Journal of trauma & treatment最新文献

英文中文

Pellet Gunfire Injuries in Head- Neck and Maxillo-Facial Region-An Experience in Kashmir Valley 头颈部和上颌面区域的弹丸枪击伤害-克什米尔山谷的经验

Journal of trauma & treatment

Pub Date : 2017-02-13 DOI: 10.4172/2167-1222.1000357

S. Showkat, A. Yousuf, I. Wazir, Nadhia Bhagat

Pellet gun injuries is quite commonly faced emergency nowadays in Kashmir because of recent turmoil in valley and has invited a different challenges in modern day to day practice of surgeons mostly otolaryngologists and ophthalmologists . For this reason a study was conducted in an only tertiary care of Otolaryngology Head and Neck Referral Center, ENT, SMHS, Srinagar between July 2016 to September 2016. The pattern, severity and outcome of injuries in head and neck and maxilla-facial region among pellets gun victims in Kashmir region was studied and their management was categorized based on demand and need.

由于最近克什米尔山谷的动荡，弹丸枪伤害现在在克什米尔非常常见，并在现代外科医生（主要是耳鼻喉科医生和眼科医生）的日常实践中带来了不同的挑战。因此，一项研究于2016年7月至2016年9月在斯利那加SMHS耳鼻咽喉头颈部转诊中心唯一的三级护理机构进行。研究了克什米尔地区弹丸枪受害者头部、颈部和上颌骨面部受伤的模式、严重程度和结果，并根据需求对其处理进行了分类。

引用次数: 1

Implications of Conversion to ICD-1-CM on Trauma Coding and Reimbursement: A Brief Report by the AAST Committee on Coding and Reimbursement 转换为ICD-1-CM对创伤编码和报销的影响：AAST编码和报销委员会的简要报告

Journal of trauma & treatment

Pub Date : 2017-02-07 DOI: 10.4172/2167-1222.1000356

P. Jenkins, P. Miller, S. Shafi, G. Utter, S. Fakhry, J. Claridge, J. Diaz, Reed Rl

引用次数: 1

Surgical Debridement Provided for Fast Recovery in MetaepiphysealHaematogenous Osteomyelitis with Adjacent Subperiostal AbscessFormation in Two Children 手术清创可使两例儿童骨骺后血液性骨髓炎伴相邻骨膜下脓肿快速恢复

Journal of trauma & treatment

Pub Date : 2017-01-27 DOI: 10.4172/2167-1222.1000354

Starlinger J, Ringl H, Weissinger M, Hajdu S

Background: Primary metaepiphyseal haematogenous osteomyelitis (HOM) with subperiostal abscess formation at initial admission is a rare but serious condition. A considerate treatment strategy is crucial to avoid damage to the adjacent physics. Methods: Charts and radiographic data of two cases were reviewed and reported in a retrospective study approved by the Institutional Review Board. Results: Two children presented with limping, painful restriction of movement and very mild laboratory findings. No trauma was remembered. Conventional radiography showed no abnormalities, but subsequent MRI revealed metaepiphyseal HOM as well as an adjacent sub-periostal abscess collection. Conclusions: Antibiotic therapy and immediate surgical debridement provided for uncomplicated healing.

背景：初次入院时形成骨膜下脓肿的原发性后骨骺血源性骨髓炎是一种罕见但严重的情况。考虑周到的治疗策略对于避免对邻近物理的损害至关重要。方法：在机构审查委员会批准的回顾性研究中，对两例病例的图表和放射学数据进行审查和报告。结果：两名儿童出现跛行、疼痛的行动受限和非常轻微的实验室检查结果。没有留下任何创伤。常规放射检查显示没有异常，但随后的MRI显示后骨骺HOM以及邻近的骨膜下脓肿集合。结论：抗生素治疗和立即手术清创可提供简单的愈合。

引用次数: 1

Pets as Emotional Aid to the Individual 宠物作为个人的情感援助

Journal of trauma & treatment

Pub Date : 2017-01-21 DOI: 10.4172/2167-1222.1000353

S. Çaya

Pets are useful to people in the psychological sense. Livestock, poultry and working animals cannot be surrogates for pets. In the modern society pets are gaining more and more importance. In Turkey, too, pet-keeping is getting to be a widespread practice in recent times. Pets represent animal love and they especially contribute to children’s healthy emotional development.

