11/923. Prosthetic rehabilitation of a warfare facial trauma.This case report presents the prosthetic treatment of a warfare facial trauma patient with the aim of providing satisfactory function, esthetics, and alleviation of deformities. Veneer crowns with rests, root coping, and metal-base partial prostheses were used for the patient therapy and treatment.- - - - - - - - - - ranking = 1keywords = trauma (Clic here for more details about this article) |
12/923. Severe jaundice in a gunshot casualty due to the coexistence of Dubin-Johnson and glucose-6-phosphate dehydrogenase deficiency.We report an unusual case of a 21-year-old man who was shot in his abdomen in the course of a robbery. He was previously diagnosed as glucose-6-phosphate dehydrogenase deficient. Mild icterus was noticed on admission to the emergency room. Exploratory laparotomy revealed a perforated ileal loop that was resected, and because the liver color was greenish black, a liver biopsy was performed during the operation. After operation the patient went through a severe icteric state that resolved spontaneously within a few days. Urinary coproporphyrin levels, along with compatible liver biopsy, confirmed the diagnosis of Dubin-Johnson disease. Severe hyperbilirubinemia after an abdominal injury is uncommon and is usually due to either a biliary duct injury or iatrogenic injury. This case presents an unusual cause of severe postoperative jaundice due to the rare coexistence of two inherited disorders.- - - - - - - - - - ranking = 34.723962273227keywords = injury (Clic here for more details about this article) |
13/923. Civilian gunshot wounds to the head with brain stem localization. A case report.The authors present a case of a patient wounded to the head and back by civilian firearm projectiles. The case peculiarity is that only one bullet reached the brain stem level causing significant neurological deficits. The final clinical picture is comparable to the "caudal pontine tegmentum syndrome". The authors describe both the bullet path and the intracranial localization taking into account ballistic details. The problems associated with prognosis, diagnosis, and treatment for gunshot wounds are discussed. In addition, the authors explain the main intracranial lesions and their mechanisms, the role of investigation, and the protocol of medical and surgical treatment. Lastly, a systematic approach for treating these types of gunshot wounds is outlined.- - - - - - - - - - ranking = 1.0883783077526keywords = brain (Clic here for more details about this article) |
14/923. Frey syndrome: treatment with temporoparietal fascia flap interposition.There is a 10% to 48% reported incidence of clinically significant gustatory sweating after parotid surgery or injury. Various medical and surgical treatments have been used in the attempt to treat this socially embarrassing condition. These treatments are not always effective and often have unwanted risks and adverse effects. They also do not address the post-parotidectomy defect. Prevention of Frey syndrome and correction of the postoperative contour deformity after parotidectomy have recently been achieved by interposition of temporoparietal fascia flap between the parotid gland and the cheek skin flap at the time of parotidectomy. This article presents the first report (to our knowledge) of an established case of Frey syndrome being treated with temporoparietal fascia flap interposition.- - - - - - - - - - ranking = 11.574654091076keywords = injury (Clic here for more details about this article) |
15/923. Transesophageal echocardiographic identification of an abdominal aortic pseudoaneurysm complemented by a transpulmonary echo contrast agent.Pseudoaneurysm of the abdominal aorta, a rare complication after traumatic injuries, represents a diagnostic challenge for which sophisticated imaging modalities are often used for its early identification. We describe a case in which transesophageal echocardiographic examination complemented by a transpulmonary echo contrast agent was useful not only in demonstrating the pseudoaneurysm, but in helping to localize the intravascular communication between the aorta and the pseudoaneurysm.- - - - - - - - - - ranking = 0.2keywords = trauma (Clic here for more details about this article) |
16/923. Five-year study on the injury of the great thoracic vessels after penetrating chest injury.In the cases of penetrating injury of the heart and the great thoracic vessels, 80% of the patients die before reaching the hospital care, nevertheless patients with sufficient vital functions can be rescued. Between 01. 01. 1994 and 31. 12. 1998 four patients were operated for penetrating injuries of the great vessels in the 2nd Department of Surgery, University Medical School of Debrecen. The left subclavian vein, arcus aortae and the pulmonary artery (2 cases) were injured. In this study authors report a detailed case operated for gunshot injury of the pulmonary artery. On the base of the situation of the projectile on X-ray picture and on the base of the entrance wound of the projectile on the skin we supposed the injury of the great thoracic vessels and we performed an urgent operation. After thoracotomy we found haemopericardium, bleeding wounds on the anterior and posterior haemorrhagic wall of the left pulmonary artery. We found the projectile inside the wall of the bronchus impacted. The bleeding wounds were finger-tamponaded and sutured. On the tenth postoperative day the patient was discharged from our clinic without complaint. The surgical approach to specific thoracic great vessels is also described.- - - - - - - - - - ranking = 127.32119500183keywords = injury (Clic here for more details about this article) |
