scholarly journals Defining current facial fracture patterns in a quaternary institution following high-velocity blunt trauma

2016 ◽  
Vol 20 (1) ◽  
Author(s):  
Senzwesihle C. Magagula ◽  
Timothy Hardcastle
Keyword(s):  
Retrospective Study ◽  
Blunt Trauma ◽  
Classification System ◽  
High Velocity ◽  
Bone Fractures ◽  
Treatment Plan ◽  
Facial Fractures ◽  
Le Fort ◽  
The Face ◽  
Le Fort Classification

Background: In the early 20th century, René Le Fort studied facial fractures resulting from blunt trauma and devised a classification system still in common use today. This classification, however, was based on low-velocity trauma. In modern practice, in a quaternary-level referral hospital, patients are often admitted following high-velocity injuries that mostly result from motor vehicle collisions.Objectives: A retrospective study to define facial bone fractures occurring subsequent to highvelocity trauma.Method: A retrospective study comprising the review of CT scans of 52 patients with highvelocity facial fractures was performed between April 2007 and March 2013. Injuries were classified using the Le Fort classification system. Deviations from the true Le Fort types, which are often depicted in the literature as occurring bilaterally and symmetrically, were documented; these included unilaterality, occurrence of several Le Fort fractures on one side of the face, occurrence of several Le Fort fractures on different levels and on different sides of the face, and occurrence of other fractures in addition to Le Fort fractures.Results: Of the 52 cases, 12 (23%) had Le Fort injuries, with true Le Fort fractures occurring in only 1, and 11 deviating from the classic description. Nine patients had Le Fort fractures and additional fractures. Mandibular and zygomatic bone fractures were found to be common associations with Le Fort injuries, occurring in 58% and 33% of the cases respectively.Conclusion: Fractures occurring in modern practice often deviate from the traditional Le Fort classification. Precise recognition of these deviations and recognition of additional associated fractures is pivotal in their management, assisting the surgeon in determining the treatment plan, such as the surgical approach and the order in which to fix the various fractured components.

scholarly journals The effects of a preoperative multidisciplinary conference on outcomes for high-risk patients with challenging surgical treatment options: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masayoshi Koike ◽  
Mie Yoshimura ◽  
Yasushi Mio ◽  
Shoichi Uezono
Keyword(s):  
Patient Safety ◽  
Retrospective Study ◽  
High Risk ◽  
Treatment Plan ◽  
Treatment Options ◽  
High Risk Patients ◽  
Appropriate Treatment ◽  
Risk Patients ◽  
Treatment Plans ◽  
Multidisciplinary Conference

Abstract Background Surgical options for patients vary with age and comorbidities, advances in medical technology and patients’ wishes. This complexity can make it difficult for surgeons to determine appropriate treatment plans independently. At our institution, final decisions regarding treatment for patients are made at multidisciplinary meetings, termed High-Risk Conferences, led by the Patient Safety Committee. Methods In this retrospective study, we assessed the reasons for convening High-Risk Conferences, the final decisions made and treatment outcomes using conference records and patient medical records for conferences conducted at our institution from April 2010 to March 2018. Results A total of 410 High-Risk Conferences were conducted for 406 patients during the study period. The department with the most conferences was cardiovascular surgery (24%), and the reasons for convening conferences included the presence of severe comorbidities (51%), highly difficult surgeries (41%) and nonmedical/personal issues (8%). Treatment changes were made for 49 patients (12%), including surgical modifications for 20 patients and surgery cancellation for 29. The most common surgical modification was procedure reduction (16 patients); 4 deaths were reported. Follow-up was available for 21 patients for whom surgery was cancelled, with 11 deaths reported. Conclusions Given that some change to the treatment plan was made for 12% of the patients discussed at the High-Risk Conferences, we conclude that participants of these conferences did not always agree with the original surgical plan and that the multidisciplinary decision-making process of the conferences served to allow for modifications. Many of the modifications involved reductions in procedures to reflect a more conservative approach, which might have decreased perioperative mortality and the incidence of complications as well as unnecessary surgeries. High-risk patients have complex issues, and it is difficult to verify statistically whether outcomes are associated with changes in course of treatment. Nevertheless, these conferences might be useful from a patient safety perspective and minimize the potential for legal disputes.

scholarly journals Partially Thrombosed Internal Maxillary Pseudoaneurysm after Gunshot Wound

2016 ◽  
Vol 9 (4) ◽  
pp. 335-337 ◽  
Author(s):  
Menachem Gold
Keyword(s):  
Gold Standard ◽  
Gunshot Wound ◽  
Bone Fractures ◽  
Maxillary Artery ◽  
Digital Subtraction ◽  
Fat Pad ◽  
Facial Bone ◽  
Artery Pseudoaneurysm ◽  
Ct Angiogram ◽  
The Face

A 29-year-old man arrived in our emergency department after being shot on the face. Computed tomography (CT) revealed multiple facial bone fractures along the bullet trajectory. On day 10 of admission, CT angiogram of the neck revealed a partially thrombosed pseudoaneurysm in the parapharyngeal fat pad. The pseudoaneurysm was successfully treated with coil embolization. This report discusses diagnosis and treatment of a partially thrombosed internal maxillary artery pseudoaneurysm. Although digital subtraction angiography is the gold standard for pseudoaneurysm diagnosis, CT angiography may provide complimentary information, as seen in this case.

