Eur J Trauma Emerg S
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Acute aortic valve insufficiency caused by laceration of the aortic valve cusp after blunt chest trauma is a rare condition. We report herein on a case of a 40-year-old patient who initially presented with cardiac tamponade and cardiac arrest after a traffic accident. The patient ultimately received aortic valve repair to treat acute aortic regurgitation due to multiple perforations on a single cusp, visualized on multidetector chest computed tomography scan (128 channels).
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The management of rib fractures and flail chest has changed considerably over the past century, and recently there has been a renewed interest in operative rib stabilization for these injuries. Despite numerous reports suggesting improved outcomes with rib stabilization, there are not well-defined indications and the approach remains somewhat controversial. ⋯ The authors offer their opinions on this operation with respect to rationale, indications, timing, technique, and postoperative care.
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Hoffa fractures are uni- or bicondylar fractures of the distal femur in a coronal tangential plane. ⋯ Traditional methods of fixation for Hoffa fractures have led either to the application of complicated constructs attempting to achieve stability, or to large articular surface defects created whilst countersinking headed lag screws. Both have negative implications for the patient. We describe a novel method, not previously described in the literature, using screws in a posterior to anterior direction. This provides compression perpendicular to the fracture site whilst protecting against shear and torsional forces, thereby providing more stable fixation. Furthermore, our method allows for a minimally invasive approach and uses headless compression screws, which reduces the chance of damage to the articular surface and is, therefore, less physiologically invasive.
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Intestinal derotation (ID) is a rarely used surgical technique which allows elegant and effective surgical access to the superior mesenteric axis and third and fourth portion of the duodenum. ID proves an extremely useful technique especially in the emergency setting when access to the "surgical soul" is needed. To master this technique the surgeon has to become familiar with the anatomical landmarks of that area along with the embryological background.
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Eur J Trauma Emerg S · Oct 2010
Simultaneous dislocation of the interphalangeal and metacarpophalangeal joints of the thumb.
Simultaneous dislocation of the interphalangeal and metacarpophalangeal joints of the thumb is an extremely rare injury, the management of which is controversial. We advocate closed reduction followed by early mobilisation in order to achieve optimal functional results.