The aetiology of posterior glenohumeral dislocations and occurrence of associated injuries

2019 ◽  
Vol 101-B (1) ◽  
pp. 15-21 ◽  
Author(s):  
M. J. Kelly ◽  
A. E. Holton ◽  
A. J. Cassar-Gheiti ◽  
S. A. Hanna ◽  
J. F. Quinlan ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Web Of Science ◽  
Road Traffic ◽  
Glenohumeral Joint ◽  
Delayed Diagnosis ◽  
Associated Injuries ◽  
Inclusion Criteria ◽  
Posterior Shoulder ◽  
Male Patients ◽  
Insight Into

AimsThe glenohumeral joint is the most frequently dislocated articulation, but possibly due to the lower prevalence of posterior shoulder dislocations, approximately 50% to 79% of posterior glenohumeral dislocations are missed at initial presentation. The aim of this study was to systematically evaluate the most recent evidence involving the aetiology of posterior glenohumeral dislocations, as well as the diagnosis and treatment.Materials and MethodsA systematic search was conducted using PubMed (MEDLINE), Web of Science, Embase, and Cochrane (January 1997 to September 2017), with references from articles also evaluated. Studies reporting patients who experienced an acute posterior glenohumeral joint subluxation and/or dislocation, as well as the aetiology of posterior glenohumeral dislocations, were included.ResultsA total of 54 studies met the inclusion criteria. In total, 182 patients were included in this analysis; study sizes ranged from one to 66 patients, with a mean age of 44.2 years (sd 13.7). There was a higher proportion of male patients. In all, 216 shoulders were included with 148 unilateral injuries and 34 bilateral. Seizures were implicated in 38% of patients (n = 69), with falls, road traffic accidents, electric shock, and iatrogenic reasons also described. Time to diagnosis varied across studies from immediate up to a delay of 25 years. Multiple associated injuries are described.ConclusionThis review provides an up-to-date insight into the aetiology of posterior shoulder dislocations. Our results showed that seizures were most commonly implicated. Overall, reduction was achieved via open means in the majority of shoulders. We also found that delayed diagnosis is common.

scholarly journals Association of aspartate aminotransferase in statin-induced rhabdomyolysis

2017 ◽  
Vol 9 (4) ◽  
pp. 316 ◽  
Author(s):  
Xu Cong Ruan ◽  
Lian Leng Low ◽  
Yu Heng Kwan
Keyword(s):  
Regression Model ◽  
Clinical Diagnosis ◽  
Aspartate Aminotransferase ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Delayed Diagnosis ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
Aspartate Transferase

ABSTRACT INTRODUCTION The risk of rhabdomyolysis in the general population is elevated by the increased prevalence of statin use. As the presentation of rhabdomyolysis is varied, there is a risk of delayed diagnosis leading to patient complications and increased healthcare costs. Creatine kinase (CK) alone is not sufficiently predictive for risk stratification. Beyond serum CK, other biomarkers such as transaminases may be used as surrogates to evaluate rhabdomyolysis severity and predict complication risks. AIM To assess if other biomarkers are associated with peak CK and severity of rhabdomyolysis to aid in clinical diagnosis of rhabdomyolysis. METHODS A retrospective study was conducted at an acute care hospital from 2008 to 2011. Inclusion criteria were: (1) patients diagnosed with statin-induced rhabdomyolysis; and (2) peak CK levels of ≥1000 IU/L. Patients with post-operational rhabdomyolysis, acute myocardial infarction and who had suffered from road traffic accidents were excluded. A total of 24,332 patients were screened, and 78 patients fulfilled our inclusion criteria. RESULTS Aspartate aminotransferase (AST) was found to be positively associated with peak CK levels in the multivariable linear regression model after adjusting for alanine aminotransferase (ALT) levels (P = 0.002; β = 83.18). Aspartate aminotransferase was found to be associated with severity of rhabdomyolysis in the multivariable logistics regression model after adjusting for ALT levels (P = 0.015; OR = 1.01). DISCUSSION Aspartate transferase is associated with raised peak CK levels and severity of rhabdomyolysis. Clinicians may consider ordering AST to aid in the clinical diagnosis of rhabdomyolysis.

scholarly journals Posttraumatic Pneumopericardium: A Sign of Severe Injury or Radiodiagnostic Rarity?

