scholarly journals Transverse process fractures of the thoracic vertebrae—the significance of this injury in the context of medicolegal opinions on high-energy trauma cases

2019 ◽  
Vol 134 (4) ◽  
pp. 1431-1440
Author(s):  
Aleksandra Borowska-Solonynko ◽  
Victoria Prokopowicz
Keyword(s):  
Test Group ◽  
Transverse Process ◽  
High Energy ◽  
Thoracic Vertebrae ◽  
Postmortem Computed Tomography ◽  
High Energy Trauma ◽  
Additional Information ◽  
Strong Force ◽  
Mechanism Of Trauma ◽  
Type Of Injury

Abstract Thoracic transverse process fractures (TTPFs) are injuries that go unnoticed during traditional autopsies, as demonstrated by a lack of medicolegal publications regarding TTPFs. However, postmortem computed tomography (PMCT) has made detection of this type of injury easy. Thus, the goal of our study was to analyze the significance of TTPFs in the context of medicolegal opinions. Forensic autopsy reports and PMCT scans of 116 people who had died from high-energy trauma were analyzed. TTPFs were found in 34.48% (n = 40) of the total test group. The highest proportions of TTPFs were found in drivers (50%, n = 8) and in victims of falls from heights (41%, n = 14). Among seven car passengers, only one victim had suffered TTPFs. In comparison with persons without TTPFs, persons with TTPFs demonstrated more severe general injuries, especially to the chest and abdomen, and more often (in 90% of cases) died at the scene of injury (all these differences were statistically significant; p < 0.0001). Pedestrian TTPFs were present only in victims struck from their front or back. TTPFs in victims of falls were found only in those cases in which the height of the fall was at least 9 m. The presence of TTPFs indicates that the application of a very strong force leads to injuries that, in most cases, result in death at the scene of the event. Detecting TTPFs provides additional information about the mechanism of trauma, especially in pedestrians, drivers, passengers, and victims of falls from heights.

scholarly journals High-Energy Transsyndesmotic Ankle Fracture Dislocation: A Case Report and Systematic Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Yinshuan Deng ◽  
Chenhui Dong ◽  
Xiaojie Yang ◽  
Rui Liu ◽  
Feiyi Hou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Literature Review ◽  
Ankle Fracture ◽  
Clinical Case ◽  
High Energy ◽  
Fracture Dislocation ◽  
High Energy Trauma ◽  
Ovid Medline ◽  
Type Of Injury

High-energy trauma can cause transsyndesmotic ankle fracture dislocation. These fractures are quite rare. Here we present a clinical case of a male patient with this type of injury. A systematic review of PubMed, Ovid MEDLINE, and Embase electronic databases revealed only two prior publications on a similar topic. We discuss the typical clinical features of these injuries, the treatment of high-energy trauma which can cause transsyndesmotic ankle fracture dislocation, and its prognosis.

scholarly journals Combined disruption of the thoracic spine and costal arch fracture: An indicator of a severe chest trauma

2021 ◽  
Author(s):  
Stefan Schulz-Drost ◽  
Stephan Kloesel ◽  
Jan Carsten Kühling ◽  
Axel Ekkernkamp ◽  
M. Sinan Bakir
Keyword(s):  
Chest Trauma ◽  
Injury Severity ◽  
High Energy ◽  
Thoracic Vertebrae ◽  
Severely Injured ◽  
High Energy Trauma ◽  
Costal Arch ◽  
Serial Rib Fracture ◽  
Rod System ◽  
Life Threatening

Abstract Background Blunt high-energy trauma increase the risk of associated thoracic and accompanying abdominal organ injuries in chest trauma. A higher overall injury severity has been shown for sternovertebral injuries caused by a flexion-compression mechanism. Literature for a hyperextension-distraction mechanism equivalent to a costal arch fracture combined with a thoracic spinal fracture is sparse. Therefore, we want to show the clinical significance of this entity. Methods A retrospective analysis of our level-one trauma center collective of severely injured patients was performed. Patients from 2013 to 2019 that involved an Injury Severity Score (ISS) ≥16 were screened for the combined thoracovertebral injury entity and analyzed concerning its accident mechanism, the injury spectrum, and the clinical course. Results The thoracovertebral injury entity is rare. Three male patients (50–65 years old) with ISS of 57, 41, and 20 could be observed from over 1000 severely injured. All patients suffered from high-energy trauma and from tearing of the thoracic vertebrae regions 7–9. The costal arch was torn in the anterior area. All cases showed a posterolateral serial rib fracture, a traumatic intercostal pulmonary hernia, and an avulsion of the diaphragm. Two patients sustained further life-threatening injuries, such as severely bleeding avulsion to the azygos vein and a rupture of the spleen. The physicians performed exploratory thoracotomy, closure of the pulmonary hernia, re-fixation of the diaphragm and angle-stable plate osteosynthesis of the fractured ribs, including the costal arch. The spine was fixed dorsally using a screw-rod system. The patients were discharged home with independent mobility and without neurological damage. Conclusions This thoracovertebral injury entity is associated with high overall injury severity and life-threatening thoracoabdominal injuries. Injuries to the costal arch can act as an indicator of severe trauma. They should be detected thorough clinical examination and assessment of the trauma CT in the soft tissue window.

