CASE REPORT Injuries Following Segway Personal
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Transolecranon Distal Humerus Fractures: a Mini Review
Patel SS, Gatta J, Lee A, Bafus BT. Transolecranon Distal Humerus Fractures: A Mini Review. J Orthopedics & Orthopedic Surg. 2021;2(1):7-12 Mini Review Open Access Transolecranon Distal Humerus Fractures: A Mini Review Shaan S. Patel*, Julian Gatta, Adrienne Lee, Blaine T. Bafus Department of Orthopaedic Surgery, MetroHealth Medical Center, Cleveland, OH, USA Article Info Abstract Article Notes Background: Transolecranon distal humerus fractures are uncommon Received: March 13, 2021 injuries. The purpose of this study is to review the outcomes and complications Accepted: April 22, 2021 associated with transolecranon distal humerus fractures. *Correspondence: Material and Methods: We performed a systematic search of PubMed *Dr. Shaan S. Patel, Department of Orthopaedic Surgery, for articles published between 1990 and 2021. Included studies reported MetroHealth Medical Center, Cleveland, OH, USA; Telephone No: (205) 495-0460; Email: [email protected]. outcomes and complications of transolecranon distal humerus fractures. Data was extracted from the included studies to describe patient demographics, ©2021 Patel SS. This article is distributed under the terms of the injury characteristics, outcome measurements, and complications. Creative Commons Attribution 4.0 International License. Results: A total of 4 studies met inclusion criteria for data extraction and Keywords analysis. Two studies evaluated an adult cohort of a total of 18 patients. The Transolecranon average Disabilities of the Arm, Shoulder, and Hand (DASH) score was 40 (range Olecranon 4.2 – 76.5). Fifteen patients (83%) had a complication. Elbow stiffness (11/18, Distal humerus 61%) was the most common complication. Eleven patients (61%) underwent Fracture Outcomes more than one procedure. Two studies evaluated a pediatric cohort of a total Complications of 9 patients. -
Diagnoses to Include in the Problem List Whenever Applicable
Diagnoses to include in the problem list whenever applicable Tips: 1. Always say acute or open when applicable 2. Always relate to the original trauma 3. Always include acid-base abnormalities, AKI due to ATN, sodium/osmolality abnormalities 4. Address in the plan of your note 5. Do NOT say possible, potential, likely… Coders can only use a real diagnosis. Make a real diagnosis. Neurological/Psych: Head: 1. Skull fracture of vault – open vs closed 2. Basilar skull fracture 3. Facial fractures 4. Nerve injury____________ 5. LOC – include duration (max duration needed is >24 hrs) and whether they returned to neurological baseline 6. Concussion with or without return to baseline consciousness 7. DAI/severe concussion with or without return to baseline consciousness 8. Type of traumatic brain injury (hemorrhages and contusions) – include size a. Tiny = <0.6 cm b. Small/moderate = 0.6-1 cm c. Large/extensive = >1 cm 9. Cerebral contusion/hemorrhage 10. Cerebral edema 11. Brainstem compression 12. Anoxic brain injury 13. Seizures 14. Brain death Spine: 1. Cervical spine fracture with (complete or incomplete) or without cord injury 2. Thoracic spine fracture with (complete or incomplete) or without cord injury 3. Lumbar spine fracture with (complete or incomplete) or without cord injury 4. Cord syndromes: central, anterior, or Brown-Sequard 5. Paraplegia or quadriplegia (any deficit in the upper extremity is consistent with quadriplegia) Cardiovascular: 1. Acute systolic heart failure 40 2. Acute diastolic heart failure 3. Chronic systolic heart failure 4. Chronic diastolic heart failure 5. Combined heart failure 6. Cardiac injury or vascular injuries 7. -
Medical Policy Ultrasound Accelerated Fracture Healing Device
