Database : MEDLINE
Search on : Rib and Fractures [Words]
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[PMID]: 29521744
[Au] Autor:Suh MK; Lee SJ; Kim YJ
[Ad] Address:JW Plastic Surgery Center, Seoul, Korea.
[Ti] Title:Use of Irradiated Homologous Costal Cartilage in Rhinoplasty: Complications in Relation to Graft Location.
[So] Source:J Craniofac Surg;, 2018 Mar 08.
[Is] ISSN:1536-3732
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Nasal septal cartilage and conchal cartilages are preferred sources of grafts in augmentation rhinoplasty. Rib cartilage can also be used, but it may evoke a patient's concerns about a scar and an extensive surgery. In such cases, irradiated homologous costal cartilage (IHCC) can be a useful alternative. However, controversy still exists in many literatures regarding complications with use of IHCC. Therefore, the authors reviewed our experiences with IHCC in rhinoplasty and analyzed the complications in relation to graft location. METHODS: A retrospective chart review was made of all patients who underwent rhinoplasty with IHCC between 2007 and 2015. A total of 323 patients were included. The authors considered the cases that required revision surgery for external aesthetic changes as complications. The authors defined major complications, including resorption, infection, fracture, or warping. RESULTS: The total complication rate was 8%. Two fractures (0.6%), 4 fragmentation (1.2%), 4 resorptions (1.2%), 4 infections (1.2%), and 2 warpings (0.6%) were noted. Most of these complications occurred for the septal extension graft. Other complications, including 1 nasal obstruction, 2 visible contours, 3 caudal septal deviations, and 4 cases of unfavorable results (patient unsatisfactions), were noted. CONCLUSIONS: Based on the outcomes of this study, the authors concluded that IHCC is a useful and reliable source of cartilage graft and can serve as an alternative graft material for rhinoplasty. However, care must be taken in use of IHCC graft in areas under tension such as septal extension graft, though its complication rate is low.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher
[do] DOI:10.1097/SCS.0000000000004440

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[PMID]: 29514720
[Au] Autor:Takayama W; Koguchi H; Endo A; Otomo Y
[Ad] Address:1Trauma and Acute Critical Care Medical Center,Tokyo Medical and Dental University Hospital of Medicine,Tokyo,Japan.
[Ti] Title:The Association between Cardiopulmonary Resuscitation in Out-of-Hospital Settings and Chest Injuries: A Retrospective Observational Study.
[So] Source:Prehosp Disaster Med;:1-5, 2018 Mar 08.
[Is] ISSN:1945-1938
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVES: The aim of this study was to assess the risk of cardiopulmonary resuscitation (CPR) performed in out-of-hospital settings for chest injuries in patients with out-of-hospital cardiac arrest (OHCA). METHODS: This retrospective, observational study was conducted in an emergency critical care medical center in Japan. Non-traumatic OHCA patients transferred to the hospital from April 2013 through August 2016 were analyzed. The outcome was defined by chest injuries related to CPR, which is composite of rib fractures, sternal fractures, and pneumothoraces. A multivariate logistic regression analysis was performed to assess the independent risk factors for chest injuries related to CPR. The threshold of out-of-hospital CPR duration that increased risk of chest injuries was also assessed. RESULTS: A total of 472 patients were identified, of whom 233 patients sustained chest injuries. The multivariate logistic regression model showed that the independent risk factors for chest injuries were age and out-of-hospital CPR duration (age: AOR=1.06 [95% CI, 1.04 to 1.07]; out-of-hospital CPR duration: AOR=1.03 [95% CI, 1.01 to 1.05]). In-hospital CPR duration was not an independent risk factor for chest injuries. When the duration of out-of-hospital CPR extended over 15 minutes, the likelihood of chest injuries increased; however, this association was not statistically significant. CONCLUSIONS: Long duration of out-of-hospital CPR was an independent risk factor for chest injuries, possibly due to the difficulty of maintaining adequate quality of CPR. Further investigations to assess the efficacy of alternative CPR devices are expected in cases requiring long transportation times. Takayama W , Koguchi H , Endo A , Otomo Y . The association between cardiopulmonary resuscitation in out-of-hospital settings and chest injuries: a retrospective observational study.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1017/S1049023X18000201