宠物在心理意义上对人们很有用。牲畜、家禽和工作动物不能代替宠物。在现代社会中，宠物越来越重要。在土耳其，最近养宠物也成为一种普遍的做法。宠物代表着对动物的爱，尤其有助于儿童健康的情感发展。

引用次数: 0

Conceptualizing trauma for children of drug addicted mothers: a developmental mapping 对吸毒母亲的孩子的创伤进行概念化:一个发展的绘图

Journal of trauma & treatment

Pub Date : 2017-01-19 DOI: 10.4172/2167-1222.1000352

S. Lombard, Darren Pullen, K. Swabey

Children of drug addicted mothers are exposed to highly stressful experiences and experience high levels of psychological and emotional distress, alongside psychiatric nosology with multiple comorbid symptoms. The following study extends the work of Lombard, et al. classify the consequences of prolonged or ongoing trauma of children of addicted mothers using lifespan domains. Children of addicted mothers are often exposed to severe and ongoing events of trauma, or environments that are not conducive to adequate development, resulting in a complex array of comorbid and compounding physical and psychological problems. Results showed that the prevalence of trauma experienced by children were categorized as being from social and physical domains, with the emotional domain (reported neglect=26) also being high. These experiences resulted predominantly in behavioral problems and emotional problems. The most salient problems included a child who reported hearing the devil speak to them in an ongoing manner, two children reporting attempted homicides on siblings, and three children reporting hurting animals. Further research in capturing and detailing the extent of the trauma experienced and the resulting lifespan domain problems is necessary.

吸毒母亲的孩子会暴露在高度紧张的经历中，经历高度的心理和情绪困扰，以及具有多种共病症状的精神疾病。以下研究扩展了Lombard等人的工作。使用寿命域对成瘾母亲的孩子长期或持续创伤的后果进行分类。成瘾母亲的孩子经常暴露在严重和持续的创伤事件中，或暴露在不利于充分发展的环境中，导致一系列复杂的共病和复杂的身体和心理问题。结果显示，儿童所经历的创伤的发生率被归类为来自社会和身体领域，情绪领域（据报道被忽视=26）也很高。这些经历主要导致行为问题和情绪问题。最突出的问题包括一名儿童报告称持续听到魔鬼对他们说话，两名儿童报告试图杀害兄弟姐妹，三名儿童报告伤害动物。有必要进一步研究所经历的创伤程度以及由此产生的寿命领域问题。

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引用次数: 2

Systematic Review on the Functional Outcome After Treatment of a Traumatic Bowing Fracture of the Lower Arm in Children. 儿童外伤性下臂弯曲骨折治疗后功能结局的系统评价。

Journal of trauma & treatment

Pub Date : 2017-01-01 Epub Date: 2017-07-21 DOI: 10.4172/2167-1222.1000384

Linde Musters, Joost Colaris

Introduction: Traumatic bowing is a commonly missed diagnosis on which only little information is available, inadequate treatment can cause permanent function loss.

Method: A systematic review would determine what the effect is of treatment of traumatic bowing of the lower arm in children on the functional outcome. A search on Embase, Medline, Web of Science, Scopus, Cochrane, Pubmed publisher, CINAHL and Google scholar, last accessed at the 15th of May 2016. Intervention of interest was treatment; with reduction, reduction and cast or cast only. The primary outcome measure was (I) function; pro and supination, (II) posttraumatic function, (III) posttreatment function and (IV) residual bowing.

Results: Five articles were included. Treatment by reduction only showed a normal function, 4 weeks to 8 weeks of cast and reduction followed by cast, both resulted in 0 degrees to 20 degrees residual of pronation loss.

