Journal articles on the topic 'Traumatism Complications'
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1
Pliska, Natalya. "Epidemiology of traumatic injuries and associated infectious complications in the Republic of Kazakhstan." Journal of Medicine and Life 15, no. 4 (April 2022): 509–14. http://dx.doi.org/10.25122/jml-2021-0377.
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Traumatism is one of the most important contemporary medical and social issues for most countries worldwide. Since the 20th century, the urgency of traumatism has been increasing. There was an increase in fatal traumatism, including non-fatal cases resulting in permanent disability or temporary disability. This study aimed to investigate the epidemiology of injuries in the Republic of Kazakhstan and identify the statistical patterns of surgical treatment. Furthermore, this study aimed to identify the incidence of infectious complications in patients who received trauma and orthopedic care, their structure and dynamics, and compare this data with the literature. From 2017 to 2019, there were more upper and lower extremity injuries in the Republic of Kazakhstan in the age group of 15–17 years, which corresponds to Russian statistics. Of the 10 injuries, one in three undergoes surgical intervention. In two large cities, Nur-Sultan and Almaty, surgical interventions are performed more often than in other regions. The most frequent infectious complication associated with traumatism is osteomyelitis, with the most causative species being staphylococci.
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Denisov, A. S., N. B. Schekolova, and V. M. Ladeischikov. "Surgical tactics for associated chest trauma in acute and following periods of traumatic disease." Perm Medical Journal 36, no. 3 (August 8, 2019): 11–17. http://dx.doi.org/10.17816/pmj36311-17.
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Aim. To present in details the surgical tactics in different periods of traumatic disease (TD) for associated chest injury.
Materials and methods. Treatment of 865 patients with associated injuries was analyzed. There were 66.9 % of men (579 persons) and 33.1 % of women. Automobile traumatism dominated. The central and peripheral hemodynamics as well as vegetative disorders were investigated. The blood viscosity and toxicity, lipid metabolism etc. were determined.
Results. The characteristic features of the course of acute and the following periods of traumatic disease in associated chest injury, taking into account the revealed complications, expression of circulatory, hypoxic, metabolic and toxic changes, were studied. The logic of surgical tactics in different periods of traumatic disease was presented. Complications and errors when treating patients were analyzed.
Conclusions. Treatment of injured patients, suffering from associated chest trauma in the acute and following periods of TD is subjected to logic of surgical tactics, taking into account prognostication of occurring possible complications and their prevention.
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Chihani, M., A. Aljalil, M. Touati, B. Bouaity, and H. Ammar. "Posttraumatic Cholesteatoma Complicated by a Facial Paralysis: A Case Report." Case Reports in Otolaryngology 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/262958.
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The posttraumatic cholesteatoma is a rare complication of different types of the temporal bone damage. Its diagnosis is often done after several years of evolution, sometimes even at the stage of complications. A case of posttraumatic cholesteatoma is presented that was revealed by a facial nerve paralysis 23 years after a crash of the external auditory canal underlining the importance of the otoscopic and radiological regular monitoring of the patients with a traumatism of the temporal bone.
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Orlov, V. M., and Y. V. Kovalyova. "Methods of reducing blood loss during reconstructive operations on the uterus." Journal of obstetrics and women's diseases 52, no. 3 (August 14, 2003): 85–94. http://dx.doi.org/10.17816/jowd88988.
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There can be no doubt about expediency of reconstructive operations on the uterus in young patients. These operations make it possible to preserve reproductive and menstrual function. However, such operations are accompanied by formation of extensive wound surfaces, considerable muscular tissue defects and characterized by high traumatism, quite often impossibility to ensure effective hemostasis and massive blood loss during operation. In this connection a number of complications during early postoperative period is higher than after hysterectomy. Taking into account the above, it is actual to use the surgical techniques which allow to reduce traumatism of operation and ensure effective hemostasis. In present review different methods used for ensuring hemostasis and reducing operative blood loss during reconstructive operations on the uterus are considered.
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Zhabchenko, I. A. "MODERN GOING NEAR PROPHYLAXIS OF OBSTETRIC TRAUMATISM AND ITS CONSEQUENCES." Reproductive Medicine, no. 2(43) (June 20, 2020): 50–55. http://dx.doi.org/10.37800/rm2020-1-15.
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The article provides up-to-date data on the frequency, risk factors and causes of obstetric injuries of the soft tissues of the birth canal. The directions of preventive measures regarding the prevention of both the injuries themselves and their immediate and delayed complications are presented. As a preventative measure, the advantages of two-stage rehabilitation of the birth canal with the help of the selective probiotic «Vagilak» are presented, which allows you to quickly eliminate the clinical signs of vaginal inflammation and prevents relapse of the process. As an aid to the prevention of obstetric injuries and the treatment of its consequences, the possibilities and advantages of “Vagilak” moisturizing gel and soap for intimate hygiene are presented. The article defines the profile of patients who show the use of these drugs before childbirth, in childbirth and in the postpartum period.
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El Ouali, Ibtissam, Onka Behyamet, Najwa Elkettani, Meriem Fikri, Mohamed Jiddane, and Firdaous Touarsa. "Spontaneous clival meningocele." SAGE Open Medical Case Reports 10 (January 2022): 2050313X2211173. http://dx.doi.org/10.1177/2050313x221117334.
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The occipital bone is an uncommon location for meningoceles protrusion. This condition occurs generally after a severe traumatism or surgical procedure. However, in some rare cases, the herniation can happen spontaneously. Nontraumatic clival meningoceles present an extremely rare entity and correspond to a herniating pachymeningeal collection containing cerebrospinal fluid through a zone of fragility in the clivus. Clinical presentation ranges from simple headache or rhinorrhea to severe complications such as recurrent bacterial meningitis or nerve compression. Computed tomography provides an analysis of the bone and magnetic resonance imaging provides a superior contrast resolution, helping to distinguish among the various types of clival lesions. We report the case of a young woman with a long history of idiopathic intracranial hypertension, who presented with a worsening headache. Magnetic resonance imaging confirmed a clival meningocele without other complications and the patient was put under medical surveillance.
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Guzeva, V. I., V. V. Guzeva, O. V. Guzeva, V. R. Kasumov, I. V. Okhrim, and V. V. Orel. "Clinical manifestations and diagnosis of consequences of traumatic brain injury in children." Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 67, no. 1 (April 8, 2022): 89–93. http://dx.doi.org/10.21508/1027-4065-2022-67-1-89-93.
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In Russia, about 140–160 thousand children are hospitalized annually with a diagnosis of childhood traumatism. Half of the surviving children with severe traumatic brain injury become disabled. Purpose. To perform a comparative analysis of clinical and anamnestic data and neurological disorders in children with traumatic brain injury (TBI). Characteristics of children and research methods. The study involved 81 children with TBI of varying severity. Statistical processing of data was carried out using Student’s test and Fisher’s exact method. Results. The study showed that the duration of the period from the moment of TBI to the hospitalization of children due to post-traumatic complications decreases linearly with increasing age at the time of traumatic brain injury. Mild traumatic brain injury was diagnosed in 47 (58.02%) children, moderate-to-severe — in 16 (19.75%) children, severe traumatic brain injury — in 18 (22.22%) children. The EEG study showed the presence of epileptiform and paroxysmal activity in children not only with moderate and severe, but also mild traumatic brain injury. Post-traumatic epilepsy was diagnosed in 28 (46.67%) children, the risk group for developing post-traumatic epilepsy was 19 (31.67%) children. MRI examination of the brain revealed organic changes in 62.07% of children. Conclusion. A special feature in children is the presence of post-traumatic consequences even after a mild traumatic brain injury. The duration of the period before hospitalization due to post-traumatic consequences in children decreases with increasing age at the time of traumatic brain injury. Focal symptoms in children with severe traumatic brain injury were detected significantly more often than in children with mild and moderate traumatic brain injury.
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SAGLAM, Ali-Osman, REBEDEA Ana Carmen, George PATRAŞCU, Luminita NIRLU, Mustafa Turgut YILDIZGOREN, Cristina POPESCU, and Gelu ONOSE. "Very complex and difficult rehabilitation process in a post traumatic SCI (Spinal Cord Injury) complete tetraplegic patient with intense and refractory spasticity and frequency of spasm with presacral pressure sores (successfully operated)- case report." Balneo Research Journal, Vol.11, no.4 (December 5, 2020): 554–55. http://dx.doi.org/10.12680/balneo.2020.403.
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Introduction. Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion.(1) As a result of the injury, the functions performed by the spinal cord are interrupted at the distal level of the injury. SCI causes serious disability among patients.(2) The treatment and rehabilitation period is long, expensive and exhausting in SCI. The results of SCI bring not only damage to independence and physical function, but also include many complications from the injury. Neurogenic bladder and bowel, urinary tract infections, pressure ulcers, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, autonomic dysreflexia, pulmonary and cardiovascular problems, and depressive disorders are frequent complications after SCI.(3) Material and method. Having the patient’s consent and The Teaching Emergency Hospital “Bagdasar-Arseni” Ethics Committee’s approval, a 48 years old patient, complete tetraplegic with intense and refractory spasticity and frequency of spasm with presacral pressure sores (successfully operated) post traumatic spinal cord injury. The patient was functionally assessed using the following scales: : Glasgow Outcome Scale Extended, Modified Rankin Scale, Modified Ashworth, Penn Spasm Frequency Scale Functional Independence Measure, FAC International Scale, Quality of Life Assessment. Conclusions. Spasticity is a common secondary impairment after SCI characterized by hypertonus, increased intermittent or sustained involuntary somatic reflexes (hyperreflexia), clonus and painful muscle spasms. Severe spasticity may contribute to increased functional impairment, contractures, ulcers, posture disorders and pain. Treatment should start as soon as possible to prevent such negative effects. Keywords: tetraplegia, spinal cord injury, spasticity, pressure sores, traumatism, rehabilitation,
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Silva, Elane de Sousa Jerônimo da, Andréia Caroline Fernandes Salgueiro, Verônica Bidinotto Brito, José Gomes Pinheiro Júnior, Antônio Adolfo Mattos de Castro, and Vanderlei Folmer. "Predictive factors for amputations: knowing the problem to seek prevention strategies." Research, Society and Development 9, no. 2 (January 1, 2020): e66922017. http://dx.doi.org/10.33448/rsd-v9i2.2017.
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Objective: To investigate the predictive factors for amputations in southern Brazil. Methods: This was a review of medical records from amputated patients in a tertiary hospital in southern Brazil. Results: One hundred and fifteen medical reports regarding to admissions of 51 amputated patients (31.37% women and 68.62% men) were analyzed. The main cause of amputation in diabetics was the neuropathy and its complications. Among nondiabetics, the main causes of amputation were polydactyly (31.58%) and traumatism (traffic accidents, home accidents, and work accidents). This data showed that the investigated amputations are predominantly in male, aging approximately sixty years old, presenting comorbidities like diabetes and arterial hypertension. Moreover, the most amputations were performed as the minor type. Conclusion: These data can contribute for implementation of targeted health education strategies and interventions, improving the prevention of amputations in persons with diabetes.
