Surfing-related renal trauma

2019 ◽  
Vol 12 (6) ◽  
pp. 411-416
Author(s):  
Margaret M Mansbridge ◽  
James Ryan ◽  
David C Hill ◽  
Martin Wullschleger
Keyword(s):  
Health Service ◽  
Retrospective Review ◽  
American Association ◽  
Clinical Suspicion ◽  
Gold Coast ◽  
Renal Trauma ◽  
Trauma Patients ◽  
High Grade ◽  
Level Of Evidence

Objectives:The objective of this study was to describe the prevalence and mechanisms of surfing-related renal trauma in a coastal town, which have not previously been published in the literature.Subjects/patients and methods:A 3 year retrospective review was completed of all renal trauma patients presenting to the Gold Coast Health Service.Results:Five injuries were identified and their mechanisms described, with three directly related to surfboard riding, one secondary to paddle boarding and one secondary to windsurfing. Surfing-related injuries accounted for 6% of the total renal trauma injuries in the study period. Injuries ranged from American Association for the Surgery of Trauma grade I–IV and were all managed non-operatively. One case was complicated by a urinoma, which resolved on interval follow-up imaging. All injuries were in males, and left-sided.Conclusion:Surfing-related activities have the potential to cause high-grade renal injuries. Diagnosis of renal trauma secondary to surfing-related activities requires a high index of clinical suspicion.Level of evidence:Level IV Evidence

Observation and treatment of renal trauma: 3 years experience

1992 ◽  
Vol 59 (1_suppl) ◽  
pp. 113-115
Author(s):  
F. Cappellano ◽  
F. Catanzaro ◽  
E. Della Morte ◽  
M. Baruffi ◽  
F. Torelli ◽  
...  
Keyword(s):  
Ct Scan ◽  
Renal Injury ◽  
Penetrating Injury ◽  
Renal Trauma ◽  
Trauma Patients ◽  
Radiological Investigation ◽  
Long Term Follow Up

The investigation and management of renal trauma have evolved during the last 15 years. The majority of patients with renal trauma can be treated conservatively with minimal radiological investigations, since the outcome is excellent in most cases. A CT scan is the radiological investigation of choice in most cases of renal trauma when the patient is hemodynamically stable and there is suspicion that he has suffered a major renal injury. Long term follow-up of renal trauma patients treated conservatively is needed to examine possible complications. We report our experience on 87 patients presenting a complication in a penetrating injury.

scholarly journals Objective Comparison of Nasojugal Fold Depth and Lower Eyelid Length After Fat Excision Versus Fat Transpositional Lower Blepharoplasty

2019 ◽  
Vol 39 (10) ◽  
pp. 1048-1054 ◽  
Author(s):  
Sathyadeepak Ramesh ◽  
Robert A Goldberg ◽  
Allan E Wulc ◽  
Alan B Brackup
Keyword(s):  
Retrospective Review ◽  
Lower Eyelid ◽  
Level Of Evidence ◽  
Aesthetic Result ◽  
Lower Blepharoplasty ◽  
The World ◽  
Aesthetic Results ◽  
Compare And Contrast

AbstractBackgroundLower blepharoplasty is one of the most commonly performed aesthetic surgeries in the world. However, there are no studies to directly compare patients who had fat excision vs fat transposition.ObjectivesThe authors sought to compare and contrast aesthetic results of fat excisional and fat transpositional lower blepharoplasty.MethodsA retrospective review was conducted of 60 patients (120 eyelids) who underwent transconjunctival lower blepharoplasty, either with fat excision or fat transposition into a preperiosteal plane. Marginal reflex distance-2, lower eyelid length, nasojugal fold depth, and pretarsal orbicularis definition were measured.ResultsMean follow-up was 5.6 months. Mean marginal reflex distance-2 did not significantly differ after either fat excision or fat transposition. Mean lower lid length decreased after fat excision only (P < 0.001), and postoperative fat excision patients had a shorter lower eyelid length than patients who underwent fat transposition (13.5 ± 2.1 mm vs 16.1 ± 1.9 mm, P < 0.0001). Pretarsal orbicularis definition increased after both surgeries (P < 0.001), and the groups did not differ (1.0 ± 0.8 vs 1.1 ± 0.9, not significant). Mean nasojugal fold depth was effaced after surgery in both groups (P < 0.001), although the nasojugal fold was significantly more effaced after fat transposition (1.5 ± 0.7 vs 0.48 ± 0.6, P < 0.001).ConclusionsIn lower blepharoplasty, fat excision resulted in a shorter lower eyelid, and fat transposition resulted in a more effaced lid-cheek junction. Surgeons should be able to balance both techniques to deliver a customized aesthetic result.Level of Evidence: 3