Discussion: The treatment was overall well tolerated, had a direct effect and lead to faster restore of function. It is unclear to what amount of bowing can be accepted without any loss of function. But in view of the few complications and good results for reduction, the overall opinion is to reduce all significant bowing fractures of the lower arm in children with limited function.

外伤性弓形是一种常见的漏诊，只有很少的信息，不适当的治疗可导致永久性功能丧失。方法:通过系统评价，确定儿童外伤性下臂弯曲治疗对功能预后的影响。检索Embase、Medline、Web of Science、Scopus、Cochrane、Pubmed publisher、CINAHL和Google scholar，最后检索时间为2016年5月15日。感兴趣的干预是治疗;具有还原，还原和铸造或仅铸造。主要结局指标为(I)功能;前旋和旋后，(II)创伤后功能，(III)治疗后功能和(IV)残余弯曲。结果:共纳入5篇文章。复位治疗仅显示功能正常，4周至8周内固定和复位后再固定，均导致0度至20度旋前缺损。讨论:治疗总体耐受良好，效果直接，功能恢复较快。目前还不清楚在不损失任何功能的情况下，什么程度的弯曲可以被接受。但鉴于并发症少，复位效果好，总体观点是对功能受限儿童所有明显的下臂弯曲骨折进行复位。

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引用次数: 1

Trauma Ultrasound Training for Latin American Countries 拉丁美洲国家创伤超声培训

Journal of trauma & treatment

Pub Date : 2016-11-26 DOI: 10.4172/2167-1222.1000346

G. Estebanez, A. Rubiano, A. Sanchez, J. Ulloa, J. Puyana

Objective: The Pan-American Trauma Society (PTS) developed a Trauma and Emergency Ultrasound Course (USET) in response to the requirement for trauma ultrasound training for low-and middle-income countries. The objective of this study was to evaluate the efficiency of this course. Method: Pre- and post-course tests were used. And interval estimation of proportions was calculated at 95% CI. Theoretical and practical pre- and post-course knowledge were assessed with the Wilcoxon Signed Rank test at 0.05 level of statistical significance. Result: Between 2005 and 2007, 114 students, including general surgeons, emergency medicine physicians, anesthesiologists, critical care physicians, and residents of these specialties, were trained in seven countries (Uruguay, Peru, Mexico, Venezuela, Aruba, Colombia, and Ecuador). The difference on complete knowledge ranked scores before and after the course was statistically significant (p<0.001). After the course, almost all participants (97.4%) demonstrated complete knowledge in final evaluation. Conclusion: The USET course is an effective approach for trauma ultrasound training. Specific training programs for trauma care providers that work in low-and middle-income countries are necessary and could be performed with low cost training programs.

目的:泛美创伤学会(PTS)根据中低收入国家对创伤超声培训的需求，制定了创伤和急诊超声课程(USET)。本研究的目的是评估该课程的有效性。方法:采用课前和课后测试。以95% CI计算比例的区间估计。采用Wilcoxon sign Rank检验评估课前和课后的理论和实践知识，在0.05水平上具有统计学意义。结果:2005年至2007年间，在7个国家(乌拉圭、秘鲁、墨西哥、委内瑞拉、阿鲁巴、哥伦比亚和厄瓜多尔)培训了114名学生，包括普通外科医生、急诊内科医生、麻醉师、重症监护医生和这些专业的住院医生。课程前后全知识排名得分差异有统计学意义(p<0.001)。课程结束后，几乎所有参与者(97.4%)在最终评估中表现出完整的知识。结论:USET课程是创伤超声训练的有效途径。为低收入和中等收入国家的创伤护理提供者提供专门的培训项目是必要的，并且可以通过低成本的培训项目来实施。

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引用次数: 0

Blunt Abdominal Trauma: The Importance of Clinical Signs for Early Detection of Jejunal Rupture 钝性腹部创伤:临床体征对早期发现空肠破裂的重要性