2006 ◽  
Vol 49 (2) ◽  
pp. 129-132 ◽  
Author(s):  
Vladimír Lonský ◽  
Jiří Manďák ◽  
Jan Harrer ◽  
Martin Tuna ◽  
Petr Dvořák ◽  
...  
Keyword(s):  
Transesophageal Echocardiography ◽  
Blunt Chest Trauma ◽  
Traffic Accidents ◽  
Chest Trauma ◽  
Road Traffic ◽  
Severe Injury ◽  
Road Traffic Accidents ◽  
Associated Injuries ◽  
Air Tamponade ◽  
Trauma Injury

We present three cases of pneumopericardium following blunt chest trauma injury. All three patients were victims of road traffic accidents. All had multiple associated injuries and pneumopericardium was found as the additional finding. Pneumopericardium was treated conservatively with thoracic drains placement and patients observation. Transesophageal echocardiography was used as a method of choice for exclusion of cardiac air tamponade. All three patients survived.

scholarly journals An epidemiological study of traumatic brachial plexus injury patients treated at an Indian centre

2012 ◽  
Vol 45 (03) ◽  
pp. 498-503 ◽  
Author(s):  
Darshan Kumar A. Jain ◽  
Praveen Bhardwaj ◽  
Hari Venkataramani ◽  
S. Raja Sabapathy
Keyword(s):  
Brachial Plexus ◽  
Traffic Accidents ◽  
Brachial Plexus Injury ◽  
Road Traffic ◽  
Time Interval ◽  
Dominant Hand ◽  
Road Traffic Accidents ◽  
Associated Injuries ◽  
Lower Velocity ◽  
Indian Centre

ABSTRACT Background: Epidemiological studies on traumatic brachial plexus injuries are few and these studies help us to improve the treatment, rehabilitation of these patients and to allocate the resources required in their management. Epidemiological factors can vary in different countries. We wanted to know the situation in an Indian centre. Materials and Methods: Data regarding age, sex, affected side, mode of injury, distribution of paralysis, associated injuries, pain at the time of presentation and the index procedure they underwent were collected from 304 patients. Additional data like the vehicle associated during the accident, speed of the vehicle during the accident, employment status and integration into the family were collected in 144 patients out of the 304 patients. Results: Road traffic accidents accounted for 94% of patients and of the road traffic accidents 90% involved two wheelers. Brachial plexus injury formed a part of multitrauma in 54% of this study group and 46% had isolated brachial plexus injury. Associated injuries like fractures, vascular injuries and head injuries are much less probably due to the lower velocity of the vehicles compared to the western world. The average time interval from the date of injury to exploration of the brachial plexus was 127 days and 124 (40.78%) patients presented to us within this duration. Fifty-seven per cent had joined back to work by an average of 8.6 months. It took an average of 6.8 months for the global brachial plexus-injured patients to write in their non-dominant hand.

scholarly journals Comprehensive study of blunt injury abdomen in single center

2020 ◽  
Vol 7 (3) ◽  
pp. 710
Author(s):  
Vinod Bhandari ◽  
Mahak Bhandari
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Age Groups ◽  
Penetrating Trauma ◽  
Blunt Injury ◽  
Age Group ◽  
Road Traffic Accidents ◽  
Common Mode ◽  
Ileal Perforation ◽  
Male Patients

Background: Blunt injury abdomen is the leading cause of morbidity and mortality in all age groups. Blunt trauma differs from penetrating trauma as different organs are characteristically injured by compression from blunt straining. Focused assessment with sonography for trauma (FAST) and computed tomography (CT) abdomen are very beneficial to detect those patients with minimal and clinically undetectable signs of abdominal injury. Objective of the study was to evaluate the incidence of blunt injury abdomen, mode of injury, organs involved in patients.Methods: A retrospective study was done on blunt injury abdomen. 48 patients were enrolled in this study.Results: Out of 48, 35 (72.9%) male patients more commonly encountered blunt injury to the abdomen. 28 (58.3%) was the highest incidence for age group 21-40 years. The most common mode of injury was road traffic accidents 36 (75.0%). Grade III splenic injuries were encountered in majority 19 cases and 13 cases involved laceration of parenchyma >3 cm depth and 6 cases were subcapsular hematoma (>50%). Spleen was the most common injured organ accounting for 25 (52.0%) and second most common injury was Ileal perforation 6 (12.5%), liver injury 6 (12.5%) of the cases.Conclusions: Blunt injury abdomen mainly affected male and the younger population between the age group 21-40 years. The most common mode of injury is road traffic accidents. In this study the spleen was found to be the most common organ injured in blunt injury abdomen.