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[PMID]: 29514343
[Au] Autor:Lichtenberger JP; Kim AM; Fisher D; Tatum PS; Neubauer B; Peterson PG; Carter BW
[Ad] Address:Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.
[Ti] Title:Imaging of Combat-Related Thoracic Trauma - Blunt Trauma and Blast Lung Injury.
[So] Source:Mil Med;183(3-4):e89-e96, 2018 Mar 01.
[Is] ISSN:1930-613X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Introduction: Combat-related thoracic trauma (CRTT) is a significant contributor to morbidity and mortality of the casualties from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Penetrating, blunt, and blast injuries are the most common mechanisms of trauma to the chest. Imaging plays a key role in the battlefield management of CRTT casualties. This work discusses the imaging manifestations of thoracic injuries from blunt trauma and blast injury, emphasizing epidemiology and diagnostic clues seen during OEF and OIF. Materials and Methods: The assessment of radiologic findings in patients who suffer from combat-related blunt thoracic trauma and blast injury is the basis of this work. The imaging modalities for this work include multi-detector computed tomography (MDCT) and chest radiography. Results: Multiple imaging modalities are available to imagers on or near the battlefront, including radiography, fluoroscopy, and MDCT. MDCT with multi-planar reconstructions is the most sensitive imaging modality available in combat hospitals for the evaluation of CRTT. In modern combat, blunt and blast injuries account for a significant portion of CRTT. Individual body armor converts penetrating trauma to blunt trauma, leading to pulmonary contusion that accounted for 50.2% of thoracic injuries during OIF and OEF. Flail chest, a subset of blunt chest injury, is caused by significant blunt force to the chest and occurs four times as frequently in combat casualties when compared with the civilian population. Imaging features of CRTT have significant diagnostic and prognostic value. Pulmonary contusions on chest radiography appear as patchy consolidations in the acute setting with ill-defined and non-segmental borders. MDCT of the chest is a superior imaging modality in diagnosing and evaluating pulmonary contusion. Contusions on MDCT appear as crescentic ground-glass opacities (opacities through which lung interstitium and vasculature are still visible) and areas of consolidation that often do not respect the anatomic boundaries of the affected lobes. Additionally, small pulmonary contusions may exhibit sub-pleural sparing and may distinguish contusion from pneumonia or other lung pathology. Although pulmonary laceration is typically the result of penetrating trauma, laceration may also be caused by displaced rib fractures or significant shearing forces on the lung without penetrating injury. Because of elastic recoil of the normal pulmonary parenchyma surrounding the injury, pulmonary lacerations may present as late as 48-72 h after injury. Pulmonary lacerations may appear similar to pulmonary contusions on chest radiography initially and will require MDCT for definitive diagnosis. Blast injury is a defining injury of modern combat. Blast lung injury is initially diagnosed with chest radiography, where the pattern of lung opacities has previously been described by clinicians as "batwing" or "butterfly" because of its central appearance in the lung. "Peribronchovascular" may be a more accurate description of primary blast lung based on its appearance on MDCT. This pattern may differentiate primary blast lung injury from other causes of thoracic trauma. Conclusion: CRTT continues to be a significant contributor to the morbidity and mortality of those injured during OEF and OIF. The distinct injury patterns and atypical imaging manifestations of blunt trauma and blast lung injury are important to recognize early because of the acuity of this patient population and the influence of accurate diagnosis on clinical management.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Data-Review
[do] DOI:10.1093/milmed/usx033

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[PMID]: 29499671
[Au] Autor:Fahrner R; Rauchfuss F; Scheuerlein H; Settmacher U
[Ad] Address:University Hospital Jena, Division of General, Visceral and Vascular Surgery, Am Klinikum 1, 07740, Jena, Germany.
[Ti] Title:Posttraumatic venous gas in the liver - a case report and review of the current literature.
[So] Source:BMC Surg;18(1):14, 2018 Mar 02.
[Is] ISSN:1471-2482
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: There are numerous causes of hepatic gas formation that range from serious pathologies to incidental findings, including mesenteric infarction, liver abscess, inflammatory bowel disease or minimally invasive hepatic interventions. CASE PRESENTATION: We report a case of a 50-year-old man who was admitted to the emergency room after a car accident. The clinical examination and further diagnostics revealed a craniocerebral injury with a fracture of the skull, concomitant soft tissue lesions and subarachnoidal bleeding. Furthermore, a blunt thoracic trauma with hemopneumothorax due to rib fractures was treated with a chest tube. No obvious abdominal pathology was seen. While in the operating theatre for the surgical revision of the cranial soft tissue lesions, a femoral venous catheter was inserted without any complications. A routine ultrasound of the abdomen six hours after the trauma revealed unclear hepatic gas formation. A contrast-enhanced computer tomography (CT) scan of the abdomen was performed, and the gas formation was found to be localized within the left hepatic vein. Afterwards, there was no specific treatment of the hepatic venous gas formation, as no alterations of liver function or liver enzymes were seen. The further course of the patient was uneventful regarding the gas formation in the liver, and another ultrasound two days later revealed no further gas in the liver. CONCLUSIONS: The placement of a femoral venous catheter is a risk factor for gas formation in liver veins. No further treatment is needed in cases with stable liver function. To rule out serious pathologies, diagnostic findings (e.g., ultrasound, CT), clinical history and underlying diseases need to be analyzed carefully after the detection of intrahepatic gas formation. With contrast-enhanced CT, the localization of the gas and its potential causes might be detectable.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Process
[do] DOI:10.1186/s12893-018-0345-z

