The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Feb 2012
Theoretical increase of thyroid cancer induction from cervical spine multidetector computed tomography in pediatric trauma patients.
The trend of increasing cervical spine multidirectional computed tomography (MDCT) imaging of pediatric trauma patients is characteristic of the overall dramatic increase in computed tomography utilization in the United States. The purpose of this study is to compare the amount of radiation a pediatric trauma patient absorbs to the thyroid from plain radiographs and MDCT of the cervical spine and to express risk by calculation of theoretical thyroid cancer induction. ⋯ The significant difference in radiation that MDCT delivers to the pediatric trauma patient when compared with plain radiographs should temper routine use of computed tomography in pediatric cervical spine clearance algorithms.
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J Trauma Acute Care Surg · Feb 2012
Cognitive-behavioral determinants of pain and disability two years after traumatic injury: A cross-sectional survey study.
Approximately, 2.5 million trauma survivors are hospitalized each year, with the majority experiencing prolonged and profound pain-related disability. The present study investigated the association between fear of movement and pain catastrophizing and pain and physical health 2 years after high-energy trauma. ⋯ Results suggest that fear of movement and catastrophizing are risk factors for poor long-term outcomes after traumatic injury. Prospective studies are warranted to test the fear-avoidance model and determine whether the model may be relevant for explaining the development of chronic pain and disability in trauma survivors. The identification of subgroups based on negative pain beliefs may have the potential to improve outcomes after traumatic injury.
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J Trauma Acute Care Surg · Feb 2012
Massive juxta-articular defects of the distal femur reconstructed by series connected double-strut free-vascularized fibular grafts.
We evaluate the clinical results of reconstructing massive juxta-articular defects of the distal femur (mean, 16.4 cm) with series-connected double-strut free-vascularized fibular grafting (FVFG) and external fixator fixation. ⋯ Massive juxta-articular defects of the distal femur are difficult and uncommon injuries. The results of this study indicate that the huge femoral defect reconstructed by series-connected double-strut FVFG provide good results in achieving bone union, reducing stress fracture rate, and achieving leg length equality.
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J Trauma Acute Care Surg · Feb 2012
Sequential duplex ultrasound screening for proximal deep venous thrombosis in asymptomatic patients with acetabular and pelvic fractures treated operatively.
Recent evidence-based practice guidelines recommend against routine ultrasound screening for proximal deep vein thrombosis (DVT) in asymptomatic pelvic fracture patients. However, the majority of trauma surgeons favor this practice. Furthermore, the timing of screening has been inconsistently described. The purpose of this study was to examine the utility of sequential scans in asymptomatic acetabular and pelvic fracture patients treated operatively. ⋯ IV.
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J Trauma Acute Care Surg · Feb 2012
Transplantation of uncultured omental adipose-derived stromal vascular fraction improves sciatic nerve regeneration and functional recovery through inside-out vein graft in rats.
Despite presence of various nerve coaptation materials and techniques, achievement of desired functional peripheral nerve regeneration is still inadequate. Effects of transplantation of uncultured and uncharacterized stromal vascular fraction (SVF) from omental adipose tissue on peripheral nerve regeneration were studied using a rat sciatic nerve transection model. ⋯ SVF could be considered as a readily accessible source of stromal cells that improve functional recovery of sciatic nerve because of reduction in the interval from tissue collection until cell injection and simplicity of laboratory procedure, especially where atraumatic injury is dealt with.