Trauma Cases and Reviews is an open access peer reviewed journal that publishes articles on all aspects of multiple injury severity causing substantial damage and it's quick management in transport and initial estimation of extent of injuries to codify a course of treatment, in order to counter loss of life.
Journal publishes Original Research Articles, Reviews, Cases, Clinical Studies and Commentaries focusing on initial effective diagnosis techniques, prevention and management of injuries and prognosis. All the articles pass through a dual review process in which two independent review comments followed by editor decision will be considered to publish the article. Journal ensures the maintenance of its standards by publishing the high quality, original and new advances in its field.
Title: Trauma Cases and Reviews
Editor-in-chief: William Min
NLM title abbreviation: Trauma Cases Rev
ISO abbreviation: Trauma Cases Rev
Other titles: TCR
Peer review: Double blind
Review speed: 3 weeks
Fast-track review: 10 days
Publication format (s): Electronic and print
Publication policy: Open Access; COPE guide
Publication type(s): Periodicals
Publisher: ClinMed International Library
Country of publication: USA
Contact email: firstname.lastname@example.org
Articles Search by Keyword | Journal title | Author name | DOI
Open Access DOI:10.23937/2469-5777/1510098
Acute Lower Extremity Posterior Compartment Syndrome: A Rare Complication of Apixaban Use
Jennifer Adams, BS, Jose H Ramos, MD, Shyama Appareddy, MD and Gustavo Garcia, MD, FACP
Article Type: Case Report | First Published: April 15, 2022
Apixaban is an oral anticoagulant that directly inhibits Factor Xa and is indicated for the prophylaxis and treatment of deep venous thrombosis and stroke prevention in nonvalvular atrial fibrillation. Acute lower extremity Posterior Compartment Syndrome is a rare complication of Apixaban use. We present a 78-year-old male with significant medical morbidities taking Apixaban for Atrial Fibrillation presenting with post-traumatic extensive hemorrhagic bullae on the left proximal pretibial region ...
Open Access DOI:10.23937/2469-5777/1510097
Complex Sacral Fracture and Associated Soft Tissue Injuries: A Case of Multidisciplinary Management in Polytrauma
Italia Odierna, MD, Carlo B Bussemi, MD, Fulvio Scarpato, MD, Daniele Scarano, MD, Iolanda Esposito, MD, Emanuela Apicella, MD, Salvatore Guerriero, MD and Vincenzo Stridacchio, MD
Article Type: Case Report | First Published: April 08, 2022
Treatment of high-energy trauma of the lumbosacral region is a challenging entity for clinicians. They are complex and often associated with other injuries such as active bleeding and substantial soft tissue injuries. Therefore, good wound healing is reliant on multiple local and systemic factors. Only a multidisciplinary approach between the trauma team and subspecialists will dictate the most appropriate management for these patients, and recent data has shown that best outcomes are obtained w...
Open Access DOI:10.23937/2469-5777/1510096
A Real-World, Case-Led Evaluation of the Haemostatic Dressing Range, Celox™ and How it Can Rapidly Stop Severe Haemorrhage to Help Preserve Life in Emergency Trauma Situations
Leon Fourie and Oliver Marshall
Article Type: Case Report | First Published: November 13, 2021
Despite significant advancements in scientific understanding and technology, severe trauma remains a major global public health issue which causes significant social and economic consequences for society. Haemorrhage from trauma is a leading cause of human mortality and accounts for one in every ten mortalities. Overall, 25% of severely injured patients have an established trauma-induced coagulopathy on arrival at an Emergency Department, a phenomenon associated with an increased rate of early a...
Open Access DOI:10.23937/2469-5777/1510095
Association between Pre-Hospital Prioritization and Outcome of Injuries from Road Traffic Accidents in Makueni County, Kenya
Anthony Wambua Mathulu, Eliab Seroney Some and Esther M Ndonga
Article Type: Research Article | First Published: November 13, 2021
Globally, about 1.3 million people die each year and others remain disabled for the rest of their life due to road traffic accidents. In Makueni County, 1450 cases and 74 deaths were reported in 2015 and 2016. The purpose of this study was to provide evidence for development of policies and programmes to reduce case-fatality rate and other complications from road traffic accidents in Kenya. The study employed the mixed method approach and crosssectional study design. Universal sampling was appli...
Open Access DOI:10.23937/2469-5777/1510094
Cutting Monopolar Needle Electrode of Electrosurgery, a Safe Tool for Skin Incision in Neurosurgery
Krishan Kumar Sharma and Asgar Ali
Article Type: Commentary | First Published: September 30, 2021
In ancient time heat was used to treat wounds. Now a days electrosurgery unit (ESU) is an important part of operation theatre equipments utilized by almost every surgeon. Electrocautery and diathermy are the term used by many operations theatre medical and paramedical persons including surgeons for electrosurgery. They altogether are three different things. Cutting monopolar needle electrode of electrosurgery is a safe tool for skin incision in neurosurgery but hardly very few surgeons are utili...
Open Access DOI:10.23937/2469-5777/1510093
Usefulness of Magnetic Resonance Imaging in Diagnostic Unstable Fracture of the Lumbar Spine
J Miguel Rodríguez Solera and Ana María Cerván de la Haba
Article Type: Case Report | First Published: September 06, 2021
Most vertebral fractures are properly diagnosed by a simple radiography and a computed tomography (CT), but sometimes this type of preoperative study is insufficient to diagnose an inestable spine lesion. We report a case of 19-years-old man who was brought to our Hospital after a bicycle accident. He had dorsolumbar pain, disability and anormal neurological examination. An X-ray and spine computerized tomography (CT) scan was performed and diagnosed a fracture at second vertebra lumbar. An unst...
Open Access DOI:10.23937/2469-5777/1510092
Heterotopic Ossification of the Triceps Muscle after Internal Fixation of Proximal Ulna Fracture: A Case Report
Chang-Song Mun, Tae-Song So and Chol-Ho Jang
Article Type: Case Report | First Published: September 04, 2021
Olecranon fractures comprise approximately 10% of all fractures around the elbow. They vary in their complexity from relatively straightforward transverse fractures to comminuted and unstable configurations. As in other articular fractures, the aims of treatment, as defined by AO group, are to restore the articular surface, achieve absolute stability of the fracture, and commence early active motion, and, finally, the restoration of function without pain. This is only possible with ORIF (open re...
Open Access DOI:10.23937/2469-5777/1510091
Olecranon Fractures - Review of Treatment and Complications
Henrique Sousa, Ricardo Oliveira, Moisés Ventura, Renato Ramos, Rita Grazina and Andreia Ferreira
Article Type: Review Article | First Published: July 25, 2021
Olecranon fractures are common upper extremity fractures usually subject to surgical fixation. Several options exist for olecranon fracture treatment, tension band, plating, intramedullary nail and fragment excision with triceps advancement are the most used but no technique is suitable for the management of all olecranon fractures and each one is associated with more or less prevalence of the most common complications, namely loss of motion, nonunion, malunion, infection, wound dehiscence, inst...
Open Access DOI:10.23937/2469-5777/1510090
Timeline of Cross Finger Flap: From its Inception to its Future
Sourabh Shankar Chakraborty, DNB, MNAMS, Sudeshna Acharya, MBBS, Manojit Midya, MS, MCh and Ranjit Kumar Sahu, MS, MCh, FCLS
Article Type: Review Article | First Published: April 07, 2021
Since the first description of the cross-finger flap in 1950 for finger injury defect cover, over the last 70 years it has been tremendously explored and has underwent innumerable refinements and modifications. Whether used alone or in combination with other flaps for the reconstruction of finger defects, traumatic or non-traumatic, cross finger flap has proven its worth as a workhorse for finger reconstruction. Despite a handful of innate disadvantages, it has given excellent sensory, functiona...
Open Access DOI:10.23937/2469-5777/1510089
Traumatic Brachiocephalic Artery Pseudoaneurysm
Sally Shepherd and Jessica Wong
Article Type: Case Report | First Published: March 13, 2021
A 19-year-old female presented to a tertiary Trauma Centre post intentional 100 km/hr motor vehicle crash into a tree. She was wearing a seatbelt in the driver's seat, airbags were deployed and required assistance extricating after entrapment for 45 minutes. She was normotensive but tachycardic with a shortened and rotated right lower limb, receiving 500 mls crystalloid and splinting to her right lower limb. On arrival in ED her airway was patent and cervical spine secured in a rigid collar. She...
Open Access DOI:10.23937/2469-5777/1510088
Tongue-Type Calcaneal Fracture due to a Low-Energy Injury
Filipa Vilabril, José Vilaça Costa, João Vieira Dias, Rui Migue Cândido and Inês Machado
Article Type: Case Report | First Published: February 17, 2021
Tongue-type fractures are unusual calcaneal fractures that produce an unique and relatively uncommon injury pattern to the bone and soft tissues, due to the separation of the calcaneal tuberosity into superior and inferior fragments. The displacement of the superior fragment has the potential to tent the skin of the posterior heel and, if not treated emergently, partial or full-thickness skin breakdown can progress quickly, and potential necrosis can occur. Early recognition by the emergency phy...
