Articles: trauma.
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Hand (New York, N.Y.) · Sep 2007
Case ReportsIntraoperative fracture of a pyrocarbon PIP total joint-a case report.
Pain or dysfunction of the finger joints due to arthritis or traumatic injuries that fail medical management may necessitate arthroplasty or joint replacement. The goals of the finger joint implant arthroplasty are to relieve pain, to correct deformity, and to improve the function and appearance of the hand. Several prosthetic implants have been used for the replacement of the proximal interphalangeal (PIP) joint. ⋯ The component was removed, and a new implant was inserted without complication. Critical evaluation revealed that there was an inadequate resection of the volar lip resulting in a stress riser on the implant during impaction. Careful attention to this technical point will hopefully minimize the occurrence of this complication as the availability and use of these implants increases.
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Eur J Trauma Emerg S · Aug 2007
Postoperative Management after Pneumonectomy for Blunt Thoracic Trauma.
Pneumonectomy for blunt thoracic injury carries a high mortality rate. We present a case of severe bilateral blunt thoracic injury in which left pneumonectomy was done. The immediate postoperative measures were directed to maintain right heart performance by minimizing hypoxia, avoiding fluid overload and limiting pulmonary hypertension. We believe that this approach contributed to the favorable outcome of this patient.
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J Bone Joint Surg Br · Jul 2007
Comparative StudyThermometric diagnosis of peripheral nerve injuries. Assessment of the diagnostic accuracy of a new practical technique.
The diagnosis of nerve injury using thermotropic liquid crystal temperature strips was compared blindly and prospectively against operative findings in 36 patients requiring surgical exploration for unilateral upper limb lacerations with suspected nerve injury. Thermotropic liquid crystal strips were applied to affected and non-affected segments in both hands in all subjects. A pilot study showed that a simple unilateral laceration without nerve injury results in a cutaneous temperature difference between limbs, but not within each limb. ⋯ Receiver operating characteristic curve analysis showed that an absolute temperature difference > or = 1.0 degrees C was diagnostic of a nerve injury (area under the curve = 0.985, sensitivity = 100%, specificity = 93.8%). Thermotropic liquid crystal strip assessment is a new, reliable and objective method for the diagnosis of traumatic peripheral nerve injuries. If implemented in the acute setting, it could improve the reliability of clinical assessment and reduce the number of negative surgical explorations.