Journal of trauma & treatment

Pub Date : 2016-10-15 DOI: 10.4172/2167-1222.1000338

W. Mouton, K. T. Mouton

Gastrointestinal tract injuries (GITI) are found in 5% to 17% of laparotomies performed for blunt abdominal trauma. Motor vehicle accidents play an important role [1]. Less than one half of the GITI's caused by blunt abdominal trauma are reported to have enough clinical findings to indicate laparotomy. Laparotomy based on clinical signs alone shows a negative exploration rate of up to 40% [1]. Clinical signs have an important role in combination with radiological examinations and observations.

消化道损伤(GITI)在5%至17%的钝性腹部创伤剖腹手术中被发现。机动车事故在交通事故中起着重要作用。据报道，只有不到一半的腹部钝性创伤引起的GITI有足够的临床表现表明需要开腹手术。仅根据临床体征剖腹探查，阴性探查率高达40%。临床表现与影像学检查和观察相结合具有重要作用。

引用次数: 0

Staged Procedures after Failing Ring Fixators of Lower Limb? Series of 15 Cases Abstract 下肢环形固定器失败后的分期手术?15例丛书摘要

Journal of trauma & treatment

Pub Date : 2016-10-14 DOI: 10.4172/2167-1222.1000337

Bahaa Kornah, H. Safwat, A. Sultan, Mohamed Abdel-AAl

Background: Failure of the fixators is a challenging, especially in the presence of osteoporosis, bone defect, pin track infection and joint stiffness. This study aims at evaluating the functional outcomes of the lower limb proposed two-stage management of non-union after failed ring external fixation. Patients and Methods: 15 patients (six females) with age range 22-65 years enrolled in this study. Four had femoral fractures and eleven with tibial fractures. All were due to high-energy trauma and all were open ones (3 grade (I), 8 grade (II) and 4 grade (III)). Categorised AO classification, 5 type (A), 4 type (B) and 6 type (C). They initially treated by ring external fixators and had radiological signs of non-union. Treatment involved removal of external fixators, pin track and blood tests until no active infection. Non-union managed by refreshing the fracture ends, opening the medullary canal, packing the non-union with autogenous bone grafts then realigning the fracture properly and stabilizing it with locked plate or interlocking nail. Results: Average duration of nonunion 9.8 months. Average delay prior to osteosynthesis after removal of external fixation 15 days. All non-unions healed on an average 5.2 months. According to the Karlstrom-Olerud scores, final functional outcome score was excellent 7cases, good 5 cases, accepted 2 cases and poor one case. Conclusions: Two-stage treatment of non-union of long bone after ring fixation is an effective tool and may be a favorable option with low risk of complications and a high level of functional outcomes.

背景:固定架失效是一个具有挑战性的问题，特别是在骨质疏松症、骨缺损、钉迹感染和关节僵硬的情况下。本研究旨在评估环外固定失败后不愈合的下肢功能结果。患者和方法:15例患者(6例女性)，年龄22-65岁。4例股骨骨折，11例胫骨骨折。所有病例均为高能创伤，均为开放性创伤(3例(I)， 8例(II)， 4例(III))。AO分类，5型(A)， 4型(B)和6型(C)。患者最初使用环形外固定架治疗，放射学表现为不愈合。治疗包括移除外固定架，针轨和血液检查，直到没有活动性感染。治疗骨不连的方法是:复位骨折端，打开髓管，用自体骨移植物填充骨不连，然后适当调整骨折，用锁定钢板或联锁钉稳定骨折。结果:平均骨不连时间9.8个月。取出外固定物后平均延迟15天进行骨固定。所有骨不连愈合时间平均为5.2个月。根据Karlstrom-Olerud评分，最终功能结局评分为优7例，良5例，一般2例，差1例。结论:环内固定后长骨不连的两阶段治疗是一种有效的工具，可能是一种低并发症风险和高水平功能预后的良好选择。

