scholarly journals Titanium Clamps for a Simple Low-Profile Autologous Osteosynthesis in the Reconstruction of Posttraumatic Craniofacial Convexital Skeletal Disruption

2017 ◽  
Vol 10 (1) ◽  
pp. 29-34 ◽  
Author(s):  
AmosOlufemi Adeleye ◽  
ToluyemiAdefolarin Malomo
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Low Cost ◽  
Low Resource ◽  
Low Profile ◽  
The Aesthetic ◽  
Craniofacial Defects ◽  
Profile Technique ◽  
Prospective Database

Attempts at reconstruction of posttraumatic craniofacial defects (PTCDs) can be a challenge in low-resource practice areas of the world where the needed biomaterials are logistically beyond reach. A simple low-profile technique of autologous osteosynthesis for PTCD using the titanium clamps is presented in this report. In addition, a 6-year prospective database on a consecutive cohort of patients who underwent this procedure was analyzed for clinical, functional, and aesthetic outcomes, both in-hospital and at midterm follow-up. The clinical data of 18 patients, all males, mean age 31.3 years (standard deviation, 9.7), were analyzed. Road traffic accidents (RTAs) were the cause of trauma in 14 of 18 patients (78%) and motorcycle crash, none helmeted, in 10 of the 18 patients (71% of RTAs). Out of 18 cases, 17 were open fractures; 89% suffered mild head injury, and associated brain injury on CT scan included pneumocephalus in 6 (5 of them significant); acute extradural hematoma in 4 and subdural in 2, and brain contusions in 9. The surgery was successful in all the cases: operative time <3 hours in 10 cases (56%), the in-hospital outcome was good in 95%. The median follow-up time was 24 months, in 6 of the 18 cases for ≥36 months. There was no case of surgical site infection in the perioperative or the follow-up period to date. The aesthetic outcome was also acceptable. This surgical technique for the reconstruction of PTCD appears effectual. Although its low cost makes it very attractive therein, it appears to be actually also recommendable even outside the low-resource developing countries.

scholarly journals P014: Incidental findings in trauma whole-body CT scans: a systematic review

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S69-S69
Author(s):  
V. Tsang ◽  
K. Bao ◽  
J. Taylor
Keyword(s):  
Systematic Review ◽  
Incidental Findings ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Subsequent Treatment ◽  
Whole Body ◽  
Trauma Patients ◽  
Patient Demographics ◽  
Study Results

Introduction: Whole-body computed tomography scans (WBCT) are a mainstay in the work-up of polytrauma or multiple trauma patients in the emergency department. While incredibly useful for identifying traumatic injuries, WBCTs also reveal incidental findings in patients, some of which require further diagnostic testing and subsequent treatment. Although the presence of incidental findings in WBCTs have been well documented, there has been no systematic review conducted to organize and interpret findings, determine IF prevalence, and document strategies for best management. Methods: A systematic review was conducted using MEDLINE, PUBMED, and EMBASE. Specific journals and reference lists were hand-mined, and Google Scholar was used to find any additional papers. Data synthesis was performed to gather information on patient demographics, prevalence and type of incidental findings (IFs), and follow-up management was collected. All documents were independently assessed by the two reviewers for inclusion and any disagreements were resolved by consensus. Results: 1231 study results were identified, 59 abstracts, and 12 included in final review. A mean of 53.9% of patients had at least one IF identified, 31.5% had major findings, and 68.5% had minor findings. A mean of 2.7 IFs per patient was reported for articles that included number of total IFs. The mean age of patients included in the studies were 44 years old with IFs more common in older patients and men with more IFs than women. IFs were most commonly found in the abdominal/pelvic region followed by kidneys. Frequency of follow-up documentation was poor. The most common reported mechanisms of injury for patients included in the study were MVA and road traffic accidents (60.0%) followed by falls from >3m (23.2%). Conclusion: Although there is good documentation on the mechanism of injury, patient demographics, and type of IF, follow-up for IFs following acute trauma admission lacks documentation and follow-up and is an identified issue in patient management. There is great need for systematic protocols to address management of IFs in polytrauma patients.

