Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Oct 2008
Thoracic Outlet Syndrome Caused by a Pseudoaneurysm After Pseudarthrosis of the Clavicle.
Clavicle fractures are common, with the majority treated conservatively. If treated conservatively, pseudarthrosis of the clavicle is reported in up to 3% of the cases. In rare cases, pseudarthrosis of the clavicle may cause pseudoaneurysm formation, resulting in compression of the brachial plexus and the adjoining vessels, which may produce neurological symptoms and circulatory disorders. ⋯ Patient's history and radiological findings are the keys to diagnosis. Without treatment, the prognosis is poor with spontaneous development of bleeding or gangrene. Therefore, surgical treatment has to be performed, especially when neurological symptoms occur.
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Eur J Trauma Emerg S · Oct 2008
Brachial Artery Injuries: A Seven-year Experience with a Prospective Database.
A Trauma Vascular Registry was established in 1998. The aim of the study was to review brachial artery injuries. ⋯ Brachial artery injuries are the commonest vascular injuries to the limbs, with a good prognosis, provided early repair is undertaken. Arteriography is usually unnecessary and limb loss is low, provided appropriate decompression of a compartment syndrome is performed, however in this group the limb loss rate is 25% compared to the overall of 2%. The repair of a brachial artery is a good training procedure for surgical trainees, associated with a low morbidity.
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Eur J Trauma Emerg S · Oct 2008
Unstable Cervical Spinal Injury in Children - Case Report and Review of the Literature.
Large studies about the management of pediatric patients with unstable flexion-distraction injuries of the midcervical spine are rare. We present the case of a 12-year-old girl who sustained a cervical spinal injury with unilateral facet dislocation and discuss details and problems of diagnostic procedures and treatment in the light of the recent literature. The management and pitfalls of a unilateral facet dislocation in a child are summarized. ⋯ A treatment of postoperative malalignment with reposition via a halo-fixator cannot be recommended. Repositioning is possible but was lost when the fixator was removed. Comparing the historic and recent literature there is only weak evidence overall, nevertheless a ventral fusion seems to be the treatment option of choice.
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Eur J Trauma Emerg S · Oct 2008
Physical and Psychosocial Factors Associated with Neck Pain after Major Accidental Trauma.
Neck pain after physical trauma is common; but previous research regarding the role of psychological and physical predictors for neck pain is inconsistent. A retrospective survey of consecutive patients presenting to a metropolitan trauma centre with major accidental trauma was performed between 1 and 6 years post injury. Possible predictor variables (demographic, injury severity, and psychosocial factors) were determined from the hospital trauma registry and the questionnaire. ⋯ Neck pain was significantly more likely to be severe in patients with a cervical spine fracture, with pre-existing chronic illnesses, those with post-traumatic stress disorder (PTSD) at the time of follow up, those who had retained the services of a lawyer regarding the injury, and those with lower education levels. Psychosocial factors are important predictors of neck pain after major physical trauma. These findings do not support models for post-traumatic neck pain that are restricted to physical factors.
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Eur J Trauma Emerg S · Oct 2008
Lateral Radiograph of the Hip in Fracture Neck of Femur: Is it a Ritual?
Historically routine work up of a patient with a fracture neck of femur has always included an antero-posterior (AP) and a lateral view of the hip. The aim of the study was to know whether a lateral view of hip influenced the decision of an Orthopedic Surgeon regarding management at a District General Hospital. ⋯ We can conclude that unless required for management a lateral X-ray of hip should be avoided routinely in all patients with fracture neck of femur as it would not only be cost effective but will also reduce radiation exposure to patient and relieve work pressure on radiographers, nursing and portering staff.