Reconstruction of the transverse and dorsal-oblique amputations of the distal thumb with volar cross-finger flap using the index finger

2014 ◽  
Vol 40 (4) ◽  
pp. 392-400 ◽  
Author(s):  
H. Y. Erken ◽  
I. Akmaz ◽  
S. Takka ◽  
A. Kiral
Keyword(s):  
Retrospective Review ◽  
Index Finger ◽  
Donor Site ◽  
Level Of Evidence ◽  
Reliable Technique ◽  
Flap Loss ◽  
Discrimination Testing ◽  
The Mean ◽  
Donor Site Complication

We performed a retrospective review of 12 patients with dorsal oblique and transverse amputations of the distal thumb who were treated with a volar cross-finger flap from the index finger. The mean patient follow-up period was 28 months postoperatively (range: 19–43 months). There were no instances of flap loss, infection, or donor site complication in our series. The mean Semmes–Weinstein monofilament testing scores on the injured thumb and the donor site were 0.65 g (range: 0.16–2 g) and 0.51 g (range: 0.16–1 g), respectively. The mean 2-point discrimination testing scores on the injured thumb and the donor site were 4.5 mm (range: 3–8 mm) and 4.3 mm (range: 3–7 mm), respectively. This study suggests that the volar cross-finger flap using the index finger is a reliable technique in repairing dorsal oblique and transverse amputations of the distal thumb. Type of study/level of evidence: Therapeutic IV

scholarly journals Management of high-grade renal traumas with collecting system injuries

2021 ◽  
Vol 15 (11) ◽  
Author(s):  
Jennifer A. Locke ◽  
Sarah Neu ◽  
Roshan Navaratnam ◽  
Andrea Phillips ◽  
Avery B. Nathens ◽  
...  
Keyword(s):  
Trauma Center ◽  
American Association ◽  
Trauma Patients ◽  
High Grade ◽  
Asymptomatic Patients ◽  
Urinary Extravasation ◽  
Prospective Trials ◽  
Level 1 ◽  
Level 1 Trauma Center ◽  
Collecting System

Introduction: Approximately 50% of all high-grade renal traumas (HGRT, American Association for the Surgery of Trauma [AAST] grade 4/5) have associated collecting system injuries. Although most of these collecting system injuries will heal spontaneously, approximately 20–30% of these injuries are managed with ureteric stents. The objective of the study was to review the management of HGRT with collecting system injuries in a level 1 trauma center. Methods: This was a single-center, retrospective cohort study of trauma patients with HGRT and collecting system injuries from 1998–2019. Results: We identified 147 patients with HGRT. Of the 105 patients who had trauma computed tomography (CT) imaging within 24 hours, 46 were found to have collecting system injuries. Seven of these patients underwent intervention based on initial CT findings; the remaining 39 patients with urinary extravasation were conservatively managed. Of the 37 patients who underwent reimaging, 22 (59%) demonstrated a stable or resolving collection and 15 (41%) demonstrated continued urinary extravasation. Resolution of extravasation on subsequent imaging was observed in 10 of those patients, while five patients (14%) required intervention (four stents, one percutaneous drain) for symptoms/signs of urinary extravasation. Conclusions: In this study, most patients with HGRT and collecting system injuries did not require intervention unless the patient became symptomatic. The majority of collecting system injuries resolved with no intervention. This study underscores the need for future prospective trials to investigate the necessity of intervening in HGRT collecting system injuries and, secondarily, the need for routine reimaging in these asymptomatic patients.

scholarly journals T1 PELVIC ANGLE IN IMPROVEMENT OF PAIN IN HIGH-GRADE LUMBAR SPONDYLOLISTHESIS

2020 ◽  
Vol 19 (2) ◽  
pp. 108-111
Author(s):  
JOSÉ ALBERTO ALVES OLIVEIRA ◽  
VINÍCIUS TAPIE GUERRA E SILVA ◽  
LUIZ EDUARDO PEREIRA COSTA ASSIS DE ALMEIDA ◽  
RICARDO DE SOUZA PORTES MEIRELES ◽  
GUILHERME DE REZENDE LOPES ◽  
...  
Keyword(s):  
Strong Correlation ◽  
Sagittal Alignment ◽  
Demographic Data ◽  
Case Series ◽  
Slip Angle ◽  
High Grade ◽  
Data Types ◽  
Level Of Evidence ◽  
Global Sagittal Alignment

