scholarly journals PO 18069 - Management of soft-tissue injuries in lower extremity fractures

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 7S
Author(s):  
Rafael Da Rocha Macedo ◽  
João Paulo Gonçalves dos Santos ◽  
Dario Putini ◽  
Luciano Miller Reis Rodrigues
Keyword(s):  
Soft Tissue ◽  
Literature Review ◽  
Lower Extremity ◽  
Soft Tissue Injuries ◽  
Tibial Plafond ◽  
Management Protocol ◽  
Definitive Surgery ◽  
Tibial Plafond Fractures ◽  
Treatment Alternatives ◽  
Severe Soft Tissue

Introduction: Patients with lower extremity fractures have a high incidence of peri- and postoperative complications, such as extensive swelling, blisters, surgical wound infection, slow wound healing, persistent wound drainage and suture dehiscence. In calcaneal and tibial plafond fractures and ankle fractures/dislocations, especially in patients older than 50 years and those with diabetes, these complications are associated with a longer hospital stay and increased treatment costs and morbidity and mortality rates. The objective of this study is to perform a literature review of the management of blisters in lower extremity fractures and, based on the findings, to develop a management protocol for these lesions.  Methods: Literature review of the state of the art in international databases. Articles published in indexed journals from 1995 to 2014 addressing soft-tissue management in ankle, calcaneal and tibial plafond fractures were selected. Results: Various treatment methods have been described in the literature: observation without intervention, application of sterile dressing, content aspiration, removal of the blister roof and application of an antibiotic ointment or topical treatment alone; all have similar outcomes regarding the delay in definitive surgery and the incidence of mild and severe soft-tissue complications. No large studies comparing these treatment alternatives are available. Conclusion: There is no consensus in the literature on the proper management of blisters. Further studies should be performed to define a protocol for the management of these lesions.

Skeletal and soft tissue injuries after manual and mechanical chest compressions

2019 ◽  
Vol 5 (3) ◽  
pp. 259-265 ◽  
Author(s):  
Niklas Friberg ◽  
Simon Schmidbauer ◽  
Charles Walther ◽  
Elisabet Englund
Keyword(s):  
Cardiac Arrest ◽  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Chest Compressions ◽  
Sternal Fracture ◽  
Tissue Injuries ◽  
Severe Soft Tissue ◽  
Severe Soft Tissue Injury

Abstract Aims To determine the rate of injuries related to cardiopulmonary resuscitation (CPR) in cardiac arrest non-survivors, comparing manual CPR with CPR performed using the Lund University Cardiac Assist System (LUCAS). Methods and results We prospectively evaluated 414 deceased adult patients using focused, standardized post-mortem investigation in years 2005 through 2013. Skeletal and soft tissue injuries were noted, and soft tissue injuries were evaluated with respect to degree of severity. We found sternal fracture in 38%, rib fracture in 77%, and severe soft tissue injury in 1.9% of cases treated with CPR with manual chest compressions (n = 52). Treatment with LUCAS CPR (n = 362) was associated with significantly higher rates of sternal fracture (80% of cases), rib fracture (96%), and severe soft tissue injury (10%), including several cases of potentially life-threatening injuries. Conclusion LUCAS CPR causes significantly more CPR-related injuries than manual CPR, while providing no proven survival benefit on a population basis. We suggest judicious use of the LUCAS device for cardiac arrest.

scholarly journals Improper Acupuncture Causing Severe Multiple Soft Tissue Damage: A Case Report

2020 ◽  
Author(s):  
yulong xie ◽  
yan peng ◽  
wengzong zhou ◽  
qiantong qin ◽  
hui wang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Acupuncture Treatment ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Soft Tissue Injuries ◽  
Small Range ◽  
Stroke Patients ◽  
Coagulation Dysfunction ◽  
Severe Soft Tissue ◽  
Severe Soft Tissue Injury

Abstract Background Acupuncture therapy is well known. But there is no report that acupuncture in patients with coagulation dysfunction in stroke may lead to severe soft tissue injury. we report a case of acupuncture leading to severe soft tissue injury.Methods A 63-year-old female patient was hospitalized for stroke rehabilitation. After 2 years of discharge, severe subcutaneous hematoma caused by acupuncture was readmitted to hospital. She received medication and physical rehabilitation. we monitored the international standardized ratio (INR) in plasma and observed the degree of dissipation of subcutaneous hematoma. the changes of patients during treatment were explored by data analysis.Findings Subcutaneous hematoma (area 20×20 cm) disappeared completely after 3 weeks of physical factor therapy. Small range (area ≤3×3 cm) subcutaneous hematoma can heal itself within 2 weeks. Improper acupuncture is only one of the causes of soft tissue injury. Stroke with coagulation dysfunction is not a contraindication of acupuncture treatment.Interpretation Our report suggests that previously unanticipated acupuncture treatment for stroke patients with coagulation dysfunction may lead to severe multiple soft tissue injuries. Although coagulation dysfunction is not a contraindication of acupuncture treatment, acupuncture treatment for stroke patients with coagulation dysfunction should be vigilant, strengthen the level of acupuncture operation, and fundamentally eliminate the problem. These cases are validation and supplement of adverse clinical reactions caused by improper acupuncture.