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Duzhyi, I. D., V. V. Shymko, M. H. Kononenko, and H. I. Piatykop. "JUSTIFICATION OF THE FEATURES OF ANTIBACTERIAL THERAPY IN CIVILIAN AND COMBAT TRAUMA." Kharkiv Surgical School, no. 4-5 (October 26, 2022): 128–33. http://dx.doi.org/10.37699/2308-7005.4-5.2022.25.
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Summary. Traumatism around the world is taking on unmanageable proportions. Suffice it to say that every year on a global scale, several million people die from traffic accidents and industrial and domestic injuries. Some die from the actual damage, and most die from purulent-inflammatory complications.
The urgency of the problem. Treatment of inflammatory complications requires significant funds for antibacterial drugs, but their more considerable amount is insufficient given the resistance of the microflora.
Aim. To substantiate the expediency of antibacterial therapy and methods of its application.
Materials and methods. Several experimental studies were conducted on rabbits to reveal the inhibitory effect of antibacterial drugs that enter the internal organs with various administration methods.
Results and their discussion. It turned out that after intramuscular administration, ceftriaxone accumulates in the organs of the abdominal cavity in an insufficient amount to inhibit the growth of microflora. After intravenous administration, ceftriaxone gets in the appendix in 60 % of the control after 1 hour, and after 2 hours, it decreases to 30 %, which is not very effective. After lymphotropic administration, the antibiotic accumulates after 1 hour in an amount sufficient for antibacterial action (70 %) and after 2 hours — in 95 %, which is evidence of the targeting and accumulation of antibiotics with such administration of the drug.
Conclusions. Taking into account the significant disruption of microcirculation in the impression zone, the «mileage» of the vascular bed, the aggregation of formed blood elements in microvessels, and the formation of microthrombi, the intravenous method of drug administration in traumatic disease cannot be considered optimal. This need is met by the lymphotropic way of delivering antibiotics to various organs of the abdominal and thoracic cavities.
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Vukosavljevic, Miroslav. "Most severe consequences of eye contusion injuries: Surgical treatment." Srpski arhiv za celokupno lekarstvo 134, no. 7-8 (2006): 278–82. http://dx.doi.org/10.2298/sarh0608278v.
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Introduction. One third of all eye injuries are contusion injuries. The most common causes of contusion eye injuries are squash ball, fist fights, sports, and work with blunt objects. Objective. The objective of our study was to analyze the surgical treatment methods and materials for managing the most severe consequences of eye contusion injuries. Method. A large number of complications of contusion eye injuries were treated at Department for Vitreoretinal Surgery of the Eye Clinic, Military Medical Academy, Belgrade. This paper analyzed two periods, from 1991-1999, and 2000-2004. During these periods, 461 patients with contusion eye injuries were surgically treated. Pars plana vitrectomy and phacoemulsification with PCL implantation were the most commonly performed operations. Results. During the analyzed period, a total of 334 pars plana vitrectomies, 253 combined operations (PHACO+ VPP) and 214 operations with PCL implantation (PHACO+VPP+PCL) were performed. Scleral fixation was carried out in 14 patients. After pars plana vitrectomy, some form of extended tamponade of vitreal space, in relation to degree of injury and complications, was performed in 194 cases. CONCLUSION Eye traumatism is still one of the leading causes of vision loss (from the earliest ages) in our region. Preventive measures that could lead to decrease of eye injuries should be fully supported, not only through expert meetings and publications, but via media as well.
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Bebezov, B. Kh, R. A. Sultangaziev, and T. A. Abdykadyrov. "Endoscopic Prophylaxis and Treatment of Portal-Genesis Oesophageal Haemorrhage." Creative surgery and oncology 12, no. 2 (July 15, 2022): 106–11. http://dx.doi.org/10.24060/2076-3093-2022-12-2-106-111.
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Background. Portal hypertension-triggered oesophageal and gastric variceal bleeding is the most dangerous and threatening complication, with an up to 50–70 % mortality at first episode. High-mortality repeated bleeding develops subsequently in 30–50 % patients, with the proved 100 % recurrence rate in the first two years following the first episode. The world experience dictates further research to continue towards developing new surgical methods and approaches.Aim: to evaluate the treatment efficacy of pneumatic endoscopic band ligation of bleeding oesophageal varices (OV).Materials and methods. The experience of applying pneumatic endoscopic ligation treatment in the patients managed at the General Surgery Unit of the Clinical Hospital of the Kyrgyz Republic Presidential Administration during 2017–2019 was analysed. Endoscopic ligation is a modern minimally invasive and less traumatic intervention used to markedly reduce mortality and improve quality of life in patients with portal hypertension syndrome. The evidence on 76 patients following endoscopic OV ligation was summarised. The patient age ranged from 11 to 70 years (mean 46.26 years); 40 men (52.6 %) and 36 women (47.4 %) were included. Among the 76 patients, portal hypertension was caused by viral cirrhosis in 38, hepatitis B in 5, delta agent hepatitis B in 18, hepatitis C in 13, a hepatitis B–C combination in 1 and a delta agent hepatitis B — hepatitis C combination in 1 patient. In 21 patients, cirrhosis was of unknown aetiology. A portal vein malformation was observed in 13 people of whom 4 had it combined with thrombosis.Results. A total of 94 ligation procedures were performed in 76 patients with grade II–III OV. Some patients needed to undergo the procedure several times, 18 patients had 2 sessions. Two cases required 3 and 4 sessions each. Moderate oesophageal soreness was reported in 32 patients for 1–6 days following the ligation. No complications were registered during the operation. In early postoperative period, 2 patients developed recurrent bleeding, with haemostasis re-achieved by a repeated vein ligation below bleeding.Conclusion. Hence, small invasiveness and minor traumatism coupled with high efficiency and lesser complications render endoscopic ligation the method of choice in primary and secondary prophylaxis and treatment of OV. Endoscopic ligation improves the patient’s quality of life, allows an extra time for conservative treatment and longer period to liver transplantation.
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Hernandez, A., A. Gargallo-Margarit, V. Barro, I. Gallardo-Calero, and A. Sallent. "Fracture of the Modular Neck in Total Hip Arthroplasty." Case Reports in Orthopedics 2015 (2015): 1–4. http://dx.doi.org/10.1155/2015/591509.
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Modularity of the components in total hip arthroplasty has had an increase in popularity in the last decades. We present the case of a 53-year-old man with a history of avascular necrosis of the femoral head due to a hypophyseal adenoma. A total hip modular arthroplasty was implanted. Three and a half years after the surgery the patient attended the emergency room due to acute left hip pain with no prior traumatism. Radiological examination confirmed a fracture of the modular neck. A revision surgery was performed finding an important pseudotumoral well-organized periprosthetic tissue reaction. Through an extended trochanteric osteotomy the femoral component was removed, and a straight-stem revision prosthesis implanted. There are several potential advantages when using modularity in total hip arthroplasty that surgeons may benefit from, but complications have arisen and must be addressed. Various circumstances such as large femoral head with a long varus neck, corrosion, patient’s BMI, and activity level may participate in creating the necessary environment for fatigue failure of the implant.
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Mansyrov, A. B. Ogly, V. Lytovchenko, M. Berezka, Ye Garyachiy, and Rami A. F. Almasri. "COMPLICATIONS IN BLOCKING INTRAMEDULLARY OSTEOSYNTHESIS (review)." Inter Collegas 7, no. 2 (July 4, 2020): 81–84. http://dx.doi.org/10.35339/ic.7.2.81-84.
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COMPLICATIONS IN BLOCKING INTRAMEDULLARY OSTEOSYNTHESIS (review)
Mansyrov A.B. Ogly, Lytovchenko V., Berezka M., Garyachiy Ye., Rami A.F. Almasri
Treatment of diaphyseal bone fractures is a complicated, controversial and ambiguous task. Blocking intramedullary osteosynthesis, which became the standard of treatment, is also not perfect and accompanied by a number of complications. The reasons for their occurrence are connected both with defects in the organization of treatment of patients, and with tactical mistakes, the definition, generalization and prevention of which became the purpose of our study. It was found that typical tactical mistakes were: use of the method against the indications, non-compliance with the technology of blocking intramedullary osteosynthesis and the use of unsubstantiated and inadequate "proprietary methods", making their own "modifications" during the surgery and changing the course of operative intervention, excessive drilling of the bone marrow canal, significant intraoperative traumatism of bone fragments and surrounding soft tissues, incorrect type of lock or timely unfulfilled dynamization, lack of consistency and restorative and rehabilitative treatment. But the most negative effect on the anatomical recovery of the bone and functional recovery of the extremity was the bone marrow canal drilling, performed without the corresponding indications and technical disadvantages. It is obvious that the violation of the endostosis of the endostal negative effect on the reparative capabilities of bone tissue, inhibits the process of bone grafting and delay recovery. Therefore, there is no doubt that the further study of the effect of bone marrow duct penetration in the course of reparative osteogenesis is relevant and appropriate.
Key words: blocking intramedullary osteosynthesis, tactical mistakes, fracture, long bones, drilling.
Резюме.
УСКЛАДНЕННЯ ІНТРАМЕДУЛЯРНОГО БЛОКУЮЧОГО ОСТЕОСИНТЕЗУ (огляд)
Мансиров А.Б. Огли, Литовченко В.О., Березка М.І., Гарячий Є.В., Рами A.Ф. Аль-масри
Лікування діафізарних переломів кісток кінцівок є складним, спірним та неоднозначним завданням. Інтрамедулярний блокуючий остеосинтез, який став стандартом їх лікування, також не позбавлений недоліків і супроводжується низкою ускладнень. Причини їх виникнення пов'язані як з дефектами організації лікування хворих, так і з тактичними помилками, визначення, узагальнення та попередження яких і стали метою нашого дослідження. Виявлено, що типовими тактичними помилками є використання методу проти показань, недотримання технології інтрамедулярного блокуючого остеосинтезу та використання необгрунтованих та неадекватних «авторських» методик, внесення власних «поправок» під час виконання операції та зміна ходу оперативного втручання, надлишкове розсвердлювання кістково-мозкового каналу, значна інтраопераційна травматизація кісткових уламків та оточуючих м'яких тканин, невірний тип блокування або вчасно невиконана динамізація, відсутність послідовності у відновному та реабілітаційному лікуванні. Але найбільш негативний вплив на анатомічне відновлення кістки та функціональне відновлення кінцівки мало розсвердлювання кістково-мозкового каналу, виконане без відповідних на те показань і з технічними недоліками. Очевидно, що порушення цілосності ендосту негативно впливає на репаративні можливості кісткової тканини, гальмує процес кісткового зрощення та відтерміновує одужання. Тому не викликає сумнівів, що подальше вивчення впливу розсвердлювання кістково-мозкового каналу на перебіг репаративного остеогенезу є актуальним та доцільним.
Ключові слова: інтрамедулярний блоковий остеосинтез, тактичні помилки, перелом, довга кістка, розсвердлювання.
Резюме.