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引用次数: 1

Minimally Invasive Spine Osteosynthesis (MISO) Technique for FracturesSpine: A Case Series 14 Cases 微创脊柱骨融合术治疗脊柱骨折14例

Journal of trauma & treatment

Pub Date : 2016-10-08 DOI: 10.4172/2167-1222.1000336

Bahaa Kornah, H. Safwat, Mohamed Abdel-AAl

Background: The choice of treatment of dorso-lumbar spinal fractures in the absence of neurological deficit depends on the classification and severity of injury. In the conventional open approach with posterior pedicle screw fixation, detachment of the Para spinal muscles may be required. In addition, this open approach may be disadvantaged by prolonged operative time, increased intraoperative bleeding and delayed functional rehabilitation. All these problems appear to encourage orthopedic surgeons to limit secondary iatrogenic insult in these patients by mini open surgery. The goal of this study is to evaluate the effectiveness of minimally invasive treatment of dorsolumbar fractures by mini open surgical pedicle screw fixation and to discuss the potential benefits and drawbacks of this procedure. Patients and methods: This is a prospective study involves 14 Patients (10 males) treated and followed between Feb. 2010 to Feb 2014. All had acute traumatic single level dorso-lumbar spine fractures, age range 17-47 years (mean 30.1 ± 7.9 yrs). Patients with pathological fractures, neurological injury, anatomical variations of the cord or vertebrae, mental illness, significant surgical contraindications, osteoporosis, refusing to sign informed consent and those with (TLICS) score ≤4 or load sharing score ≥7 were excluded from the study. All the cases had been treated by minimal invasive posterior approach. Total of 56 screws and 28 rods were applied utilizing the conventional posterior instrumentation. Results: Mean post-operative hospital stay 3.8 days. No major complications as spinal cord, nerve root or blood vessel injuries occurred. No screws were broken and just two screws were malpositioned. All patients improved clinically, and the outcome (according to modified MacNab criteria) was considered excellent in six patients, good in seven, and poor in one patient. Conclusion: Mini open surgery for posterior pedicle screws fixation has attracting increasing attention as it brings a multitude of advantages including: less bleeding, lower incidence of postoperative intractable low back pain and reduced hospitalization stay. However; some shortcomings as limited indications, unsuitability for long segment fusion and high load-sharing score patients restricts its worldwide prevalence.

背景:无神经功能缺损的腰背部骨折的治疗选择取决于损伤的分类和严重程度。在传统的开放入路后路椎弓根螺钉固定中，可能需要分离脊柱旁肌肉。此外，这种开放入路可能会延长手术时间，增加术中出血和延迟功能康复。所有这些问题似乎鼓励骨科医生通过小型开放手术来限制这些患者的继发性医源性损伤。本研究的目的是评估微创微创治疗腰背骨折的效果，并讨论该方法的潜在优点和缺点。患者和方法:这是一项前瞻性研究，涉及14例患者(10名男性)，于2010年2月至2014年2月接受治疗和随访。所有患者均为急性创伤性单节段背腰椎骨折，年龄17 ~ 47岁(平均30.1±7.9岁)。病理性骨折、神经损伤、脊髓或脊椎骨解剖变异、精神疾病、重大手术禁忌症、骨质疏松、拒绝签署知情同意书以及(TLICS)评分≤4分或负荷分担评分≥7分的患者被排除在研究之外。所有病例均经微创后路手术治疗。采用常规后路内固定，共使用56颗螺钉和28根棒。结果:术后平均住院时间3.8天。无脊髓、神经根、血管损伤等重大并发症。没有螺钉断裂，只有两个螺钉错位。所有患者均有临床改善，结果(根据修改的MacNab标准)6例为优，7例为良，1例为差。结论:微创开放手术治疗后路椎弓根螺钉固定术因其具有出血少、术后顽固性腰痛发生率低、住院时间短等优点而越来越受到人们的重视。然而;适应症有限、不适合长节段融合、负荷分担评分高等缺点限制了其在世界范围内的普及。

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