11/73. Management of splenic trauma in the pediatric hemophiliac patient: Case series and review of the literature.In July and August 1998, 3 patients who attend the Hemophilia Treatment Center required emergency admission to the authors' hospital for management of hemorrhagic shock caused by splenic injury. Computed tomography was used to diagnose and grade the splenic injuries, which ranged from II to IV on the organ injury scale. Two patients had Christmas disease (factor ix deficiency) and were treated with splenorrhaphy and factor ix replacement. One patient who has severe von Willebrand disease (Type 3) had grade II splenic injury that required splenectomy to secure hemostasis. The coagulopathic deficiency was aggressively treated in each patient. All patients required operative intervention with attempted splenorrhaphy. All patients survived their operative experience, and none suffered a rebleeding episode. With correction of the coagulopathy throughout the perioperative period and local hemostatic control by operative techniques, salvage procedures for splenic injury were successful for 2 of these 3 patients.- - - - - - - - - - ranking = 1keywords = injury, trauma (Clic here for more details about this article) |
12/73. Nasoethmoid orbital fractures: diagnosis and management.BACKGROUND AND OBJECTIVES: Trauma to the central midface may result in complex nasoethmoid orbital fractures. Due to the intricate anatomy of the region, these challenging fractures may often be misdiagnosed or inadequately treated. The purpose of this article is to aid in determining the appropriate exposure and method of fixation. methods AND MATERIALS: This article presents an organized approach to the management of nasoethmoid orbital fractures that emphasizes early diagnosis and identifies the extent and type of fracture pattern. It reviews the anatomy and diagnostic procedures and presents a classification system. The diagnosis of a nasoethmoid orbital fracture is confirmed by physical examination and CT scans. Fractures without any movement on examination or displacement of the NOE complex on the CT scan do not require surgical repair. Four clinical cases serve to illustrate the surgical management of nasoethmoid fractures. RESULTS AND/OR CONCLUSIONS: Early treatment using aggressive techniques of craniofacial surgery, including reduction of the soft tissue in the medial canthal area and restoration of normal nasal contour, will optimize results and minimize the late post-traumatic deformity. A high index of suspicion in all patients with midfacial trauma avoids delays in diagnosis.- - - - - - - - - - ranking = 0.051604701708721keywords = trauma (Clic here for more details about this article) |
13/73. Facial trauma and ocular/orbital injury.BACKGROUND AND OBJECTIVES: Ocular injuries occur commonly in patients with facial trauma. patients with significant eye injuries may present with grossly normal eyes and good visual acuity; however, subsequent ocular disorders may become apparent. The estimates of incidence vary considerably. Trauma is the second leading cause of blindness, and a review is, therefore, warranted. methods AND MATERIALS: Several extensive studies are reviewed. Blunt and penetrating trauma are examined by their respective subdivisions. The initial assessment and ophthalmologic examination of patients with facial trauma are discussed, and the type of injury that may occur secondary to trauma is delineated. Management is reviewed and discussed, including a recently developed diagnostic scoring system. Three clinical cases illustrate the procedure. RESULTS AND/OR CONCLUSIONS: The diagnosis of ocular injuries resulting from trauma is difficult. The recently introduced scoring system was found to improve the procedure. Based on this system, the authors have devised an algorithm to assist the clinician, with emphasis on visual acuity and the importance of visual examination.- - - - - - - - - - ranking = 1.3532094034174keywords = injury, trauma (Clic here for more details about this article) |
14/73. Posttraumatic anosmia in craniofacial trauma.Although the clinical implications of anosmia can be significant, posttraumatic anosmia is generally given relatively little attention in the clinical setting. patients who sustain craniofacial trauma are most at risk. The incidence of posttraumatic anosmia varies according to the severity of injury and has an overall estimated incidence of 7%. Factors that increase the risk of developing anosmia include anterior skull base fractures, bilateral subfrontal lobe injury, dural lacerations, and cerebrospinal fluid leakage. recovery of function has been estimated to be approximately 10%. time of recovery, if it occurs, varies between 8 weeks and 2 years. Presented herein are the clinical, radiographic, pathophysiologic, and anatomic substrata of posttraumatic anosmia.- - - - - - - - - - ranking = 0.7580235085436keywords = injury, trauma (Clic here for more details about this article) |