Medical Policy Ultrasound Accelerated Fracture Healing Device Table of Contents Policy: Commercial Coding Information Information Pertaining to All Policies Policy: Medicare Description References Authorization Information Policy History Policy Number: 497 BCBSA Reference Number: 1.01.05 Related Policies Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures, #498 Electrical Bone Growth Stimulation of the Appendicular Skeleton, #499 Bone Morphogenetic Protein, #097 Policy Commercial Members: Managed Care (HMO and POS), PPO, and Indemnity Members Low-intensity ultrasound treatment may be MEDICALLY NECESSARY when used as an adjunct to conventional management (i.e., closed reduction and cast immobilization) for the treatment of fresh, closed fractures in skeletally mature individuals. Candidates for ultrasound treatment are those at high risk for delayed fracture healing or nonunion. These risk factors may include either locations of fractures or patient comorbidities and include the following: Patient comorbidities: Diabetes, Steroid therapy, Osteoporosis, History of alcoholism, History of smoking. Fracture locations: Jones fracture, Fracture of navicular bone in the wrist (also called the scaphoid), Fracture of metatarsal, Fractures associated with extensive soft tissue or vascular damage. Low-intensity ultrasound treatment may be MEDICALLY NECESSARY as a treatment of delayed union of bones, including delayed union** of previously surgically-treated fractures, and excluding the skull and vertebra. 1 Low-intensity ultrasound treatment may be MEDICALLY NECESSARY as a treatment of fracture nonunions of bones, including nonunion*** of previously surgically-treated fractures, and excluding the skull and vertebra. Other applications of low-intensity ultrasound treatment are INVESTIGATIONAL, including, but not limited to, treatment of congenital pseudarthroses, open fractures, fresh* surgically-treated closed fractures, stress fractures, arthrodesis or failed arthrodesis. -
Downloads As of 6/2011.) 2
CURRICULUM VITAE Michael J. Prayson, MD Department of Orthopaedic Surgery, Sports Medicine & Rehabilitation Wright State University Boonshoft School of Medicine 30 E. Apple Street, Suite 2200 Dayton, Ohio 45409 937-208-2128 937-208-2920 Fax EDUCATION Institution Concentration Degree/Date Kent State University & Combined 6-Year Program BS/MD 1989 Northeastern Ohio Universities College of Medicine Rootstown, Ohio POST GRADUATE EDUCATION Item Date Orthopaedic Surgery Internship & Residency Training 1989-1994 Akron General Medical Center, Akron, Ohio Orthopaedic Traumatology Fellowship 1994-1995 Department of Orthopaedic Surgery University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania ACADEMIC EXPERIENCE Institution Position Date Northeastern Ohio Universities College of Medicine Clinical Instructor 1993-1994 Rootstown, Ohio University of Missouri Assistant Professor 1995-1998 Department of Orthopaedic Surgery Kansas City, Missouri Akron General Medical Center Assistant Professor 1998-1999 Department of Orthopaedic Surgery Akron, Ohio University of Pittsburgh Medical Center Assistant Professor 1999-2004 Department of Orthopaedic Surgery Pittsburgh, Pennsylvania Wright State University Boonshoft School of Medicine Associate Professor 2004-2009 Department of Orthopaedic Surgery, Director of Orthopaedic Sports Medicine & Rehabilitation Undergraduate Education 2004-2006 Dayton, Ohio Trauma Fellowship Director 2006-Present Director of Orthopaedic Trauma 2004-Present Section Chair of Orthopaedic Trauma 2008-2010 Vice Chairman 2008-Present -
Cervical Spine Injury Risk Factors in Children with Blunt Trauma Julie C
Cervical Spine Injury Risk Factors in Children With Blunt Trauma Julie C. Leonard, MD, MPH,a Lorin R. Browne, DO,b Fahd A. Ahmad, MD, MSCI,c Hamilton Schwartz, MD, MEd,d Michael Wallendorf, PhD,e Jeffrey R. Leonard, MD,f E. Brooke Lerner, PhD,b Nathan Kuppermann, MD, MPHg BACKGROUND: Adult prediction rules for cervical spine injury (CSI) exist; however, pediatric rules abstract do not. Our objectives were to determine test accuracies of retrospectively identified CSI risk factors in a prospective pediatric cohort and compare them to a de novo risk model. METHODS: We conducted a 4-center, prospective observational study of children 0 to 17 years old who experienced blunt trauma and underwent emergency medical services scene response, trauma evaluation, and/or cervical imaging. Emergency department providers recorded CSI risk factors. CSIs were classified by reviewing imaging, consultations, and/or telephone follow-up. We calculated bivariable relative risks, multivariable odds ratios, and test characteristics for the retrospective risk model and a de novo model. RESULTS: Of 4091 