A Differential Approach to the Choice of Treatment of Facial Bone Fractures in the Children

10.12737/3564 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 1-5
Author(s):  
Тихонов ◽  
E. Tikhonov ◽  
Харитонов ◽  
D. Kharitonov ◽  
Гаршина ◽  
...  
Keyword(s):  
High Speed ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Bone Fractures ◽  
Facial Bone ◽  
Differential Approach ◽  
Fractures In Children ◽  
Choice Of Treatment ◽  
Post Traumatic

The choice of treatment of facial bone fractures in the early age remains a challenge for dentists and maxillofacial surgeons due to the peculiarities of child organism. The purpose of this study was to develop a differential approach to the choice of treatment of children´s facial bone fractures taking into account the age of a child, location of injury and possible complications. This paper presents the analysis of current epidemiological situation regarding to facial bone fractures in children in Voronezh city and Voronezh region. It is shown that the most common injuries is a fall from a height of its own growth, i.e. low-trauma; at the same time the number of high-speed traumas, such as road-traffic accidents, high falls, has decreased. The analysis was carried out 58 cases of facial bone fractures in a group of children from 1 month to 16 years being treated in Maxillofacial Department of Voronezh Regional Pediatric Hospital №2. The developed model of differential choice of treatment of facial bone fractures in children allows to choosing the method taking into account a child age, location of injury and severity, as well as possible consequences of surgery. The clinical monitoring has proved the efficacy of the model which gives an opportunity to decrease post-traumatic complications associated with growth and occlusion deformations as well as complications of inflammatory genesis. It was convincingly shown the need for follow-up care of children with facial fracture that the doctor-orthodontist should continue. The presented data of this study about correlation between surgical and conservative treatment of facial bone fractures in children coincide with the worldwide statistics showing the current tendency to a wide application of mini-invasive methods of fractures fragments immobilization.

scholarly journals Evaluation of Clinical Outcome in Traumatic Facial Nerve Paralysis

2021 ◽  
Author(s):  
Abhijit Shankar ◽  
Shibu George ◽  
Satheesh Somaraj
Keyword(s):  
Clinical Outcome ◽  
Facial Nerve ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Objective Evaluation ◽  
Facial Nerve Paralysis ◽  
Temporal Bone Fracture ◽  
Nerve Paralysis ◽  
Tertiary Center

Abstract Introduction The facial nerve is the most commonly paralyzed nerve in the human body, resulting in far-reaching functional, aesthetic and emotional concerns to the patient. Objective Evaluation of the clinical outcome of 47 patients with traumatic facial nerve paralyses, with respect to clinical recovery and audiological sequelae. Methods A descriptive longitudinal study was conducted over 24 months between January 2017 and December 2018 at a tertiary center with detailed clinical, topodiagnostic, audiometric and radiological evaluation and regular follow-up after discharge. Results Road traffic accidents constituted 82.98% of the trauma cases, out of which 76.60% were found to be under the influence of alcohol.Delayed facial paralysis was observed in 76.60% cases. Temporal bone fracture was reported in 89.36%, with otic capsule (OC) sparing fractures forming 91.49% of the cases. Topologically, the injury was mostly at the suprachordal region around the second genu. The majority of the patients (65%) attained full recovery of facial nerve function with conservative medical management. Audiometrically, 77.27% of the patients had hearing loss at the time of presentation, of which 64.71% were conductive in nature; 51.22% attained normal hearing at follow-up visits. Conclusion Early initiation of steroid therapy, concurrent eye care and physiotherapy are the cornerstones in the management of traumatic facial nerve paralysis.

