scholarly journals RECTAL CULTURE SURVEILLANCE AND DEVELOPED SYSTEMIC INFECTIONS IN VANCOMYCIN-RESISTANT ENTEROCOCCI AND CARBAPENEM-RESISTANT KLEBSIELLA PNEUMONIAE CARRIERS

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Çiğdem Arabacı ◽  
Salih Emre
Keyword(s):  
Pelvic Ring ◽  
High Energy ◽  
Pelvic Fractures ◽  
Young Age ◽  
Economic Losses ◽  
Severe Bleeding ◽  
Care Hospital ◽  
Age Group ◽  
High Energy Trauma ◽  
Unstable Fractures

Introduction: Globally, in the young age group of people mortality and morbidity is due to the high-energy trauma.  The losing of young age group of population will get impact in the social economic losses of family as well as the nation. Fractures are generally caused by high-energy trauma, high-impact accidents and are often associated with injuries to other organic lesions like abdominal viscera, genitourinary system, neurovascular, musculoskeletal structures and central nervous system. There was relatively low rate of occurrence of facture of pelvic injuries that associated with high levels of morbidity and mortality. According to the studied of the post-mortem examined only in children 66 deaths caused by trauma that showing pelvic fracture and severe bleeding to be the cause of death in 42% of the cases. In the case of adult in cases of unstable pelvic fractures retroperitoneal bleeding is the worst complication. Aim: The main objective of this study is to study of Unstable Pelvic Fractures from children in tertiary care hospital Material and methods: In this study total 10 patients were included who had suffered unstable fractures of the pelvic ring with the age from  1 to 15 years old.. From all the patients detail clinical history were taken with analysis of the pre and postoperative radiographs by presence of the triradiate cartilage of the iliac. Result: In this study total 10 patients were included with unstable fractures of the pelvic ring evaluated where female were 6 and male were 4 with the ration 6: 4. The age ranges were 2 to 15 years with the mean age 7.5±4 years old. Symphysis disjunctions of the pubic facture were present in maximum with the facture of two rami and facture of four rami respectively. In five of the cases Sacroiliac dislocation correspond to posterior lesion were seen. The AO-OTA classification was used to evaluate the cases with the following distribution as 61 B1 (one case); 61 B2 (one case); 61 C3 (one cases), 61 C2 (one case) and 61 C1 (seven cases). Conclusion: Now  a day’s also many research which still have a controversy  for treatment,  which  has  been  recommended  for  treating  these  fractures  for  many  years. Their concerns relate  to  the  complications  encountered that in  leg  length  and  residual  pain in  the  sacroiliac  joint. Keywords:  unstable pelvic facture, pelvic asymmetry, children

scholarly journals STUDY OF UNSTABLE PELVIC FRACTURES FROM CHILDREN IN TERTIARY CARE HOSPITAL

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Shiva Acharya
Keyword(s):  
Tertiary Care Hospital ◽  
Pelvic Ring ◽  
Tertiary Care ◽  
High Energy ◽  
Pelvic Fractures ◽  
Young Age ◽  
Care Hospital ◽  
Age Group ◽  
High Energy Trauma ◽  
Unstable Fractures

INTRODUCTION: Globally, in the young age group of people mortality and morbidity is due to the high-energy trauma.  The losing of young age group of population will get impact in the social economic losses of family as well as the nation. Fractures are generally caused by high-energy trauma, high-impact accidents and are often associated with injuries to other organic lesions like abdominal viscera, genitourinary system, neurovascular, musculoskeletal structures and central nervous system. There was relatively low rate of occurrence of facture of pelvic injuries that associated with high levels of morbidity and mortality. According to the studied of the post-mortem examined only in children 66 deaths caused by trauma that showing pelvic fracture and severe bleeding to be the cause of death in 42% of the cases. In the case of adult in cases of unstable pelvic fractures retroperitoneal bleeding is the worst complication. AIM: The main objective of this study is to study of Unstable Pelvic Fractures from children in tertiary care hospital MATERIAL AND METHODS: In this study total 10 patients were included who had suffered unstable fractures of the pelvic ring with the age from  1 to 15 years old.. From all the patients detail clinical history were taken with analysis of the pre and postoperative radiographs by presence of the triradiate cartilage of the iliac. RESULT: In this study total 10 patients were included with unstable fractures of the pelvic ring evaluated where female were 6 and male were 4 with the ration 6: 4. The age ranges were 2 to 15 years with the mean age 7.5±4 years old. Symphysis disjunctions of the pubic facture were present in maximum with the facture of two rami and facture of four rami respectively. In five of the cases Sacroiliac dislocation correspond to posterior lesion were seen. The AO-OTA classification was used to evaluate the cases with the following distribution as 61 B1 (one case); 61 B2 (one case); 61 C3 (one cases), 61 C2 (one case) and 61 C1 (seven cases). CONCLUSION: Now  a day’s also many research which still have a controversy  for treatment,  which  has  been  recommended  for  treating  these  fractures  for  many  years. Their concerns relate  to  the  complications  encountered that in  leg  length  and  residual  pain in  the  sacroiliac  joint. KEYWORDS:  unstable pelvic facture, pelvic asymmetry, children