Open Access DOI:10.23937/2469-5777/1510087
A Case Report of Negative Pressure Wound Therapy in Post- Traumatic Raw Area
Naim Sulaiman Abuzarifa and Wan Azman Wan Sulaiman
Article Type: Case Report | First Published: January 30, 2021
Traumatic wounds vary from abrasions and minor skin incisions or tears to wounds with extensive tissue damage or loss and damage to bone and internal organs. The use of economic negative-pressure wound therapy for managing wounds and negative-pressure wound therapy is known for improving a wide range of acute and chronic wounds. This medical device involves applying a wound dressing through which negative pressure is applied and wound discharges drawn out from the wound. The treatment aims to pr...
Open Access DOI:10.23937/2469-5777/1510086
Maxillofacial Injuries due to Motorcycle Accidents Caused by Stray Animals: An Etiology ‘Kept Out Of Sight’: A Report of 5 Cases
D.S. Thalakiriyawa, BDS, R.M.S.H.B Medawela BDS, W.M.S.N.Weerasinghe BDS, S.A.K.J. Kumara BDS, MS and N.S.S. Jayasuriya BDS, MS
Article Type: Case Series | First Published: December 31, 2020
The oral and maxillofacial region occupies the most prominent position of the human body rendering it vulnerable to injuries quite frequently. These injuries are commonly associated with high morbidity resulting in increased costs of care and varying degrees of physical, functional, and cosmetic disfigurement. Multiple etiologies of oral and maxillofacial trauma include road traffic accidents, falls, assaults, industrial injuries etc. out of which road traffic accidents is the commonest etiology...
Open Access DOI:10.23937/2469-5777/1510085
Severe Spinal Cord Insult after Reverse Shoulder Arthroplasty
Eva García-Jarabo, Juan María Pardo-García, Leandro Manuel Ramos-Ramos and Manuel Ramón García-Rayo Rodriguez-Barbero
Article Type: Case Report | First Published: December 05, 2020
We present a case of a cervical spine cord ischemia with hemorrhage in a patient with a proximal humeral fracture treated with reverse shoulder arthroplasty (RSA), a rare complication, non-well described in the current literature. The aim of this study is to review immediate neurological post-operative complications of RSA that can be related to surgery or anesthetic technique. Thus, we describe a severe, rare central system neurological complication after RSA. Proximal humeral fractures (PHFs) ...
Open Access DOI:10.23937/2469-5777/1510084
Gunshot Abdomen in a Patient with Situs Inversus Totalis
T Gvilia, MD, FS, PhD and M Tun, FCR, FCS
Article Type: Case Report | First Published: December 05, 2020
Situs inversus totalis is a congenital condition in which major visceral organs are reversed or mirrored from normal position. The incidence accounts from 1/8000 to 1/25000 live born infants. Individuals with situs inversus can live normal healthy lives, without any complications related to their medical condition. Initial examination of an abdomen showed gunshot wound on left upper quadrant of anterior axillary line, without outlet. Tenderness mostly upper part, non-distended, no peritoneal sig...
Open Access DOI:10.23937/2469-5777/1510083
Spontaneous Lung Herniation after Coughing: A Case Series
Robbert Jan Herman Knoef, TM Wemeijer, P Steenvoorde and R de Groot
Article Type: Case Series | First Published: August 30, 2020
Lung tissue protruding out the thoracic cavity is a rare phenomenon called a lung hernia or pneumocele. Most often lung hernias are acquired as a result of trauma or past surgical interventions. In the absence of prior injuries, spontaneous herniation of the lung occurs in small number patients. Since the first documented occurrence in the 15th century there are very limited reported cases, making a spontaneous lung hernia an exceptionally rare diagnosis. Surgical intervention can be considered ...
Open Access DOI:10.23937/2469-5777/1510082
Successful Management of Penetrating Cardiac Injury: Case Report
Carlos Pacheco Molina, Hector Vergara Miranda, Oscar Rene Garcia de Leon, Ilse Andrea Moreno Arquieta and Gerardo Enrique Munoz Maldonado
Article Type: Case Report | First Published: April 30, 2020
Penetrating Cardiac Injury (PCI) is a rare but life-threatening clinical condition in trauma patients. According to previous reports, incidence of PCI admissions to trauma centers has been reported to be of 0.16%, with heterogeneous survival rates being as low as 3% and as high as 84%. This type of injury is a clinical challenge for surgeons due to its short therapeutic window and the fact that its treatment is dictated by the underlying mechanism of injury and hemodynamic status of the patient....
Open Access DOI:10.23937/2469-5777/1510081
Orbital Penetrating Injury by Bamboo-Stick, Mimicking Air in Computed Tomography: A Case Study
Michael Pesis, Navot Givol, Anatoliy Ilgiyaev and Ronit Yagev
Article Type: Case Report | First Published: March 14, 2020
A case report of a penetrating foreign wooden body that was not identified as such on physical examination but was demonstrated on CT scan. A 25-year-old man arrived sedated to the emergency room (ER). On physical examination, a wooden foreign body was observed on the right side of the upper lip. On CT scan, an air mimicking cylinder foreign body was noticed. 3D reconstruction demonstrated a cylinder-shapedobject penetrating into the orbit, breaking the orbital floor, deflecting the globe crania...
Open Access DOI:10.23937/2469-5777/1510080
Imaging Modality and Management of Hepatic Injury in the Trauma Setting
Anthony J Brusnahan
Article Type: Case Report | First Published: February 20, 2020
Through the use of imaging, liver injuries in the setting of blunt abdominal trauma have become easier to grade. These liver injury grades, formed by The American Association for the Surgery of Trauma, have been used to recommend operative versus non-operative management. However, the utilization of a relatively new approach offered by the World Society of Emergency Surgery is taking hemodynamic stability into account. As a result, more patients with severe liver injuries are being managed non-o...
Open Access DOI:10.23937/2469-5777/1510079
Complex Thoraco-Abdominal Trauma: Transdiaphragmatic Intercostal Hernia and Rib Fractures
Sally Shepherd, MD, Annelise Cocco, MBBS, FRACS, Phillip Antippa, MBBS, FRACS and Jacob McCormick, MBBS, FRACS
Article Type: Case Report | First Published: October 14, 2019
Injuries to the costal margin which involve herniation of abdominal contents into the chest are rare. Two major mechanisms of transdiaphragmatic intercostal hernia are recognised: post-traumatic and spontaneous. It is hypothesised that disruption of either the diaphragm or intercostal muscles leads to herniation of the abdominal contents, and that negative intra-thoracic pressure then draws the herniated viscera further into the chest. A 66-year-old male was transferred to the emergency departme...
Open Access DOI:10.23937/2469-5777/1510078
Isolated Avulsion Fracture Lesser Tuberosity of the Humerus, a Rare Presentation Post Seizure
Jaya TS, Hadizie D and TMS Muzaffar
Article Type: Case Report | First Published: September 18, 2019
Isolated humeral lesser tuberosity fracture is rare and is usually associated with fractures of the proximal humerus. Trauma precedes most reported cases. We report a isolated fractured lesser tuberosity occurring in a gentleman post seizure. Open reduction and internal fixation was performed. Functional outcome was successful, and the patient regained his normal pain-free shoulder function 3 months surgery. Avulsion Fracture Lesser Tuberosity of The Humerus is a rare injury that usually occurs...
Open Access DOI:10.23937/2469-5777/1510077
Successful Non-Operative Management of Multi-Trauma Patient Suffering from Multiple Intra-Abdominal Injuries - A Case Report
Georgios Theodoros Liagkos, MD, Christos Chouliaras, MD, Aris Papadopoulos, MD and Constantine Vagianos, MD
Article Type: Case Report | First Published: September 14, 2019
Trauma represents the main cause of death among people under the age of 35 worldwide. Until the 90s, the operative management (OM) was the golden standard of treatment for trauma patients with abdominal bleeding. Over the last few decades, though, a shift has been made from operative to non-operative management (NOM) in haemodynamically stable trauma patients with findings of recent intra-abdominal bleeding and no signs of peritonitis. However, NOM may be particularly challenging in patients wit...
Open Access DOI:10.23937/2469-5777/1510076
Trauma and Compassion Fatigue in Mental Health Professionals Who Help Refugees in the Middle East
Walid Khalid Abdul-Hamid, MBChB, MRCPsych, PhD
Article Type: Original Article | First Published: August 22, 2019
The impact of working with people and helping them with difficult or traumatic experienced has long been recognized. The problems that affect helping professionals have been termed Compassion Fatigue, Secondary Traumatic Stress, Burnout, Vicarious Traumatization. Since the Iraq War and the Arab Spring, the Middle East has been in constant turmoil that results in traumatisation for the local population and to those trying to help them from local and international mental health care organisations....