Oberlin’s Transfer: Long Term Outcomes

2018 ◽  
Vol 23 (02) ◽  
pp. 176-180 ◽  
Author(s):  
Karlis Verdins ◽  
Martins Kapickis
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Short Interval ◽  
Young Patients ◽  
Elbow Flexion ◽  
Dash Score ◽  
Salvage Procedure ◽  
Daily Work ◽  
Transfer Operation

Background: Brachial plexus injury is very commonly associated with road traffic accidents, and frequently affects young adults, causing significant disability and impact on quality of life. The successful treatment of upper plexus injury with the Oberlin technique to restore elbow flexion with good functional results. Methods: We retrieved the records of all patients with upper plexus injury who underwent Oberlin transfer operation between March 2007 and July 2012. Outcomes were assessed using the Medical Research Council (MRC) power grading system for biceps muscle, Disabilities of the Arm, Shoulder and Hand score (DASH) for patient functional outcomes and the Visual Analogue Scale for daily disability (VAS where 0- no restrictions; 10- significant limitations) for overall patient satisfaction. Follow-up was performed for at least 12 months post-operatively. Results: The average follow up period was 43.6 months. Six cases gained effective elbow flexion, improving to MRC grade 5/5 and four cases improved to MRC grade 4/5 for biceps function. The average DASH score was 27.25. One patient had serious disability with no changes after Oberlin’s transfer operation. No permanent impairment of ulnar nerve function was observed. Seven out of 10 patients had begun daily work, with no discomfort and no functional impact on activities of daily living. Conclusions: We found The Oberlin transfer is a useful salvage procedure and most effective results are for young patients with short interval between injury and operation.

scholarly journals Unpredictable Outcome of Large Traumatic Oesophageal Injury: An Experience and Challenges

2021 ◽  
Author(s):  
Mahaveer Singh Rodha ◽  
Satya Prakash Meena ◽  
Subhash Chandra Soni ◽  
Pawan Kumar Garg ◽  
Althea Vency Cardoz
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Thoracoscopic Surgery ◽  
Delayed Diagnosis ◽  
Oesophageal Perforation ◽  
Feeding Jejunostomy ◽  
Oesophageal Injury ◽  
Life Threatening ◽  
Thoracic Oesophagus

Oesophageal injury following blunt or penetrating injury due to road traffic accidents is a rare cause of morbidity and mortality. The outcome of delayed diagnosis of oesophageal injury is mostly life threatening conditions. A 23-year-old female presented with respiratory distress, fever, chest pain and facial deformity, following road traffic accident 15 days back. After evaluation, the patient was diagnosed with septicaemia due to large thoracic oesophageal perforation with left pyothorax. The patient was managed by Video Assisted Thoracoscopic Surgery (VATS) decortication with feeding jejunostomy followed by diversion cervical oesophagostomy. The patient was planned for oesophageal reconstructive surgery electively in follow-up period. After six weeks in the follow-up period, surprisingly large thoracic oesophagus perforation and cervical oesophagostomy was healed spontaneously which was confirmed by gastrograffin study. Spontaneous closure of large thoracic oesophageal perforation is the rare outcome of this injury.

scholarly journals Clinical and audiological evaluation of post traumatic hearing loss

2020 ◽  
Vol 6 (12) ◽  
pp. 2258
Author(s):  
Abhijit Shankar ◽  
Shibu George ◽  
Satheesh Somaraj
Keyword(s):  
Hearing Loss ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Post Injury ◽  
Temporal Bone Fracture ◽  
Mixed Hearing Loss ◽  
Hearing Thresholds ◽  
Post Traumatic ◽  
Conductive Hearing

<p><strong>Background</strong>: Post traumatic hearing loss is one of the most common problems encountered among trauma victims. It can manifest as conductive, sensorineural or mixed hearing loss. It is against this background that the study evaluated the clinical and audiological outcome of 47 patients of trauma.</p><p><strong>Methods</strong>: A descriptive longitudinal study was conducted over a period January 2017 to March 2018. Follow up was done after 3 months of discharge. Study consisted of 47 patients presenting with features of trauma related injuries. After carrying out systematic clinical, audiometric and radiological evaluation, patients were managed conservatively.</p><p><strong>Results</strong>: Of the 47 patients studied, 89.98% were related to road traffic accidents (RTAs); and 76.60% were under the influence of alcohol at the time of trauma. Among the 32 cases of the RTAs involving two wheelers, 29 patients (90.62%) were not using protective devices like helmet. Nearly 90% of patients had temporal bone fracture. Audiological evaluation confirmed hearing loss in 77% of patients at presentation. There was significant improvement of hearing thresholds with 51% attaining normal hearing at follow up with conservative management.</p><p><strong>Conclusions</strong>: Post traumatic hearing loss was very common, conductive hearing loss being the most common type. It resolved over a few days to few weeks post injury. Timely diagnosis and management with early steroid therapy showed encouraging results for patients with traumatic sensorineural hearing loss or mixed hearing loss.</p>