ОСЛОЖНЕНИЯ ИНТРАМЕДУЛЛЯРНОГО БЛОКИРУЮЩЕГО ОСТЕОСИНТЕЗА (огляд)
Мансыров А.Б. Оглы, Литовченко В.А., Березка Н.И., Гарячий Е.В., Рами A.Ф. Аль-масри
Лечение диафизарных переломов костей конечностей является сложной, спорной и неоднозначной задачей. Интрамедуллярный блокирующий остеосинтез, который стал стандартом их лечения, также имеет недостатки и сопровождается рядом осложнений. Причины их возникновения связаны как с дефектами в организации лечения больных, так и с тактическими ошибками. Поэтому целью исследования было их определение, обобщение и пути предупреждения. Установлено, что типичными тактическими ошибками были: применение метода без показаний, нарушение его технологии и применение необоснованных и неадекватных «авторских» методик, внесение собственных «поправок» во время выполнения операции и изменение хода оперативного вмешательства, избыточное рассверливание костно-мозгового канала, значительная интраоперационная травматизация костных отломков и окружающих мягких тканей, неправильно выбранный тип блокирования или не вовремя выполненная динамизация, отсутствие преемственности в восстановительном и реабилитационном лечении. Однако наиболее негативное влияние на анатомическое восстановление кости и функциональное восстановление конечности имело рассверливание костно-мозгового канала, выполненное без соответствующих показаний и с техническими огрехами. Очевидно, что нарушение целостности эндоста негативно влияет на репаративные возможности костной ткани, тормозит процесс костного сращения и отдаляет выздоровление.Поэтому не вызывает сомнений, что дальнейшее изучение влияния рассверливания костно-мозгового канала на течение репаративного остеогенеза является актуальным и целесообразным.
Ключевые слова: интрамедуллярный блокирующий остеосинтез, тактические ошибки, перелом, длинная кость, рассверливание.
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Feyta, Yu R., and V. I. Pyrohova. "Optimization of prevention measures of septic complications in women with high infectious risk." HEALTH OF WOMAN, no. 3(129) (April 30, 2018): 108–13. http://dx.doi.org/10.15574/hw.2018.129.108.
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Despite the introduction of modern diagnostic technologies, prophylaxis and treatment techniques in obstetrical practice, the incidence of postpartum purulent-septic complications (PPSC) remains rather high and is an important medical and social problem, as they take one of the leading places in the structure of maternal morbidity and mortality. The objective: to improve the management of parturient womenwith a perineal birth injury in anamnesis, as part of an effective prevention of purulent-septic complications of puerperium. Materials and methods. The study included 77parturient women. Main and comparative groups were formed by women with a violation of the integrity of the perineum in the previous labor and with a high risk of developing infectious complications in puerperium. Women of the main group (n = 24) during each vaginal examination in labor (and an additional injection in 15-30 minutes after the rupture of the membranes) and twice a dayat a dose of 5 ml for 5 days postpartum, an antiseptic agent in the form of a vaginal gel, which consists of: 0.02% decamethoxin (antiseptic component), 0.5% hyaluronic acid (regenerating component) and lactate buffer (regulatory component). The comparison group included 27 women, without using vaginal gel in laborand using traditional wound treatment techniques in the postpartum period. The control group consisted of 26 women with uncomplicated somatic status, physiological course of pregnancy and labor. The evaluation of the effectiveness of the prescribed treatment was based on subjective symptoms (pain, discomfort, burning in the region of the perineal sutures), clinical data (swelling, hyperemia, nature of suturing healing), generally accepted indicators in dynamics (bacterioscopy of vaginal contents, pH-metry of the vaginal environment). Results. At the background of the use of three-component vaginal gel in the main group, the level of injury of soft tissues of the birth canal in these deliveries was lower by 19.9% than in the comparison group, prevalence of the 1st degreeperineumruptures, decreased the need for repeated episio- and perineotomy, which reduced the duration stay at hospital and improved postpartum rehabilitation in relation to the comparison group. On the third day of puerperium, hyperemia and edema of the wound area in women of the main group were observed almost three times less compared with the comparison group. On the fifth day of the puerperium in the main group the complaints were insignificant and appeared on the average 5 times less often, the healing was by the primary tension without infectious complications. The use of vaginal gel reduced the number of leukocytes in wound secretions by shortening the time of wound epithelization (1.5 times faster than in the parous from the comparison group). On the fifth day of using vaginal gel, 2/3 of the patients observed normalization of the vaginal microflora, the restoration of pH was observed. The results indicate the benefits of early onset of prophylactic measures and high effectiveness of topical antiseptic therapy in women with high infectious risk. Conclusions.In order to prevent antibiotic resistance tactics of prevention of PPSC in the group of high-risk septic complications provides one of the elements of anintegrated approach to use local antiseptics. Inclusion of the latter into a complex of prophylactic and treatment measures in the management of a high-riskwomen in puerperium contributes to the reduction of traumatic and infectious complications and provides more favorable course of labor and the postpartum period. Key words: labor traumatism, postpartum purulent-septic complications, local antiseptic.
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Ananev, V. A., V. N. Pavlov, and A. M. Pushkarev. "Comparative Assessment of Original vs. Standard Surgery Techniques in Treatment for Purulent Pyelonephritis." Creative surgery and oncology 11, no. 4 (December 21, 2021): 288–92. http://dx.doi.org/10.24060/2076-3093-2021-11-4-288-292.
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Background. Modern minimally invasive surgical techniques reduce traumatism of operative interventions and aggressive anaesthesia, which accordingly shortens the patient’s hospital stay and rehabilitation period.Aim. An improvement of surgical outcomes in patients with purulent pyelonephritis via introduction of laparoscopic techniques.Materials and methods. Th e study included 80 purulent pyelonephritis patients operated at the Territorial Clinical Hospital during 2006—2018. Th e patients were divided between two cohorts. Cohort 1 included 40 (50 %) patients operated with standard techniques (ST), cohort 2 — 40 (50 %) patients having surgery by an original minimally invasive technique (OT). Kidney decapsulation was found to outcome in parenchymal decompression and blood circulation restore in cortical layer. Intraarterial infusion of alprostadil prevents further spread of purulent-destructive processes in kidney.Results and discussion. In patients with the minimally invasive technique, postoperative period proceeded at no complications. On day 1, the patients reported reduced pain syndrome in the surgical area. Contrasted renal MSCT before and aft er surgery showed the recovery of renal blood flow and significant diminishing of destruction foci in short term. Nephrectomy was not performed as no-indication.Conclusion. The treatment outcomes in 40 patients having the new surgical technique demonstrate its efficacy and applicability in clinical practice.
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Kurochka, V., and N. Korolyuk. "Obstetric and perinatal aspects of pregnancy and labor in single women." HEALTH OF WOMAN, no. 7(143) (September 30, 2019): 71–73. http://dx.doi.org/10.15574/hw.2019.143.71.
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A clear tendency to increase the number of pregnancies and childbirth in single women has become a characteristic medical, social and psychological problem in modern obstetrics. Over the past decade, the number of births in single women has doubled in Ukraine. The objective: assess the impact of psychological and social factors on the course of pregnancy and childbirth, the state of newborns in single women. Materials and methods. Conducted clinical and statistical analysis of the subjects, studied the course and complications of pregnancy and childbirth, the state of newborns. The main group – 110 single mothers and their newborns, control group – 110 married mothers and their newborns. Results. The article presents data on the course of pregnancy and childbirth depending on the marital status of women. The average of single women was 29.3±0.5 years, married – 23.7±0.6 years; among the lone 24.5% women are over 30 years old. In 73.6% of women in the main group pregnancy is unplanned, which is 3 times higher than that of the control group. It was detected in 71.8% of single women suffering a somatic anamnesis and 64.5% – burdened gynecological anamnesis, which causes high of placental dysfunction (60%), of the threat of abortion (47.2%). The high cardiovascular diseases (23.6%) and diseases of the genitourinary system (20%) in single women causes a 4 times higher level of preterm labor compared to married (7.2% and 1.8% respectively). In 30% of single women, childbirth was completed by cesarean section, which is 2.8 times higher than married (10.9%). In the main group, fetal distress was found to be 14.9%, which is 1.6 times more often than the control group (9.3%). Maternal traumatism was observed in 55.4% of single pregnant women, which is 2 times that of the control group. Complications of the postpartum period in single mothers are found to be 18.7%, which is 3 times more often than the married ones. Conclusion. Lonely women constitute high-risk groups for the development of obstetric and perinatal complications, due to a number of medical and social causes. Key words: pregnancy and childbirth, single women, perinatal complications.
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Del Vecchio, Jorge Javier, Mariano Codesido, Anuar Emanuel Uzair, Mauricio Esteban Ghiloldi, and Juan Manuel Yañez Arauz. "Presentación inusual de una fractura-luxación peritalar. [Unusual presentation of a peritalar fracture dislocation]." Revista de la Asociación Argentina de Ortopedia y Traumatología 83, no. 2 (May 11, 2018): 118. http://dx.doi.org/10.15417/issn.1852-7434.2018.83.2.693.
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<p>Una luxación peritalar implica la disrupción simultánea de las articulaciones talocalcanea y talonavicular. Es relativamente poco frecuente y representa aproximadamente del 1% al 1,5% de todas las lesiones traumáticas del pie.</p><p>Las luxaciones peritalares laterales son menos frecuentes (17%) y las posteriores (2,5%) y anteriores son raras (1%). Aproximadamente el 55% de los subtipos medial y el 72% de los subtipos laterales se asocian con fracturas. Una mujer de treinta y seis años sufrió un traumatismo indirecto (kite-surf) después de caerse del kite-board (tabla) cerca de la playa y tratando de evitar un accidente debido al viento intenso. Presentó una luxación peritalar lateral con fracturas de escafoides tarsiano, calcáneo y peroné asociadas. Después de la evaluación primaria, se intentó una reducción cerrada tres días después del trauma. Después de seis días de la lesión se realizó la cirugía. Las fracturas se trataron con osteosíntesis mínimamente invasiva y en el postoperatorio la paciente desarrolló un síndrome de dolor regional complejo. Se recomienda un diagnóstico precoz de las luxaciones peritales y un rápido reconocimiento de fracturas asociadas e infrecuentes y de esta forma evitar complicaciones evitables. </p><p> </p><p><strong>Abstract</strong></p><p><strong></strong><br />A peritalar dislocation involves simultaneous disruption of the talocalcaneal and talonavicular joints. It is relatively uncommon and account for approximately 1% to 1.5% of all traumatic foot injuries. Medial dislocation is the most frequent type accounting for approximately 80% of reported cases. Lateral peritalar dislocations are less common (17%), and posterior (2.5%) and anterior dislocations are rare (1%). Approximately 55% of medial and 72% of lateral subtypes are associated with fractures. We report the case of a 36-year-old woman who suffered an indirect traumatism during kitesurf practice, after falling from the kite-board trying to avoid an accident. She presented a lateral peritalar dislocation with associated navicular, calcaneal and fibular fractures. A closed reduction was attempted three days from trauma. Six days after the lesion, surgery was performed. We recommend an early diagnosis of peritalar dislocations and a correct recognition<br />of infrequent fractures to avoid usual complications.</p><p> </p>
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Afanasyeva, Marina H., Vyacheslav M. Bolotskih, and Victoria O. Polyakova. "Signal molecules as biomarkers of prediction of the premature rupture of membranes (clinicodiagnostic aspects)." Journal of obstetrics and women's diseases 65, no. 6 (December 15, 2016): 19–27. http://dx.doi.org/10.17816/jowd65619-27.
