Definitive External Fixation for Anterior Stabilization of Combat-related Pelvic Ring Injuries, With or Without Sacroiliac Fixation.

CONCLUSION: In this series of patients with severe combat-related pelvic ring injuries who were treated anteriorly with definitive external fixation because of a severe soft-tissue injury, high infection risk, or unacceptable physiologic cost of internal fixation, malunion and chronic pelvic pain were less common than previously observed. Prior studies primarily differ in their lack of sacroiliac or lumbopelvic stabilization for posteriorly unstable fracture patterns, likely accounting for much of these differences. There may have been important between-study differences such as extremely severe injuries, concomitant injuries, and study population. Our study also differs because we specifically analyzed a large cohort of patients who sustained open pelvic ring injuries. Future studies should prospectively investigate the ideal construct type and pin material, optimize the length of treatment and assessment of healing, and improve radiographic measures to predict long-term functional outcomes. LEVEL OF EVIDENCE: Level IV, therapeutic study. PMID: 32229751 [PubMed - in process]
Source: Clinical Orthopaedics and Related Research - Category: Orthopaedics Authors: Tags: Clin Orthop Relat Res Source Type: research

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‚ÄčThe wrist is not commonly aspirated in the emergency department, but emergent arthrocentesis may be indicated for extreme or concerning cases, and tapping the wrist to determine the underlying pathology or relieve pain may be of great value. The synovial fluid from the joint space can be analyzed for crystals, infection, and blood. This information may help determine the overall plan and aid in decision-making and consultation. The ultimate treatment plan may include admission, intravenous antibiotics, multiple aspirations, and even surgical washout.A swollen, painful wrist that is hot to the touch is concerning for sep...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Abstract Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for perioperative complications. The frequency of complications depends on the severity of COPD, the type of anesthesia used, the surgical site, and other comorbidities. Patients undergoing upper abdominal surgery have significant changes in lung volumes, likely secondary to changes in diaphragm function and abdominal pain, and these changes increase the risk for complications, including acute respiratory failure, atelectasis, pneumonia and unplanned reintubation. We discuss a patient with COPD who did well for the first 3 da...
Source: The American Journal of the Medical Sciences - Category: General Medicine Authors: Tags: Am J Med Sci Source Type: research
Joong-Goo Kim1,2, Han-Bin Lee2 and Sang-Beom Jeon2* 1Department of Neurology, Jeju National University Hospital, Jeju, South Korea 2Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea Objectives: The use of dexmedetomidine and ketamine (DEX–KET) combination for magnetic resonance imaging (MRI) sedation has not been evaluated. We investigated the efficacy and safety of DEX–KET for sedation of patients undergoing MRI of the brain. Methods: This quasi-experimental study was conducted to compare the DEX–KET combination and midazolam for MRI sed...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusion Trochlear pain (trochleodynia) is becoming recognized as a set of disorders that can present in isolation or concomitantly with co-existing migraines, tension-type headaches, or other headache disorders, possibly explaining subpar symptom control in a small but significant number of individuals globally. Trochleodynia features unilateral periocular pain that may involve the ipsilateral hemicranium. Pain exacerbation occurs with trochlear palpation and supraduction of the affected eye especially in the adducted position. Trochleodynia may respond to oral NSAIDs if symptoms are mild and of recent onset. While ora...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Publication date: Available online 4 January 2019Source: Orthopaedics &Traumatology: Surgery &ResearchAuthor(s): Jean Charles Le Huec, Andreas Tsoupras, Amelie Leglise, Paul Heraudet, Gabriel Celarier, Bengt SturressonAbstractThe sacro-iliac joint (SIJ) located at the transition between the spine and the lower limbs is subjected to major shear forces. Mobility at the SIJ is very limited but increases during pregnancy and the post-partum period. Familiarity with the anatomy and physiology of the SIJ is important. The SIJ is a diarthrodial joint that connects two variably undulating cartilage surfaces, contains synov...
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
Rationale: The scapula is relatively rare site for osteochondroma. Scapula osteochondroma is usually asymptomatic, however it may present with features such as pseudowinging, snapping scapula, bursa formation, chronic pain, and cosmetic deformities. To our best knowledge, this is the first report in the English literature about osteochondroma of ventral scapula associated with chest pain due to rib cage compression. Patient concerns: A 14-year-old boy was transferred to the orthopedic clinic from thoracic surgery department with a complaint of intermittent, dull, and diffuse aching pain around left chest wall and back...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
She could have been my charming tiny kindergarten teacher, sitting there nonchalantly in her wheelchair with neatly folded arms in her lap. The delicate, airy cloud of silvery blonde hair on her head resembled Queen Elizabeth’s style. I named her Ms. Elizabeth. A few moments ago, though, she looked like a young child who could not comprehend the meaning of her condition. Whenever she was spoken to, her mind seemed to fixate only on one thing: could her pain management intensity be increased? Due to her chronic pain, Ms. Elizabeth begged for more morphine, more pills and more medication. As a medical scribe, I was tuc...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Pain Management Source Type: blogs
Conclusions Branches of the FNs and ONs consistently provided innervation to the anterior hip capsule. The AON also contributed innervation in many specimens. The relationship of the articular branches from these 3 nerves to the inferomedial acetabulum and the space between the anterior inferior iliac spine and iliopubic eminence may suggest potential sites for radiofrequency ablation.
Source: Regional Anesthesia and Pain Medicine - Category: Anesthesiology Tags: Chronic and Interventional Pain: Original Articles Source Type: research
This report reinforces the need for resuscitation and airway management equipment to be readily available where interventional procedures are performed, as well as the need for adequate proficiency in airway management and resuscitation techniques in Pain Medicine training. PMID: 26355013 [PubMed - in process]
Source: Revista Brasileira de Anestesiologia - Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research
Conclusions: SPECT imaging is helpful in diagnosing sacroiliac joint syndrome and facetal syndrome. Epidural injections were a better choice in cases of low backache, where clinically, the patient had no signs of sacroiliac joint syndrome and facetal syndrome. Spinal injections with steroid and local anaesthetic had better relief. Radiotracer uptake at the pain generating area is a good predictor of outcome. Image guided spinal injection improves the accuracy of the injection.
Source: Neurology India - Category: Neurology Authors: Source Type: research
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