The issues and complexities of establishing methodologies to differentiate between vertical and horizontal impact mechanisms in the analysis of skeletal trauma: An introductory femoral test

Osteosynthesis at pelvic injuries in toy-breed dogs

Veterinaria Kubani ◽

10.33861/2071-8020-2020-3-32-33 ◽

2020 ◽

pp. 32-33

Author(s):

Nikolay I. Antonov ◽

Keyword(s):

Surgical Treatment ◽

Urban Environment ◽

Pelvic Trauma ◽

X Rays ◽

Skeletal Trauma ◽

Companion Dogs ◽

Pelvic Injuries ◽

Behavioral Features ◽

Osteosynthesis Techniques ◽

One Year

Pelvic injuries account for 16 to 25% of all skeletal trauma in small pets. Small dogs as companion dogs are now widespread. Unusual exterior and behavioral features have made them popular and at the same time vulnerable in the modern urban environment. The author defined the nature of injuries and adapted technique of transosseous osteosynthesis for the treatment of toy-breed dogs with pelvic trauma. The study of the X-rays in 226 dogs with pelvic injuries demonstrated that toy-breed dogs accounted for 16% of the total. Multiple pelvic trauma was revealed in 95% of them. Surgical treatment was performed in 24 dogs, conservative one - in 13, that amounted to 65% and 35%, respectively. Surgical treatment consisted in open juxtaposing of fragments and focal transosseous and/or internal osteosynthesis with subsequent external fixation using devices of various designs. The external structures were of three types: half-ring support or U-shaped staple, pair of parallel curved plates connected by two threaded rods with each other, and pair of curved plates located bilaterally on both sides of the pelvis and connected by two threaded rods with the help of threaded ends. The terms of fixation for pelvic injuries in toy-breed dogs at the age under one year were 42 days on the average, and in the dogs at the age above one year - 60 days. Surgical treatment in toy-breed dogs with pelvic injuries was performed more often in comparison with conservative one. Pelvic trauma was accompanied by pronounced pain shock. The osteosynthesis techniques used in toy-breed dogs are little traumatic and not limiting functions thereby contributing to recovery of all the structures of pelvis and pelvic limbs.

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Infrapopliteal Arterial Pseudoaneurysm Development Secondary to Blunt Trauma: Case Series and Literature Review

Vascular and Endovascular Surgery ◽

10.1177/1538574420907184 ◽

2020 ◽

Vol 54 (4) ◽

pp. 367-374

Author(s):

Matthew T. Chrencik ◽

Brian Caraballo ◽

John Yokemick ◽

Peter J. Pappas ◽

Brajesh K. Lal ◽

...

Keyword(s):

Literature Review ◽

Blunt Trauma ◽

Case Series ◽

Duplex Ultrasound ◽

Endovascular Coiling ◽

Skeletal Trauma ◽

Delay In Diagnosis ◽

Tibial Arteries ◽

Pulsatile Mass ◽

Orthopedic Injuries

Objectives: Infrapopliteal arterial pseudoaneurysms (IAP) following blunt trauma with associated orthopedic injuries are uncommon, often present in a delayed fashion, and encompass a diagnostic and therapeutic dilemma. Herein, we present a series of IAPs that were diagnosed following blunt trauma and their management. Methods: Case series consisting of 3 patients and a review of the international literature. Results: Our case series included 3 patients presenting with IAPs following blunt trauma with associated orthopedic injuries. They were all identified in a delayed manner (>3 weeks) after the orthopedic injuries were treated. All patients presented with pain and a pulsatile mass while one concurrently had neurologic deficits. The pseudoaneurysms were diagnosed by duplex ultrasound and confirmed by angiography to be originating from the tibioperoneal trunk, anterior tibial, and posterior tibial arteries respectively. Two patients were treated with surgical excision. Of these, one required an arterial bypass procedure while the other underwent direct ligation only. The third patient was treated by endovascular coiling. A literature review from 1950 to the present found 51 reported cases of IAP resulting from blunt trauma. Ninety percent of trauma-related infrapopliteal injuries occurred in men with a mean delay in diagnosis of 5.6 months (median 1.8 months) after injury. Since 1950, management has shifted from primarily ligation to incorporating minimally invasive endovascular techniques when appropriate. Conclusions: Infrapopliteal artery pseudoaneurysms are rare following blunt skeletal trauma. A delay in diagnosis often occurs and can result in major morbidity and extensive surgical intervention. We recommend a high index of suspicion and a thorough vascular examination in patients with lower extremity skeletal trauma to help identify and treat these injuries early and effectively.

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Can forensic anthropologists accurately detect skeletal trauma using radiological imaging?