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One of the most commonly encountered pregnancy complications is the premature rupture of membranes. This pathology results in the increase of frequency of operative delivery, birth traumatism and neonatal complications. The purpose of the research described was verification of key signal molecules, providing integrity of fetal membranes, with subsequent development of possible biomarkers of non-invasive prediction of the premature rupture of membranes. This work presents the comparison studies of expression of VEGF, MMP-9, connexin 37, connexin 40, endorphins, enkephalins, actin, miosin in a buccal epithelium and fetal membranes for 70 patients of the basic group (with premature rupture of membranes) and for 70 patients of the control group (with timely rupture of membranes). Research of fetal membranes and buccal epithelium was carried out by means of primary monoclonal mouse antibodies to the investigated markers. The universal basis set was used as the secondary antibodies, containing of biotinylated anti-mouse immunoproteins. The study of the preparations was carried out in the confocal microscope OLYMPUS FLUOVIEW FV 1000 at the image enlargement of ×400 and ×1000 with use of the system MRC-1024, with the software suite for computer processing OLYMPUS FLUOVIEW 5.0. Statistical processing of the material was carried out with the application of the standard statistical software suite Statistica 10.0. Obtained in a group with the premature rupture of membranes and in a control group were the reliable differences of expression of MMP-9, VEGF, connexin 37 and connexin 40 were. The multifactorial analysis of the indices of expression of signal molecules allowed to discover the high information significance for premature rupture of membranes prediction, matrix metalloproteinase ММP-9, connexin 37 and connexin 40, as well as VEGF. Matrix metalloproteinase ММP-9, connexin 37 and connexin 40, VEGF can be considered as non-invasive markers of premature rupture of membranes prediction.
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Inoyatov, J. Sh, O. V. Snurnitsyna, M. V. Lobanov, O. Yu Malinina, Yu L. Demidko, M. S. Taratkin, L. M. Rapoport, M. E. Enikeev, and P. V. Glybochko. "Minimally invasive combined surgical treatment of postcoital cystitis." Andrology and Genital Surgery 21, no. 2 (July 5, 2020): 20–25. http://dx.doi.org/10.17650/2070-9781-2020-21-2-20-25.
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Introduction. Urethral transposition remains the most popular operation for postcoital cystitis, however, traumatism and complications, especially such as pudendal neuropathies, dyspareunia and anorgasmia, make us continue to search for effective, but safer techniques.The study objective is to evaluate the efficacy and safety of the proposed treatment of postcoital cystitis, including removal of urethrogymenal adhesions and subsequent paraurethral filler implantation, in comparison with isolated hymenoplasty.Materials and methods. Since 2013, 75 patients with postcoital cystitis have been treated. Patients were divided into two groups: main group – hymenoplasty (removal of urethral adhesions) with paraurethral filler implantation (n = 45), control group – hymenoplasty (n = 30). The gel was injected paraurethrically, fan-shaped, in the volume of 1–2 ml, from a point on the 6-hour conditional dial, creating a gel cushion and thus raising the meautus and distal urethra. To assess the quality of treatment, profile questionnaires were used.Results. In the main group of patient, the quality of life improved in 35 (78 %); in 5 patients, due to the process of biodegradation of the gel during 1 year, the cystitis recidivated, which required the filler reimplantation. In 5 patients, the operation was not effective. In the control group the efficiency of isolated hymenoplasty was noted in 3 (10 %) patients, relapse of cystitis occurred in 27 (90 %) patients, which later required the implantation of a filler. No complications were observed.Conclusions. The suggested combined technique allows to improve the results of treatment of patients with postcoital cystitis. The operation does not carry the risk of damage to the sprigs of the genital nerve, can serve as an alternative to traditional urethral transposition. The main disadvantage is the natural biodegradation of the gel, which may create the need for its reintroduction.
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Krochek, Igor Viktorovich, Sergey Vladimirovich Sergiyko, Valeriy Alexeevich Privalov, Igor Ivanovich Shumilin, Yuliya Grigorievna Shekunova, and Anastasiya Yevgenievna Anchugova. "Intracavitary laser obliteration of Baker cyst under ultrasonic navigation." Journal of Experimental and Clinical Surgery 11, no. 4 (December 9, 2018): 256–63. http://dx.doi.org/10.18499/2070-478x-2018-11-4-256-263.
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Relevance. Baker's cyst is the formation in the popliteal region, resulting from the accumulation of synovial fluid in the semimembranous bursa due to anastomosis between the joint cavity and the synovial bursa of the popliteal region. Trauma and/or some inflammatory diseases of the joints are the main causes of these cysts. Despite the success of endoscopic methods of treatment of this category of patients, the frequency of postoperative complications is 3-10%.
The aim is to conduct a comparative analysis of the Baker's cysts treatment results using intracavitary laser obliteration and traditional cyst excision.
Materials and methods. The treatment results of 39 patients with Baker cysts, who entered the clinic for the period from 2012 to 2017, are analyzed. Patients were divided into 2 representative groups. Ultrasound-guided intracavitary laser obliteration of Baker's cyst was performed in 24 (62%) patients of the main group. Traditional radical excision of all cyst elements with application of the primary suture was performed for 15 (38%) patients of the control group. A russian single-wave programmable three-mode laser scalpel LSP - "IRE-Polyus" was used in the work.
Results. The patients of the main group had almost no pain syndrome, the duration of hospital treatment and rehabilitation were 4 times shorter than in the group of traditional operations (p≤0,05). Satisfaction with the laser treatment results of the patients from this group was 83.3%, while in the traditional treatment group - only 66.6%.
Conclusion. The minimum number of the disease recurrences after ultrasonic-controlled intracavitary laser obliteration of Baker's cysts, the simplicity and low-traumatism of manipulation, the low level of complications, coupled with the high patient satisfaction with the treatment results, set apart this technology from traditional one, which allows recommending this method for wide application.
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Chernyavskiy, M. A., B. S. Artyushin, A. V. Chernov, D. V. Chernova, N. N. Zherdev, Yu A. Kudaev, and I. O. Chuikova. "A clinical case of hybrid treatment of a patient with multilevel arterial occlusive disease in lower limb arteries." Patologiya krovoobrashcheniya i kardiokhirurgiya 22, no. 4 (December 29, 2018): 103. http://dx.doi.org/10.21688/1681-3472-2018-4-103-110.
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<p>Treatment of patients with multilevel arterial occlusive disease in lower limb arteries is one of the challenges in vascular surgery. The need in blood flow restoration in several arterial segments usually leads to the problem of choosing a surgical procedure. Open surgery of several arterial segments is linked with a high risk of intraoperative complications, while endovascular procedures are not always possible, especially with long lesions. In such cases, hybrid surgery turns out to be a method of choice. We report the case of 50-year old patient with complaints of the right lower limb pain at rest, trophic ulcers in the right foot. The medical record showed 5-year claudification, with a gradual decrease in painless walking distance. In 2017, he underwent right common iliac artery stenting without a positive effect. Upon admission, occlusion of the right external iliac artery and superficial femoral artery was identified. After additional examination, crossing of lesions, balloon angioplasty and stenting of aorto-iliac and femoral-popliteal segments were successfully performed. The presented clinical case demonstrates high effectiveness in combination of open and endovascular procedures, while treating multilevel arterial occlusive disease. Hybrid surgical procedures allow to reduce traumatism, risk of postoperative complications and length of in-hospital stay. The main advantages and disadvantages of current surgical methods for treatment of multilevel aorto-iliac-femoral lesions are discussed. Performing hybrid surgical procedures is possible only with an experienced vascular team and in specialized hybrid operating room.</p><p>Received 3 August 2018. Revised 26 November 2018. Accepted 30 November 2018.</p><p><strong>Informed consent:</strong> The patient’s informed consent to use his records for medical purposes is obtained.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>
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Myzin, A. V., Vasily G. Kuleshov, A. E. Stepanov, N. V. Gerasimova, and K. Yu Ashmanov. "RESULTS OF SURGICAL TREATMENT OF NON-PARASITIC SPLENIC CYSTS IN CHILDREN." Russian Journal of Pediatric Surgery 22, no. 1 (March 28, 2018): 32–35. http://dx.doi.org/10.18821/1560-9510-2018-22-1-32-35.
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Introduction. Currently, there are different views on the treatment of non-parasitic spleen cysts in children. The choice of method of treatment is under discussion. The aim of our study was to evaluate and analyze the immediate and long-term results of surgical interventions performed on nonparasitic spleen cysts in children. Material and methods. There are presented results of surgical treatment of the 21 patient, who was on treatment at the Department of Abdominal Surgery of the Russian Children Clinical Hospital over the period from 2013 to 2016. Patients were examined by means of ultrasound of the abdominal cavity, CT, MRI. All patients have been operated. 22 surgical interventions were performed by using laparoscopic access, out of which 2 partial resections of the spleen, 1 splenectomy, 19 fenestrations of spleen cysts.Results. During the course of the operation and in the immediate postoperative period there were no complications. Patients were observed for the period of from 1 year to 3 years. Good results of treatment were obtained in 20 (95.2%) children. In a long-term period a relapse occurred in the one patient one year after the operation. The patient was reoperated, splenectomy was performed. Conclusion. The surgical treatment of spleen cysts is the basic one. It is indicated for cysts sized larger than 5 cm and cysts with clinical symptoms. Minimally invasive interventions in children are optimal because of their low traumatism and good cosmetic effect. Our study showed a high efficiency of laparoscopic operations in children suffered from non-parasitic spleen cysts with good long-term results.
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Charyshkin, A. L., and M. M. Yartsev. "A NEW METHOD OF TREATMENT FOR APPENDICEAL STUMP." Russian Sklifosovsky Journal "Emergency Medical Care" 7, no. 2 (July 25, 2018): 129–33. http://dx.doi.org/10.23934/2223-9022-2018-7-2-129-133.
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Background.In 30% of acute destructive appendicitis, the disease is accompanied by typhlitis, which makes it difficult to perform classical methods of appendiceal stump treatment.Aim of study.To improve the way of appendiceal stump treatment in the destructive form of acute appendicitis complicated by significant typhlitis.Material and methods.We studied 57 cases of acute destructive appendicitis complicated by typhlitis, which were divided into two groups depending on the method of treatment. The first group (comparison group) consisted of 30 patients who underwent a standard method for treating the appendiceal stump after appendectomy, such as ligation at the base and putting the stump into the cupula of the cecum and fixing it with interrupted serous-muscular sutures or with a purse and Z-shaped sutures. The second (main) group included 27 patients, who were treated by the method we proposed. The essence of the method is successive U-shaped stitching of the stump. After that, the stump curls in the form of a cochlea, peritonizes, reaching the necessary tightness without going into the cupula of the cecum. In this case, the abdominal cavity of patients in both groups was adequately sanitized and drained.Results.In the first group of patients there were technical difficulties associated with immersion of the appendiceal stump, which caused the serous damage, hematoma of the cupula of the cecum in 7 (23.3%) patients. In the second group of patients, due to the developed method of forming the appendiceal stump, technical difficulties did not arise, there were no complications. The duration of appendectomy in the first group of patients with standart treatment (interrupted serous-muscular sutures or purse and Z-shaped stiches) was 28.7±5.4 minutes, and in the second group of patients appendectomy with stump management with the suggested method lasted 20.3±6.1 minutes, p <0.05, which reduced the operation time by 8 minutes on the average. Purulent-inflammatory wound complications in the first group were detected in 7 patients (23.3%), and in 1 (3.7%) patient of the second group, which is significantly less by 19.6%.Conclusion.The proposed method is technically simple, as peritonization of the stump is performed without putting it into the cupula of the cecum. The use of this method is indicated in destructive forms of acute appendicitis complicated by severe typhlitis, which significantly reduces the operation trauma and contributes to reduction in the number of postoperative wound purulent-inflammatory complications by 19.6%. Findings The proposed method for treating the appendiceal stump during appendectomy for acute destructive appendicitis complicated by typhlitis is simple enough, reliable, characterized by low traumatism and shortens the duration of surgery by 8 minutes on the average (p <0.05).