enrolled children, 74 (1.8%) had CSIs. Fourteen factors had bivariable associations with CSIs: diving, axial load, clotheslining, loss of consciousness, neck pain, inability to move neck, altered mental status, signs of basilar skull fracture, torso injury, thoracic injury, intubation, respiratory distress, decreased oxygen saturation, and neurologic deficits. The retrospective model (high-risk motor vehicle crash, diving, predisposing condition, neck pain, decreased neck mobility (report or exam), altered mental status, neurologic deficits, or torso injury) was 90.5% (95% confidence interval: 83.9%–97.2%) sensitive and 45.6% (44.0%–47.1%) specific for CSIs. -
Anesthesia for Trauma
Anesthesia for Trauma Maribeth Massie, CRNA, MS Staff Nurse Anesthetist, The Johns Hopkins Hospital Assistant Professor/Assistant Program Director Columbia University School of Nursing Program in Nurse Anesthesia OVERVIEW • “It’s not the speed which kills, it’s the sudden stop” Epidemiology of Trauma • ~8% worldwide death rate • Leading cause of death in Americans from 1- 45 years of age • MVC’s leading cause of death • Blunt > penetrating • Often drug abusers, acutely intoxicated, HIV and Hepatitis carriers Epidemiology of Trauma • “Golden Hour” – First hour after injury – 50% of patients die within the first seconds to minutesÆ extent of injuries – 30% of patients die in next few hoursÆ major hemorrhage – Rest may die in weeks Æ sepsis, MOSF Pre-hospital Care • ABC’S – Initial assessment and BLS in trauma – GO TEAM: role of CRNA’s at Maryland Shock Trauma Center • Resuscitation • Reduction of fractures • Extrication of trapped victims • Amputation • Uncooperative patients Initial Management Plan • Airway maintenance with cervical spine protection • Breathing: ventilation and oxygenation • Circulation with hemorrhage control • Disability • Exposure Initial Assessment • Primary Survey: – AIRWAY • ALWAYS ASSUME A CERVICAL SPINE INJURY EXISTS UNTIL PROVEN OTHERWISE • Provide MANUAL IN-LINE NECK STABILIZATION • Jaw-thrust maneuver Initial Assessment • Airway cont’d: – Cervical spine evaluation • Cross table lateral and swimmer’s view Xray • Need to see all seven cervical vertebrae • Only negative CT scan R/O injury Initial Assessment • Cervical -
Clinical Efficacy of Extended Modified Posteromedial Approach Versus
Clinical ecacy of extended modied posteromedial approach versus posterolateral approach for surgical treatment of posterior pilon fracture: a retrospective analysis Qin-Ming Zhang Aliated Hospital of Jining Medical University Hai-Bin Wang Aliated Hospital of Jining Medical University Xiao-Yan Li Aliated Hospital of Jining Medical University Feng-Long Chu Aliated Hospital of Jining Medical University Liang Han Aliated Hospital of Jining Medical University Dong-Mei Li Aliated Hospital of Jining Medical University Bin Wu ( [email protected] ) Alited Hospital of Jining Medical University https://orcid.org/0000-0003-3707-0056 Research article Keywords: posterior pilon fracture, approach, fracture xation, buttress plate Posted Date: March 30th, 2020 DOI: https://doi.org/10.21203/rs.3.rs-19392/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/12 Abstract Background: Posterior pilon fracture is a type of ankle fracture associated with poorer treatment results compared to the conventional ankle fracture. This is partly related to the lack of consensus on the classication, approach selection, and internal xation method for this type of fracture. This study aimed to investigate the clinical ecacy of posterolateral approach versus extended modied posteromedial approach for surgical treatment of posterior pilon fracture. Methods: Data of 67 patients with posterior pilon fracture who received xation with a buttress plate between January 2015 and December 2018 were retrospectively reviewed. Patients received steel plate xation through either the posterolateral approach (n = 35, group A) or the extended modied posteromedial approach (n = 32, group B). Operation time, intraoperative blood loss, excellent and good rate of reduction, fracture healing time, American Orthopaedic Foot & Ankle Society (AOFAS) Ankle- Hindfoot Scale score, and Visual Analogue Scale score were compared between groups A and B. -
Pediatric Orthopedic Injuries… … from an ED State of Mind
