scholarly journals Clinic and diagnostics of the non-penetrating gun-shoot craniocerebral injuries in the local war

2021 ◽  
Vol 36 (2) ◽  
pp. 34-43
Author(s):  
A.O. Danchin ◽  
O. M. Goncharuk ◽  
M.S. Altabrowry ◽  
G.O. Danchin ◽  
S.A. Usatov ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Tissue Injury ◽  
Head Injuries ◽  
Skull Fracture ◽  
Soft Tissue Injury ◽  
Clinical Manifestations ◽  
Gunshot Wounds ◽  
Skull Fractures ◽  
Craniocerebral Injuries ◽  
Diagnostic Capabilities

Objective ‒ to evaluate the features of the clinical manifestations and effectiveness of multi-slice computed tomography (MSCT) of the head for the diagnosis of non-penetrating gun-shoot head injuries in the local war.Materials and methods. The medical data of 155 patients who received a non-penetrating gun-shoot head injuries during the war in the Eastern Ukraine between 2014‒2020 were analyzed. All patients were males between 18 and 60 years (average age ‒ 35.1 years). The peculiarities of clinical manifestations and results of diagnostic evaluation of non-penetrating gun-shoot head injuries during specialized neurosurgical care in medical institutions on the third and fourth levels of medical aid have been studied.Results. Wide diagnostic capabilities of MSCT were revealed for determination of the wounds localization, type of the projectile, the nature of the wound channel, gunshot skull fractures, and associated intracranial injuries. It was found that with non-penetrating bullet and shrapnel tangential cranio-cerebral wounds, incomplete and depressed fractures usually occurred, and with single and multiple shrapnel blind wounds, incomplete ‒ perforated and depressed fractures with the presence of bone fragments. The pathomorphological features of the nature of the wound channels and intracranial injuries were determined. They are always associated by traumatic subarachnoid hemorrhages and brain contusions, in most cases – focal. Intracranial hematomas were observed in 3.1 % of the patients.Conclusions. Clinical manifestations of the non-penetrating craniocerebral gunshot wounds depend not only on the type of cranial soft tissue injury, but also on the nature of the skull fracture and are mainly occurred because of the severity of the traumatic brain injury. MSCT of the head makes it possible to determine the localization of the wound, the type of the wounding projectile, the nature of the cranial soft tissues damage, wound channel, gunshot skull fractures and associated intracranial injuries.

The Hazards of Skateboard-Riding

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 793-793
Author(s):  
◽  
Fernando Atienza ◽  
Calvin Sia
Keyword(s):  
Emergency Department ◽  
Soft Tissue ◽  
Bone Fractures ◽  
Tissue Injury ◽  
Skull Fracture ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Major Surgery ◽  
Cerebral Concussion ◽  
Tissue Injuries

Skateboard-riding has become increasingly popular among Hawaii's children. The thrill of the ride and the challenge of keeping one's balance and working intricate maneuvers while speeding down a hill captures the fancy of many of our young. This sport, however, has produced an alarmingly high toll of injury and illness. Pediatricians and emergency departments of our major hospitals have seen and taken care of large numbers of patients (aged between 3 years and 35 years, but with a distribution overwhelmingly pediatric) with significant injuries which include cerebral concussion, fractures, soft tissue injuries of varying degrees of severity and complications, and injury to internal organs. During a three-month period at the Kauikeolani Children's Hospital, July to August 1975, there were 16 patients admitted with the following: seven cerebral concussions, one skull fracture, five assorted bone fractures, one soft tissue injury and infection, one retroperitoneal hemorrhage, and one instance of major surgery for removal of the spleen. During the months of August and September 1975 the Emergency Department of Straub Clinic reported the following skateboard injuries: 14 fractures, 14 soft tissue injuries, 5 lacerations, and 2 cerebral concussions. Of the 35 patients seen, three were admitted—one with an open fracture, one with cerebral concussion, and one with a skull fracture. During a four-week period (two weeks in June and July and two weeks in August and September) at the Emergency Department of Kaiser Medical Center, 66 cases of skateboard injuries were seen with six patients requiring admission for fractures and brain concussion.