scholarly journals A STUDY ON SKELETALLY IMMATURE UNSTABLE PELVIC FRACTURES IN CHILDREN

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Rakesh Kumar Gupta ◽  
Dr. Mohkam Singh
Keyword(s):  
Surgical Treatment ◽  
Pelvic Fracture ◽  
Sacroiliac Joint ◽  
Pelvic Ring ◽  
Health Centre ◽  
High Energy ◽  
Pelvic Fractures ◽  
Severe Bleeding ◽  
Fractures In Children ◽  
Unstable Fractures

Introduction: Out of all factures the pelvic facture showed relatively less which account for 3%. In children Pelvic fractures are relatively rare as less than 0.2% of all paediatric fractures and 1-5% of admissions to tertiary children’s health centre. Pelvis is a structure like a basin shaped bony which supports the spinal column and protects the abdominal organs. It may be facture due to high energy forces such as fall from a height or motor vehicle crash.  Incident of pelvic fracture is increasing and these are associated with a high mortality rate of 25%. There was relatively low rate of occurrence of facture of pelvic injuries that associated with high levels of morbidity and mortality. According to the studied of the post-mortem examined only in children 66 deaths caused by trauma that showing pelvic fracture and severe bleeding to be the cause of death in 42% of the cases. In the case of adult in cases of unstable pelvic fractures retroperitoneal bleeding is the worst complication. When involving emergency situation cases with hemodynamic instability immediate treatment must be conducted using an external fixation, though it is only for temporarily to prioritise controlling the bleeding and saving the patient’s life. Aim: The main objective of this study is to study the surgical treatment for unstable pelvic fractures in children and stabilisation on basic primary care provided at an emergency service. Material and methods: In this study total 10 children patients were included who had suffered unstable fractures of the pelvic ring. From all the patients detail clinical history were taken with analysis of the pre and postoperative radiographs by presence of the triradiate cartilage of the iliac. This study was based on radiographic quantification and the outcome of the residual pelvic and after the surgery treatment using the method of Keshishyan et al[i] for comparison of pre and post operative findings. Result: In this study unstable fractures of the pelvic ring evaluated where female were 7 and male were 3 with the ration 7: 3. The ranges were 2 to 13 years with the mean age 7.2 years old. For all the patients operation was done on an average of 12.3 days after the facture. The maximum cases the initial traumas were due to the run over followed by motorcycle accident and fall from height respectively.  The injuries of the pelvis joint were divided inti anterior and posterior.  Symphysis disjucction of the pubic facture were present in maximum with the facture of two rami and facture of four rami respectively. In five of the cases Sacroiliac dislocation correspond to posterior lesion were seen. Unilateral fractures of the posterior ilium were also seen whereas unilateral anterior opening of the sacroiliac joint was also present. Conclusion: In children facture of pelvic ring is rare and an indication for surgical treatment is unusual.  Their concerns relate  to  the  complications  encountered that in  leg  length  and  residual  pain in  the  sacroiliac  joint. Hence for the justification, this study finding provides justifies the option of surgical treatment for reduction and correction of pelvic deformities, of the pelvic ring at an early stage, at the time of the injury. Keywords: children, unstable pelvic facture, pelvic ring, Pelvic asymmetry

scholarly journals STUDY OF CLINICOPATHOLOGIC PROFILES OF PATIENTS WITH BENIGN BREAST DISEASE

