1/7. subcutaneous emphysema of upper limb.A case is reported of subcutaneous emphysema involving upper limb resulting from a trivial laceration to the elbow. Gas in the soft tissues after the injury can be caused by infection with a gas forming organism or by a variety of non-infective causes. It is hypothesised that this minor skin wound has acted like a ball-valve mechanism leading to air being trapped in the soft tissue.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
2/7. 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 = organ (Clic here for more details about this article) |
3/7. 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 = 1keywords = organ (Clic here for more details about this article) |
4/7. High bifurcation of median nerve at the wrist causing common digital nerve injury in endoscopic carpal tunnel release.A 45-year-old right-handed woman was treated by endoscopic carpal tunnel release under local anaesthetic. When cutting the proximal half of the flexor retinaculum with the retrograde blade, she complained of an electric shock-like pain in her middle and ring fingers. Open exploration of the carpal tunnel was performed and a laceration of the middle/ring common digital nerve, which bifurcated at the unusually high level of the wrist crease, was found.- - - - - - - - - - ranking = 149.22149414062keywords = nerve (Clic here for more details about this article) |
5/7. The role of intramuscular nerve repair in the recovery of lacerated skeletal muscles.The repair of lacerated muscle often results in suboptimal recovery. An important cause of poor outcome is denervation of the distal segment. The rabbit medial gastrocnemius muscle laceration model was used to assess whether intramuscular nerve repair resulted in better recovery. Lacerated rabbit muscles were divided into three groups: group A had no muscle repair; group B underwent muscle repair; and group C had muscle repair with intramuscular nerve repair. At 7 months, groups A and B showed significantly greater muscle atrophy, replacement of muscle fiber with scar and adipose tissue, and change of muscle fiber type from a fast-twitch to a slow-twitch pattern compared to group C. A clinical case study subsequently demonstrated feasibility of intramuscular nerve repair; reinnervation of the distal belly led to rapid functional recovery. In conclusion, primary intramuscular nerve repair results in better functional outcomes following repair of lacerated muscles.- - - - - - - - - - ranking = 132.641328125keywords = nerve (Clic here for more details about this article) |
6/7. Delayed detection of a traumatic diaphragmatic injury caused by positive pressure ventilation: a case report and a proposed system of classification of delayed diagnosis of traumatic injuries.The establishment of regional trauma centers in the united states has resulted in a significant reduction in morbidity and mortality from traumatic injuries. It has also led to a decrease in the incidence of delayed diagnosis of injuries ("missed injuries"), which are not detected during the initial evaluation of these patients. The surgeon managing an acutely injured trauma patient in the initial "golden hour" is faced with leadership, organizational, diagnostic, and therapeutic challenges. The algorithmic approach to the care of the trauma patient has led to the development of protocols to eliminate or at least reduce the incidence of these undetected injuries. The majority of these missed injuries are difficult to reliably detect by conventional diagnostic modalities, are usually asymptomatic, or attention was erroneously diverted to other more overt injuries. We report a case of a patient who sustained a traumatic laceration of his left hemi-diaphragm, which was detected only after positive pressure mechanical ventilation was discontinued. A proposed system of classification of delayed diagnoses is also presented.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
7/7. Look beneath the skin: an unlikely source of median nerve injury.A 4 1-year-old man presented with an occult median nerve injury. This report highlights the importance of adequate wound exploration and reinforces the significance of adequate history and examination in patients with signs of nerve injury.- - - - - - - - - - ranking = 99.48099609375keywords = nerve (Clic here for more details about this article) |