Open Access DOI:10.23937/2469-5777/1510075
Focused Assessment with Sonography in Trauma (FAST) Examination in a Patient with Situs Inversus and Splenic Contusion
Antonio E Muñiz, MD, FACEP, FAAP
Article Type: Case Report | First Published: May 30, 2019
Situs inversus totalis is a rare anatomic anomaly in which the normal arrangement of the heart and viscera is reversed to form a mirror picture of their usual anatomic position. It typically poses a diagnostic dilemma during the initial assessment acute thoracoabdominal trauma. A case is presented of the findings found on the focused assessment with sonography in trauma (FAST) examination of a young adult with situs inversus who sustained solid organ injury from blunt trauma....
Open Access DOI:10.23937/2469-5777/1510074
A Comparison of Blood Loss with or without Haemostasis after the Tourniquet Released in Minimally Invasive Total Knee Arthroplasty
Fujiang Cao, Tao Liu, Yunqiang Xu and Shiqing Feng
Article Type: Research Article | First Published: May 29, 2019
Eighty-four patients were recruited for a cohort study of the minimally invasive total knee arthroplasty (MISTKA) for the treatment of osteoarthritis. They were divided into two groups, 42 patients with thorough haemostasis in the minimally invasive total knee arthroplasty (group A) and the other 42 patients without a thorough haemostasis procedure in the minimally invasive total knee arthroplasty (group B). The surgery in both groups was carried out by a single surgeon at one institution using ...
Open Access DOI:10.23937/2469-5777/1510073
Choosing the Most Distally Located Digital Artery Perforator as the Pedicle of the Homodigital Island Flap
Article Type: Case Report | First Published: May 29, 2019
It is difficult to cover distal defects of the dorsum, ulnar or radial sides of the finger like those of the nail matrix or a terminal extensor tendon, because there is less soft tissue in this region. Appropriate reconstruction should preserve the aesthetic appearance, provide sensate coverage without pain in important anatomical regions, and minimize donor-site morbidity....
Open Access DOI:10.23937/2469-5777/1510072
STEMI due to Severe Blunt Chest Trauma
Joseph Shiber, MD, FACP, FACEP, FCCM, David Skarupa, MD, FACS and Timothy Hester, DO
Article Type: Case Report | First Published: April 24, 2019
A 50-year-old man was ejected during an ATV collision. On arrival to the trauma center, he was endotracheally intubated for hypoxemic respiratory distress and was noted to have palpable subcutaneous air and decreased breath sounds; thoracostomy tubes were placed bilaterally. New-onset atrial fibrillation with rapid ventricular response (heart rate > 160) was found with ST-segment elevation most pronounced in Inferior leads (Figure 1) Chest radiograph confirmed severe right-sided pulmonary contus...
Open Access DOI:10.23937/2469-5777/1510071
Use of Mouthguards by Amateur Basketball Athletes in Greece and The USA
Elena-Lito Exarchou, Ioannis Kotsanos and Nikolaos Kotsanos
Article Type: Original Article | First Published: April 11, 2019
Mouthguard use reduces the consequences of oral trauma in sports with intense physical contact. The use of mouthguards is recommended by the Academy for Sports Dentistry for all sports involving physical contact and collision, and by the American Academy of Pediatric Dentistry for sports in which orofacial injury can occur, e.g. basketball. The aim of this study is to evaluate mouthguard use and relative knowledge by male amateur Greek and collegiate American basketball athletes....
Open Access DOI:10.23937/2469-5777/1510070
Successful Outcome of Severe Fibrous Dysplasia of the Tibia in a Patient with Mccune-Albright Syndrome, Treated Using a Combined Ortho-Plastic Multidisciplinary Approach
Samena Chaudhry, Saqib Noor, Rob Warner and Paul Fenton
Article Type: Case Report | First Published: March 25, 2019
McCune-Albright syndrome is a genetic disease, defined by a clinical triad of polyostotic fibrous dysplasia of bone, café-au-lait skin spots, and precocious puberty. The case of a young man with McCune-Albright syndrome and fibrous dysplasia resulting in a severe tibial deformity is presented. Due to previous surgeries as a child, and subsequent complications with ongoing infection and soft tissue breakdown, the patient was keen to seek any reconstructive option with a chance of limb salvage......
Open Access DOI:10.23937/2469-5777/1510069
Two-Stage Detected Traumatic Right Diaphragm Rupture after Blunt High-Velocity Trauma
Graulich T, Ringe BP, Wilhelmi M, Zwirner U, Krettek C and Wilhelmi M
Article Type: CASE REPORT | First Published: February 26, 2019
A 30-year-old healthy man was brought to our level-one trauma center after a high-velocity trauma. While riding a quad he was hit by a car with about 60 km/h. Initial scores of Glasgow Coma Scale (GCS) and injury severity score (ISS) were 15. Extremity trauma with moderate craniocerebral injury and abdominal trauma with splenic and hepatic laceration was diagnosed. During follow up on the intensive care unit (ICU) the patient reported unspecific abdominal pain and dyspnea. Sonographic controls o...
Open Access DOI:10.23937/2469-5777/1510068
Penetrating Abdominal Trauma with Vascular Injury: Case Report
Rodolfo Franco Marquez, Marcela Anahi Narro Martinez, Pedro Chavez Jimenez, Oscar Rene Garcia de Leon and Estefania Boland Rodriguez
Article Type: Case Report | First Published: February 07, 2019
Traumatic injuries account for 9.6% of the global burden of disease, they represent the third most common cause of death in young adults and adolescents among patients admitted to hospital facilities; penetrating abdominal trauma remains an important cause of mortality and morbidity. This type of lesions can cause vascular injuries that are associated with massive hemorrhage and could develop physiologic exhaustion, resulting in high reported mortality. Inferior's cava injuries secondary to pene...
Open Access DOI:10.23937/2469-5777/1510067
Ocular Bungee Cord Injury: Case-Report and Literature Review
Jessica Ruel-Laliberte, Louis Morin, Alice Turcot and Patricia Ann Laughrea
Article Type: Case Report | First Published: December 15, 2018
A 27-year-old female patient sustained a left eye injury while manipulating a hook end bungee-type elastic cord. She suffered from severe anterior and posterior segments ocular trauma that required two surgeries and left her with permanent sequelae. The aim of this paper is to present a literature review on ocular trauma associated with bungee cords. On December 7th 2012, a 27-year-old female patient was injured in the left eye in the context of her work. While she was transporting a trolley on ...
Open Access DOI:10.23937/2469-5777/1510066
Medial Clavicle Fracture Dislocation Surgically Treated: Case Report
Miguel Frias, Renato Ramos, Marco Bernardes, Tiago Pinheiro Torres and Pedro Lourenco
Article Type: Case Report | First Published: November 30, 2018
The medial clavicle fracture is a rare injury and almost all the times conservatively treated. Therefore, the number of operations reported in the literature are limited. Posterior dislocation can result in serious complications and such injuries require rapid diagnosis followed by effective treatment to avoid future complications. The present case reports a case of a 33-year-old healthy man that was involved in a high-fall, being diagnosed with a rare displaced medial clavicular fracture associ...
Open Access DOI:10.23937/2469-5777/1510065
A Pharmacokinetic Analysis of Continuously Infused Piperacillin/Tazobactam in Critically Ill Trauma Patients
Kevin M Silinskie, Bradley D Domonoske and Christine S Cocanour
Article Type: Research Article | First Published: November 16, 2018
To define the serum pharmacokinetics of a fixed-dose of piperacillin/tazobactam at 24, 48, and 72 hours of therapy when administered as a continuous infusion in critically ill trauma patients. Although we found a wide variability in serum piperacillin/tazobactam concentrations, the administration of a 16/2 g per day dose as a continuous infusion achieves optimal pharmacokinetic parameters for commonly isolated microorganisms in critically ill trauma patients....
Open Access DOI:10.23937/2469-5777/1510064
Assessing Familiarity of Personnel in an Army-Clinic with New American Heart Association's Basic Life Support (AHA- BLS) 2015 Guideline Updates: A Cross-Sectional Study & Commentary
Article Type: Research Article | First Published: November 16, 2018
"Despite Accidents, Injuries are predictable and preventable". Cardiovascular events are categorized as common sudden death causes in almost every epidemiological study worldwide, which concerns everybody's preparation and readiness to overcome these issues in the scene of accident. This study was designed as a descriptive cross-sectional one to assess familiarity of an army-clinic personnel with new changes and updates of the latest resuscitation guidelines. For this purpose, a questionnaire wa...