Detecting Associations Between Knee Rotational Laxity and Kinematics in a Healthy Population

2013 ◽  
Author(s):  
Mahta Baghoolizadeh ◽  
Michael Zabala ◽  
Alison Keiper ◽  
Thomas Andriacchi
Keyword(s):  
Clinical Evidence ◽  
Soft Tissues ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Knee Kinematics ◽  
Knee Laxity ◽  
Healthy Population ◽  
Rotational Laxity ◽  
Rotational Kinematics ◽  
Clinical Problems

Passive knee laxity, which is determined by the soft tissues and articular structures of the knee, allows for the translation and rotation of the knee 1. While laxity increases following soft tissue injury, there is a lack of clinical evidence demonstrating a relationship between increased passive laxity and subsequent clinical problems such as osteoarthritis. However, there is increasing evidence that abnormal active rotational kinematics during walking are a potential risk factor for osteoarthritis (OA) initiation and progression 2. Establishing a relationship between passive knee laxity and active knee kinematics is therefore clinically important, but at present there is a paucity of information on the interaction between passive and active knee rotational movement.

scholarly journals Staged Subtalar Fusion for Severe Calcaneus Fractures with Bone Loss

2013 ◽  
Vol 7 (1) ◽  
pp. 614-618 ◽  
Author(s):  
Chad G. Williams ◽  
Michael J. Coffey ◽  
Peter Shorten ◽  
James D. Lyions ◽  
Richard T. Laughlin
Keyword(s):  
Soft Tissue ◽  
Bone Loss ◽  
Soft Tissues ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
High Energy ◽  
Fusion Procedure ◽  
Subtalar Fusion ◽  
Thorough Debridement ◽  
Calcaneus Fractures

Background: With high energy fractures to the calcaneus there is the potential for significant bone loss. The loss of bone can make it difficult to fully regain calcaneal alignment. In addition these fractures are often associated with significant soft tissue injury. These two factors make it difficult to address this injury in a single stage, and can have significant complications. To address these issues our initial goal in treatment has been restoration of calcaneal alignment and stabilization of the surrounding soft tissue, followed by delayed/staged subtalar arthrodesis. Methods: Patients with calcaneus fractures treated by a single surgeon from 2002 to 2012 were reviewed. Injuries which were found to have medial extrusion of the posterior facet and bone loss, and subsequently underwent a staged protocol involving early provisional fixation and late subtalar fusion were included. Results: We treated 6 calcaneus fractures with bone loss. All patients were treated with staged subtalar fusion after initial irrigation and debridement and provisional fixation. No soft-tissue complications were noted after the fusion procedure in any of the six cases. Fusion occurred in all six patients at an average of 20.6 weeks (range, 13-23 weeks). All patients were able to ambulate and wear a regular shoe by one year following the initial injury. Conclusion: It is important in the high energy calcaneus fracture to assess for both soft tissue integrity and bone loss. A thorough debridement of both the soft tissues and any devitalized bone should be performed as well as provisional fixation which attempts to restore near normal calcaneal anatomy. Definitive fusion should not be performed until the soft tissues have fully recovered.

scholarly journals Saracatinib is an efficacious clinical candidate for fibrodysplasia ossificans progressiva

2020 ◽  
Author(s):  
Eleanor Williams ◽  
Jana Bagarova ◽  
Georgina Kerr ◽  
Dong-Dong Xia ◽  
Elsie S. Place ◽  
...  
Keyword(s):  
Heterotopic Ossification ◽  
Soft Tissues ◽  
Kinase Inhibitor ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Biologically Active ◽  
Fibrodysplasia Ossificans Progressiva ◽  
Heterotopic Bone ◽  
Transgenic Mouse Line ◽  
Clinical Candidate