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Rameshwar Dayal Goyal ◽  
Dr. Akhlesh Kumar Srivastava
Keyword(s):  
Surgical Treatment ◽  
Pelvic Fracture ◽  
Sacroiliac Joint ◽  
Motor Vehicle ◽  
Pelvic Ring ◽  
Health Centre ◽  
High Energy ◽  
Pelvic Fractures ◽  
Severe Bleeding ◽  
Unstable Fractures

Introduction: Out of all factures the pelvic facture showed relatively less which account for 3%. In children Pelvic fractures are relatively rare as less than 0.2% of all paediatric fractures and 1-5% of admissions to tertiary children’s health centre. Pelvis is a structure like a basin shaped bony which supports the spinal column and protects the abdominal organs. It may be facture due to high energy forces such as fall from a height or motor vehicle crash.  Incident of pelvic fracture is increasing and these are associated with a high mortality rate of 25%. There was relatively low rate of occurrence of facture of pelvic injuries that associated with high levels of morbidity and mortality. According to the studied of the post-mortem examined only in children 66 deaths caused by trauma that showing pelvic fracture and severe bleeding to be the cause of death in 42% of the cases. In the case of adult in cases of unstable pelvic fractures retroperitoneal bleeding is the worst complication. When involving emergency situation cases with hemodynamic instability immediate treatment must be conducted using an external fixation, though it is only for temporarily to prioritise controlling the bleeding and saving the patient’s life. Aim: The main objective of this study is to study the surgical treatment for unstable pelvic fractures in children and stabilisation on basic primary care provided at an emergency service. Material and methods: In this study total 10 children patients were included who had suffered unstable fractures of the pelvic ring. From all the patients detail clinical history were taken with analysis of the pre and postoperative radiographs by presence of the triradiate cartilage of the iliac. This study was based on radiographic quantification and the outcome of the residual pelvic and after the surgery treatment using the method of Keshishyan et al[i] for comparison of pre and post operative findings. Result: In this study unstable fractures of the pelvic ring evaluated where female were 7 and male were 3 with the ration 7: 3. The ranges were 2 to 13 years with the mean age 7.2 years old. For all the patients operation was done on an average of 12.3 days after the facture. The maximum cases the initial trauma were due to the run over followed by motorcycle accident and fall from height respectively.  The injuries of the pelvis joint were divided inti anterior and posterior.  Symphysis disjucction of the pubic facture were present in maximum with the facture of two rami and facture of four rami respectively. In five of the cases Sacroiliac dislocation correspond to posterior lesion were seen. Unilateral fractures of the posterior ilium were also seen whereas unilateral anterior opening of the sacroiliac joint was also present. Conclusion: In children facture of pelvic ring is rare and an indication for surgical treatment is unusual.  Their concerns relate  to  the  complications  encountered that in  leg  length  and  residual  pain in  the  sacroiliac  joint. Hence for the justification, this study finding provides justifies the option of surgical treatment for reduction and correction of pelvic deformities, of the pelvic ring at an early stage, at the time of the injury. Keywords: children, unstable pelvic facture, pelvic ring, Pelvic asymmetry

Angiography in patients with pelvic fractures and contrast extravasation on CT following high-energy trauma

2021 ◽  
Author(s):  
Jonathan Hammerschlag ◽  
Yehuda Hershkovitz ◽  
Itamar Ashkenazi ◽  
Zahar Shapira ◽  
Igor Jeroukhimov
Keyword(s):  
High Energy ◽  
Pelvic Fractures ◽  
Contrast Extravasation ◽  
High Energy Trauma

Management of urological trauma associated with pelvic fractures

2021 ◽  
Vol 82 (1) ◽  
pp. 1-9
Author(s):  
Amaury Trockels ◽  
Aashish K Ahluwalia ◽  
Andrew Chetwood
Keyword(s):  
Pelvic Ring ◽  
High Energy ◽  
Pelvic Fractures ◽  
Initial Assessment ◽  
Urethral Injury ◽  
Bladder Rupture ◽  
Collaborative Management ◽  
High Incidence ◽  
Pelvic Ring Disruption