Reconstruction After Grizzly Bear Attack in Wyoming

2021 ◽  
pp. 000313482110505
Author(s):  
Bryce M. Ingram ◽  
Christina M. Colosimo ◽  
John S. Weaver ◽  
Caleb J. Mentzer ◽  
James R. Yon
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Multidisciplinary Care ◽  
Upper Extremities ◽  
Grizzly Bear ◽  
Facial Fractures ◽  
Injury Patterns ◽  
Upper Lip ◽  
The Face ◽  
Head Neck

Bear attacks are rare, although global incidents have been increasing. Injury patterns of bear attacks against humans consistently include injuries to the face, head, neck, chest, and upper extremities. Here, we have a brief report of a 59-year-old male hunter who was attacked by a grizzly bear in Wyoming. He sustained multiple lacerations to his face which included an avulsion of his nose and upper lip, as well as extensive associated facial fractures. Additional injuries included soft tissue and bony injuries to the upper extremities. He underwent 53 operations during his first hospitalization, primarily of facial reconstruction, which required nose and upper lip replant to his arm. His course was complicated by pressure ulcers, bacteria, acute kidney injury, and a urinary tract infection. After successful coordinated multidisciplinary care and a prolonged hospitalization, he was ultimately discharged to his home.

P.124 A retrospective study of the ethiopathogenesis of the facial fractures in the last five years in our department

2006 ◽  
Vol 34 ◽  
pp. 163
Author(s):  
R. Luaces Rey ◽  
J.L. Crespo Escudero ◽  
B. Patiño ◽  
J.L. López-Cedrún
Keyword(s):  
Retrospective Study ◽  
Facial Fractures

Facial Fractures: Beyond Le Fort

2008 ◽  
Vol 41 (1) ◽  
pp. 51-76 ◽  
Author(s):  
Rebecca E. Fraioli ◽  
Barton F. Branstetter ◽  
Frederic W.-B. Deleyiannis
Keyword(s):  
Facial Fractures ◽  
Le Fort

Real-life efficacy and safety of ingenol mebutate for the treatment of actinic keratosis of the face and scalp: A single arm retrospective study

2016 ◽  
Vol 27 (6) ◽  
pp. 525-530 ◽  
Author(s):  
Francesco Ricci ◽  
Sara Tambone ◽  
Luca Neri ◽  
Luca Fania ◽  
Antonella Piccioni ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Actinic Keratosis ◽  
Real Life ◽  
Efficacy And Safety ◽  
Ingenol Mebutate ◽  
The Face

Precision of Le Fort I osteotomy: planning versus outcome. A multi-centre retrospective study

2017 ◽  
Vol 44 (1) ◽  
pp. 8-13 ◽  
Author(s):  
Stefan Abela ◽  
David Tewson ◽  
Sharon Prince ◽  
Martyn Sherriff ◽  
Dirk Bister
Keyword(s):  
Retrospective Study ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Le Fort I

scholarly journals Histo-pathological correlation of BI-RADS 4 lesions on mammography with emphasis on microcalcification patterns.

2008 ◽  
Vol 12 (4) ◽  
pp. 84
Author(s):  
F Ismail ◽  
J Holl ◽  
Z Lockhat ◽  
H J Akande
Keyword(s):  
Retrospective Study ◽  
Physical Examination ◽  
Digital Mammography ◽  
Classification System ◽  
Breast Imaging ◽  
Data System ◽  
Architectural Distortion ◽  
Final Histology ◽  
Radiological Appearance ◽  
Study Population

A retrospective study of 20 patients with Breast Imaging Reporting and Data System (BI-RADS) 4 lesions was undertaken. These patients were classified as BI-RADS 4 lesions due to presence of a mass (clinical or on mammography), architectural distortion and microcalcifications (MC). In some patients, the pattern of MC was benign but there were other features that were suspicious of malignancy. A comparison was made with the histological diagnosis in order to compare the radiological appearance of benign and malignant microcalcification patterns with the final histology. The study design included retrospective analysis of patients with MC on digital mammography who underwent biopsy. An analysis of the histology was then undertaken. Other factors in the history and physical examination were also considered. Results showed that although the study was not statistically significant due to limited study population, interesting trends are determined in assessing calcification patterns using the Breast Imaging Reporting and Data System (BI-RADS) classification system, since some lesions that were thought to have benign calcification patterns were actually malignant and vice versa. Further study in this field is required.

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