Forensic Imaging ◽

10.1016/j.fri.2020.200424 ◽

2021 ◽

Vol 24 ◽

pp. 200424

Author(s):

Amy Joy Spies ◽

Maryna Steyn ◽

Daniel Nicholas Prince ◽

Desiré Brits

Keyword(s):

Radiological Imaging ◽

Skeletal Trauma

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186 Acute Kidney Injury in Skeletal Trauma Admissions to Intensive Care: An Under-Estimated Complication

British Journal of Surgery ◽

10.1093/bjs/znab134.537 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

O Brown ◽

T Crisp ◽

M Flatman ◽

C Hing

Keyword(s):

Acute Kidney Injury ◽

Intensive Care ◽

Injury Severity ◽

Penetrating Trauma ◽

Kidney Injury ◽

Long Bone ◽

Trauma Patients ◽

Skeletal Trauma ◽

Body Regions ◽

Intensive Care Stay

Abstract Introduction Acute kidney injury (AKI) is associated with prolonged admission and 3.5 times increased mortality for trauma patients requiring intensive care (ICU) treatment. Blunt trauma confers greater risk of AKI than penetrating trauma, potentially related to long bone fracture. The relationship between skeletal trauma and AKI in ICU has not previously been investigated. Method Retrospective data was analysed from 202 consecutive adult patients admitted to ICU with skeletal trauma from 01/06/2018 to 01/06/2019. AKI was defined by creatinine rise >1.5 times baseline. Results AKI was found in 70/202 (34.65%) patients aged 16-99 years, 138 males and 64 females. Mean limb Abbreviated Injury Scale (AIS) was significantly higher in AKI (AIS= 2.57 (SD 0.53) versus non-AKI AIS=2.38 (SD 0.61), p = 0.027). Other body regions and total Injury Severity Score (ISS) were non-significant. AKI was associated with a significantly worse Glasgow Outcome Score (AKI 3.28 (SD 1.52) versus 4.02 (SD 1.08) p < 0.001), increased intensive care stay (AKI 7.03 (SD 8.30) days versus non-AKI 3.8 (SD 4.1) days p < 0.001) and increased 30-day mortality (AKI 18/70 (25.71%) versus non-AKI 10/132 (7.58%) p < 0.001) Conclusions Skeletal trauma patients have a high incidence of AKI, which was significantly correlated with severity of skeletal limb trauma but not overall ISS.

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Skeletal trauma in children: what is different?

Emergency Radiology ◽

10.1007/s10140-008-0718-1 ◽

2008 ◽

Vol 16 (1) ◽

pp. 35-36

Author(s):

Leonard E. Swischuk

Keyword(s):

Skeletal Trauma

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COMMITTEE ON ACCIDENT PREVENTION

PEDIATRICS ◽

10.1542/peds.20.3.565 ◽

1957 ◽

Vol 20 (3) ◽

pp. 565-566

Author(s):

Keyword(s):

Emergency Care ◽

Surgical Care ◽

Electrical Energy ◽

Civil Defense ◽

Accident Prevention ◽

Skeletal Trauma ◽

Leg Injuries ◽

Arm Injuries ◽

Cervical Injuries ◽

Open Injuries

The Committee on Accident Prevention of the American Academy of Pediatrics, in co-operation with the Surgical Section of the same organization, has prepared the following statements to cover the emergency management of childhood skeletal trauma and burns. Both of these statements are endorsed by the Committee on Trauma of the American College of Surgeons and have been approved by the Federal Civil Defense Administration. EMERGENCY CARE OF CHILDHOOD SKELETAL TRAUMA 1. Evaluate and splint where they lie before moving. Do not attempt reduction. 2. Move cervical injuries face up on a rigid support with manual traction applied gently by cupping chin at the time of moving. Sand bags on either side of neck to prevent turning, if possible. 3. Spine injuries should not be flexed in transportation. 4. Lower leg injuries, transport in pillow strapped with belt. 5. Upper leg injuries, transport with both legs and trunk bound to board without circulatory interference. 6. Lower arm injuries, transport with splint such as rolled newspaper, gentle compression wrapping and sling. 7. Upper arm can be bound to chest with lower arm supporting in sling. 8. Open injuries or open wounds, cover with sterile dressing, do not dust with antibiotic, but systemic antibiotic is useful. Do not attempt to retract bone back under skin. Get to surgical care promptly. 9. Do not cover distal tips of extremities if it can be avoided thus allowing a circulation check to be made from time to time. EMERGENCY CARE OF BURNS 1. Burns are due to thermal agents (scalds or fire); chemical agents (battery acid or lye); radiation (sunburn or nuclear); and electrical energy.

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