Traumatic Orthopedics Peds RC Exam Review February 28, 2019 Dr. Naminder Sandhu, FRCPC Pediatric Emergency Medicine Objectives to cover today • Normal bone growth and function • Common radiographic abnormalities in MSK diseases • Part 1: Atraumatic – Congenital abnormalities – Joint and limb pain – Joint deformities – MSK infections – Bone tumors – Common gait disorders • Part 2: Traumatic – Common pediatric fractures and soft tissue injuries by site Overview of traumatic MSK pain Acute injuries • Fractures • Joint dislocations – Most common in ED: patella, digits, shoulder, elbow • Muscle strains – Eg. groin/adductors • Ligament sprains – Eg. Ankle, ACL/MCL, acromioclavicular joint separation Chronic/ overuse injuries • Stress fractures • Tendonitis • Bursitis • Fasciitis • Apophysitis Overuse injuries in the athlete WHY do they happen?? Extrinsic factors: • Errors in training • Inappropriate footwear Overuse injuries Intrinsic: • Poor conditioning – increased injuries early in season • Muscle imbalances – Weak muscle near strong (vastus medialus vs lateralus patellofemoral pain) – Excessive tightness: IT band, gastroc/soleus Sever disease • Anatomic misalignments – eg. pes planus, genu valgum or varum • Growth – strength and flexibility imbalances • Nutrition – eg. female athlete triad Misalignment – an intrinsic factor Apophysitis • *Apophysis = natural protruberance from a bone (2ndary ossification centres, often where tendons attach) • Examples – Sever disease (Calcaneal) – Osgood Schlatter disease (Tibial tubercle) – Sinding-Larsen-Johansson -
Management of the Traumatized Airway
CLINICAL CONCEPTS AND COMMENTARY Jerrold H. Levy, M.D., F.A.H.A., F.C.C.M., Editor Management of the Traumatized Airway Uday Jain, M.D., Ph.D., Maureen McCunn, M.D., M.I.P.P., Charles E. Smith, M.D., Jean-Francois Pittet, M.D. IRWAY injury is a major cause of early death in Anatomy of Trauma to the Airway 1,2 A trauma. The incidence of traumatic airway injuries is Airway injuries can be divided into three types: maxillofa- 3,4 low, although it is recently increasing. In contrast, mortal- cial, neck, and laryngeal injury. ity due to traumatic airway injuries is high, in part, because of associated injuries to other organs, which are present in Maxillofacial Trauma about one half of the cases of blunt or penetrating airway Blunt or penetrating trauma to the face can affect the max- 1,2 trauma. Patients with a significant injury severity (scored illary/mandibular or mid-facial region and extend intra- 5 on a scale of 0 to 75, which accounts for the most severely cranially12–14 (table 1). Maxillofacial trauma can result in traumatized body systems) have a higher predicted mortality. life-threatening airway and hemorrhage problems and lead In a retrospective review of 12,187 civilian patients treated to significant ocular, nasal, and jaw dysfunction. Bleeding at a regional trauma center in Toronto from 1989 to 2005, may complicate airway management. Swallowing of blood 36 patients (0.3%) had blunt airway trauma (injury sever- clears the airway and is facilitated with the patient in the sit- ity score, 33; mortality, 36%) and 68 patients (0.6%) had ting position. -
Hand Rehabilitation Current Awareness Bulletin NOVEMBER 2015
1 Hand Rehabilitation Current Awareness Bulletin NOVEMBER 2015 2 Lunchtime Drop-in Sessions The Library and Information Service provides free specialist information skills training for all UHBristol staff and students. To book a place, email: [email protected] If you’re unable to attend we also provide one-to-one or small group sessions. Contact library@ or katie.barnard@ to arrange a session. Literature Searching October (12pm) An in -depth guide on how to search Thurs 8th Statistics the evidence base, including an introduction to UpToDate and Fri 16th Literature Searching Anatomy.tv. Mon 19th Understanding articles Tues 27th Statistics Useful for anybody who wants to find the best and quickest way to source articles. November (1pm) Weds 4th Literature Searching Thurs 12th Understanding articles How to understand an article Fri 20th Statistics How to assess the strengths and Mon 23rd Literature Searching weaknesses of published articles. Examining bias and validity. December (12pm) Tues 1st Understanding articles Weds 9th Statistics Medi cal Statistics Thurs 17th Literature Searching A basic introduction to the key statistics in medical articles. Giving an overview of statistics that compare risk, test confidence, analyse clinical investigations, and test difference. 3 Contents Contents .................................................................................................................................................. 3 New from Cochrane Database of Systematic Reviews .......................................................................... -