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[PMID]: 29506834
[Au] Autor:Haines KL; Zens T; Beems M; Rauh R; Jung HS; Agarwal S
[Ad] Address:Division of Trauma and Critical Care, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
[Ti] Title:Socioeconomic disparities in the thoracic trauma population.
[So] Source:J Surg Res;224:160-165, 2018 Apr.
[Is] ISSN:1095-8673
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Health-care disparities based on socioeconomic status have been well documented in the trauma literature; however, there is a paucity of data on how these factors affect outcomes in patients experiencing severe thoracic trauma. This study aims to identify the effect of insurance status and race on patient mortality and disposition after thoracic trauma. METHODS: The National Trauma Data Bank was queried from 2007 to 2012 for patients with sternal fractures, rib fractures, and flailed chest. Demographics data were examined for the cohort based on insurance status. Univariate and multivariate logistic regression models were used, controlling for patient comorbidities, age, injury severity score, and associated injuries, to determine the impact of race and insurance status on length of stay, mortality, and discharge disposition. RESULTS: A total of 152,655 thoracic traumas were included in our analysis. As compared to privately insured patients, uninsured patients with thoracic trauma were 1.9 times more likely to die (odds ratio [OR]: 1.91, confidence interval [CI]: 1.76-2.09) and 4.6 times more likely to leave against medical advice (OR: 4.61, CI: 3.14-6.79). When compared to Caucasians, Hispanics had slightly higher in-hospital mortality (OR: 1.14, CI: 1.02-1.27), but there was no survival difference seen in black patients (OR: 0.95, CI: 0.86-1.05). CONCLUSIONS: Insurance status appears to have a more significant effect on thoracic trauma patient outcomes than race, but substantial socioeconomic disparities were seen in this patient population. Further studies are needed to show reproducibility of our findings and to investigate the impact of universal health care and expansion of insurance availability on thoracic trauma outcomes. LEVEL OF EVIDENCE: Level 3, economic/decision.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:In-Data-Review

  6 / 4144 MEDLINE  
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[PMID]: 29502222
[Au] Autor:Scheirs S; Langenhorst W; Malgosa A; Ortega-Sánchez M; McGlynn H; Santos C; Jordana X; Rodriguez-Baeza A; Galtés I
[Ad] Address:Forensic Anthropology Unit, Institut de Medicina Legal i Cienciès Forense (IMLCFC), Ciutat de la Justícia, Gran Via de les Corts Catalanes, 111 Edifici G, 08075, Barcelona, Spain.
[Ti] Title:Perimortem fracture pattern in ribs by blunt force trauma.
[So] Source:Int J Legal Med;, 2018 Mar 03.
[Is] ISSN:1437-1596
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Literature on timing of rib trauma is scarce but remains challenging during forensic cases. This study analysed the macroscopic fracture patterns of perimortem rib fractures and compared them to experimentally reproduced rib fractures on fresh and dry ribs. Six distinctive macroscopic traits were found in ribs that might provide information about the timing of trauma, fracture mechanism and/or trauma circumstances. These traits are peels, folds, differential fracture edges, incomplete fractures, plastic deformation and longitudinal lines. Peels, folds and plastic deformation might provide information about trauma timing. Folds and different fracture edges might provide information about the fracture mechanism. Statistical analyses showed that longitudinal lines, folds and incomplete fractures might provide information about the trauma circumstances and that age might have an influence on the occurrence of complete fractures, longitudinal lines and peels (p ≤ 0.05). The new insights presented in this study might be valuable for forensic anthropologists in rib trauma analysis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180304
[Lr] Last revision date:180304
[St] Status:Publisher
[do] DOI:10.1007/s00414-018-1806-8

