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.

Atrial fibrillation and supraventricular arrhythmias

2021 ◽  
pp. 719-739
Author(s):  
Demosthenes G Katritsis ◽  
A John Camm
Keyword(s):  
Atrial Fibrillation ◽  
Differential Diagnosis ◽  
Cycle Length ◽  
Accessory Pathway ◽  
Atrial Arrhythmias ◽  
Supraventricular Arrhythmias ◽  
Acute Setting ◽  
Epidemiology Data ◽  
Life Threatening ◽  
Appropriate Therapy

The term supraventricular tachycardia (SVT) refers to atrial arrhythmias, including atrial fibrillation, atrioventricular nodal reentry, and atrioventricular reentry due to accessory pathway(s). In clinical practice, SVT may present as narrow- or wide-QRS tachycardias, and with the potential exception of atrial fibrillation, most of them are usually, although not invariably, manifest as regular rhythms. They are usually intrusive, symptomatic, and anxiety provoking but not dangerous. However, depending on their cycle length and the patient's background, they could also be, rarely, life-threatening conditions. In the acute setting, consideration of epidemiology data, clinical presentation, and the 12 lead ECG can provide diagnostic clues for differential diagnosis between SVT and ventricular arrhythmias, and guide appropriate therapy.

scholarly journals Traumatic infra-renal aortic dissection after a high-energy trauma: a case report of a primary missed diagnosis

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Holger Godry ◽  
Guido Rölleke ◽  
Achim Mumme ◽  
Thomas A. Schildhauer ◽  
Martin Gothner
Keyword(s):  
Aortic Dissection ◽  
Ct Scan ◽  
High Energy ◽  
The Body ◽  
Trauma Patients ◽  
Traumatic Injuries ◽  
High Energy Trauma ◽  
Missed Injuries ◽  
Lumbar Vertebral Body ◽  
Life Threatening

A traumatic infra-renal aortic dissection is a rare but life-threatening injury that follows deceleration injuries. The mechanism of blunt abdominal aortic injury involves both direct and indirect forces. The successful management of patients with traumatic injuries depends on a prompt suspicion of the injury and early diagnosis and therapy. Missed injuries in trauma patients are well-described phenomena and implementation of the ATLS® trauma schedule led to a decrease in the number of missed injuries, but trauma computed tomography (CT) scans in injured patients are still not standard. We report on a 54-year old Caucasian female patient who was involved in a car accident. The fellow passenger of the car was seriously injured. The patient had been previously treated at two different hospitals, and a dislocated acetabular fracture had been diagnosed. Because of this injury, the patient was transferred to our institution, a level 1 trauma-center where, according to the nature of the accident as a high-energy trauma, a complete polytrauma management was performed at the time of admission. During the body check, a moderate tension of the lower parts of the abdomen was detected. During the CT scan, an aneurysm of the infra-renal aorta with a dissection from the height of the second lumbar vertebral body to the iliac artery was observed. The patient required an operation on the day of admission. After 19 days post-trauma care the patient was able to leave our hospital in good general condition. Therefore, missed injuries in multiple injury patients could be fatal, and it is essential that the orthopedic surgeon leaves room for suspicion of injuries based on the nature of the trauma. Traumatic injuries of the abdominal aorta are rare. According to the ATLS® trauma schedule, all of the patients who have experienced high-energy trauma and associated fractures should undergo routine screening using a trauma CT scan with contrast agents to detect potential life-threatening injuries. In case of abdominal trauma, an aortic dissection, which can easily be overlooked, has to be considered.

scholarly journals Double Trouble: Two Scapulothoracic Dissociation in a Single Head-On Collision

2019 ◽  
Vol 3 (3) ◽  
pp. 169
Author(s):  
Ng Bing Wui ◽  
Ong Kean Long ◽  
Mohammad Fittry Bin Safian ◽  
Abdul Muttalib Bin Abdul Wahid
Keyword(s):  
Upper Limb ◽  
Rare Case ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
High Energy ◽  
Health Sciences ◽  
Vehicle Accident ◽  
Life Threatening ◽  
Scapulothoracic Dissociation

Scapulothoracic dissociation is a potentially limb-threatening and life-threatening high energy injury. Diagnosis could be obscured due to other associated trauma sustained by the patient. We present a rare case of motor vehicle accident involving 2 motorcyclists who collided onto each other, resulting in both victims sustaining left upper limb scapulothoracic dissociation.International Journal of Human and Health Sciences Vol. 03 No. 03 July’19. Page: 169-171

The management of unexplained collapse in service age personnel

2015 ◽  
Vol 101 (2) ◽  
pp. 160-166
Author(s):  
AS Martin ◽  
IA Edgar ◽  
J Walker
Keyword(s):  
Differential Diagnosis ◽  
Differential Diagnoses ◽  
Medical Practitioners ◽  
Diagnosis And Management ◽  
Common Presentation ◽  
Methodical Approach ◽  
Wide Range ◽  
Life Threatening ◽  
The Military ◽  
The Impact

AbstractUnexplained collapse is a common presentation to medical practitioners, with a wide range of differential diagnoses making assessment problematic. Without a methodical approach to the patient presenting with unexplained collapse, potentially life-threatening conditions may not be recognised, whilst benign presentations can be over-investigated. This article will review the assessment, differential diagnosis and management of unexplained collapse, whilst considering the impact in the military environment.

Lunate dislocations: anatomy, diagnosis and management

2021 ◽  
pp. 1-10
Author(s):  
Madeleine Garner ◽  
Branavan Rudran ◽  
Amir Khan ◽  
Quen Tang ◽  
Philip Mathew
Keyword(s):  
Injury Severity ◽  
Life Support ◽  
High Energy ◽  
Acute Onset ◽  
Advanced Trauma Life Support ◽  
Diagnosis And Management ◽  
Energy Mechanism ◽  
Permanent Loss ◽  
Life Threatening ◽  
Mechanism Of Trauma

Lunate dislocation is an uncommon but serious wrist injury, often resulting from a high energy mechanism of trauma. Advanced trauma life support protocols should be followed to diagnose and treat concomitant life-threatening pathology. Thorough neurovascular and soft tissue examination is required to identify open wounds and median nerve dysfunction, including acute onset carpal tunnel syndrome. Imaging is undertaken to appreciate injury severity, which is graded by the Mayfield classification. Closed reduction in the emergency department is the initial management, which alleviates pressure on neurovascular structures. Definitive management is surgical, most commonly via open reduction and direct ligamentous stabilisation. The aims of surgery are to restore anatomical carpal alignment and maintain stability, allowing repair and healing of the important wrist ligaments. Medium-to long-term functional outcomes are adequate, with most patients returning to work within 6 months. However, progressive radiographic midcarpal arthrosis is common, as well as permanent loss of grip strength, range of motion and chronic pain. This article considers the anatomy, diagnosis and management of acute lunate and perilunate dislocations.

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.

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