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Насирли, Д. А. "Surgical Tactics for Optimizing Total Hip Arthroplasty Technology." Хирургия. Восточная Европа, no. 4 (December 13, 2022): 558–70. http://dx.doi.org/10.34883/pi.2022.11.4.021.
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Введение. Результаты исследований показывают преимущества артропластики тазобедренного сустава с применением миниинвазивного доступа перед стандартными хирургическими вмешательствами, что подтверждается более высоким уровнем физической активности и выраженным снижением интенсивности болевого синдрома в послеоперационном периоде. Цель. Оценить отдаленные результаты тотального эндопротезирования тазобедренного сустава с использованием малоинвазивного хирургического доступа. Материалы и методы. Проведен сравнительный анализ течения болезни у 55 пациентов с диспластическим коксартрозом до и после эндопротезирования тазобедренного сустава. Средний возраст пациентов составил 51,6±0,55 и 50,3±0,71 года соответственно в контрольной группе, где использовалась традиционная техника хирургического доступа (n=25), и в основной группе, где внедрялся предложенный нами миниинвазивный метод (n=30). Пациентам с целью определения эффективности методов хирургического доступа выполнялся общий анализ крови, проведено определение сывороточных концентраций уровня СОЭ и С-реактивного белка (СРБ), а также оценивалась степень выраженности болевого синдрома в суставе с использованием визуальной аналоговой шкалы боли (ВАШ). Результаты. В ходе выполненного исследования разработан и научно обоснован предложенный эффективный метод малоинвазивного хирургического доступа при тотальном эндопротезировании пациентов с диспластическим коксартрозом тазобедренного сустава, в основе которого лежит обеспечение достаточного обзора операционной зоны и значительное сокращение реабилитационного периода на фоне снижения травматизма оперативного приема за счет меньшего разреза и сокращения длины раны мягких тканей, более щадящего воздействия на мышечные ткани, профилактики повреждений сосудисто-нервных образований и инфекционных осложнений. По результатам клинико-лабораторной оценки эффективности предложенной методики хирургического доступа для эндопротезирования тазобедренного сустава при диспластическом коксартрозе ВАС, СОЭ и СРБ (снижение с 8,4±0,26 до 5,4±0,11 мг/л) достигли более выраженного в сравнении с группой контроля снижения количественных показателей по сравнению с первоначальными показателями (р<0,001), что позволяет значительно уменьшить вероятность возникновения и развития осложнений воспалительного генеза и повысить качество жизни пациентов. Заключение. Преимущества предложенной методики хирургического доступа: минимально инвазивно, низкий уровень риска инфицирования; низкая травматичность, сокращение периода реабилитации; существенное снижение показателей по шкале боли ВАШ. Introduction. The results of the studies reveal the advantages of hip arthroplasty with minimally invasive approach over standard surgical interventions, as confirmed by a higher level of physical activity and a pronounced decrease in pain intensity in the postoperative period. Purpose. To evaluate the long-term results of total hip arthroplasty with minimally invasive surgical approach. Materials and methods. A comparative analysis of the course of disease in 55 patients with dysplastic coxarthrosis before and after hip arthroplasty was carried out. The average age of patients was 51.6±0.55 and 50.3±0.71 years, respectively, in the control group, where the traditional surgical approach technique was used (n=25), and in the main group, where our proposed minimally invasive method was introduced (n=30). In order to determine the effectiveness of surgical access methods, patients underwent a complete blood count, determination of serum concentrations of ESR and C-reactive protein (CRP), and the severity of pain in the joint was assessed using a visual analog pain scale (VAS). Results. In the course of the study, the proposed effective method of minimally invasive surgical access for total arthroplasty in patients with dysplastic coxarthrosis of the hip joint based on providing a sufficient overview of the operating area and a significant reduction in the rehabilitation period against the background of reduced traumatism of surgical admission due to a smaller incision and a shorter soft tissue wound length, as well as a more gentle effect on muscle tissue and prevention of neurovascular injuries and infectious complications was developed and scientifically substantiated. According to the results of clinical and laboratory evaluation of the effectiveness of the proposed method of surgical access for hip arthroplasty in dysplastic coxarthrosis, VAC, ESR and CRP (decrease from 8.4±0.26 to 5.4±0.11 mg/l) reached a more pronounced reduction in quantitative indicators than in the control group, as compared with baseline indicators (p<0.001), which could significantly reduce the occurrence and development of complications of inflammatory genesis and improve patients’ quality of life. Conclusion. The proposed method of surgical access offers the following advantages: minimally invasive, low risk of infection, low traumatism, shortened rehabilitation period, significant decrease in VAS pain scale.
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Startseva, Nadezhda M., Viktor E. Radzinsky, Olga V. Papysheva, Larisa N. Esipova, Marina A. Oleneva, Olga B. Lukanovskaya, Olgа N. Cheporeva, and Еvgenij K. Tazhetdinov. "Programmable Births in Gestational Diabetes Mellitus: Minimizing Risks — Improving Maternal and Perinatal Outcomes." Annals of the Russian academy of medical sciences 76, no. 5S (December 4, 2021): 525–32. http://dx.doi.org/10.15690/vramn1624.
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Background. Modernity is characterized by an avalanche-like increase in the frequency of gestational diabetes mellitus (in 45 times over the past 20 years). The main tasks of the work in the risk strategy of gestational diabetes mellitus are: prediction of pregnancy complications and the searchingh for new technologies for their delivery. To date, there are still very controversial questions about the timing and methods of delivery of patients with gestational diabetes mellitus. Due to the high incidence of unfavourable perinatal outcomes in gestational diabetes mellitus, the percentage of cesarean sections in some countries reaches 60%, which leads to maternal morbidity and a decrease in the reproductive health of the population. Aims is to improve of maternal and neonatal outcomes based of the rational choice of delivery technology in gestational diabetes mellitus. Methods. A retrospective analysis of delivery methods was performed in 9769 patients with gestational diabetes mellitus at full-term gestation. Results. The developed and implemented programmed delivery technique was an alternative to cesarean sections, it allowed to reduce the frequency of abdominal delivery, while improving maternal and neonatal outcomes. The frequency of cesarean sections in programmed delivery was 2 times lower than in the presented facilities and significantly lower than in the population (10.010.7%). In the programmed delivery group there was a significant reducing morbidity of hypoglycemia in newborns compared to planned caesarean section by 2 times and respiratory distress syndrome by 2.5 times (p 0.05). The indices of cerebral status impairment, birth traumatism corresponded to physiological childbirth and did not exceed the average population. Conclusions. The method of programmed delivery presented in this paper was one of the reserves for reducing the frequency of cesarean sections and allowed to personalize delivery in respiratory distress syndrome.
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Suominen, Eetu N., and Antti J. Saarinen. "Traumatic Hip Dislocation in Pediatric Patients: Clinical Case Series and a Narrative Review of the Literature with an Emphasis on Primary and Long-Term Complications." Children 10, no. 1 (January 4, 2023): 107. http://dx.doi.org/10.3390/children10010107.
Full textAbstract:
Traumatic hip dislocation is a rare injury in pediatric populations. Dislocation may be associated with low-energy trauma, such as a minor fall. Traumatic hip dislocation is associated with severe complications, such as avascular necrosis of the femoral head. Timely diagnosis and reposition decrease the rate of complications. In this study we retrospectively assessed traumatic hip dislocations in pediatric patients during a 10-year timespan in a university hospital. There were eight cases of traumatic hip dislocations. All patients had a minimum follow-up of two years and were followed with MRI scans. One patient developed avascular necrosis during the follow-up which resolved conservatively. There were no other significant complications. In conclusion, traumatic hip dislocation is a rare injury which is associated with severe complications. Patients in our case series underwent a timely reposition. The complication rate was similar to previous reports.
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Gurzhiy, O. V., I. M. Tkachenko, and S. V. Kolomiiets. "APPLICATION OF RADIO-WAVES COAGULATION TECHNIQUE FOR THE TREATMENT OF HEMANGIOMAS OF THE MAXILLOFACIAL AREA." Ukrainian Dental Almanac, no. 2 (June 19, 2019): 10–13. http://dx.doi.org/10.31718/2409-0255.2.2019.02.
Full textAbstract:
Statistics of the last years indicates the significant incidence of vascular neoplasms, the most of which are located at the maxillofacial area – 68–80 %, multi sites simultaneously – 20%. According to histological signs the capillary tumors are 51%, cavernous – 42%, combined – 4%, mixed – 3% of cases.
Currently, in surgical dentistry, the problematic choice of new technical means and technologies that can increase the effectiveness of surgical treatment for the most common types of pathologies remains relevant.
Despite numerous methods of treatment for benign vascular tumors (surgical, radiation, cryosurgical, electrosurgical, laser, sclerotherapy), the results leave much to be desired, as many authors note a significant percentage of tumor recurrence, as well as complications during the operation. As a rule, they are characterized by multiple procedures and are not accompanied by a more radical removal of hemangiomatous tissues, in this connection constant seek for new methods of hemangiomas treatment for children and adults is provided.
At the same time, the expediency and effectiveness of radio wave coagulation remains an open question, as one of the latest among the high-tech methods of tissue dissection.
This publication presents the results of cavernous hemangiomas treatment for the maxillofacial area by radio-wave coagulation.
In all clinical cases, operations were performed practically with noninvasive technique. In the early postoperative period, there was a slight swelling of the tissues without the infiltration in the area of the wound. Healing process of the wound in all patients occurred below the crust, which persisted on average 7-10 days after the procedure, with the formation of the hardly noticeable scar, the shape, size and elasticity of which did not change during the first year of observation. The state of the scar in 52 cases (91%) was estimated as good (7-9 points according to the scale), in 5 (9%) – satisfactory (10-11 points according to the scale). A review in dynamics after 6 months allowed detecting recurrent disease in 4 patients (7%) with localization of hemangiomas in the scalp area, upper and lower lip. Recurrence cases of hemangiomas were noticed as small-spotted hemangiomatous lesions of the skin at the border of the tumor or in the area of the postoperative scarring, which were re-operated with a needle-shaped electrode of 0.02 mm in diameter.