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[PMID]: 29500508
[Au] Autor:Berninger MT; Kellermann F; Woltmann A; Bühren V; Lang M
[Ad] Address:BG Unfallklinik Murnau, Prof.-Küntscher-Str. 8, 82418, Murnau am Staffelsee, Deutschland. Markus.Berninger@bgu-murnau.de.
[Ti] Title:"Single-port-VATS"-assistierte Osteosynthese von Rippenserienfrakturen. [Single-port VATS-assisted internal fixation of serial rib fractures].
[So] Source:Unfallchirurg;, 2018 Mar 02.
[Is] ISSN:1433-044X
[Cp] Country of publication:Germany
[La] Language:ger
[Ab] Abstract:This article describes the operative stabilization of a flail chest due to traumatic serial rib fractures with extensive chest wall deformation and respiratory insufficiency. Initial conservative treatment including systemic and regional pain management and non-invasive positive pressure ventilation did not improve the pain or ventilation. Therefore, a single-port video-assisted thoracoscopic surgery (VATS) assisted internal fixation of the ribs was performed. The thoracoscopy enabled easy repositioning of the ribs and additionally an estimation of intrathoracic injuries.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:Publisher
[do] DOI:10.1007/s00113-018-0471-1

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[PMID]: 29493501
[Au] Autor:Halberg R; Neckelmann K
[Ad] Address:rikke.hagelberg@rsyd.dk.
[Ti] Title:[Surgical stabilization of multiple rib fractures can shorten inpatient stay].
[So] Source:Ugeskr Laeger;180(8), 2018 Feb 19.
[Is] ISSN:1603-6824
[Cp] Country of publication:Denmark
[La] Language:dan
[Ab] Abstract:Flail chest is a common complication in patients with blunt chest wall traumas resulting in high mortality rates. In this case report a 43-year-old woman was stepped on by a horse, thereby receiving multiple rib fractures and pneumohaemothorax. She was not able to wean from epidural analgesia after ten days and maintained a "thoracic floating feeling". In opposition to the non-operative management previously preferred, a surgical stabilization was then performed in the patient, who was discharged only five days later. Thus, surgical fixation of multiple rib fractures may reduce inpatient stay.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[St] Status:In-Data-Review

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[PMID]: 29429475
[Au] Autor:Neckelmann K; Hagelberg R
[Ad] Address:kirsten.neckelmann@rsyd.dk.
[Ti] Title:[Osteosynthesis of rib fractures, unstable chest wall, pseudoarthroses, and acquired defects of the chest wall].
[So] Source:Ugeskr Laeger;180(6), 2018 02 05.
[Is] ISSN:1603-6824
[Cp] Country of publication:Denmark
[La] Language:dan
[Ab] Abstract:Several patients suffer from rib fractures after traumas, and in severe cases it can be life-threatening. Until recently, attempts to perform surgical fixation in patients with instability have been unsuccessful. Chronic non-union causes persistent pain, disability and loss of quality of life. Implementation of surgical stabilization of rib fractures with tailored plates seems to improve pain relief, especially in cases of non-union but also in patients with instability of the chest wall after severe traumas, where advanced pain treatment (epidural catheter) is insufficient or weaning off fails.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180227
[Lr] Last revision date:180227
[St] Status:In-Process

  10 / 4144 MEDLINE  
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[PMID]: 29479940
[Au] Autor:Yusufoglu K; Erdogan MÖ; Tayfur I; Afacan MA; Çolak S
[Ti] Title:CPR-related thoracic injuries: comparison of CPR guidelines between 2010 and 2015
[So] Source:Turk J Med Sci;48(1):24-27, 2018 Feb 23.
[Is] ISSN:1300-0144
[Cp] Country of publication:Turkey
[La] Language:eng
[Ab] Abstract:Background/aim: This study aimed to evaluate traumatic thorax complications in post-CPR patients and to investigate whether or not there has been a decrease in these complications since the adoption of current chest compression recommendations. Materials and methods: Post-CPR patients with return of spontaneous circulation (ROSC) were admitted between January 2014 and January 2016 were analyzed retrospectively. Patients admitted to the ED in 2014 were resuscitated according to 2010 AHA CPR guidelines, while those admitted to the ED in 2015 were resuscitated according to current ERC CPR guidelines. Results: The study population comprised 48 male and 35 female patients. Of the 2010 AHA guideline patients, 39.21% experienced pulmonary contusion, while 54.83% of 2015 ERC guideline patients had pulmonary contusion. It was found that 11.76% of 2010 AHA guideline patients and 3.22% of 2015 ERC guideline patients had pneumothorax, while 9.8% of 2010 AHA guideline patients and 12.9% of 2015 ERC guideline patients experienced hemothorax. Incidence rates of lung contusion, pneumothorax, and hemothorax were higher in patients with rib fractures. Conclusion: In this study, traumatic thoracic complications were investigated in patients with ROSC after CPR. The incidence of CRP-related injuries did not decrease on application of the new 2015 ERC CPR guideline recommendations. The most common injury in this study was rib fracture, followed by sternal fracture, lung contusion, hemothorax, and pneumothorax. Statistically, rib fracture had a positive relationship with lung contusion, hemothorax, and pneumothorax.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:In-Data-Review
[do] DOI:10.3906/sag-1708-59


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