Tibial plafond fractures

2011 ◽  
Author(s):  
J.L. Marsh
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Preoperative Planning ◽  
Distal Tibia ◽  
Soft Tissue Envelope ◽  
Tibial Plafond ◽  
Tibial Plafond Fractures

♦ Tibial plafond fractures demand respect, largely due to the fragile soft tissue envelope that surrounds the distal tibia♦ Careful preoperative planning followed by meticulous operative handling of the soft tissues is required to avoid devastating complications.

Soft Tissue Infection after Missile Injuries to the Extremities–A Non-Randomized, Prospective Study in Gaza City

2007 ◽  
Vol 22 (2) ◽  
pp. 106-108 ◽  
Author(s):  
Hazem M. Hamouda ◽  
Eivind Witsø ◽  
Nedal K.E. Moghani ◽  
Ahmed Shahwan ◽  
Øystein P. Nygaard
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Tissue Damage ◽  
Soft Tissue Injuries ◽  
Tissue Infection ◽  
Soft Tissue Damage ◽  
Safe Procedure ◽  
Infected Wound ◽  
Severe Soft Tissue

AbstractIntroduction:Patients with soft tissue injuries caused by missile attacks during wartime have been treated with radical debridement and delayed closure. In a study in Gaza City, the rate of infection of missile injuries to the extremities when treated with minimal surgical intervention, was measured.Methods:Patients with severe soft tissue damage, compound fractures, and injuries to major blood vessels and/or nerves were excluded from the study. One hundred fourteen patients were treated according to a standardized regime that included a superficial, minor surgery revision of the inlet and the outlet opening, and antibiotic treatment. Local soft tissue infection was defined as the presence of at least two signs of local infection.Results:A total of 109 out of 114 patients attended the first follow-up visit. Eleven (10%) of these patients had an infected wound. A total of 105 of the patients (92%) attended a second follow-up. None of these patients had an infected wound.Conclusions:Under conditions with a high number of causalities, minimal surgical treatment followed by the administration of antibiotics is a safe procedure for patients with penetrating missile injuries and less severe soft tissue damage.

Complications and Soft Tissue Coverage Following Complete Articular, Open Tibial Plafond Fractures

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jeffrey J. Olson ◽  
Krishna Anand ◽  
John G. Esposito ◽  
Arvind G. von Keudell ◽  
Edward K. Rodriguez ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Coverage ◽  
Tibial Plafond ◽  
Tibial Plafond Fractures

1343 Post-Operative Outcomes of Circular External Fixation in The Treatment of Tibial Plafond Fractures: A Systematic Review

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
P Legg ◽  
Y Ibrahim ◽  
K Malik-Tabassum
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
External Fixation ◽  
Complication Rate ◽  
Risk Of Bias ◽  
Tibial Plafond ◽  
Anatomic Reduction ◽  
Outcome Scores ◽  
Tibial Plafond Fractures ◽  
Mean Time

Abstract Introduction Tibial plafond fractures (TPF) are uncommon but potentially devastating injuries to the ankle. Meticulous care of the associated soft tissue injury is imperative in managing these fractures. The reported benefits of circular external fixation (CEF) include the ability to affect fracture reduction and create stable fixation, while limiting further soft tissue insult. This article provides the systematic review of the clinical and functional outcomes of TPF treated definitively with CEF. Method A literature search from inception to 13th November 2020 was performed. Quality and risk of bias was assessed using standardised scoring tools. Results 16 studies were included. 303 patients were analysed. Mean follow-up was 35 months. The mean time in CEF was 18 weeks and mean time to union was 21 weeks. Non-union and malunion occurred in 3.2% and 12.4% respectively. The overall complication rate was 12.3%. The rate of deep infection was 4.8%. No amputations were reported. Minor soft tissue infection (including pin site infections) accounted for 56.7% of complications. Almost two-thirds achieved good-to-anatomic reduction radiologically. Mean range of motion assessments were 11.8 and 24.8 degrees in dorsiflexion and plantarflexion, respectively. Approximately one-third reported excellent functional outcome scores. Quality of the studies was deemed satisfactory. A moderate risk of bias was acknowledged. Conclusions This systematic review provides an evidence-based summary, which highlights CEF as an acceptable treatment option with comparable complication rate and outcome scores to that of internal fixation. However, we acknowledge that high quality evidence is still lacking.

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