15/73. Management of avulsive injuries of the nasal bones: review of the literature and three case reports.Blunt contusions, lacerations, and avulsion-type trauma are the most often reported nasal injuries sustained in motor vehicle accidents. The nasal skeleton and soft tissues are frequently involved and may require surgical repair of the injuries. The primary reconstruction often requires the use of autogenous grafts, and secondary revision surgery may be necessary. The treatment may require a multidisciplinary surgical team or a single surgeon who knows how to manage the injury. Optimally, the reconstruction of nasal bone avulsions is performed primarily, using autogenous graft materials. This article presents reconstruction of the nasal deformities in 3 patients involved in motor vehicle accidents. The authors describe and evaluate the various graft materials and surgical techniques utilized. The advantages and disadvantages of autogenous and alloplastic materials are discussed. Studies with more patients and long-term follow-up are required for a definitive evaluation.- - - - - - - - - - ranking = 0.25keywords = injury, trauma (Clic here for more details about this article) |
16/73. Management of orbital-sinus foreign bodies.Orbital-sinus foreign bodies traverse the orbit and lay, at least partially, within the paranasal sinuses. Most of these injuries occur as a result of facial trauma. In most cases, history alone is not sufficient to rule out a retained foreign body. Early magnetic resonance imaging is necessary to evaluate the full extent of injury. Since these foreign bodies may cause a severe orbital infection and threaten the patient's vision, surgical removal is recommended. Endoscopic sinus surgery provides a safe and effective approach for extraction of these foreign bodies that can be used alone or in conjunction with other surgical approaches. The case of an orbital-sinus foreign body is presented together with a comprehensive approach for diagnosis and management of this type of injury.- - - - - - - - - - ranking = 0.47419764914564keywords = injury, trauma (Clic here for more details about this article) |
17/73. Posttraumatic scar revision: a review and case presentation.Scar revision is a well-established procedure, but the achievement of satisfying long-term results may present a challenge. An appropriate initial management of wounds is of importance, since it has a role in determining the degree of revision required postoperatively. In addition to the conventional treatment and maturation of the scar tissue, a combination of procedures are now available which may alter the appearance of the final scar. Scar revision, followed by wound care that consists of silastic sheeting, steroid injection, and laser skin resurfacing with carbon dioxide laser (CO2), may be used as adjuncts to achieve camouflage of facial scars. Two case reports are presented to document the procedure, followed by treatment evaluation and protocol.- - - - - - - - - - ranking = 0.10320940341744keywords = trauma (Clic here for more details about this article) |
18/73. Traumatic tricuspid insufficiency--a case report.Traumatic tricuspid insufficiency following blunt chest trauma, although an uncommon entity, has been reported more frequently over the past 2 decades. Increased physician awareness of the possibility of myocardial trauma accompanied by proper clinical evaluation and follow-up are the keys to a successful outcome regardless of whether a medical or surgical approach to treatment is initially selected. Early surgical correction has become the preferred treatment in most instances and may be influenced by clinical status and other associated comorbid conditions. A patient with a combination of myocardial contusion, valve laceration, and papillary muscle rupture is presented.- - - - - - - - - - ranking = 0.051604701708721keywords = trauma (Clic here for more details about this article) |
19/73. A minimally invasive approach to bile duct injury after blunt liver trauma in pediatric patients.A 12-year-old boy presented with a large liver laceration after blunt abdominal trauma. He was treated nonoperatively and subsequently had bile peritonitis from a bile leak. Endoscopic retrograde cholangiopancreatography (ERCP) visualized the bile duct injury and allowed decompression of the biliary tree with an endoscopically placed biliary stent. A drain also was placed over the laceration through a small subcostal incision. The patient recovered rapidly after this minimally invasive procedure and went home 9 days later.- - - - - - - - - - ranking = 1.25keywords = injury, trauma (Clic here for more details about this article) |
20/73. rupture of the flexor digitorum superficialis: occurrence after tendon repair of an adjacent digit.A patient had a ruptured flexor digitorum sublimis tendon of the long finger in the region of decussation. The injury occurred several weeks after repair of a zone 2 flexor digitorum sublimis and flexor digitorum profundus tendon of the index finger.- - - - - - - - - - ranking = 0.22419764914564keywords = injury (Clic here for more details about this article) |
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