The application of radiosurgical technique allows us to conclude that this is a tool to minimize the risk of intra- and postoperative complications and reduce the period of rehabilitation of patients.
Thus, the application of radio-wave coagulation for the treatment of maxillofacial hemangiomas is promising and allows us to discover the following advantages: greatly facilitates the work of the surgeon, reduces the traumatism and duration of surgical intervention; minimizes blood loss; reduces the percentage of postoperative complications; contributes to the formation of aesthetic scar.
The obtained data indicate the expediency of using the method of radio-wave coagulation in the treatment of cavernous hemangiomas of the maxillofacial area.
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Alali, Aziz S., David Gomez, Victoria McCredie, Todd G. Mainprize, and Avery B. Nathens. "Understanding Hospital Volume–Outcome Relationship in Severe Traumatic Brain Injury." Neurosurgery 80, no. 4 (January 28, 2017): 534–42. http://dx.doi.org/10.1093/neuros/nyw098.
Full textAbstract:
Abstract BACKGROUND: The hospital volume–outcome relationship in severe traumatic brain injury (TBI) population remains unclear. OBJECTIVE: To examine the relationship between volume of patients with severe TBI per hospital and in-hospital mortality, major complications, and mortality following a major complication (ie, failure to rescue). METHODS: In a multicenter cohort study, data on 9255 adults with severe TBI were derived from 111 hospitals participating in the American College of Surgeons Trauma Quality Improvement Program over 2009-2011. Hospitals were ranked into quartiles based on their volume of severe TBI during the study period. Random-intercept multilevel models were used to examine the association between hospital quartile of severe TBI volume and in-hospital mortality, major complications, and mortality following a major complication after adjusting for patient and hospital characteristics. In sensitivity analyses, we examined these associations after excluding transferred cases. RESULTS: Overall mortality was 37.2% (n = 3447). Two thousand ninety-eight patients (22.7%) suffered from 1 or more major complication. Among patients with major complications, 27.8% (n = 583) died. Higher-volume hospitals were associated with lower mortality; the adjusted odds ratio of death was 0.50 (95% confidence interval: 0.29-0.85) in the highest volume quartile compared to the lowest. There was no significant association between hospital-volume quartile and the odds of a major complication or the odds of death following a major complication. After excluding transferred cases, similar results were found. CONCLUSION: High-volume hospitals might be associated with lower in-hospital mortality following severe TBI. However, this mortality reduction was not associated with lower risk of major complications or death following a major complication.
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Tagizadieh, Ali, Payman Moharamzadeh, Alireza Ala, Elham Salami, and Kavous Shahsavari Nia. "Pulmonary Complications and Related Consequences in Patients with Traumatic Injuries." Advances in Bioscience and Clinical Medicine 7, no. 1 (January 31, 2019): 27. http://dx.doi.org/10.7575/aiac.abcmed.v.7n.1p.27.
Full textAbstract:
Background and Purpose: Trauma is considered to be one of the main causes of death in the world and the number of deaths caused by traumatic incidents has experienced an annual increase of 15%. Despite this fact that comprehensive information on the incidence of pulmonary complications in traumatic patients, the patients’ fate in the country and factors affecting it is not available, the present study was conducted to determine the incidence of these complications and the main factors causing them in patients with traumatic injuries visiting the emergency room of the largest medical, educational, and research center in the province, which is considered to be the most important transfer center for traumatic patients from other medical centers in the region. Methods: This is a cross-sectional prospective study conducted on the injured people who visited the emergency room of Imam Reza Hospital in Tabriz in 2015. The incidence of pulmonary complications and factors affecting them were recorded in a valid and reliable researcher-developed checklist that included demographic information and information related to the incident. The significance level was set at p < 0.05. Results: Of all the 482 traumatic patients, 63.5% were men with a mean age of 41.6±15.4, with pulmonary complications reported in 48.1% of them. Pneumonia was the most common complication among these patients which was reported in 161 (33.4%) patients, and pneumothorax and ARDS were the second and third most common complications with the frequencies 41 (8.5%) and 39 (8.1%), respectively. The main causes of the incidence of pulmonary complications were reported to be an age of above 45 (p < 0.001), reduced consciousness level based on GCS criterion (p = 0.01), single trauma to the chest (p < 0.001), synchronous trauma to the chest and other organs (p < 0.001), hospitalizations of longer than one week (p < 0.001), intubation (p < 0.001) and finally transfer of the patient to the operation room (p < 0.001). It should be noted that a pulse rate of more than 100 beats in a minute was accompanied by a decrease in the incidence of pulmonary complications (p = 0.01). In the evaluation of the patients’ fate, it was found out that only 15 (3.1%) patients were discharged from the emergency room. Finally, 34 patients (7.05%) died during the study, with the age group 15-29 years accounting for one third of the patients investigated. Pneumonia (33.4%) was the most common pulmonary complication. For 152 patients (34.8%) the duration of hospitalization was longer than seven days. Conclusion: The fact that the incidence of pulmonary complications in traumatic patients visiting the Location of research was 48.1% highlights the need for further attention to and proper management of complications in these patients. Delayed pulmonary complications are more common among traumatic patients, since the most common complication in this study was reported to be delayed pneumonia. Therefore, given the significance of such a high incidence, further studies and taking effective preventive and medical measures are strongly suggested.
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Jammal, Omar Al, Julian Gendreau, Bejan Alvandi, Neal A. Patel, Nolan J. Brown, Shane Shahrestani, Brian V. Lien, et al. "Demographic Predictors of Treatment and Complications for Spinal Disorders: Part 2, Lumbar Spine Trauma." Neurospine 18, no. 4 (December 31, 2021): 725–32. http://dx.doi.org/10.14245/ns.2142614.307.
Full textAbstract:
Objective: To study the impact of demographic factors on management of traumatic injury to the lumbar spine and postoperative complication rates.Methods: Data was obtained from the National Inpatient Sample (NIS) between 2010–2014. International Classification of Diseases, 9th revision, Clinical Modification codes identified patients diagnosed with lumbar fractures or dislocations due to trauma. A series of multivariate regression models determined whether demographic variables predicted rates of complication and revision surgery.Results: A total of 38,249 patients were identified. Female patients were less likely to receive surgery and to receive a fusion when undergoing surgery, had higher complication rates, and more likely to undergo revision surgery. Medicare and Medicaid patients were less likely to receive surgical management for lumbar spine trauma and less likely to receive a fusion when operated on. Additionally, we found significant differences in surgical management and postoperative complication rates based on race, insurance type, hospital teaching status, and geography.Conclusion: Substantial differences in the surgical management of traumatic injury to the lumbar spine, including postoperative complications, among individuals of demographic factors such as age, sex, race, primary insurance, hospital teaching status, and geographic region suggest the need for further studies to understand how patient demographics influence management and complications for traumatic injury to the lumbar spine.
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Naidoo, L., and A. Nanan. "Post-traumatic cholesteatoma... a rare occurrence." South African Journal of Radiology 12, no. 2 (March 5, 2008): 46. http://dx.doi.org/10.4102/sajr.v12i2.570.
Full textAbstract:
Temporal bone fractures and their acute complications have been well described in radiology and ENT journals. This is in contrast to the delayed and rare complication of implantation cholesteatomas. We present the CT findings of two cases of infiltrating cholesteatomas that developed many years following temporal bone trauma.
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HEO, C. Y., S. KWON, G. H. BACK, and M. S. CHUNG. "Complications of Distraction Lengthening in the Hand." Journal of Hand Surgery (European Volume) 33, no. 5 (October 2008): 609–15. http://dx.doi.org/10.1177/1753193408090767.
Full textAbstract:
This study examined the features of 16 complications from 51 distraction lengthenings in the hands of 43 patients. From 1996 to 2006, 24 metacarpals and 27 phalanges were lengthened at a rate of 0.5 and 0.25 mm/day, respectively, using a callus distraction technique. The indications were congenital (33 cases in 27 patients) and traumatic (18 cases in 16 patients) deformities. The average percentage lengthening in the phalanges and metacarpals was 62% (16 mm) and 63% (34 mm), respectively. The distraction rates in the phalanges and metacarpals were 69 and 52 days/cm, respectively. The overall complication rate was 31%. Major complications requiring secondary procedures were non-union (one case), fracture (one case), premature union (one case), angulations (two cases) and dislodgment of pins (two cases). The minor complications encountered were delayed callus formation (four cases), joint stiffness (four cases) and soft tissue thinning (one case). Traumatic deformities had more complications than the congenital ones (nine of 18 cases and seven of 33 cases, respectively). The phalanges had a higher rate of complication than the metacarpals (11 of 27 cases and four of 24 cases, respectively). Most patients with complications except for two children with dislodgment were as satisfied with the final results as those without complications. Although callus distraction in the hand requires a long treatment period and has a relatively high rate of complication, it appears to be effective in achieving adequate bone length. A high level of patient compliance and prompt management of complications by an experienced surgeon are essential for achieving good results.
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Leite, Victor Figueiredo, Daniel Rubio de Souza, Marta Imamura, and Linamara Rizzo Battistella. "Intra-hospital complications in acute traumatic spinal cord injury." Acta Fisiátrica 25, no. 1 (March 31, 2018): 36–39. http://dx.doi.org/10.11606/issn.2317-0190.v25i1a158833.
Full textAbstract:
There is scarce data about intra-hospital complications in acute traumatic spinal cord injury (TSCI). Objective: To report characteristics of complications in patients with TSCI in a major trauma center. Method: This is a cross-sectional study with 434 patients with acute TSCI from 2004 to 2014. Outcomes were frequency and description of complications, length of hospital stay (LOS), and causes of increased LOS. Results: Patients presented at least 1 complication in 82.2% of the cases: urinary tract infection (UTI) = 64.4%, pressure ulcers (PU) = 50.6%, and pneumonia = 23.7%. Pneumonia, intubation and cases of surgical corrections for PU were independently associated with increased LOS. Conclusion: UTIs and PUs were the most frequent complications. Investigating its causes and consequences is paramount in the care of patients with SCI. Possible reasons for such complications could comprise time, and frequency of repositioning in bed. Investigating intra-hospital complications is paramount in SCI centers.
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Thakur, Geetika, Aruna Kumar, and Deepti Gupta. "Analytical Study of Complications of Third Stage of Labour in a Tertiary Care Centre in Bhopal, Madhya Pradesh - An Observational Prospective Study." Journal of Evidence Based Medicine and Healthcare 8, no. 32 (August 9, 2021): 2923–27. http://dx.doi.org/10.18410/jebmh/2021/534.