ABSTRACT Objective To evaluate the correlation between global sagittal alignment variables and pain improvement after surgery for High-Grade Spondylolisthesis (HGS). Methods A sample with 20 patients with L5-S1 HGS, submitted to arthrodesis with instrumentation from 01/2004 to 12/2016. Patients’ demographic data, types of surgeries, complications, sagittal alignment parameters, and Visual Analog Scale (VAS) score (ranging from 0 to 4) were recorded before surgery and at the last follow-up. The data were processed in SPSS 22.0. The confidence level was 0.05. Results The majority of the sample were women, 17 (85%); age at surgery: 52.60 ± 17.15 years; mean follow-up: 3.58 ± 1.62 years; isthmic etiology, 16 (80%) and dysplastic, 4 (20%); Meyerding Grading 3: 12 (60%), Grading 4: 3 (15%) and Grading 5: 5 (25%); SDSG type 4: 6 (30%), type 5a: 3 (15%), 5b: 3 (15%), type 6: 7 (35%) and not classified 1 (5%); surgery: in situ fusion 3 (15%) and reduction 17 (85%); fusion levels: L3-S1: 1 (5%), L3-Iliac: 1 (5%), L4-S1: 1 (5%), L4-Iliac: 6 (30%) and L5-S1: 11 (55%). Comparing the pre- and postoperative parameters, a significant improvement (p <0.05) was seen in the VAS, T1 slope, T1 pelvic angle (TPA), slip angle, Dubousset’s lumbosacral angle and slip %. Evaluating the correlation between the variation in sagittal parameters and the improvement in VAS scale, it was found that the TPA showed a strong correlation (r = 0.709, p = 0.032). Conclusions the present study found a strong correlation between the improvement/reduction in TPA values and the reduction in pain intensity in the VAS. Level of evidence IV; Case Series.

scholarly journals Contemporary management of renal trauma in Canada: A 10-year experience at a level 1 trauma centre

2018 ◽  
Vol 13 (6) ◽  
Author(s):  
Uday Mann ◽  
Logan Zemp ◽  
Keith F. Rourke
Keyword(s):  
Penetrating Trauma ◽  
Injured Patient ◽  
Trauma Centre ◽  
Renal Trauma ◽  
Trauma Patients ◽  
High Grade ◽  
Mechanism Of Injury ◽  
Level 1 ◽  
Grade 3 ◽  
Urological Intervention

Introduction: Contemporary Canadian renal trauma data is lacking. Our objective is to describe 10-year outcomes of renal trauma at a Canadian level 1 trauma centre using a conservative approach. Methods: The Alberta Trauma Registry at the University of Alberta was used to identify renal trauma patients from October 2004 to December 2014. Hospital records and imaging were reviewed to identify clinic-radiographical factors, including patient age, gender, Injury Severity Score (ISS), American Association of the Surgery for Trauma (AAST) grade, computerized tomography (CT) findings, urological interventions, length of stay, transfusion and death rates. Descriptive statistics, Chi-square, and t-tests were used when appropriate. Results: A total of 368 renal trauma patients were identified. Mechanism of injury was blunt trauma in 89.1% of cases, mean age was 36.2 years, and mean ISS was 30.8 (±13.6). AAST grade distribution was 16.6% (Grade 1), 22.8% (Grade 2), 36.4% (Grade 3), 20.9% (Grade 4), and 3.3% (Grade 5). Overall, 9.5% (35) of patients required urological intervention for a total of 40 treatments, including ureteral stenting (3.0%), angioembolization (3.3%), percutaneous drainage (0.3%), or open intervention including nephrectomy (2.4%) and renorrhaphy (0.5%). No Grade 1 or 2 injuries required intervention, while 1.5%, 31.2%, and 75.0% of Grade 3, 4, and 5 injuries did, respectively. The overall renal salvage rate was 97.6%, which did not differ by mechanism of injury (p=0.25). Patients with penetrating trauma were more likely to require urological intervention (20.0% vs. 8.2%; p=0.04). Of the high-grade (III–V) renal injuries identified, 15.7% (35/223) required urological intervention, 4.9% (11) required open surgical intervention, and only 4.0% (9) of patients with high-grade renal injury required nephrectomy. Conclusions: The trend towards conservative treatment of renal trauma in Canada appears well-supported even in a severely injured patient population, as over 90% of patients avoid urological intervention and only 3% require operative intervention resulting in renal salvage rates of 97.6%.

MP79-01 NEPHRECTOMY AFTER HIGH-GRADE RENAL TRAUMA: RESULTS FROM THE AMERICAN ASSOCIATION FOR THE SURGERY OF TRAUMA (AAST) GENITOURINARY TRAUMA STUDY

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Sorena Keihani ◽  
Yizhe Xu ◽  
Angela P. Presson ◽  
Brian P. Smith ◽  
Patrick M. Reilly ◽  
...  
Keyword(s):  
American Association ◽  
Renal Trauma ◽  
High Grade ◽  
Genitourinary Trauma