Open Access DOI:10.23937/2469-5777/1510063
Isolated Traumatic Close Dislocation of Tarsal Navicular Bone after a Complex Forced Movement of the Foot: A Case Report
Guifo Marc Leroy, Danwang Celestin, Ngo Yamben Marie Ange, Tekpa Bertrand Jean De Dieu, Dubois-Ferriere Victor and Ibrahima Farikou
Article Type: CASE REPORT | First Published: August 30, 2018
Tarsal navicular bone dislocation is a rare condition which can lead to long term disability, mainly due to difficulties to obtain an anatomical reduction. Only few cases have been reported. We report a case of a 21-year-old Cameroonian male who was admitted to the emergency department after a road traffic accident. The physical examination reveals a patient unable to bear weight, with a painful swelling of the antero-medial dorsal region of the right foot, without neurovascular deficits or anot...
Open Access DOI:10.23937/2469-5777/1510062
Intra Capsular but Extra Synovial Foreign Body in the Knee Joint
Article Type: Case Report | First Published: July 11, 2018
Intra-articular foreign bodies especially in the knee joint are well reported. Knee joint is commonly involved due to the large joint area and also due to it being a superficial joint. Foreign bodies enter the joint either by direct inoculation or migration from nearby tissues. Potential complications of intra articular foreign bodies include infection, damage to articular surface and locking of joint. This is a report on a penetrating injury to the knee resulting in an intra capsular but extra ...
Open Access DOI:10.23937/2469-5777/1510061
Temporary External Fixation for Forearm Fractures in Damage Control Orthopedics Procedures: Use of a Simplified Frame
Laurent Mathieu, Antoine Grosset, Ismael Hassan Farah, Nicolas de l'Escalopier, James-Charles Murison and Sylvain Rigal
Article Type: Case Report | First Published: July 06, 2018
External fixation of the forearm may be indicated for Gustilo grade 3B-C open fractures or in unstable polytraumatized patients as part of a damage-control orthopedics (DCO) strategy to prepare secondary conversion to internal fixation by plates. Because conventional forearm frames with separate stabilization of the radius and ulna do not meet DCO requirements, the authors propose to use a single unilateral frame. A case of severe forearm open fracture related to a gunshot wound is presented to ...
Open Access DOI:10.23937/2469-5777/1510060
Traumatization and Trauma Cases: Childhood Adversity and Deafness
Trevor Archer and Madeleine ET Zoller
Article Type: Review Article | First Published: June 14, 2018
The association between adverse childhood experience and later adult psychological health has been well-documented. Thus, the presence of adult, parental, low income, social support and adult adversity are the avenues through which adverse childhood presents its influence upon psychological and somatic health deficits during adulthood. The early childhood environment governs an early highly sensitive period for the development of regional brain circuitry for cognition and emotion, attention, sel...
Open Access DOI:10.23937/2469-5777/1510059
Open Medial Hoffa Fracture with Ipsilateral Femoral Shaft Fracture. Case Report
Abdullah Saad A Abdullah, Nedal Alkhatib, Syed Imran Ghouri and Mohammed Mubarak Alkhayarin
Article Type: Case Report | First Published: April 16, 2018
Hoffa fracture is coronal plane fracture of the femoral condyle that affects the lateral femoral condyle much more than the medial. The combination of medial femoral condyle Hoffa fracture with ipsilateral femoral shaft fracture is very rare combination with only 3 cases was reported previously. This fracture type usually require high energy trauma and it was reported following a motor injury....
Open Access DOI:10.23937/2469-5777/1510058
Improved Outcomes after Surgical Stabilization of Rib Fractures in Patients with Polytrauma and Associated Chest Wall Fractures
Maria Alfaro, Ruby Skinner and Andrea Pakula
Article Type: Original Article | First Published: February 17, 2018
Non-operative management of rib fractures can lead to significant morbidity such as chronic pain, and dyspnea. Up to 40% may also fail to return to work. Over the last decade rib fixation has made resurgence and there are emerging data supporting early fixation in patients that fail aggressive pain control even in non-flail segments. We describe our early experience with early rib fixation in a small cohort of patients with severe chest wall injury....
Open Access DOI:10.23937/2469-5777/1510057
Overall Anatomic Severity and Prognosis in Patients Presenting with, or Requiring a Major Lower Limb Amputation from Civilian Trauma
Sanchez-Arteaga Alejandro, Lusilla-Lopez Alejandro, Zarain-Obrador Leire, Burneo-Esteves Mauricio, Rey-Valcarcel Cristina, Perez-Diaz MaDolores and Turegano-Fuentes Fernando
Article Type: Original Article | First Published: February 01, 2018
Trauma is one of the most frequent mechanisms causing limb amputation. However, major limb amputations are rare in the civilian population, the largest numbers being seen in the military, often caused by explosive devices, and are considered to have, in general, a poorer prognosis, needing more aggressive treatments....
Open Access DOI:10.23937/2469-5777/1510056
Adolescent Idiopathic Torticollis: Morphological Vertebral Changes of the Spinal Canal and the Spinal Cord Position: A Case Report
Pedro Gutiérrez Carbonell and Ruiz Miñana E
Article Type: Case Report | First Published: November 11, 2017
Cervical spinal canal deformities can be caused by muscular deforming forces, as in the case of a 10-year-old male with inveterate left torticollis. Atlas and axis bone deformities were observed, including subluxation of the odontoid apophysis, hypertrophy of the anterior arch of the atlas, hypoplasia of the posterior arches of atlas, and deformation of the spinal canal accompanied by an eccentric position of the spinal cord....
Open Access DOI:10.23937/2469-5777/1510055
Saved by the Bar: A Report of Bullet Deflection by Nuss Bar
Farris Serio and Andrew McCague
Article Type: Case Report | First Published: October 27, 2017
This is the case of a 17-year-old male who was saved from a penetrating thoracic gunshot wound by the extra-thoracic segment of a Nuss bar, placed 7 months earlier for treatment of a pectus excavatum defect. We discuss the significance of non-penetrating thoracic trauma and the workup involved....
Open Access DOI:10.23937/2469-5777/1510054
Fixation of a Distal Diaphyseal Tibia Fracture with Neurovascular Tissue Incarceration: Surgical Technique Using a Lesser Invasive Approach
Wilson Belaieff, Dennis Dominguez and Axel Gamulin
Article Type: Case Report | First Published: July 19, 2017
Soft tissue incarceration in a distal diaphyseal tibia fracture may predispose to adverse fracture healing. Incarcerated soft tissue may include nerves and/or vessels, with the potential for neurovascular complications....
Open Access DOI:10.23937/2469-5777/1510053
Traumatological Application of 3D Model in Complex Acetabular Fractures
Battiato C, Basiglini L and Giovannini F
Article Type: Case Report | First Published: April 14, 2017
Three-dimensional reconstruction (3D) and rapid prototyping (RPT), starting from computed tomographic (CT) examinations, is a promising technology in traumatology. It facilitates the planning and surgical results of complex fractures. Here, we used it in a complex bilateral acetabulum fracture for the assessment of the injury type and for improving knowledge of the fracture fragments....
Open Access DOI:10.23937/2469-5777/1510052
Life-Threatening Hemorrhage from Scrotal Arteriovenous Malformation Post Pelvic Fracture: A Case Report and Review of the Literature
Wei Wei, Bryan Collier and John Ferrara
Article Type: Case Report | First Published: March 25, 2017
We report a rare case of a patient with known Child Class B type alcoholic cirrhosis who developed bleeding from an arteriovenous malformation (AVM) of scrotum after suffering a traumatic pelvic fracture. The patient subsequently developed hemorrhagic shock secondary to spontaneous bleeding from the scrotal AVM. Emergent pelvic angiogram with selective embolization was successful in controlling the bleeding....
Open Access DOI:10.23937/2469-5777/1510051
I Can't Find the Left Iliac Artery! Abdominal Stab Wound Leading to Uncontrollable Hemorrhage
TL Freeborn, R Shinar, B Siegrist, N Keric, NY Patel and AJ Feinstein
Article Type: Case Report | First Published: February 28, 2017
he patient was taken immediately to the operating room for laparotomy and was found to have an expanding retropertioneal hematoma. Aortic occlusion did not slow progression. The left iliac artery could not be located. A femoral cut down and proximal control of the femoral artery was also not helpful....
Open Access DOI:10.23937/2469-5777/1510050
Kirschner Wire Migration from Proximal Humerus into the Lung: Brief Report
Guy Aristide Bang, Albert Nana Muluem, Blondel Nana Oumarou, Marie Ange Ngo Yamben and Daniel Hany Eone
Article Type: Case Report | First Published: February 27, 2017
Although uncommon, migration of wires to solid organs or body cavities has been reported in the literature with potentially lethal complications. Wire migration into the lung is rare....
Open Access DOI:10.23937/2469-5777/1510049
Bilateral Patella Sleeve Avulsions in an Otherwise Healthy Nine-Year-Old Girl: A Case Report and Review of the Literature
Shazaan F Hushmendy, Timothy T Roberts, Elaine Tran and Garrett R Leonard
Article Type: Case Report | First Published: February 25, 2017
A patella sleeve avulsion is a rare but devastating injury seen in children aged 8-to-12 years. This soft-tissue disruption is frequently missed upon initial presentation. The radiographic findings may be subtle and advanced imaging is often necessary to elucidate the pathology....