Full textAbstract:
BACKGROUND The third stage of labour starts when the fetus has completely delivered and ends with the complete expulsion of the placenta. The third stage of labour is usually uneventful, although significant complications can occur in this period, the most common is postpartum haemorrhage (PPH). The purpose of this study was to identify the various third stage complications, their incidence, and associated risk factors in patients admitted to the centre. METHODS This is a prospective observational study performed in the Department of Obstetrics and Gynaecology, Gandhi Medical College and Sultania Zanana Hospital (SZH), Bhopal conducted from 1 st October 2010 to 30th September 2011. All patients who delivered in our centre or outside and developed a third stage complication were included in the study. RESULTS There were a total of 10,277 deliveries during the study period and 171 cases of third stage complications. The incidence of third stage complication was 1.66 %. The most common third stage complication was traumatic PPH (52.1 %) and the least common was inversion of uterus (2 %) but the case fatality rate (20 %) was higher in the latter. The incidence of traumatic PPH was highest among the primipara patients (72.9 %) and in the grand multipara, atonic PPH topped the list occurring in 57.8 % of the patients. CONCLUSIONS As third stage complications occur in approximately 1 in 60 deliveries and cause 19.3 % of the total maternal deaths, it is of utmost importance to outline an effective treatment for the management of postpartum haemorrhage. This could further help in reducing maternal mortality significantly. KEYWORDS Third Stage of Labour, Atonic Postpartum Haemorrhage, Traumatic Postpartum Haemorrhage, Retained Placenta, Uterine Inversion, Peripartum Hysterectomy
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Zhumakaev, M. D., K. Т. Shakeyev, N. А. Kabildina, A. M. Zhumakaev, B. U. Usembekov, Sh S. Nuraly, and A. A. Kokimov. "Surgical management of pancreatoduodenal tumors: the experience of using the developed operation technique." Oncologia i radiologia Kazakhstana 61, no. 3 (November 12, 2021): 21–26. http://dx.doi.org/10.52532/2663-4864-2021-3-61-21-26.
Full textAbstract:
Relevance: The results of surgery in patients with pancreaticoduodenal cancer remain unsatisfactory. This complicates the choice of an optimal surgical technique in modern oncology.
Surgery in the pancreaticoduodenal zone is associated with complications due to anatomical and physiological features
of the pancreas and technical challenges of this surgical intervention. Despite preventive actions and innovative technologies, such a traumatic operation as pancreatoduodenal resection often produces complications, though recently fewer.
This article describes a pancreaticoduodenal resection technique that reduces postoperative complication frequency and
lethality in operable pancreaticoduodenal cancer.
The purpose of the study was to assess the efficiency of an authorial pancreaticoduodenal resection technique (pancreaticojejunal invagination anastomosis) in pancreaticoduodenal cancer.
The proposed pancreaticojejunal anastomosis-forming technique allowed reducing the postoperative complication frequency from 54.2% to 38,0% and postoperative lethality from 22.8% to 9,5%.
Conclusion: This highly traumatic surgery is associated with postoperative complications (up to 50-70% of cases), which
are quite severe and difficult to resolve and result in high fatality. The proposed pancreaticojejunal anastomosis forming technique has efficiently reduced postoperative complications and fatality to a significant extent.
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Zhumakaev, M. D., K. Т. Shakeyev, N. А. Kabildina, A. M. Zhumakaev, B. U. Usembekov, Sh S. Nuraly, and A. A. Kokimov. "Surgical management of pancreatoduodenal tumors: the experience of using the developed operation technique." Oncologia i radiologia Kazakhstana 61, no. 3 (September 30, 2021): 21–26. http://dx.doi.org/10.52532/2521-6414-2021-3-61-21-26.
Full textAbstract:
Relevance: The results of surgery in patients with pancreaticoduodenal cancer remain unsatisfactory. This complicates the choice of an optimal surgical technique in modern
oncology.
Surgery in the pancreaticoduodenal zone is associated with
complications due to anatomical and physiological features of
the pancreas and technical challenges of this surgical intervention. Despite preventive actions and innovative technologies,
such a traumatic operation as pancreatoduodenal resection
often produces complications, though recently fewer.
This article describes a pancreaticoduodenal resection
technique that reduces postoperative complication frequency
and lethality in operable pancreaticoduodenal cancer.
The purpose of the study was to assess the efficiency of
an authorial pancreaticoduodenal resection technique (pancreaticojejunal invagination anastomosis) in pancreaticoduodenal cancer.
Results: The proposed pancreaticojejunal anastomosis
forming technique allowed reducing the postoperative complication frequency from 54.2% to 38.0% and postoperative
lethality from 22.8% to 9.5%.
Conclusion: This highly traumatic surgery involves quite
severe and difficult to resolve postoperative complications
(up to 50-70% of cases) and the resulting high fatality. The
proposed pancreaticoduodenal anastomosis forming technique
has efficiently reduced postoperative complications and fatality to a significant extent
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Cornell, J. "Presentation and management of traumatic pneumothorax in the deployed setting." Journal of The Royal Naval Medical Service 104, no. 3 (2018): 187–91. http://dx.doi.org/10.1136/jrnms-104-187.
Full textAbstract:
AbstractPneumothorax is a potentially life-threatening complication of traumatic chest injury. Rapid assessment, recognition and management in the deployed pre-hospital and hospital environment is essential, as complications such as hypoxia and cardiovascular collapse require urgent intervention. This article aims to describe the evidence for presentation, management and occupational aspects of traumatic pneumothorax, which can prevent selection into specialist roles such as diving, submarine service and aviation.
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Mondello, Stefania, Amy Cantrell, Domenico Italiano, Vincenzo Fodale, Patrizia Mondello, and Darwin Ang. "Complications of Trauma Patients Admitted to the ICU in Level I Academic Trauma Centers in the United States." BioMed Research International 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/473419.
Full textAbstract:
Background. The aims of this study were to evaluate the complications that occur after trauma and the characteristics of individuals who develop complications, to identify potential risk factors that increase their incidence, and finally to investigate the relationship between complications and mortality.Methods. We did a population-based retrospective study of trauma patients admitted to ICUs of a level I trauma center. Logistic regression analyses were performed to determine independent predictors for complications.Results. Of the 11,064 patients studied, 3,451 trauma patients developed complications (31.2%). Complications occurred significantly more in younger male patients. Length of stay was correlated with the number of complications(R=0.435,P<0.0001). The overall death rate did not differ between patients with or without complications. The adjusted odds ratio (OR) of developing complication for patients over age 75 versus young adults was 0.7(P<0.0001). Among males, traumatic central nervous system (CNS) injury was an important predictor for complications (adjusted OR 1.24).Conclusions. Complications after trauma were found to be associated with age, gender, and traumatic CNS injury. Although these are not modifiable factors, they may identify subjects at high risk for the development of complications, allowing for preemptive strategies for prevention.
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Cheung, N. K., A. James, and R. Kumar. "Large Traumatic Pneumatocele in a 2-Year-Old Child." Case Reports in Pediatrics 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/940189.
Full textAbstract:
Traumatic pneumatoceles are a rare complication of blunt chest trauma in children. Although they characteristically present as small, regular shaped lesions which can be safely treated nonoperatively, larger traumatic pneumatoceles pose diagnostic and management difficulties for clinicians. This case study reports one of the largest traumatic pneumatoceles reported to date in the paediatric population, which resulted in aggressive surgical intervention for both diagnostic and treatment reasons. This case adds further evidence to the current literature that significantly large traumatic pneumatoceles with failure of initial conservative management warrant surgical exploration and management to optimise recovery and prevent complications.
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Smith, I. M., P. J. Anderson, M. J. Wilks, and D. J. David. "Traumatic Arteriovenous Malformation following Maxillary Le Fort I Osteotomy." Cleft Palate-Craniofacial Journal 45, no. 3 (May 2008): 329–31. http://dx.doi.org/10.1597/06-223.
Full textAbstract:
Objective: Complications following maxillary Le Fort I osteotomy are rare. The authors present the rare complication of an arteriovenous malformation following such a procedure in a 25-year-old woman with a cleft lip and palate that was treated successfully with radiologically guided embolization.
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Mostafa Elkatatny, Amr Abdelmonam Abdelaziz, Yasser Ahmed Abd Elreheem, and Tarek Hamdy. "Traumatic Dural Venous Sinuses Injury." Open Access Macedonian Journal of Medical Sciences 7, no. 19 (August 15, 2019): 3225–34. http://dx.doi.org/10.3889/oamjms.2019.535.
Full textAbstract:
The traumatic dural venous sinus injury is one of the most dangerous complications of TBI, either due to fatal intracranial compressing venous bleeding, or disturbing the intracranial pressure which could be caused by injury to the SSS
On the other hand, post traumatic dural sinus thrombosis is considered a rare complication which may lead to hemorrhagic infarction with its serious consequences including epilepsy, neurological deficits, or death. Therefore, knowledge of the appropriate treatment of this kind of head injury is essential.
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Vikmanis, Andris, and Andris Jumtins. "The Treatment of Acetabular Fracture Complications in a Combination of Post-traumatic Hip Joint Osteoarthritis and Femoral Fracture for Polytrauma Patient." Acta Chirurgica Latviensis 11, no. 1 (January 1, 2011): 164–66. http://dx.doi.org/10.2478/v10163-012-0035-3.
Full textAbstract:
The Treatment of Acetabular Fracture Complications in a Combination of Post-traumatic Hip Joint Osteoarthritis and Femoral Fracture for Polytrauma PatientPelvic bone fractures are related to a high energy injury. Therefore with an increase of the traffic intensity simultaneously grows the number of polytrauma patients, who have pelvic bone fractures of various severity levels. In the case of acetabular fractures, as the most frequent complication is the hip joint post-traumatic degeneratively destructive osteoarthritis, in whose treatment very often the hip joint arthroplasty is necessary. The frequency of this complication is affected by the precision of repositioning and the strength of fixation of an acetabular fracture.
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Staub, Jacob R., Kristen Manto, James Mellen, Zachary Koroneos, and Michael C. Aynardi. "90-Day Reoperation and Wound Complication Rates in Lateral Approach to Total Ankle Replacement for Post-Traumatic Arthritis." Foot & Ankle Orthopaedics 7, no. 4 (October 2022): 2473011421S0095. http://dx.doi.org/10.1177/2473011421s00954.
Full textAbstract:
Category: Ankle Arthritis; Ankle; Diabetes Introduction/Purpose: Total ankle replacement (TAR) has achieved relatively successful outcomes with respect to postoperative complications; however, mixed evidence exists regarding early complication rates, reoperation, and infection1-5. The largest study of TAR to date indicates a statistically significant risk of postoperative infection in tobacco users and diabetic patients6. Unlike currently established anterior approaches to arthroplasty, the lateral transfibular approach potentially avoids disruption of perfusion to the skin, possibly decreasing postoperative complications7. The lateral ankle allows surgeons to correct malunion of the fibula in post-traumatic arthritis deformity cases and achieve appropriate coronal and sagittal implant alignment to achieve similar physiological joint orientation8,9. The purpose of this study was to report 90-day reoperation and wound complication rates in lateral approach to total ankle replacement for post-traumatic arthritis (PTA). Methods: A retrospective chart review of lateral TAR cases from 2016-2022 was conducted at a single institution. Only patients undergoing TAR for post-traumatic arthritis were included in this review. A total of 49 patients (22 females and 27 males) underwent total ankle replacement with the Zimmer Biomet Trabecular MetalTM Total Ankle by a single surgeon. Patient demographics, operative data, complications, and adverse events requiring corrective surgery were recorded within 90 days of arthroplasty. Results: The patient sample included 6 active smokers, 11 diabetics, and 32 patients with hypertension with an average age of 60.7 and average BMI of 34.3 (Table 1). Three of the 49 (6.1%) patients required secondary surgery within 3 months of surgery (Table 2). Revision surgery indications included: 1 (2.0%) for removing painful hardware, 2 (4.1%) due to infection, and 1 (2.0%) for tarsal tunnel syndrome after surgery. There were 0 nonunions of the fibula at 90 days and through 1 year follow up. Of the patients requiring secondary surgery for infection, 1 was a smoker and 1 had a history of ankle fusion nonunion and avascular necrosis which was converted to a TAR (Table 4). Conclusion: This retrospective study demonstrates a comparable rate of secondary surgeries following TAR via lateral approach in the early postoperative period (6.1%) while having a slightly higher rate of infection than those previously reported (4.1%)7,8. Notwithstanding, we observed a 100% healing rate of fibula osteotomies; however, we failed to demonstrate a lower incidence of wound complications than previously reported. Surgeons should counsel patients of these risks in those with PTA undergoing lateral TAR, especially in smokers and diabetics.