scholarly journals Outcome of Distal Femoral Fracture Treated with Locking Plate

2021 ◽  
Vol 15 (6) ◽  
pp. 2142-2144
Author(s):  
Muhammad Shoaib Zardad ◽  
Abdus S. Awan ◽  
Muhammad Younas ◽  
Shahkeel A. Shah ◽  
S. Sohail Akhtar ◽  
...  
Keyword(s):  
Femoral Fracture ◽  
Traffic Accidents ◽  
Locking Plate ◽  
Road Traffic ◽  
Femoral Fractures ◽  
Delayed Union ◽  
Distal Femoral Fracture ◽  
Non Union ◽  
One Year

Objective: The aim of this study is to determine the outcome of distal femoral fracture treated with locking plate. Study Design:Prospective study Place and Duration: Conducted at Orthopaedic Unit Ayub Medical Teaching Institute, Abbottabad for one year duration from 1stJanuary 2020 to 31st December 2020. Methods: Total 90 patients of both genders were presented in this study.Patients were aged between 18-80 years of age. Patients’ detailed demographics including age, sex and body mass index were recorded after taking informed written consent. All the patients had distal femoral fracture treated with locking plate. Radiological assessment was done. Mean union time and complications associated to procedure were examined.Functional outcomes were analyzed according to the Flyn’s criteria. Follow-up was taken at 6 months postoperatively. Complete data was analyzed by SPSS 24.0 version. Results:There were 58 (64.4%) patients were males and 32 (35.6%) were females. Mean age of the patients were 42.61±12.88 years with mean BMI 27.65±9.56 kg/m2. According AO/OTA classification 55 (61.1%) had A1, A2 fracture was among 18 (20%) cases and the rest were 17 (18.9%) had A3. 62 (68.9%) fractures were caused due road traffic accidents, falling from height were among 17 (18.9%) cases and 11 (12.2%) cases were due to sports. Right side fracture was the most common side of fracture among 54 (60%). Mean union time among patients was 5.16±1.27 months.According to Flyn’s criteria, 38 (42.2%) cases had excellent results, 32 (35.6%) patients had good, fair results were among 16 (17.8%) cases and poor results were among 4 (4.4%) cases. Complications were delayed union, stiffness, varus deformityand non union observed among all cases. Conclusion: We concluded in this study that the locking plate for the treatment of distal femoral fractures was effective in terms of good results with fewer complications. Keywords:Distal femoral fracture, Locking plate, RTA, Complications

scholarly journals EMDR for Childhood PTSD After Road Traffic Accidents: Attentional, Memory, and Attributional Processes

2010 ◽  
Vol 4 (4) ◽  
pp. 138-147 ◽  
Author(s):  
Tracy Ribchester ◽  
William Yule ◽  
Adam Duncan
Keyword(s):  
Traffic Accidents ◽  
Stress Disorder ◽  
Road Traffic ◽  
Standardized Assessments ◽  
Anxiety And Depression ◽  
Road Traffic Accidents ◽  
Modified Stroop ◽  
Childhood Ptsd ◽  
Attributional Processes

Eye movement desensitization and reprocessing (EMDR) was used with 11 children who developed posttraumatic stress disorder (PTSD) after road traffic accidents. All improved such that none met criteria for PTSD on standardized assessments after an average of only 2.4 sessions. Significant improvements in PTSD, anxiety, and depression were found both immediately after treatment and at follow-up. Attentional, memory, and attributional processes associated with PTSD were assessed and their relationship to therapeutic change examined. Treatment was associated with a significant trauma-specific reduction in attentional bias on the modified Stroop task, with results apparent both immediately after therapy and at follow-up.