Open Access DOI:10.23937/2469-5777/1510048
Surgical Management of an Atypical Femoral Non-Union Fracture with Bone Morphogenic Protein Supplementation
Jike Lu and Masumi Maruo Holledge
Article Type: Case Report | First Published: February 23, 2017
This is a case report of a surgical treatment of the non-union of an atypical femoral fracture (AFF), associated with prolonged bisphosphonate use. The case is one of a subtrochanteric non-union and implant failure, after an index procedure of a trochanteric entry-point-locked cephalomedullary nailing....
Open Access DOI:10.23937/2469-5777/1510047
Delayed-Onset Pericarditis in Non-penetrating Blunt Force Trauma: A Case Report
Andrew Mc Cague, Kerala Serio and Joanne Leibe
Article Type: Case Report | First Published: December 24, 2016
There have been rare documented instances where blunt-force trauma has been suspected to cause a delayed disease process that manifests days or weeks after the initial injury. This is a case report of a 30 year old male who suffered blunt chest trauma during a motor vehicle accident. On hospital day five the patient began to complain of significant chest pain, an increase in pain with each heartbeat, increased pain when sitting up, shortness of breath and experienced a syncopal episode in the sh...
Open Access DOI:10.23937/2469-5777/1510046
Isolated Pancreas Injury by Blunt Trauma, a Case Report
Samet Sahin, Raziye Duruk, Cengiz Ceylan, Erdinc Cetinkaya and Mesut Tez
Article Type: Case Report | First Published: December 24, 2016
We here in present our experience with the rare injury of main pancreatic duct because of the blunt trauma and managed by pancreatico-enterostomy. A 35-year-old male patient presented with a motor vehicle accident and was diagnosed isolated pancreas main duct ınjury by blunt trauma. Computerized tomography (CT) was used as a diagnostic method and were confirmed by Endoscopic retrograde cholangiopancreatography (ERCP)....
Open Access DOI:10.23937/2469-5777/1510045
Isolated Dislocation of the Tarsal Navicular without Fracture: Case Report
Maicon Bonaldo Dias, Bruna Zagonel, Melissa Sofia Dickel, Jessica Arsego Talheimer, Isabel Schuster Argenton, Jeniffer Charlene Silva Dalazen, Bruno Vicenzo Thomas Bresolin, Gabriel Alves Martinelli, Osvaldo Iha Yoshida, Patricia Tirelli Lena, Romualdo de Lima Pilecco, Vitor Hugo Peijo Galerani, Ana Cristina Eickhoff, Eduardo Rosa Otharan and Rafael Duvelius Ott
Article Type: Case Report | First Published: November 28, 2016
Isolated dislocation of the tarsal navicular bone is a rare lesion. The mechanism of this specific trauma is still not well to understood, due to the strength needed in different ways and directions for its occurrence, in a complex way. Few cases of an isolated dislocation of the navicular reported in medical literature, and there is little information about complications how the patients evolve after years of postoperative. The authors present a case of a woman, 39-years-old, who suffered a com...
Open Access DOI:10.23937/2469-5777/1510044
Free Flap Coverage of a Medial Ankle Wound in a Patient with Arteria Peronea Magna
Steven L Peterson and Tuan A Nguyen
Article Type: Case Report | First Published: November 28, 2016
While the vascular anatomy to the lower extremity is fairly consistent, anatomical variants do exist. One such variant is the arteria peronea magna. This anatomic variant results in single vessel arterial flow to the foot through an enlarged peroneal artery with unique distal branching. The focus of interest in this vascular pattern in microsurgery has been increased risk of lower extremity devascularization during harvest of a free fibular flap for reconstruction at other anatomical sites. This...
Open Access DOI:10.23937/2469-5777/1510043
Bilateral Simultaneous Rupture of the Quadriceps Tendons in Healthy Individuals
Takuro Moriya and Abe Yoshihiro
Article Type: Case Report | First Published: October 18, 2016
Quadriceps tendon rupture is an uncommon injury in healthy individuals. This paper presents two case reports of patients of bilateral quadriceps tendon rupture, who were misdiagnosed as muscle weakness of quadriceps with contusion of the knee joint. Subsequent physical examination showed a supra-patellar gap, moderate hemarthrosis of both knees, and failure of active knee extension. MRI showed bilateral rupture of the quadriceps tendons at the osteotendinous junction. Radiographs described the d...
Open Access DOI:10.23937/2469-5777/1510042
Tillaux and Volkmann Fractures: A Report on Two Cases, Treatment Determined by Syndesmosis Instability
Jike Lu and Masumi Maruo Holledge
Article Type: Case Report | First Published: September 15, 2016
We report two cases of isolated Tillaux fracture and Volkmann fracture without other associated ankle fractures. The case of Tillaux fracture was a 15-year-old female who tripped and fell over during a 400 m hurdle running competition. Preoperative radiographs and CT scans showed Salter-Harris type III, an isolated Tillaux fragment, with more than 2 mm anterior and lateral displacement. Surgical stabilization of Tillaux fragment was performed via anterolateral minimal invasive approach with anat...
Open Access DOI:10.23937/2469-5777/1510041
Subtrochanteric Fracture Non-Union with Implant Failure Managed with Exchange Intramedullary Nail with Autogenous Bone Graft and Supplement of Bone Morphogenic Protein
Jike Lu and Masumi Maruo Holledge
Article Type: Case Report | First Published: September 14, 2016
We report unusual subtrochanteric non-union and metalwork failure after an index procedure of a trochanteric entry-point-locked cephalomedullary nailing. We treated this non-union case successfully with the exchange of a thicker and longer intramedullary (IM) nail, supplemented by autologous iliac crest bone graft and bone morphogenic protein 7 (BMP-7). We think the success is due to the optimisation of the mechanical environment (the revision of fixation) along with the enhancement of the biolo...
Open Access DOI:10.23937/2469-5777/1510040
Cyst-Like Cortical Defects Following Fractures in Children: Series of 5 Cases
Inmaculada Gonzalez Perez, Jose T Lopez Salinas, Luis A Gomez Navalon, Patrick Pilkington Woll and Patricia Vivar del Hoyo
Article Type: Clinical Cases | First Published: August 14, 2016
Purpose: The cyst-like defect following a fracture is an uncommon lesion with a few cases described in the literature. We want to present a series of 5 cases showing up in different locations, with treatment required for one of the defects. Methods: We present a series of 5 cases of cyst-like defect following fractures in children. The cyst-like defects were in different locations....
Open Access DOI:10.23937/2469-5777/1510039
Wilderness Care of Acute Traumatic Wounds Curriculum
Caleb D Sunde and Susanne J Spano
Article Type: Perspective | First Published: July 20, 2016
A comprehensive approach to wound care is critical when in the wilderness where definitive care may be hours, days or weeks away. The limitation of resources and the variety of acute traumatic wounds presents a management challenge. Resources for wilderness experiences with wound care are sparse. We developed an adaptable curriculum to teach participants of all levels how to appropriately manage wounds using established and improvised techniques....
Open Access DOI:10.23937/2469-5777/1510038
Outcome of Bilateral Simultaneous Fracture Neck of Femur in Patients with Low Socioeconomic Status
Mahmoud A Hafez, Hosamuddin Hamza and Ahmed Mounir Al-Dars
Article Type: Research Article | First Published: June 27, 2016
Fracture neck of femur (NoF) is a rare injury but represents a serious condition in low-income countries. It results from major or minor-repetitive trauma(s) or from different pathological conditions such as parathyroid or renal dysfunction, antiepileptic medication, seizure and tumors. Similarly to other hip fractures, the diagnosis of this condition can be missed where management becomes more complicated. The present study was conducted in a country with low socioeconomic status to assess the ...
Open Access DOI:10.23937/2469-5777/1510037
Bilateral Osteochondrosis of Medial Cuneiform and Tarsal Scaphoid: A Case Report
Ceccarelli F, Carolla A and Calderazzi F
Article Type: Case Report | First Published: May 27, 2016
Osteochondrosis has been found in most of the bones of the body. We report a rare case report of bilateral osteochondrosis of medial cuneiform and tarsal scaphoid. A five year-old white child with a completely benign medical history presented with bilateral foot pain. Radiographical studies showed a bilateral irregular outline and an increased density of medial cuneiforms and tarsal scaphoids. Physical activity restriction and medical therapy appear to be sufficient for pain relief. This "syndro...
Open Access DOI:10.23937/2469-5777/1510036
Pigmented Villonodular Synovitis: Unusual Locations in Two Young Soccer Players
Yanguas Javier, Domi nguez David, Florit Daniel, Terricabras Joaquim, Puigdelli vol Jordi, Brau Juan Jose, Lizarraga Mari a Antonia and Pruna Ricard
Article Type: Clinical Cases | First Published: May 01, 2016
Pigmented villonodular synovitis is a relatively rare idiopathic proliferative disorder affecting the synovium of joints, bursae and tendon sheaths. Knee and hip are the most affected joints. We report two cases of unusual locations in two young male soccer players (17 and 13 years old): distal tibiofibular joint and pes anserine bursa. Diagnoses were confirmed by magnetic resonance imaging (MRI). In the first case the treatment was conservative, followed-up by MRI and computed tomographic sever...