AbstractCurrently, no effective therapies exist for fibrodysplasia ossificans progressiva (FOP), a rare congenital syndrome in which heterotopic bone is formed in soft tissues due to dysregulated activity of the bone morphogenetic protein (BMP) receptor kinase ALK2/ACVR1. From a screen of known biologically active compounds, we identified saracatinib as a potent ALK2 kinase inhibitor. In enzymatic and cell-based assays, saracatinib preferentially inhibited ALK2 compared with other receptors of the BMP/TGFβ signaling pathway, and induced dorsalization in zebrafish embryos consistent with BMP antagonism. We further tested the efficacy of saracatinib using an inducible ACVR1Q207D transgenic mouse line, which provides a model of heterotopic ossification, as well as an inducible ACVR1R206H knock-in, which serves as a genetically and physiologically faithful model of FOP. In both models, saracatinib was well tolerated and potently inhibited the development of heterotopic ossification even when administered transiently following soft tissue injury. Together, these data suggest that saracatinib is an efficacious clinical candidate for repositioning in the treatment of FOP, offering an accelerated path to clinical proof of efficacy studies and potentially significant benefits to individuals with this devastating condition.

scholarly journals Intra- and interobserver agreement on the Oestern and Tscherne classification of soft tissue injury in periarticular lower-limb closed fractures

2014 ◽  
pp. 173-178 ◽  
Author(s):  
Carlos Oliver Valderrama-Molina ◽  
Mauricio Estrada-Castrillón ◽  
Jorge Andres Hincapie ◽  
Luz Helena Lugo-Agudelo
Keyword(s):  
Soft Tissue ◽  
Tibial Plateau ◽  
Interobserver Agreement ◽  
Soft Tissues ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Case Series ◽  
Lower Extremities ◽  
Tibial Pilon ◽  
Pilon Fractures

Background: The soft tissues injury in periarticular fractures of the lower extremities determines the proper time to perform bone fixation. Objetive: The aim of this study was to determine the intra and interobserver agreement in the Tscherne classification. Methods: This is a descriptive, prospective study for patients admitted to the Pablo Tobón Uribe Hospital (PTUH) with tibial plateau or tibial pilon fractures. We performed a standardize evaluation using video photography at the time of admission and 24, 48, and 72 h after admission. Fifteen five reviewers who had various levels of training produced a total of 1,200 observations. The intra- and interobserver agreement was assessed using a weighted kappa for multiple raters and more than two categories. Results: Twenty patients were admitted with tibial plateau and tibial pilon fractures. The intraobserver agreement for all 15 raters was kappa 0.81 (95% CI 0.79-0.83), and the interobserver agreement for all 15 raters was kappa 0.65 (95% CI 0.55-0.73). The interobserver agreement at 24 h was kappa 0.67 (95% CI 0.46-0.86). Conclusions:Classifying the severity of soft tissue injury is critical in planning the surgical management of fractures of the lower extremities. Based on our results, we can reasonably argue that the Tscherne classification produced an adequate level of agreement and could be used to standardize and to guide the treatment, and to conduct research studies. Level of Evidence: Level IV, Case Series

Sprains, strains and bruises

1976 ◽  
Vol 14 (17) ◽  
pp. 66-68
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Loss Of Function ◽  
Partial Tear ◽  
Complete Rupture

Sprain, strain and bruise are terms loosely used to denote injury of soft tissues. More precisely a sprain may be defined as a partial or complete rupture of a ligament, a strain as a partial tear of muscles and a bruise as a rupture of tissue leading to a haematoma. Any soft-tissue injury may lead to a haematoma, scarring and fibrosis and loss of function.