Management of renal injury in a UK major trauma centre

Trauma ◽  
2018 ◽  
Vol 22 (1) ◽  
pp. 26-31
Author(s):  
Robert Torrance ◽  
Abigail Kwok ◽  
David Mathews ◽  
Matthew Elliot ◽  
Andrew Baird ◽  
...  
Keyword(s):  
Renal Injury ◽  
Major Trauma ◽  
Trauma Centre ◽  
University Hospital ◽  
Research Network ◽  
Renal Trauma ◽  
High Grade ◽  
Major Trauma Centre ◽  
Renal Injuries

Introduction This study reviews the type, severity, management and follow-up of renal trauma presenting to a major trauma centre in the northwest of England in the four years following inception of the major trauma centre. Given the recent introduction of major trauma centres nationally, research is needed within every specialty to ensure that the centralisation of services benefits all patients affected by these changes. Methods Patients presenting to Aintree University Hospital with renal trauma between June 2012 and June 2016 were identified using the Trauma Audit and Research Network (TARN) database. The data gathered retrospectively for each patient included mechanism of injury, injury severity score, American Association for the Surgery of Trauma (AAST) grading, management of injury, and follow-up. Results Out of a total of 2595 trauma patients, 33 renal injuries were identified. The 31 patients who received imaging were classified according to AAST grading, with 8 Grade I (25.8%), 4 Grade II (12.9%), 8 Grade III (25.8%), 4 Grade IV (12.9%), and 7 Grade V (22.6%) injuries. Twenty-five out of the 30 surviving patients received conservative treatment, three patients received angioembolisation (AE), one patient received a laparotomy with renal suturing, and one patient required a nephrectomy. Of these 30 surviving patients, seven received urology follow-up in clinic (23%). Conclusion The findings appear to support the growing trend towards the conservative management of high-grade renal injuries, and provide further evidence for the value of AE in renal trauma. The success of AE in this study appears to support the centralisation of services in renal trauma; however, the low nephrectomy rate could be interpreted as suggestive of the opposite. The study revealed that improvements to follow-up are needed, and that further research should seek to inform the optimal radiological follow-up of high-grade renal injury.

Clinical Outcome of a Modified Coracoid Tunnel-Free Coracoclavicular Sling Technique With Remnant Preservation for the Treatment of High-Grade Acromioclavicular Joint Separation: A Report of 48 Cases With 2 to 5 Years of Follow-up

2021 ◽  
pp. 036354652110021
Author(s):  
Fenglong Li ◽  
Yue Li ◽  
Yi Lu ◽  
Yiming Zhu ◽  
Chunyan Jiang
Keyword(s):  
Los Angeles ◽  
Surgical Techniques ◽  
Case Series ◽  
Complication Rates ◽  
High Grade ◽  
Ac Joint ◽  
Level Of Evidence ◽  
Remnant Preservation ◽  
Joint Separation

Background: High-grade acromioclavicular (AC) joint separation injuries (Rockwood type IV or V) are surgically indicated because of complete disruption of the AC and coracoclavicular (CC) ligaments, leading to instability and pain. In surgical techniques that require a suspensory system, coracoid tunnel-related complications are not uncommon. Purpose: To report subjective and objective clinical outcomes and complication rates of a modified coracoid tunnel-free CC sling technique combined with CC ligament remnant preservation for a minimum 2-year follow-up. Study Design: Case series; Level of evidence, 4. Methods: Between January 2014 and January 2017, we prospectively enrolled patients who underwent a modified CC sling technique performed by 1 senior surgeon using the AC TightRope System in a coracoid tunnel-free fashion. The CC distance (CCD) and Rockwood AC joint classification were evaluated on radiographs preoperatively, immediately postoperatively, and at the final follow-up. The visual analog pain score, range of motion, American Shoulder and Elbow Surgeons score, Constant-Murley score, and University of California Los Angeles score were recorded preoperatively and at the final follow-up. Results: In total, 48 of 54 patients (88.9%) were included for the evaluation with a mean ± SD follow-up of 39.3 ± 8.9 months (range, 24.7-64.3 months). The CCD was significantly decreased from 22.7 ± 4.2 to 9.8 ± 2.3 mm ( P < .01) immediately after surgery and to 11.2 ± 1.8 mm ( P < .01) at final follow-up. At the final follow-up, the side-to-side difference of CCD was 3.5 ± 0.6 mm. Compared with the preoperative level, all subjective evaluations were significantly improved at the final follow-up. We observed that 4 of the 48 patients (8.3%) had a loss of reduction at the final follow-up, but no pain or instability was documented. Further, no coracoid-related complication or other complications were recorded. Conclusion: The coracoid tunnel-free CC sling technique using the AC TightRope System combined with CC ligament remnant preservation demonstrated significant improvement regarding both clinical and radiological outcomes, with a reduction loss rate of 8.3%. It is a safe method that could achieve satisfactory result without any coracoid drilling-related complications.

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