Open Access DOI:10.23937/2469-5777/1510035
Acute Compartment Syndrome Following Anterior Cruciate Ligament Reconstruction with Autologous Hamstring Graft
Benjamin Wheatley and Matthew Oetgen
Article Type: Case Report | First Published: April 01, 2016
Compartment syndrome is an extremely rare complication described in association with anterior cruciate ligament (ACL) reconstruction. Previous reports have described this complication as a result of extravasation of fluid into dependent compartments. One proposed mechanism is from a capsular defect that allows irrigation fluid to flow from the joint into lower leg muscular compartments. However, no reports could be found linking the development of compartment syndrome to bleeding from the graft ...
Open Access DOI:10.23937/2469-5777/1510034
Lasanka De Silva, Lachlan Mc Combie Batty, Neil Fergus Mackay and Jonathan Seymour Mulford
Article Type: Case Report | First Published: March 17, 2016
A 76 year old right hand dominant male retired anaesthetist presented with a painful and swollen right wrist after falling from standing height, landing on the ulnar aspect of his out stretched right hand. The injury was closed and the limb was neurovascularly intact. He had a previous distal radius fracture years ago previously treated non-operatively. Wrist radiographs demonstrated an isolated scaphoid dislocation (Figure 1)....
Open Access DOI:10.23937/2469-5777/1510033
The Trauma Associated with TMJA and Surgical Methods of Temporomandibular Joint Ankylosis
Jin Qiu and Ming Zhang
Article Type: Case Report | First Published: February 25, 2016
Temporomandibular Joint Ankylosis (TMJA) is a severe disease which affects the function of oral and maxillofacial system. It leads to mouth opening limitation, facial deformity and OSAHS in the severe cases. The most common cause of ankylosis involves trauma, most frequently associated with condylar fractures....
Open Access DOI:10.23937/2469-5777/1510032
Tibial Plateau in Combination with Diaphyseal Fracture: A Case Study
Ran Atzmon, Zachary Sharfman T, Oded Rabau, Gabriel Agar, Yiftah Beer and Dror Lindner
Article Type: Case Report | First Published: February 09, 2016
Simultaneous tibial plateau and diaphyseal tibial fractures are a rare occurrence and have seldom been reported in the literature. Each fracture requires a different surgical approach, which creates challenges for the operating physician. Tibial plateau fractures require anatomical reduction and restoration of the joint line in order to achieve rigid fixation and immediate mobilization of the joint. Conversely, diaphysis tibial fractures can be treated with relative stability and do not require ...
Open Access DOI:10.23937/2469-5777/1510031
A Case Report of a Rare Complication of an Intrapelvic Migration of the Lag Screw of a Gamma Nail: Review of the Literature
Dimitrios Georgiannos, Vasilios Lampridis and Ilias Bisbinas
Article Type: Case Report | First Published: February 06, 2016
Gamma nail is a safe internal fixation device widely used for treatment of pertrochanteric fractures. Cut out of lag screw has been reported to be the most frequent mechanical complication. Penetration of acetabulum and intrapelvic migration of the lag screw of the gamma nail is an extremely rare complication. We report two cases of medial migration and penetration of the medial wall of acetabulum by the lag screw of a gamma nail and a comprehensive review of the literature....
Open Access DOI:10.23937/2469-5777/1510030
Raoul van Vugt and Peters J
Article Type: Clinical Image | First Published: February 06, 2016
A 65-year-old male with a history of an oligodendroglioma (for which debulking surgery in 2012) was presented in our emergency department by ambulance paramedics after he had fallen in his kitchen. Initial examinations revealed an awake, hemodynamically normal patient with a knife penetrating the medial side of his face, just below the right eyeball. Looking at the depth and position of the knife, the assessment was that it was a sharp, pointed knife that went in with a lot of force....
Open Access DOI:10.23937/2469-5777/1510029
18-Fluordesoxiglucose Positron Emission Tomography (PET) in Evaluating Neurological Prognosis after Cardiac Arrest Resulting from Hanging: A Case Report
Marco Ciapetti, Andrea Cecchi, Marco Mangini, Valentina Berti, Matteo Bartolini, Alberto Pupi and Adriano Peris
Article Type: Case Report | First Published: January 30, 2016
We report clinical and 18 - FDG PET features of a 58 years old woman found in cardiac arrest after an attempt of hanging. The patient was resuscitated and transferred to our Emergency Intensive Care Unit (ICU), where she was treated for 23 days and then she was discharged to a neuro rehabilitation long term care center with a Glasgow Coma Scale (GCS) of 6. A 18 F - FDG PET with semi quantitative glucose metabolism measurements was performed showing a global reduction in supra tentorial areas, in...
Open Access DOI:10.23937/2469-5777/1510028
Radial Head Fractures Treated with Open Reduction and Internal Fixation
Moghaddam A, Raven TF, Kaghazian P, Studier-Fischer S, Swing T, Grutzner PA and Biglari B
Article Type: Research Article | First Published: January 21, 2016
Radial head fractures are responsible for 2 to 5% of adult fractures. Especially problematic is the treatment of dislocated and unstable fractures which often have a worst prognosis. The purpose of this study was to evaluate the results of open reduction and internal fixation (ORIF) in the treatment of radial head fractures....
Open Access DOI:10.23937/2469-5777/1510027
Missed Spinal Lesions in Traumatized Patients
Ana M Cervan de la Haba, Miguel Rodriguez Solera J, Miguel S Hirschfeld Leon and Enrique Guerado Parra
Article Type: Case series | First Published: January 15, 2016
Overlooked spinal injuries and delayed diagnosis are still common in traumatized patients. The management of trauma patients is one of the most important challenges for the specialist in trauma. Proper training and early suspicion of this lesion are of overwhelming importance. The damage control orthopaedics, diagnosis and treatment algorithm applied to multitrauma patients reduces both morbidity and mortality in polytrauma patients due to missed lesions....
Open Access DOI:10.23937/2469-5777/1510026
Association between Sequential Organ Failure Assessment Score and In-hospital Deaths of Surgical, Critically Ill Patients with Sepsis
Noboru Harada, Ken Shirabe, Shinji Itoh, Hideaki Uchiyama, Motoyuki Yamagata, Fumiaki Kishihara, Takashi Maeda, Nao Kinjo, Kensaku Sanefuji, Yosuke Kuroda, Kazutoyo Morita, Tomoharu Yoshizumi, Toru Ikegami, Yo-ichi Yamashita, Yoshihiko Maehara and Study group of refractory disease in hepato-pancreato-biliary surgery
Article Type: Original Article | First Published: January 13, 2016
Sepsis, defined as infection-induced systemic inflammatory response syndrome (SIRS), is the leading cause of death in non-cardiac critically ill patients. In the United States, nearly 200,000 deaths per year are attributed to sepsis. Worldwide, as many as 20 million people may experience sepsis annually, with a mortality rate of about 35%. Sepsis involves multiple mechanisms, including the release of cytokines and the activation of the complement, coagulation and fibrinolytic systems....
Open Access DOI:10.23937/2469-5777/1510025
Using D-β-Hydroxybutyrate Containing Solutions to Treat Hyperglycemia Induced by Shock or Injury Instead of Insulin may Circumvent Insulin Resistance and Provide Cells with the Energy Required to Maintain Vital Processes through Preserving Normal Mitochondrial Function without Causing Hypoglycemia
Veech RL and Valeri CR
Article Type: Review Article | First Published: January 13, 2016
Severe injury, infection and hemorrhage all cause insulin resistance and hyperglycemia. Insulin resistance blocks glucose entry into cells and the conversion of pyruvate to acetyl CoA impairing cellular energy production. During insulin resistance, glucose cannot enter muscle and fat cells nor can the cell metabolize the lactate given in lactated Ringer's solution with the occurrence of hyperglycemia. More importantly in all cells the mitochondrial pyruvate dehydrogenase (PDH) activity is decrea...
Open Access DOI:10.23937/2469-5777/1510024
Liver Injury Associated with Chest Compression in Cardiopulmonary Arrest Patients
Takeshi Nishimura, Ayana Okamoto, Noritomo Fujisaki, Yoshiyuki Orihara, Ten Saita, Kunihiro Shirai, Isamu Yamada, Atsunori Nakao and Joji Kotani
Article Type: Review Article | First Published: January 12, 2016
We reviewed and summarized fifteen cases associated with liver injury following chest compression for CPA reported in Japan. In some cases, cardiopulmonary resuscitation (CPR) was administered by medical assistants such as doctors or medical technicians, but in other cases, CPR was given by bystanders. Five patients were male and eight were female, with ages ranging from 31 to 83 years old. Unfractionated heparin was administered to ten patients as a treatment for embolism or indication of veno-...