SURGICAL TACTICS FOR PURULENT-SEPTIC COMPLICATIONS OF COMBAT BELLY INJURIES

2021 ◽  
pp. 103-108
Author(s):  
O. S. Gerasimenko ◽  
Y. I. Gaida ◽  
A. V. Okolets ◽  
K. R. Muradian
Keyword(s):  
Surgical Treatment ◽  
Soft Tissues ◽  
Clinical Manifestations ◽  
Gunshot Wounds ◽  
Treatment Method ◽  
Combat Trauma ◽  
Comprehensive Treatment ◽  
Vacuum Therapy ◽  
Septic Complications ◽  
Severity Of Injury

Summary. Combat injury of the abdomen, according to the ATO / OOS is from 6.7 to 9 %. The specificity of gunshot wounds to the abdomen causes the development of functional disorders and complications (51–81 %) and, as a consequence, a high mortality rate (12–31 %). Objective: To improve the effectiveness of surgical treatment of purulent-septic complications in the wounded with combat trauma to the abdomen (BTC). Materials and methods. The Military Medical Clinical Center of the Southern Region (VMKC PR) analyzed the treatment of 86 wounded who were hospitalized with purulent-septic complications of BTZ from 2014 to 2020, taking into account the location, clinical manifestations and severity of injury, used modern treatment methods , namely: puncture and drainage interventions under the control of ultrasonography and installation of NPWT systems. Comprehensive treatment was supplemented with antibacterial therapy and oxygen barotherapy. First of all, the wounded underwent puncture and drainage interventions under ultrasonic navigation and gradual rehabilitation for diagnostic and therapeutic purposes. NPWT therapy was used in 11 patients with extensive wounds and purulent-septic complications of the soft tissues of the anterior abdominal wall. Thus, the use of interventional sonography, as the primary diagnostic and treatment method for the treatment of purulent-inflammatory complications of combat trauma to the abdomen, has improved the quality of diagnosis and reduced traumatic interventions, which has reduced postoperative complications and inpatient treatment. Results and discussion. Eleven (14.2 %) cases of puncture and drainage interventions were ineffective, in connection with which we had to resort to traditional methods of treatment — opening and drainage of purulent-inflammatory foci and the use of NPWT-therapy. Vacuum therapy is an effective method of treatment of purulent-septic complications of gunshot wounds of the soft tissues of the abdomen, which in combination with puncture-drainage interventions, can reduce by 2.5 times the number of repeated operations (mainly multi-stage surgical treatments), thereby reducing 1.8 times the length of stay of patients in the hospital. Conclusions. Thanks to the use of modern methods it was possible to improve the results of surgical treatment of purulent-septic complications in the wounded with purulent-septic complications of combat trauma to the abdomen. The use of the latest techniques has helped reduce the number of invasive treatments, accelerate recovery, reduce bed rest, reduce intoxication, and increase the rate of return of servicemen.

Hindfoot Containment Orthosis for Management of Bone and Soft-Tissue Defects of the Heel

2005 ◽  
Vol 26 (3) ◽  
pp. 198-203 ◽  
Author(s):  
Jeffrey E. Johnson ◽  
Jonas R. Rudzki ◽  
Erick Janisse ◽  
Dennis J. Janisse ◽  
Ray R. Valdez ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Revision Surgery ◽  
Soft Tissues ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Soft Tissue Defects ◽  
Heel Pad ◽  
Periodic Monitoring ◽  
Growth Change ◽  
Tissue Defects

Background: Bone, soft-tissue, and nerve deficits of the weightbearing surface of the foot are frequent sequelae from foot trauma or diabetes mellitus and present challenging treatment issues. Injury to the specialized, shock-absorbing, heel-pad tissue containing spirally arranged fat chambers is particularly difficult to manage. Appropriate footwear modifications and shoe inserts for protection of this skin are essential to the long-term management of bone and soft-tissue defects of the heel. This study evaluated the performance of a new custom total contact foot orthosis (Hindfoot Containment Orthosis, HCO) which was designed to contain the soft tissues of the heel, reduce shear forces, redistribute weightbearing load, and accommodate bone or soft-tissue deformity of the heel. Methods: Twenty-two patients treated with HCO were retrospectively reviewed. Followup averaged 26 months. The effectiveness of the orthosis was assessed by how well the integrity of the soft tissue was maintained (e.g. the number of ulcerations since dispensing the orthosis), the number of refabrications of the orthosis that were required, and whether or not revision surgery was required. Results: Ten patients had superficial ulcerations. No patient required revision surgery. A total of 62 refabrications of the orthoses in 22 patients were required over a 2-year period. Overall results were good in 17 (77%) patients, fair in four (18%), and poor in one. Conclusions: The HCO is effective for preservation of soft-tissue integrity of the heel pad after bony or soft-tissue injury. Important factors in achieving success with the HCO are patient compliance and periodic monitoring for refabrication of the orthosis to accommodate skeletal growth, change in foot size or shape, and compression or wear of insert materials.