Urological trauma is frequently encountered in patients with high energy pelvic fractures and can have debilitating long-term sequelae for patients without appropriate multidisciplinary management. Anterior pelvic ring disruption causes a high incidence of bladder rupture and urethral injuries, and initial assessment requires urological tract imaging and emergent bladder drainage before subsequent surgical repair. Pelvic ring disruption requires urgent fixation and should be managed as an open fracture in the context of significant bladder and urethral injury with urinary leakage. Long-term outcomes are variable and genitourinary dysfunction is commonly reported among patients with pelvic fractures. Optimisation of patient outcomes relies heavily on collaborative management between orthopaedic and urological specialists and requires an appreciation of the anatomical intricacies of the pelvis. This article provides an overview of the British Orthopaedic Association Standards for Trauma and Orthopaedics management of urological trauma in the context of pelvic fractures.

scholarly journals Simultaneous Ipsilateral Pediatric Fractures of the Elbow and Forearm Attending a Tertiary Care Hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 35 ◽  
Author(s):  
Ruban Raj Joshi ◽  
Rajeev Dwivedi ◽  
Subin Byanjankar ◽  
Rahul Shrestha
Keyword(s):  
Forearm Fracture ◽  
Tertiary Care ◽  
High Energy ◽  
Care Hospital ◽  
Forearm Fractures ◽  
Supracondylar Fractures ◽  
High Energy Trauma ◽  
K Wires ◽  
Floating Elbow

Introduction: Ipsilateral supracondylar humerus and forearm fractures in the pediatric population are an uncommon injury associated with high-energy trauma. The incidence varies between 3% and 13%. Our aim was to conduct a descriptive analysis on seventeen cases of children with floating elbow injuries who attended our institution and to review the literature relating to this topic.   Methods: Between April 2013 to March 2016, data were obtained through the medical records. Children who had completely displaced supracondylar fractures of the humerus associated with ipsilateral forearm fracture were reviewed. All patients underwent operative reduction and percutaneous K-wire stabilization. At mean follow up of 12.9 months, all patients were assessed clinically and radiologically. The following variables were used: age, gender, side, mechanism, type of fracture, classification, treatment and complications.   Results: Seventeen pediatric "floating elbow" cases that had operative management were identified. Twelve (70.5%%) were male and five (29.4%) female. The mean age was 9.5 (SD=2.1) years, ranging from six to 14 years. The left side was predominantly affected (70.5%). The commonest injury mechanism was fall from a height (76.47%). All the supracondylar fractures were Gartland type III. Majority of forearm fractures (76.4%) were at distal meta diaphyseal region. Distal radius physeal fractures were diagnosed in three patients. Open fractures occurred in three cases (17.6%). All supracondylar fractures were reduced and fixed using K-wires. There was one radial nerve, and three median nerve injury. Five patients had pin tract related complications. Fifteen (88.2%) patients had good to excellent, two had fair in terms of modified Flynn criteria in last month follow up. All patients went on to radiographic union without secondary procedures.   Conclusions: This, uncommon injury in most cases, results from high-energy trauma. Early surgical treatment for both fractures is required in the form simultaneous closed reduction of the displaced forearm fracture followed by supracondylar fixation with K-wires. This provides not only stable fixation but also allows close observation for early sign and symptom of development of compartment syndrome.

Risks and Strategies to Avoid Approach-Related Complications During Operative Treatment of Pelvic Ring or Acetabular Fractures

2019 ◽  
Author(s):  
Markus Alexander Küper ◽  
Alexander Trulson ◽  
Christian Minarski ◽  
Fabian Stuby ◽  
Ulrich Stöckle ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Impact Energy ◽  
Geriatric Patients ◽  
Pelvic Ring ◽  
Young Patients ◽  
High Energy ◽  
Surgical Approaches ◽  
Acetabular Fractures ◽  
Anatomical Structures ◽  
High Energy Trauma

AbstractInjuries of the pelvic ring or the acetabulum are either to be found in young patients with high energy trauma mechanisms or in geriatric patients after simple falls with very low impact energy. The indication for surgical stabilization is given by the grade of instability. Exact knowledge of the different possible surgical approaches is essential for the planning of the surgical treatment. Both, knowledge of reachable anatomical structures and possible risks of the different approaches are important. In this review, we summarize the standard surgical approaches to the pelvic ring and to the acetabulum. We describe the reachable anatomical structures for each approach, approach-related pitfalls, and we focus on strategies to reduce approach-related complications.