Open Access DOI:10.23937/2469-5777/1510023
Symptomatic Yuxta-articular Facet Cyst: A Case Report
J Miguel Rodriguez Solera, Ana M Cervan de la Haba, Miguel S Hirschfeld Leon and Enrique Guerado Parra
Article Type: Case Report | First Published: December 30, 2015
We report a case of 66 years-old male with left leg pain that began six months earlier. The pain was aggravated by sitting or climbing stairs but was relieved in the standing position. The physical examination was consistent with a left radiculopathy without sensory or motor deficit. His initial MRI lumbar spine demonstrated a cystic mass with T1 and T2 hyperintensity on the L3-L4 level with considerable thecal sac and nerve root compression. The lesion originated next to the left L3-4 facet joi...
Open Access DOI:10.23937/2469-5777/1510022
Fracture-Dislocation of the Upper Thoracic Spine without Neurologic Associated Injury: Two Cases Report
J Miguel Rodriguez Solera, Ana Maria Cervan de la Haba, Miguel S Hirschfeld Leon and Enrique Guerado Parra
Article Type: Case Report | First Published: December 22, 2015
We report a case of 51 years-old male with no past medical history, who was brought to our Hospital after falling from a 10 meters high roof. He had 15 points at Glasgow Coma Scale (GCS) and a completely normal neurological examination. A whole body computerized tomography (CT) scan was performed and diagnosed a fracture-dislocation at T8-T9. Acute surgery was decided, performing an open reduction and internal fixation with pedicle screws from T6 to T1. Clinical outcome was favorable....
Open Access DOI:10.23937/2469-5777/1510021
Investigation of Intraventricular Hemorrhage Volume in Motor Vehicle Crash Occupants
Jillian E Urban, Christopher T Whitlow and Joel D Stitzel
Article Type: Original Article | First Published: December 17, 2015
Motor Vehicle Crashes (MVCs) are a leading cause of traumatic intracranial injuries which often have devastating impacts on morbidity and mortality. Intraventricular hemorrhage (IVH) is one type of head injury that is identified on post-traumatic computed tomography (CT) scans. IVH is observed less frequently in patients with head trauma, however it is often associated with severe head trauma and negative prognostic outcomes and causation of traumatic IVH is not well-understood. The severities o...
Open Access DOI:10.23937/2469-5777/1510020
Fracture of the Femoral Neck: SOIB Method
Rinaldo Giancola, Lorenzo Marchesi and Guido Antonini
Article Type: Case Report | First Published: December 14, 2015
Treating fractures of the proximal femur remains a controversial problem. Fractures of the femoral neck occur almost exclusively amongst the elderly (fractures due to bone frailty associated with osteoporosis), whereas fractures in younger people are due to high-energy trauma. The current treatment trend in clinical practice and the literature for these fractures is prosthetic replacement. In this article the authors describe the case of an 81-year-old woman who underwent osteosynthesis due to a...
Open Access DOI:10.23937/2469-5777/1510019
Split Fracture and Displacement of Mandibular Lingual Cortical Plate of Mandibular Symphysis Requires Fixation
Masaki Fujioka, Kenji Hayashida and Hiroto Saijo
Article Type: Case Report | First Published: December 3, 2015
The first priority in the management of comminuted mandibular fractures is the prevention of acute upper airway obstruction. Each division of mandibular fractures may cause respiratory obstruction. Among the variety of such fractures, split fracture of the symphyseal lingual cortical plate has a significant influence on the oropharyngeal and laryngopharyngeal airway spaces, and causes a markedly restricted ventilatory function. As the bony fragment is pedicled to the geniohyoid and genioglossus ...
Open Access DOI:10.23937/2469-5777/1510018
Third Metacarpal Shortening Osteotomy to Improve Hand Appearance after Index Ray Amputation
Perez-Garcia A, Cavadas PC, Lorca-Garcia C, Thione A and Aranda F
Article Type: Case Report | First Published: December 2, 2015
Ray amputation is a good option in failure or no possible replantation, or in cases of useless finger or stump. Index ray amputation poses a decrease in grip strength, but does not represent a major impairment to the usual activities because its role in precision and key pinch can be adopted by the third finger. The cosmetic aspect is highly acceptable; however, after this procedure, the long finger loses its central position in the hand, which leads to a less natural appearance....
Open Access DOI:10.23937/2469-5777/1510017
A Rare Cause of Lower Airway Obstruction Due to Inhalation of Illicit Drug Packet
P Ruggiano, MC Ferraro, A Franci, N Stanflin, M Bonizzoli, A Peris and Filippo Socci
Article Type: Case Report | First Published: November 23, 2015
We report a case of a previously healthy 29-year-old male who experienced a severe traumatic brain injury with right temporal extracerebral intracranic hematoma and splenic injury after massive trauma sustained after a car accident. The patient was on his bike, he missed a red traffic light, and a car invested him and threw him 4 meters away. In the prehospital setting, the patient was found with GCS 3, with pupils equals, round and reactive to light with good hemodynamics. The medical emergency...
Open Access DOI:10.23937/2469-5777/1510016
Orbital Floor Reconstruction in Facial Asymmetry: A Clinical Case
Maglione Michele, Sossi Davide, Paolo Cecchini and Rizzo Roberto
Article Type: Case Report | First Published: November 21, 2015
Orbital floor blowout fractures may cause severe facial asymmetry, particularly when combined with panfacial fractures with wide bone defects. Surgical repair recommendations depend on multi-disciplinary clinical evaluation and digital imaging to assess the amount of soft tissues herniation, the infraorbital nerve and rectum inferioris muscle entrapments, the ocular bulbus dislocation, and the ocular diplopia. A second surgery intervention may be required particularly when the orbital floor frac...
Open Access DOI:10.23937/2469-5777/1510015
Epidemiology and Diagnosis of Ipsilateral Femoral Neck and Shaft Fractures: A Systematic Review of 1761 cases in 1758 Patients (I.1990-VI.2015)
Antonio Barquet, Joao Matheus Guimaraes, Enrique Barrios, Mariela Garau, Robert D Zura and William C Eward
Article Type: Review article | First Published: November 14, 2015
Objectives: Ipsilateral femoral neck and shaft fractures [IFNSF] are uncommon. The existing literature is characterized by a diversity of small reports with a lack of consensus. We performed a systematic review to examine the epidemiology and diagnosis of this injury. Methods: Nineteen databases were used to find articles published between January 1990 and June 2015 with no language restriction. Inclusion criteria were studies describing a minimum of five patients 16 years old or older with acu...
Open Access DOI:10.23937/2469-5777/1510014
Is That Only a Spinous Process Fracture? Report of a Case of a C6 Spinous Process Fracture with Accompanying Complex Ligamentous Injury Resulting in a Delayed Unilateral Facet Dislocation at the C6-7 Level
Gergely Bodon, Juergen Degreif, Harald Seifarth and Tobias Pitzen
Article Type: Case Report | First Published: November 10, 2015
A 76 years old patient suffered a motor vehicle accident and was brought to our hospital with neck pain and an occipital wound. On the initial polytrauma computed tomography (CT) an isolated spinous process fracture of C6 with hematoma among the posterior soft tissues was diagnosed as well as fracture of the right L1 transverse process. CT of the cervical spine showed no signs of segmental instability. Conservative treatment was introduced and the patient was provided with a soft cervical collar...
Open Access DOI:10.23937/2469-5777/1510013
The Impact of a Progressive Multidisciplinary Program for Trauma in the Elderly: Outcomes were impacted at the Extremes of Age
Nadir Adam, Ruby Skinner, Satbir Dhillon and Maureen Martin
Article Type: Research Article | First Published: November 5, 2015
The growing elderly population requires special consideration for high-risk medical and surgical care related to traumatic injury. The aim of our study is to evaluate the impact of multidisciplinary care program on outcomes in elderly trauma patients. In addition, the impact of the extremes of age on outcomes was evaluated in the elderly cohort....
Open Access DOI:10.23937/2469-5777/1510012
Organ Donation in a Pediatric Trauma Victim
Jessica Gantz and Savithiri Ratnapalan
Article Type: Case Report | First Published: October 24, 2015
A previously well 7 year old female was struck by a car traveling 60-70 kms/hr while crossing the street on her bicycle. She had no helmet on at the time of the collision, was thrown 15 feet and landed on her head according to witnesses at the scene. Initial assessment by paramedics within 5 minutes of the event demonstrated a palpable pulse, a patent airway, but no respiratory effort. Initial Glasgow Coma Scale (GCS) was recorded as 3. Other obvious injuries noted were an open right femur frac...