Factors Affecting Implant Failure in Fracture of the Shaft of Femur

2003 ◽  
Vol 42 (148) ◽  
Author(s):  
S Lakhey ◽  
J Maheshwari ◽  
R Malhotra
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Femur Fracture ◽  
Implant Failure ◽  
Road Traffic Accidents ◽  
Factors Affecting ◽  
Technical Errors ◽  
Anatomic Reduction ◽  
Initial Injury

17 cases of implant failure of fracture of shaft of femur were studied. All cases were young adults less than40 years of age. 15 were males. 16 of 17 cases sustained their initial injury in road - traffic accidents. Platefailures were detected earlier than those of nails as nails kept on providing splintage to an otherwise ununitedfracture. 10 of 17 cases were treated by interlocking nailing during the resurgery. Cortico-cancellous bonegrafting was done in 9 of 17 cases as per merit of each case. Follow-up ranged from 6 months to 2 years. 15of 17 cases went on to sound union after the second operation.The wrong choice of implant, implants improperly applied and bone grafting not done as recommended(i.e. technical errors) is the major cause of implant failure. Nails with diameter more than 10 mm should beused as far as possible. Early detection and resurgery for K-nail failure should be done to prevent greateramount of shortening. Wherever plating is done, instead of attempting anatomic reduction and devascularisingthe bone, biological method of fixation should be used.Key Words: Implant Failure, Shaft of Femur, Fracture.

scholarly journals Emergency management of maxillary dentoalveolar fracture: A case report

2021 ◽  
Vol 9 (2) ◽  
pp. 76-79
Author(s):  
Archana H. Dhusia ◽  
Heena Sonawane ◽  
Rishi S Verma ◽  
Pooja Uchale ◽  
Harshada Jagdale
Keyword(s):  
Traffic Accidents ◽  
Alveolar Bone ◽  
Road Traffic ◽  
Physical Violence ◽  
Sports Injury ◽  
Arch Bar ◽  
Good Patient Compliance ◽  
History Of ◽  
Tissue Attachment

Dentoalveolar trauma occurs in relation to injuries of fall, road traffic accidents, sports injury or physical violence. There may be injury limited to the tooth, or may involve the periodontium around, or in severe cases, alveolar bone or oral mucosa may be traumatised. There can be myriad injuries of the same structure depending upon the severity of impact. The injuries of tooth most commonly being crown fractures, followed by root fractures, luxation or complete avulsion of the tooth. Every type of dentoalveolar injury requires a specific set of clinical protocols to be followed in order to successfully diagnose and manage the particular case.We hereby report a case of a 29-year-old male patient with a history of fall under the influence of alcohol, who had fallen flat on his face and had suffered intrusive luxation of permanent maxillary right central incisor and avulsion of permanent maxillary left central and lateral incisors. The exarticulated teeth still had slight soft tissue attachment to the socket. On the patients first visit to dental OPD, being a dental emergency, the avulsed teeth were immediately restored back into the socket under local anaesthesia after adequately irrigating and debriding the socket, followed by repositioning of the internally luxated tooth, so that all were in their correct anatomical position. After checking for occlusion, they were splinted in position with Erich’s arch bar and 26 gauge SS wire and after giving post-operative instructions patient was asked to follow up after 6 weeks. At 6 weeks, the affected teeth were found to be firm and so arch bar were removed. Patient was advised to follow up further. At periodic follow ups, the patient was asymptomatic and maintained adequate oral functioning of the injured teeth, thus with good patient compliance and proper diagnosis and treatment, dentoalveolar fractures can be managed successfully. The main purpose of this article is to lay emphasis on the timing of treatment of the dentoalveolar injuries. The earlier they are managed, the better is the outcome.

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