University of Washington Orthopaedics & Sports Medicine
Discoveries 2018 University of Washington Orthopaedics & Sports Medicine University of Washington Department of Orthopaedics and Sports Medicine Discoveries 2018 Department of Orthopaedics and Sports Medicine University of Washington Seattle, WA 98195 EDITOR-IN-CHIEF: Howard A. Chansky, MD [email protected] ASSISTANT EDITORS: Christopher H. Allan, MD [email protected] Stephen A. Kennedy, MD, FRCSC [email protected] Adam A. Sassoon, MD, MS [email protected] MANAGING EDITOR: Fred Westerberg [email protected] Front Cover Illustration: Angie Kennedy, MSc, is a Seattle-based mixed media artist. She specializes in custom collage pieces that use mementos and artifacts to celebrate people and special life events. She drew on her experience as a former scientific researcher to create this collage of images from the pages of the current publication. The ‘W’ in the background is a nod to the University of Washington with an overlay of the current imagery arranged in an abstract assemblage. For more information www.americanheavyweight.com A pdf of this publication is available at our website: www.orthop.washington.edu. Permission Requests: All inquiries should be directed to the Managing Editor, University of Washington, Department of Orthopaedics and Sports Medicine, 1959 NE Pacific Street, Box 356500, Seattle, WA 98195-6500, or at the email address above. Contents 1 Foreword 2 From The Assistant Editors: The Modern Art of Musculoskeletal Research, Education, and Clinical Care 3 2018 Distinguished Alumnus, David J. Belfie, MD 4 New Faculty 6 Department of Orthopaedics and Sports Medicine Faculty 12 Visiting Lecturers Validation of a Rabbit Model of Trauma-Induced 14 Brandon J. Ausk, PhD, Philippe Huber, BS, Heterotopic Ossification Ted S. -
Radial Head Fractures Treated with Open Reduction and Internal Fixation
Moghaddam et al. Trauma Cases Rev 2016, 2:028 Volume 2 | Issue 1 ISSN: 2469-5777 Trauma Cases and Reviews Research Article: Open Access Radial Head Fractures Treated with Open Reduction and Internal Fixation Moghaddam A1*, Raven TF1, Kaghazian P1, Studier-Fischer S2, Swing T1, Grützner PA2 and Biglari B2 1Trauma & Reconstructive Surgery, University hospital Heidelberg, Germany 2BG Unfallklinik, Ludwigshafen, Germany *Corresponding author: Prof. Dr. med. Arash Moghaddam, Consultant Orthopaedic & Trauma Surgeon Center of Trauma, Orthopaedics & Paraplegiology, Division of Trauma & Reconstructive Surgery, University hospital Heidelberg, Schlierbacher Landstraße 200a, 69118 Heidelberg, Germany, Tel: 0049-6221-5626263, Fax: 0049- 6221-26298, E-mail: [email protected] to a high percentage of associated injuries [6]. The combination of a Abstract dislocated fracture and unstable joint makes operative treatment as Background: Radial head fractures are responsible for 2 to 5% of well as early mobilization difficult. Other treatment options include adult fractures. Especially problematic is the treatment of dislocated the implantation of a radial head prosthesis and resection of the and unstable fractures which often have a worst prognosis. The radial head. The radial head prosthesis has become established as the purpose of this study was to evaluate the results of open reduction choice of treatment for multi-fragmented radial head fractures with and internal fixation (ORIF) in the treatment of radial head fractures. associated injuries, while resection of the radial head has increasingly Materials and Methods: Between June 2001 and January 2006, fallen out of use and is now reserved for isolated fractures of the 41 reconstructive surgical procedures were executed. Thirty-seven radial head without associated injuries [7].