Gastrointestinal Perforation in Children Due to Blunt Abdominal Trauma in Hazara, Northern Pakistan

2003 ◽  
Vol 33 (3) ◽  
pp. 168-170 ◽  
Author(s):  
Arshad Zafar ◽  
Nasir Orakzai ◽  
Aamir Ghafoor ◽  
Sajjad Ahmad
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Gastrointestinal Perforation ◽  
X Rays ◽  
Associated Injuries ◽  
Simple Closure ◽  
Single Region ◽  
Mean Time

A retrospective study of 25 children with gastrointestinal perforation due to blunt abdominal trauma in a single region of Pakistan is presented. The age, sex, aetiology, site of perforation, abdominal and X-ray findings, associated injuries, surgical procedures and outcome were analysed. There were 20 boys and 5 girls: mean age was 10 years. The injuries were the result of road traffic accidents 12 (48%), falls 11 (44%) and ‘struck by animals’ two (8%). Associated injuries occurred in 19 (76%). On admission 20 (80%) patients had peritonitis while 18 (72%) had pneumoperitoneum. Mean time from trauma to admission was 10 hours and admission to operation was 5 hours. Ileum was the most common site of perforation. Simple closure was the most common surgical procedure. Complications occurred in nine (36%) patients — six (24%) died. Delay in presentation and operation was associated with increased morbidity and mortality. Frequent evaluation of the child and abdominal X-rays are still the important tools for early diagnosis of gastrointestinal perforation following blunt abdominal trauma.

scholarly journals Pattern of maxillofacial and associated injuries in road traffic accidents

2008 ◽  
Vol 84 (6) ◽  
Author(s):  
M K Akama ◽  
M L Chindia ◽  
F G Macigo ◽  
S W Guthua
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Road Traffic Accidents ◽  
Associated Injuries

scholarly journals Management of Vascular Injury in a Vascular Center of a Developing Country

2021 ◽  
Vol 36 (1) ◽  
pp. 32-37
Author(s):  
Quazi Abul Azad ◽  
Aizizul Islam Khan ◽  
Abdullah Al Mamun ◽  
Nirmal Kanti Dey ◽  
Sajia Sajmin Siddiqua ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Developing Country ◽  
Vascular Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Young Male ◽  
Developed Countries ◽  
Limb Amputation ◽  
Vascular Injuries ◽  
Associated Injuries

In surgical practice management of vascular injuries are challenging. Vascular injuries are well addressed in developed countries but there is scarcity of vascular surgeons in developing countries like us and a large number of victims fail to reach specialist in time with consequent loss of limbs or lives. To observe the pattern and outcome of management of vascular injury in a developing country this retrospective study was conducted at the department of vascular surgery, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh. All patients with vascular injury arrived alive were included in the study. Date in terms of age, sex, cause of injury, segment of vessel involved, associated injuries, time elapsed after injury, vascular procedures done and postoperative complications were taken from records of the department and were analyzed. Out of 2174 patients with vascular injury 11 patients died at resuscitation & 52 did not come back after referral to other hospitals for management of associated injuries. Most of the patients were young male & road traffic accidents was the most common cause (91.50%). Majority (53.60%) of the patients presented after 6 hours. Majority of the cases lower limb vessels were injured (64.05%). Among the associated injuries combine orthopedic & soft tissue injuries were most common (60.58%). Among the vascular procedures antilogous venous graft (42.39%) followed by end to end anastomosis (27.79%) were in majority of the cases. In case of extremity vascular injury limb amputation rate was 35.40%. This morbidity can be reduced by improvement of road safely measures, encouraging doctors to vascular surgery specialty and effective training of orthopedic & general surgeons in the management of extremity vascular injury till the availability of vascular surgeons for provision of vascular services in remote areas. Bangladesh Heart Journal 2021; 36(1) : 32-37

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