Emergent management of the suspected pelvic fracture: challenges in the obese patient

2018 ◽  
Vol 164 (6) ◽  
pp. 432-435 ◽  
Author(s):  
Sarah K Stewart ◽  
M Khan
Keyword(s):  
Obese Patient ◽  
Pelvic Fracture ◽  
Independent Risk Factor ◽  
High Energy ◽  
Pelvic Fractures ◽  
Morbidity And Mortality ◽  
High Energy Trauma ◽  
Pelvic Binder ◽  
Trauma Population ◽  
Obese Population

Pelvic fractures, although infrequent, are a significant cause of morbidity and mortality in the trauma population. Currently, the mainstay of emergent management of a suspected pelvic fracture is placement of a pelvic binder, and their use in the prehospital setting is recommended for any individual involved in high-energy trauma. Obesity in the trauma patient has been shown to be an independent risk factor of morbidity and mortality, and the incidence of pelvic and lower extremity fractures has consistently demonstrated to be higher in the obese patient compared with an individual with a normal body habitus. This article aims to highlight the challenges associated with pelvic fracture in the obese population.

scholarly journals A Traumatic Direct Inguinal Hernia from Pelvic Ring Disruption

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Kevin L. Chow ◽  
Eduardo Smith-Singares ◽  
James Doherty
Keyword(s):  
Inguinal Hernia ◽  
Abdominal Wall ◽  
Pelvic Fracture ◽  
Pelvic Ring ◽  
Abdominal Wall Reconstruction ◽  
High Energy ◽  
Pelvic Fractures ◽  
Open Book ◽  
Direct Inguinal Hernia ◽  
Muscle Fascia

Introduction. Pelvic fractures usually involve a high-energy traumatic mechanism and account for approximately 3% of all blunt traumatic skeletal injuries. Additional musculoskeletal injuries are found in over 80% of unstable pelvic fractures. Traumatic abdominal wall hernias (TAWHs) are a rare entity, and traumatic inguinal hernias (TIHs) associated with open-book pelvic fractures have not been described previously.Case Presentation. We present the case of a 45-year-old male motorcyclist involved in a collision resulting in a traumatic direct inguinal hernia due to abdominal wall disruption from an open-book pelvic fracture. He underwent a combined operation with an open reduction and internal fixation (ORIF) of his pelvic fracture and an abdominal wall reconstruction with a modified Stoppa technique utilizing mesh for his hernia.Discussion. This is a unique presentation of a TIH due to an open-book pelvic fracture after blunt abdominal trauma. The formation of TAWH is typically from a combination of local tangential shearing forces and a sudden rise in intraabdominal pressures damaging the muscle, fascia, and peritoneum while the skin remains intact. In patients without hollow viscous injuries and gross contamination, these hernias can be repaired safely with mesh in the acute setting simultaneously with pelvic reduction.

scholarly journals Management of Hemodynamically Unstable Pelvic Ring Fractures

2020 ◽  
Vol 7 ◽  
Author(s):  
Kim E. M. Benders ◽  
Luke P. H. Leenen
Keyword(s):  
Pelvic Ring ◽  
Treatment Algorithm ◽  
High Energy ◽  
Pelvic Trauma ◽  
Pelvic Fractures ◽  
Origin Time ◽  
Pelvic Packing ◽  
Pelvic Ring Fractures ◽  
Primary Means ◽  
Set Up

Hemodynamically unstable pelvic fractures are challenging high-energy traumas. In many cases, these severely injured patients have additional traumatic injuries that also require a trauma surgeon's attention. However, these patients are often in extremis and require a multidisciplinary approach that needs to be set up in minutes. This calls for an evidence-based treatment algorithm. We think that the treatment of hemodynamically unstable pelvic fractures should primarily involve thorough resuscitation, mechanical stabilization, and preperitoneal pelvic packing. Angioembolization should be considered in patients that remain hemodynamically unstable. However, it should be used as an adjunct, rather than a primary means to achieve hemodynamic stability as most of the exsanguinating bleeding sources in pelvic trauma are of venous origin. Time is of the essence in these patients and should therefore be used appropriately. Hence, the hemodynamic status and physiology should be the driving force behind each decision-making step within the algorithm.

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