scholarly journals The Surgical Outcomes of Unstable Ankle Fractures in Patients Aged >65 Years

2021 ◽  
Vol 12 ◽  
pp. 215145932199776
Author(s):  
Adem Sahin ◽  
Anıl Agar ◽  
Deniz Gulabi ◽  
Cemil Erturk
Keyword(s):  
Surgical Outcomes ◽  
External Rotation ◽  
High Energy ◽  
Ankle Fractures ◽  
Medial Malleolus ◽  
Aofas Score ◽  
Non Union ◽  
The Mean ◽  
Medial Malleolus Fracture ◽  
Mechanism Of Trauma

Aim: To evaluate the surgical outcomes and complications of patients over 65 years of age, with unstable ankle fractures. Material and Method: The study included 111 patients (73F/38 M) operated on between January 2015 and February 2019 and followed up for a mean of 21.2 months (range, 6-62 months).Demographic characteristics, comorbidities, fracture type, and mechanisms of injury were evaluated. Relationships between postoperative complications and comorbidities were examined. In the postoperative functional evaluations, the AOFAS score was used and pre and postoperative mobilization (eg, use of assistive devices) was assessed. Results: The mean age of the patients was 70.5 ± 6.1 years (range, 65-90 years). The mechanism of trauma was low-energy trauma in 90.1% of the fractures and high-energy trauma in 9.9%. The fractures were formed with a SER injury (supination external rotation) in 83.7% of cases and bimalleolar fractures were seen most frequently (85/111, 76%).Complications developed in 16 (14.4%) patients and a second operation was performed in 11 (9.9%) patients with complications. Plate was removed and debridement was performed in 5 of 6 patients due to wound problems. Nonunion was developed in the medial malleolus in 4 patients. Revision surgery was performed because of implant irritation in 2 patients and early fixation loss in the medial malleolus fracture in one patient. Calcaneotibial arthrodesis was performed in 3 patients because of implant failure and ankle luxation associated with non-union. A correlation was determined between ASA score and DM and complications, but not with osteoporosis. The mean follow-up AOFAS score was 86.7 ± 12.5 (range, 36-100).A total of 94 (84.7%) patients could walk without assistance postoperatively and 92 (82.9%) were able to regain the preoperative level of mobilization. Conclusion: Although surgery can be considered an appropriate treatment option for ankle fractures in patients aged >65 years, care must be taken to prevent potential complications and the necessary precautions must be taken against correctable comorbidities.

Clinical and economic effects of selective radiological evaluation of high-energy trauma patients: a prospective experience of a level 1 busy trauma centre

2014 ◽  
Vol 32 (7) ◽  
pp. 535-538 ◽  
Author(s):  
Shahram Paydar ◽  
Armin Ahmadi ◽  
Behnam Dalfardi ◽  
Alireza Shakibafard ◽  
Hamidreza Abbasi ◽  
...  
Keyword(s):  
High Energy ◽  
Trauma Centre ◽  
Economic Effects ◽  
Trauma Patients ◽  
Radiological Evaluation ◽  
High Energy Trauma ◽  
Level 1

Angiography in patients with pelvic fractures and contrast extravasation on CT following high-energy trauma

2021 ◽  
Author(s):  
Jonathan Hammerschlag ◽  
Yehuda Hershkovitz ◽  
Itamar Ashkenazi ◽  
Zahar Shapira ◽  
Igor Jeroukhimov
Keyword(s):  
High Energy ◽  
Pelvic Fractures ◽  
Contrast Extravasation ◽  
High Energy Trauma

scholarly journals X-ray Properties of 3C 111: Separation of Primary Nuclear Emission and Jet Continuum

Universe ◽  
2020 ◽  
Vol 6 (11) ◽  
pp. 219
Author(s):  
Elena Fedorova ◽  
B.I. Hnatyk ◽  
V.I. Zhdanov ◽  
A. Del Popolo
Keyword(s):  
Accretion Disk ◽  
Power Law ◽  
Line Emission ◽  
High Energy ◽  
Power Law Model ◽  
X Ray ◽  
Additional Information ◽  
Observational Dataset ◽  
Simple Power ◽  
Photon Index