Biomechanics of the toddler head during low-height falls: an anthropomorphic dummy analysis

2010 ◽  
Vol 6 (1) ◽  
pp. 57-68 ◽  
Author(s):  
Nicole G. Ibrahim ◽  
Susan S. Margulies
Keyword(s):  
Mechanical Load ◽  
Tissue Injury ◽  
Head Injuries ◽  
Skull Fracture ◽  
Angular Acceleration ◽  
Soft Tissue Injuries ◽  
Altered Mental Status ◽  
Neurological Impairment ◽  
Clinical Findings ◽  
Facial Soft Tissue

Object Falls are the most common environmental setting for closed head injuries in children between 2 and 4 years of age. The authors previously found that toddlers had fewer skull fractures and scalp/facial soft-tissue injuries, and more frequent altered mental status than infants for the same low-height falls (≤3 ft). Methods To identify potential age-dependent mechanical load factors that may be responsible for these clinical findings, the authors created an instrumented dummy representing an 18-month-old child using published toddler anthropometry and mechanical properties of the skull and neck, and they measured peak angular acceleration during low-height falls (1, 2, and 3 ft) onto carpet pad and concrete. They compared these results from occiput-first impacts to previously obtained values measured in a 6-week-old infant dummy. Results Peak angular acceleration of the toddler dummy head was largest in the sagittal and horizontal directions and increased significantly (around 2-fold) with fall height between 1 and 2 ft. Impacts onto concrete produced larger peak angular accelerations and smaller impact durations than those onto carpet pad. When compared with previously measured infant drops, toddler head accelerations were more than double those of the infant from the same height onto the same surface, likely contributing to the higher incidence of loss of consciousness reported in toddlers. Furthermore, the toddler impact forces were larger than those in the infant, but because of the thicker toddler skull, the risk of skull fracture from low-height falls is likely lower in toddlers compared with infants. Conclusions If similar fracture limits and brain tissue injury thresholds between infants and toddlers are assumed, it is expected that for impact events, the toddler is likely less vulnerable to skull fracture but more vulnerable to neurological impairment compared with the infant.

scholarly journals Is the skull x-ray a useful tool in paediatric blunt head injury and are we familiar with an abnormal finding?

2001 ◽  
Vol 5 (1) ◽  
pp. 45-47
Author(s):  
S. Andronikou ◽  
C. Welman ◽  
E. Kader ◽  
J. Venter ◽  
T. Kilborn
Keyword(s):  
Head Injury ◽  
Head Injuries ◽  
Skull Fracture ◽  
Ct Scanning ◽  
Skull Fractures ◽  
Subdural Haemorrhage ◽  
Abnormal Finding ◽  
X Ray ◽  
Neurologically Normal ◽  
Air Pockets

Skull X-ray (SXR) has been, and still is, used in some institutions to detect skull fractures in paediatric head injuries. When no clinical/neurological indication for computed tomography (CT) scanning exists, the presence of a skull fracture may be used as an indication for this. This case report demonstrates an unusual SXR finding of oval lucencies in a neurologically normal child who had sustained a head injury. The subsequent CT scan demonstrated a subacute subdural haemorrhage with air pockets, highlighting the need to recognise intracranial air. The literature is reviewed regarding the usefulness of SXR in childhood head injury.

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