Open Access DOI:10.23937/2469-5777/1510011
Segmental Bone Muscle and Skin Cross Leg Flap for the Treatment of Posttraumatic Infected Segmental Bone Defect in a Child - A Case Report
Piotr Pedzisz, Ireneusz Babiak, Jakub Janowicz and Mateusz Kulig
Article Type: Case Report | First Published: September 21, 2015
A mangled limb in a pediatric patient produces therapeutic dilemma whether to amputate or salvage greater than in adult. We herein present a case of a 10 year old child with high energy injury to both lower limbs. The bone muscle and skin segment of the limb planned for amputation has been used as a 'spare part' for the contralateral shin defect in order to save at least one weight bearing limb. The cross leg flap has been successful. The patient walks without limp using PTB prosthesis....
Open Access DOI:10.23937/2469-5777/1510010
Managing Fractures at the Thoracolumbar Junction in Developing Nations: A Review of 89 Cases
Article Type: Review Article | First Published: September 21, 2015
Fractures at the thoracolumbar junction are the most commonly encountered spine injuries in developing countries. Despite the devastating consequences for those with concomitant neurologic deficits, within hospitals having limited resources there remains an attitude akin to 'therapeutic nihilism'; i.e. simply keeping these patients at prolonged bedrest and then bracing them, while 'hoping for the best'. Over an 18-year period encompassing some 100 working/teaching trips abroad to underserved are...
Open Access DOI:10.23937/2469-5777/1510009
Gun Shot Wound to Left Chest with 'Transmediastinal' Trajectory. A Case Report and Review
Reilly D. Hobbs, Joshua A. Marks, John C. Kucharczuk and Patrick M. Reilly
Article Type: Case Report | First Published: September 18, 2015
A 21-year old African American male presented with a single gunshot wound to the left posterior chest inferior and medial to the scapular spine. EMS performed a left needle thoracostomy for tension pneumothorax. In the trauma bay, the patient was hemodynamically stable with a GCS 15 and moving all extremities. A chest tube was placed with an initial output of 700 mL of blood and the patient was intubated. A portable chest radiograph demonstrated a bullet overlying the right inferior hilum....
Open Access DOI:10.23937/2469-5777/1510008
The Safety and Therapeutic Effectiveness of Universal Donor Frozen RBC, Frozen Platelets and Frozen Plasma Stored at - 80℃ in Mechanical Freezers to Treat Wounded Casualties
C.R. Valeri and G. R. Giorgio
Article Type: Review Article | First Published: September 12, 2015
The frozen blood products will eliminate or reduce the severe adverse events of mortality and morbidity associated with the current FDA approved red blood cell products, platelet products and plasma products. The universal donor group O positive and O negative frozen RBC, group O leukoreduced single donor frozen platelets, and AB frozen plasma obtained from male donors will provide blood products that are compatible with acceptable in vivo survival and function to treat patients and reduce or el...
Open Access DOI:10.23937/2469-5777/1510007
Analysis of a Clinically Failed, Mechanically Intact, Reconstructive Compression Plate
Bharadwaj Cheruvu, Sunil Karmacharya, Richard Laughlin and Tarun Goswami
Article Type: Research Article | First Published: September 07, 2015
A reconstructive orthopedic bone plate was submitted for analysis. Traditional failure analysis methods were used to assess the mode of the plate failure. Metallographic investigation of the plate was carried out in this report. Since limited data was available in the literature and clinical data related to subject demography, date of removal as well as reasons for removal unknown, in depth analysis was not possible. However, the plate was received in in-tact condition with minor biological depo...
Open Access DOI:10.23937/2469-5777/1510006
Traumatic Bilateral Renal Artery Thrombosis: A Case of Kidney Salvage with Local Lytic Therapy and Systemic Anticoagulation in the Setting of Poly-trauma
Allan Capote, Martin Goldman, Kevin Kemp and Ruby Skinner
Article Type: Case Report | First Published: August 28, 2015
With the advent of advances in endovascular techniques and interventional radiology, the treating physician has added very useful and relatively less invasive methods of managing otherwise complex traumatic injuries compared to open surgical techniques. One such application is in the treatment of acute traumatic solid organ injuries, and some of the earliest applications related to the management of blunt spleen and liver injuries. Acute traumatic renal artery occlusion is a rare pattern of kidn...
Open Access DOI:10.23937/2469-5777/1510005
Primary Total Elbow Arthroplasty in the Treatment of Complex Elbow Fracture: A Case Report
Pedro Miguel Campos, Barbara Rosa, Andre Barros, Carlos Durao, Gloria Magalhaes, Clara Julio and Pedro Quinaz Neto
Article Type: Case Report | First Published: August 01, 2015
A 54-year-old male patient presented at our emergency department in the sequence of a motorcycle accident, which caused an open fracture of the left elbow, classified as type IIIB of Gustilo and Anderson. The X-ray showed comminuted fractures of distal humerus and proximal ulna with bone loss from both epiphysis. He started antibiotherapy and was submitted to immediate surgical debridement, provisional fixation with an external fixator and skin closure. The external fixator was removed 2 months ...
Open Access DOI:10.23937/2469-5777/1510004
Early Stage Tibia Osteomyelitis Despite The Use of Hydroxyapatite Schanz Screws: A Case Report
Ali Cagri Tekin, Murat Cakar, Mujdat Adas, Mehmet Kursad Bayraktar, Haluk Cabuk, Ali Yuce and Yusuf Ozcan
Article Type: Case Report | First Published: July 16, 2015
In a 7-year old patient with a right cruris Grade 1 open fracture, an external fixator was applied using hydroxyapatite-covered Schanz screws. After 6 weeks the fixator and screws were removed. Two months after the removal of the fixator, the patient presented with pain in the proximal of the medial pin site and osteomyelitis was determined in the proximal right cruris. Surgical debridement was applied and from the pathology examination of material taken intraoperatively, osteomyelitis was deter...
Open Access DOI:10.23937/2469-5777/1510003
Childhood Maltreatment Trauma: Relevance for Adult Physical and Emotional Health. A Review
Lindsay Hamilton, Valerie Micol-Foster and Maria Muzik
Article Type: Review Article | First Published: June 04, 2015
Childhood maltreatment (CM) is a widespread public health concern in the U.S. as it affects almost four million children annually. The adverse consequences of CM can be seen across development from attachment disturbances and developmental delays in infancy to an increased risk for conduct and emotional problems in later childhood and adolescence. In addition, the associations between CM and negative outcomes have been traced as far as adulthood to mental and physical wellbeing of adult survivor...
Open Access DOI:10.23937/2469-5777/1510002
A Metabolic Stress Fracture of the Mandibular Condylar Head
Sabah Kalamchi and Trent C Clifton
Article Type: Case Report | First Published: May 02, 2015
Fractures of the mandibular condyle and neck are very common with well recognized anatomical features. This patient sustained an anatomically unusual right condylar head fracture with subluxation secondary to ictal myocontraction where there was no fall or facial trauma during or after the seizure. Investigation suggested an underlying disturbance in bone metabolism. We found one case report of mandibular stress fracture as a result of reflexive myo contraction of the temporalis and lateral pter...
Open Access DOI:10.23937/2469-5777/1510001
Algorithms of Flap Reconstruction in High-Voltage Electrical Injuries: 26 Years Experience
Cengiz Eser, Erol Kesiktas, Eyuphan Gencel, Omer Kokacya, Metin Yavuz and Rauf Kerimov
Article Type: Research Article | First Published: May 02, 2015
Electricity is an indispensable part of a comfortable modern life. However, multipurpose electricity use in daily life increases the risks of accidents, injury or death. High-voltage (>1000 volts) electrical burns cause the greatest tissue damage and sequelae, as well as the largest number of deaths. To minimize the functional effects caused by delayed recovery, reconstruction with skin flaps or grafts should be performed as soon as possible in a High-voltage Electrical Injury (HVEI)....
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ClinMed Journals Index Copernicus Values
Clinical Medical Image Library: 93.51
International Journal of Critical Care and Emergency Medicine: 92.83
International Journal of Sports and Exercise Medicine: 91.84
International Journal of Womens Health and Wellness: 91.79
Journal of Musculoskeletal Disorders and Treatment: 91.73
Journal of Geriatric Medicine and Gerontology: 91.55
Journal of Infectious Diseases and Epidemiology: 91.55
Clinical Medical Reviews and Case Reports: 91.40
International Archives of Nursing and Health Care: 90.87
International Journal of Ophthalmology and Clinical Research: 90.80
International Archives of Urology and Complications: 90.73
Journal of Clinical Nephrology and Renal Care: 90.33
Journal of Family Medicine and Disease Prevention: 89.99
Journal of Clinical Gastroenterology and Treatment: 89.54
Journal of Dermatology Research and Therapy: 89.34
International Journal of Clinical Cardiology: 89.24
International Journal of Radiology and Imaging Technology: 88.88
Obstetrics and Gynaecology Cases - Reviews: 88.42
International Journal of Blood Research and Disorders: 88.22
International Journal of Diabetes and Clinical Research: 87.97