi":"10.4172/2167-1222.1000306","DOIUrl":"https://doi.org/10.4172/2167-1222.1000306","url":null,"abstract":"Purpose: Pediatric hip fractures are very uncommon and the complications of these fractures are very serious. With this purpose in mind we evaluated retrospectively the treatment of pediatric femur neck fractures admitted during proceeding five years in our hospital. The Aim of study was to evaluate the outcome of our treatment and know preventable complications of pediatric neck fractures in comparison with literature. Method: We evaluated 19 pediatric femur neck fractures with age from 3-12 years including 12 males 7 females. Treatment was by closed reduction and internal fixation at average of 4.5 days after hospital admission. Spica cast was applied for all patients up to age 10. Clinical and radiological evaluation was done by RATLIFF CRITERIA Results: We enrolled 23 cases in study 4 lost to follow up and thus excluded from final study. We had 10 cases of Delbet type II, 7 cases type III and 2 cases of type IV. Patients were treated by closed reduction and internal fixation at average of 4.5 days after admission. Our results were 12 good, 3 fair and 4 poor. Complications encountered included avascular necrosis in 5 patients, 1 coxa vara, 2 cases of superficial infection and 1 septic sequel of sab acute septic arthritis. Conclusion: Fluoroscopic aided reduction and internal fixation is a very good method of treatment for pediatric neck femur fractures. Emphasis should be on measures to reduce avascular necrosis and infection and give maximum smile to the children and their parents. In our under eloped and far-flung area complications are unavoidable but preventable once infrastructure and facilities of emergency and postoperative care are improved. Education regarding prevention of pediatric fractures in general and neck femur in particular and active participation of parents will help in minimizing complication of these fracture thus limiting diability and morbidity of these fractures.","PeriodicalId":90636,"journal":{"name":"Journal of trauma & treatment","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70826103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-05-16DOI: 10.4172/2167-1222.1000305
J. Beck, H. Granehed, L. Akyürek, P. David
Background: Emergency thoracotomy (ET) has previously been studied and evaluated in an American and African perspective. The mechanism of injury (MOI) varies between different parts of the world. In the Northern European setting, blunt trauma is the most common MOI. Regarding penetrating thoracic injuries stab wounds compromises the majority whereas gunshot wounds (GSW) are relatively scarce. The aim of this study was to describe the situation at a Scandinavian Trauma Hospital. Method: This study was a retrospective case series involving all patients who underwent an ET between 2004 and 2011 at a single centre. Patients were identified and data collection of demographics, trauma scores and physiological values were retrieved from hospital charts and trauma registry. Statistical analyses were performed. Results: A total of 45 ET patients were identified. The patients were predominately male (82%), and severely injured with median ISS of 48. The overall survival rate was 31%. Blunt trauma accounted for 60% of the patients. Survival following penetrating thoracic trauma had a 50% survival rate, whereas blunt trauma had a 19% survival rate. Conclusion: The injury pattern preceding ET is different between America and Europe. Blunt trauma accounts for the majority of cases. Penetrating trauma is mostly caused by stab wounds which carry a better prognosis than gunshot wounds (GSW). There is clearly a value in performing ET for selected cases following penetrating thoracic violence. Most of the surviving cases of thoracotomy for blunt trauma were for aortic cross clamping to control abdominal bleeding. Isolated blunt trauma to the chest carried a dismal prognosis.
{"title":"Emergency Thoracotomy in a Swedish Setting: A Consecutive Series of 45 Patients from a Scandinavian Trauma Hospital","authors":"J. Beck, H. Granehed, L. Akyürek, P. David","doi":"10.4172/2167-1222.1000305","DOIUrl":"https://doi.org/10.4172/2167-1222.1000305","url":null,"abstract":"Background: Emergency thoracotomy (ET) has previously been studied and evaluated in an American and African perspective. The mechanism of injury (MOI) varies between different parts of the world. In the Northern European setting, blunt trauma is the most common MOI. Regarding penetrating thoracic injuries stab wounds compromises the majority whereas gunshot wounds (GSW) are relatively scarce. The aim of this study was to describe the situation at a Scandinavian Trauma Hospital. Method: This study was a retrospective case series involving all patients who underwent an ET between 2004 and 2011 at a single centre. Patients were identified and data collection of demographics, trauma scores and physiological values were retrieved from hospital charts and trauma registry. Statistical analyses were performed. Results: A total of 45 ET patients were identified. The patients were predominately male (82%), and severely injured with median ISS of 48. The overall survival rate was 31%. Blunt trauma accounted for 60% of the patients. Survival following penetrating thoracic trauma had a 50% survival rate, whereas blunt trauma had a 19% survival rate. Conclusion: The injury pattern preceding ET is different between America and Europe. Blunt trauma accounts for the majority of cases. Penetrating trauma is mostly caused by stab wounds which carry a better prognosis than gunshot wounds (GSW). There is clearly a value in performing ET for selected cases following penetrating thoracic violence. Most of the surviving cases of thoracotomy for blunt trauma were for aortic cross clamping to control abdominal bleeding. Isolated blunt trauma to the chest carried a dismal prognosis.","PeriodicalId":90636,"journal":{"name":"Journal of trauma & treatment","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70826084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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