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Круглякова, Людмила, and Lyudmila Kruglyakova. "HEMOTHORAX AS A LETHAL COMPLICATION OF THE SUBCLAVIAN VEIN PUNCTURE (CASE FROM PRACTICE)." Bulletin physiology and pathology of respiration 1, no. 68 (June 7, 2018): 92–95. http://dx.doi.org/10.12737/article_5b19ec161d5ac2.91942328.
Full textAbstract:
Any professional medical activity carries the danger of complications. According to the ICD-10, any pathological process which resulted from a medical action is iatrogenesis. Now, when the aggression of therapy surpasses the severity of the disease, the problem of iatrogenesis is of particular importance. The complications caused by catheterization of a subclavian vein make 2.7-11.2% cases of iatrogenesis, serious complications – 1.2%. The hemothorax is an infrequent complication of this manipulation, its frequency doesn't exceed 0.4-0.6%. The hemothorax with a lethal outcome is a medical casuistry. This work is devoted to one case of traumatic iatrogenesis, i.e. to a complication of a puncture of a subclavian vein by hemothorax with the volume not less than 4.5 liters, with development of an acute respiratory failure and a lethal outcome.
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Chaoui, B., I. Nassar, and N. MoatassimBillah. "Faecopneumothorax revealing a neglected traumatic diaphragmatic hernia." Journal of Lung, Pulmonary & Respiratory Research 6, no. 2 (March 26, 2019): 26–27. http://dx.doi.org/10.15406/jlprr.2019.06.00201.
Full textAbstract:
Introduction: Tension fecopneumothoraxis a rare but serious complication of traumatic diaphragmatic hernias. The diagnosis of the hernia can be delayed from a few days to some years and will be made on occasion of complications representing the dramatic evolution of the “latent stage” of disease. Only few cases of post-traumatic faecopneumothorax are described in the literature. This clinical evolution is associated to a significant increase in morbidity (30–80% of cases). This is particularly the case with our patient. Case presentation: We report the case of a 26-year-old who had a trauma of the left hypochondrium about a year ago and who presented an acute intestinal occlusion, an X ray abdomen and chest was performed, showing abundant hydropneumothorax, thethoracoabdominal scan reveals an abundant effusion with heterogeneous density in the left pleural cavity, associated with an intrapleural hernia of the large intestine Discussion: Tension fecopneumothorax is a very rare complication of traumatic diaphragmatic hernia, only few cases are described in the literature, the mechanisms of the injury can blunt or penetrating, it occurs after intrapleural perforation of a strangulated colon, and very often its life threatening. Conclusion: According to our knowledge and review of the literature, Tension fecopneumothorax complicating a traumatic diaphragmatic hernia is very rare; the diagnosis is made by thoracic radiography and thoracoabdominalCT, which also allow orientation of the therapeutic attitude with non-negligible post-operative complications.
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Mirzaeva, Lyudmila M., Sergei V. Lobzin, Inga V. Chistova, Olga A. Rizahanova, and Alexander A. Dulaev. "Predictors of complications and mortality in traumatic spinal cord injuries." Kuban Scientific Medical Bulletin 27, no. 1 (February 20, 2020): 59–71. http://dx.doi.org/10.25207/1608-6228-2020-27-1-59-71.
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Background. One of the most common causes of death is trauma. The World Health Organization predicts a 40 % increase in injuries and injury-related deaths over the next 10 years. Despite the achievements of modern medicine, mortality in spine and spinal cord injuries remains high. This is explained not only by the severity of traumas, but also a large number of secondary complications,.Aim. To study the frequency of complications and the mortality rate of traumatic spinal cord injuries; to identify factors affecting the outcome of such injuries. Materials and methods. A retrospective analysis covered 322 medical records from patients diagnosed with traumatic spinal cord injury and admitted to neurosurgical departments of Saint Petersburg in 2012–2016.Results. Secondary complications (outside of the central nervous system) were found in 33 % cases, with the most common and serious being respiratory complications, pressure ulcers and thromboembolism. Complications more often occurred in elderly patients (over 75), as well as in severe injuries at the cervical and thoracic level. Complications developed significantly more frequently in patients with concomitant traumatic brain injury (TBI) and persons with alcohol consumption before injury. Complications noticeably increased the length of hospital stay and increased the risk of death by 43 times. 14 % of the patients died during primary stay in hospital. The spinal cord injury incompatible with life occurred only in 1 % of the patients. The lethal outcome correlated with age, severity, level of injury, concomitant TBI and alcohol consumption.Conclusion. We have found a high incidence of unfavourable outcomes for traumatic spinal cord injuries (every third patient had at least one complication, every seventh died during the primary hospitalisation). In addition to unmodifiable factors, a statistically significant negative role of alcohol in the frequency of complications and death after spinal cord injury was found. Promoting a healthy lifestyle with low alcohol consumption, optimising preventive and therapeutic measures aimed at reducing the frequency of infectious and thromboembolic complications will improve the outcome of traumatic spinal cord injuries, reduce the length of hospital stay and decrease the economic burden of spinal cord injuries.
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Arifin, Muhammad Z., Andi N. Sendjaja, and Ahmad Faried. "Application of the surgical Apgar score (SAS) to predict postoperative complication(s) in the patients with traumatic brain injury: Study of single center in Indonesia." Open Access Macedonian Journal of Medical Sciences 9, B (April 20, 2021): 225–29. http://dx.doi.org/10.3889/oamjms.2021.5843.
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BACKGROUND: Traumatic brain injury (TBI) is a major health problem. Surgery in patients with TBI is associated with a high rate of complications and mortality. The surgical Apgar score (SAS) is a simple quantitative and objective intraoperative tool for predicting major post-operative complications including mortality. AIM: Our study aimed to analyze the use of SAS as a predictor of post-operative complications in patients with TBI. METHODS: This was a prospective cohort study at our center in RSHS, Bandung, Indonesia, throughout 2017 by assessing SAS based on calculating intraoperative estimated blood loss, lowest mean arterial pressure, and lowest heart rate for each patient with TBI, as well as the incident complications within 30 days post-operative were recorded. RESULTS: One hundred fifty-six patients with TBI underwent surgery in 2017 with 123 patients met the inclusion criteria. Among those, 63 patients (51.2%) developed major complications with 8 patients (12.7%) experienced death. The mean SAS for patients without complication was 8.20, whereas for patients with complication was 6.11. SAS has an inverse correlation (r = –0.754) and an association (p < 0.005) with post-operative complication (s) within 30 days. CONCLUSIONS: The SAS has an inverse correlation and an association with incidence of complications thus potentially useful as an intraoperative predictor for incident complications within 30 days post-operative care in patients with TBI.
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Musukuma, Mwiche, Brian Sonkwe, Isaac Fwemba, and Patrick Musonda. "The Use of Multiple Imputation Techniques on Short-Term Clinical Complications of Patients Presenting with Traumatic Spinal Cord Injuries." Open Public Health Journal 12, no. 1 (February 28, 2019): 45–55. http://dx.doi.org/10.2174/1874944501912010045.
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Background: With the increase in the use of secondary data in epidemiological studies, the inquiry of how to manage missing data has become more relevant. Our study applied imputation techniques on traumatic spinal cord injuries data; a medical problem where data is generally sporadic. Traumatic spinal cord injuries due to blunt force cause widespread physiological impairments, medical and non-medical problems. The effects of spinal cord injuries are a burden not only to the victims but to their families and to the entire health system of a country. This study also evaluated the causes of traumatic spinal cord injuries in patients admitted to the University Teaching Hospital and factors associated with clinical complications in these patients. Methods: The study used data from medical records of patients who were admitted to the University Teaching Hospital in Lusaka, Zambia. Patients presenting with traumatic spinal cord injuries between 1st January 2013 and 31st December 2017 were part of the study. The data was first analysed using complete case analysis, then multiple imputation techniques were applied, to account for the missing data. Thereafter, both descriptive and inferential analyses were performed on the imputed data. Results: During the study period of interest, a total of 176 patients were identified as having suffered from spinal cord injuries. Road traffic accidents accounted for 56% (101) of the injuries. Clinical complications suffered by these patients included paralysis, death, bowel and bladder dysfunction and pressure sores among other things. Eighty-eight (50%) patients had paralysis. Patients with cervical spine injuries compared to patients with thoracic spine injuries had 87% reduced odds of suffering from clinical complications (OR=0.13, 95% CI{0.08, 0.22}p<.0001). Being paraplegic at discharge increased the odds of developing a clinical complication by 8.1 times (OR=8.01, 95% CI{2.74, 23.99}, p<.001). Under-going an operation increased the odds of having a clinical complication (OR=3.71, 95% CI{=1.99, 6.88}, p<.0001). A patient who presented with Frankel Grade C or E had a 96% reduction in the odds of having a clinical complication (OR=.04, 95% CI{0.02, 0.09} and {0.02, 0.12} respectively, p<.0001) compared to a patient who presented with Frankel Grade A. Conclusion: A comparison of estimates obtained from complete case analysis and from multiple imputations revealed that when there are a lot of missing values, estimates obtained from complete case analysis are unreliable and lack power. Efforts should be made to use ideas to deal with missing values such as multiple imputation techniques. The most common cause of traumatic spinal cord injuries was road traffic accidents. Findings suggest that paralysis had the greatest negative effect on clinical complications. When the category of Frankel Grade increased from A-E, the less likely a patient was likely to succumb to clinical complications. No evidence of an association was found between age, sex and developing a clinical complication.
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Roward, Zachary, and L. Daniel Latt. "Fracture Through a Distal Fibular Tunnel Used for an Anatomic Lateral Ankle Ligament Reconstruction." Foot & Ankle Orthopaedics 3, no. 2 (May 9, 2018): 247301141876359. http://dx.doi.org/10.1177/2473011418763593.
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Anatomic lateral ankle ligament reconstruction using free tendon graft with osseous tunnels has become a popular technique for revision reconstruction of the lateral ankle ligaments. With the procedure’s burgeoning popularity, an accompanying increase in postoperative complications is likely to occur. We report on one such complication: traumatic distal fibula fracture through the transosseous tunnels.