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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We studied the effect of hypothermia on intracranial pressure, systemic and intracranial hemodynamics, and metabolism in patients with severe traumatic brain injury to clarify the optimal temperature for hypothermia, with a view toward establishing the proper management techniques for such patients. ⋯ These results suggest that, after traumatic brain injury, decreasing body temperature to 35 to 35.5 degrees C can reduce intracranial hypertension while maintaining sufficient cerebral perfusion pressure without cardiac dysfunction or oxygen debt. Thus, 35 to 35.5 degrees C seems to be the optimal temperature at which to treat patients with severe traumatic brain injury.