3C111 is BLRG with signatures of both FSRQ and Sy1 in X-ray spectrum. The significant X-ray observational dataset was collected for it by INTEGRAL, XMM-Newton, SWIFT, Suzaku and others. The overall X-ray spectrum of 3C 111 shows signs of a peculiarity with the large value of the high-energy cut-off typical rather for RQ AGN, probably due to the jet contamination. Separating the jet counterpart in the X-ray spectrum of 3C 111 from the primary nuclear counterpart can answer the question is this nucleus truly peculiar or this is a fake “peculiarity” due to a significant jet contribution. In view of this question, our aim is to estimate separately the accretion disk/corona and non-thermal jet emission in the 3C 111 X-ray spectra within different observational periods. To separate the disk/corona and jet contributions in total continuum, we use the idea that radio and X-ray spectra of jet emission can be described by a simple power-law model with the same photon index. This additional information allows us to derive rather accurate values of these contributions. In order to test these results, we also consider relations between the nuclear continuum and the line emission.

scholarly journals Changing presentation of knee dislocation and vascular injury from high-energy trauma to low-energy falls in the morbidly obese

2013 ◽  
Vol 57 (5) ◽  
pp. 1196-1203 ◽  
Author(s):  
Andrew G. Georgiadis ◽  
Farah H. Mohammad ◽  
Kristin T. Mizerik ◽  
Timothy J. Nypaver ◽  
Alexander D. Shepard
Keyword(s):  
Vascular Injury ◽  
Knee Dislocation ◽  
High Energy ◽  
Low Energy ◽  
Morbidly Obese ◽  
High Energy Trauma

scholarly journals Scapulothoracic dissociation

2019 ◽  
Vol 92 (1101) ◽  
pp. 20190090
Author(s):  
Kimia Khalatbari Kani ◽  
Felix S Chew
Keyword(s):  
Differential Diagnosis ◽  
Shoulder Girdle ◽  
High Energy ◽  
Imaging Evaluation ◽  
Acute Setting ◽  
High Energy Trauma ◽  
Diagnosis And Management ◽  
Life Threatening ◽  
Spectrum Imaging ◽  
Scapulothoracic Dissociation

Scapulothoracic dissociation is a rare and potentially limb- and life-threatening injury, that results from high-energy trauma. Scapulothoracic dissociation has the potential to be overlooked in the acute setting, especially in the setting of polytrauma. Therefore, a careful search for this condition should be performed in all patients with high-energy shoulder girdle injuries. The goals of this article are to review the anatomy of the scapulothoracic articulation as well as the spectrum, imaging evaluation, differential diagnosis and management of scapulothoracic dissociations.

scholarly journals Features of surgical treatment of intra- and periarticular fractures of the lower third of the femur in patients with polytrauma

2019 ◽  
Vol 26 (2) ◽  
pp. 14-18
Author(s):  
E. I Solod ◽  
N. V Zagorodni ◽  
A. F Lazarev ◽  
M. A Abdulkhabirov ◽  
Ya. M Alsmadi ◽  
...  
Keyword(s):  
Distal Part ◽  
Distal Femur ◽  
Traumatic Shock ◽  
High Energy ◽  
Optimal Time ◽  
Prospective Analysis ◽  
Severity Scale ◽  
Duration Of Treatment ◽  
High Energy Trauma ◽  
Results Of Treatment

Treatment of patients with fractures of femur has a particular relevance in modern traumatology, especially in patients with polytrauma. The treatment of such fractures is complicated by the fact that it depends not only on the nature of the fracture, but also on the general condition of the patient. These fractures are caused by high-energy trauma, they have the tendency to be splintered or fragmented, and often accompanied by neurovascular complications, especially in the distal part. Such fractures are often accompanied by soft tissue damage. Purpose: improving the results of treatment of intra-and periarticular fractures of the distal femur in patients with polytrauma. Material and methods. In the present study, a prospective analysis of using conversion osteosynthesis in the treatment of 72 patients with intra-and periarticular fractures of the lower third of the femur patients with polytrauma, according to the ISS severity scale (ISS 17-40) was performed in a multidisciplinary hospital. Results. The most optimal time for conversion osteosynthesis to patients with polytrauma was 5-7 days, which prevented the occurrence of traumatic shock and prevented the occurrence of inflammatory complications in the postoperative period. Conclusion. The study confirmed the feasibility of conversion osteosynthesis in the treatment of patients with intra-and periarticular fractures of the lower third of the femur. The use of the technique of transferring the fixation of fragments by the external fixation to the internal osteosynthesis (conversion) contributed to a reduction in the duration of treatment of patients in the hospital with fractures of the long bones.

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