17/923. incidence of intracranial bullet fragment migration.Migration of retained bullets or bullet fragments may present as a complication of gunshot wounds to the head. This phenomenon has been reported in cases of abscess formation or retained copper fragments. Management of such migratory fragments is controversial. The purpose of this study is to determine the incidence of fragment migration in a population of neurosurgical patients treated for gunshot wounds to the head. Two-hundred and thirteen cases treated at Detroit Receiving Hospital between 1985 and 1987 were reviewed. Each patient treated had initial and one week follow-up imaging studies. Nine cases of documented migratory intracranial bullet fragments were identified. Thus, the incidence in this population is 4.2%. The fragments in eight cases were composed of copper, and in the remaining case, lead. No case was associated with an abscess. Fragments in the anterior fossa were found to migrate towards the sella turcica, while those of the middle fossa and posterior hemispheres migrate towards the confluence of sinuses (Torcula Herophili). Fragment migration was documented as early as 36 h post-injury. Based on this study, we recommend serial imaging studies to look for migrating bullet fragments and surgical removal aided by intra-operative ultrasound to localize the fragment when possible.- - - - - - - - - - ranking = 11.574654091076keywords = injury (Clic here for more details about this article) |
18/923. Digital nerve repair by autogenous vein graft in high-velocity gunshot wounds.Gunshot wounds to the hands are high-energy injuries that cause widespread tissue damage, including to the nerves. Great difficulty is encountered in later reconstruction with nerve grafting of gaps in these destructive and scarred wounds. We present our experience with three patients with digital nerve repair by autogenous vein graft performed at an early stage in this type of injury. Based on our experience and that of others, this simple and rapid technique suggests a high rate of satisfactory results. It also avoids extensive and destructive late dissection and the morbidity associated with other late reconstructive procedures.- - - - - - - - - - ranking = 11.574654091076keywords = injury (Clic here for more details about this article) |
19/923. Pseudoaneurysm of the internal carotid artery after shrapnel injury in World war II: demonstration by CT angiography with 3D MIP reconstruction.A case of pseudoaneurysm of the left internal carotid artery (ICA) after shrapnel injury is demonstrated by intra-arterial digital subtraction angiography (DSA) and computed tomography angiography (CTA) with subtraction technique. Although the pseudoaneurysm was well demonstrated by intra-arterial DSA, CTA was the only modality to demonstrate the three-dimensional shape of the perfused part of pseudoaneurysm and the aneurysmal neck, which affected the therapeutic strategy. The CTA technique is useful in the assessment of large pseudoaneurysms and for therapeutic planning.- - - - - - - - - - ranking = 57.873270455379keywords = injury (Clic here for more details about this article) |
20/923. Non-free osteoplasty of the mandible in maxillofacial gunshot wounds: mandibular reconstruction by compression-osteodistraction.We have treated 33 young men with medium to large (3-8 cm) bony and soft tissue defects of the lower third of the face caused by gunshot wounds. After debridement, collapsing the proximal segments for primary approximation of soft and hard tissues and a closed osteotomy of a small fragment of mandible, we used an original compression-distraction device, designed in 1982 and tested during 1983 (analogous devices were absent at that time) to reposition the mandible and cause callus to form (during distraction) between the fragment and to use the remaining stumps of bone to fill in the defect. The soft tissues were repaired at the same time. Twenty-eight of the patients presented within a few hours of injury, and the remaining five had old injuries. The only complications were in the group with old injuries where four patients developed abscesses that required drainage, but these did not interfere with the process of osteogenesis. All 33 patients had good functional and aesthetic results within 3-4.5 months. The method allows a bloodless minimally traumatic procedure which can be carried out in one stage. The results compare very favourably with the classic methods of the treatment of mandibular gunshot injuries.- - - - - - - - - - ranking = 11.774654091076keywords = injury, trauma (Clic here for more details about this article) |
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