Sarah Razaq;James Geffner;Asma Khan;Harry Mee;Cynthia Udensi;Fahim Anwar
Journal of Trauma and Injury
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v.36
no.3
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pp.269-275
/
2023
A Morel-Lavallée lesion results from a degloving injury between the muscle fascia and the subcutaneous layer. It is most commonly found in the trochanteric area but can occur at other sites. The treatment of the condition varies according to the medical circumstances, as well as the size and chronicity of the condition. A case of large (18×6 and 10×5 cm) bilateral posttraumatic Morel-Lavallée lesions with no underlying bone fracture is presented; the case occurred in a 49-year-old male patient 4 weeks posttrauma. Ultrasound scans showed bilateral large collections of anechoic fluid, which were aspirated under ultrasound guidance and further managed by compression bandages. There were no further complications. The objective of this case report is to present this unique and educational case, as well as to provide an overview of the pathophysiology, diagnosis, and management of Morel-Lavallée lesions. We conclude by discussing the importance of having a high index of suspicion to ensure early detection and prompt treatment of such lesions to avoid complications.
The purpose of this study was (a) to develop carbon nanotube-based shock absorbers for reducing potentially harmful impact forces and excessive foot pronation, and (b) to briefly determine how the effects of carbon nanotube-based shock absorbers on biomechanical variance during drop landing. A university student(age: 24.0 yrs, height: 176.2 cm, weight: 679.5 N) who has no musculoskeletal disorder was recruited as the subject. Hardness, specific gravity, tensile strength, elongation, 100% modulus, tear strength, split tear strength, compression set, resilience, vertical GRF, and loading rate were determined for each material. For each dependent variable, a descriptive statistics was used for different conditions. The property test results showed that tensile strength, tear strength, split tear strength, compression set, and resilience in carbon nanotube-based shock absorbers were greater than general Ethylene Vinyl Acetate(EVA). These indicated that resistance against variable strength in developed carbon nanotube-based shock absorbers were greater than general EVA. In vertical GRF of CNTC was less than those of EVA during drop landing and loading rate of CNTC was greater than EVA. It seems that the use of CNT can be a effective way of reducing and controlling shock from impact.
Oral prostaglandin E1 (PGE1) is a medicine that is clinically applied during a treatment of patients suffering with vascular disease with chronic arterial obstruction because it has vasodilation and anti-platelet effects. The mechanisms of lumbosacral symptoms associated with spinal stenosis probably include vascular insufficiency with hypoxic injury to the cauda equina and the nerve roots. Thus, increasing the blood supply would be beneficial to improve the pathophysiologic condition. Several studies on the improvement of clinical symptoms of spinal stenosis by PGE1 treatment have been reported on. In this case, 47-year old female underwent posterior compression and posterolateral fusion with a cage at L2-4 due to L3 compression fracture, and she did not show improvement of the radiating pain of her right leg after the operation. Therefore, she received repetitive epidural catheterization and adhesiolysis, epidural block and physical therapy, but her symptoms deteriorated after temporary improvement. Finally, she was given PGE1 and the radiculopathy was completely improved, although some muscle weakness still remained.
Objective : Subdural hygroma (SDG) is a complication occurring after head trauma that may occur secondary to decompressive craniectomy (DC). However, the mechanism underlying SDG formation is not fully understood. Also, the relationship between the operative technique of DC or the decompressive effect and the occurrence and pathophysiology of SDG has not been clarified. Purpose of this study was to investigate the risk factors of SDG after DC in our series. Methods : From January 2004 to December 2008, DC was performed in 85 patients who suffered from traumatic brain injury. We retrospectively reviewed the clinical and radiological features. For comparative analysis, we divided the patients into 2 groups : one group with SDG after craniectomy (19 patients; 28.4% of the total sample), the other group without SDG (48 patients; 71.6%). The risk factors for developing SDG were then analyzed. Results : The mean Glasgow Outcome Scale (GOS) scores at discharge of the groups with and without SDG were 2.8 and 3.1, respectively (p<0.0001). Analysis of radiological factors showed that a midline shift in excess of 5 mm on CT scans was present in 19 patients (100%) in the group with SDG and in 32 patients (66.7%) in the group without SDG (p<0.05). An accompanying subarachnoid hemorrhage (SAH) was seen in 17 patients (89.5%) in the group with SDG and in 29 patients (60.4%) in the group without SDG (p<0.05). Delayed hydrocephalus accompanied these findings in 10 patients (52.6%) in the group with SDG, versus 5 patients (10.4%) in the group without SDG (p<0.05). On CT, compression of basal cisterns was observed in 14 members (73.7%) in the group with SDG and in 18 members of the group without SDG (37.5%) (p<0.007). Furthermore, tearing of the arachnoid membrane, as observed on CT, was more common in all patients in the group with SDG (100%) than in the group without SDG (31 patients; 64.6%) (p<0.05). Conclusion : GOS showed statistically significant difference in the clinical risk factors for SDG between the group with SDG and the group without SDG. Analysis of radiological factors indicated that a midline shifting exceeding 5 mm, SAH, delayed hydrocephalus, compression of basal cisterns, and tearing of the arachnoid membrane were significantly more common in patients with SDG.
Kim Sun Young;Kim Min-Su;Seo Kang-Moon;Nam Tchi-Chou
Journal of Veterinary Clinics
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v.22
no.4
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pp.297-301
/
2005
This study was performed to evaluate the effects of the combination of electroacupuncture (EA) and surgical decompression on paraplegia due to spinal compression in dogs. Ten clinically healthy dogs were assigned into two groups (group A and group B). The one is for the combination of EA and surgical decompression, and the other is for surgical decompression alone. After decompression, neurological function was evaluated daily with modified Tarlov grading system. SEPs were measured as objective evaluation of normal spinal cord function before spinal compression and after neurological recovery. The period of rehabilitation in group A was significantly shorter than that in group B (p<0.05). Conduction velocity of SEPs showed a tendency to return to normal when the dogs got full recovery. According to these results, it was considered that the EA with surgical decompression was more effective than surgical decompression alone for paraplegia resulting from spinal cord injury in dog.
Objective : The study was performed to evaluate the effect of treatment for thoracolumbar compression fracture by using Bee Venom Acupuncture that is well known for anti-inflammatory and analgesic effect. Methods : We investigated 39 cases of patient with thoracolumbar compression fracture. The patients with thoracolumbar compression fracture were treated at the department of acupuncture & moxibustion of Kyung-Won University Oriental Hospital from 1st January 2001 to 30th August 2002. We selected for two groups. One group was treated by Bee Venom Acupuncture therapy(Bee Venom Acupuncture Group : BAG), the other group was treated by Filiform Acupuncture therapy(None Bee Venom Acupuncture Group : NBAG). Results : 1. The distribution showed female predominance in sex and 70's predominance in age. The largest group was "accidental fall" and the next was "lifting heavy objects" in causes, and within 2 weeks in the duration of disease 2. In the duration of admission, the largest group was within 4 weeks. In regard to level of injury, T12 was found to be most predominant, followed in turn by L1, L2, L5. In regard to grade of clinical symptoms, Grade III was most predominant, followed by Grade II, Grade IV. 3. In the results of treatment, 87.5% were above "Good" in BAG and 47.8% in NBAG. 4. In the result of treatment due to the grade of clinical symptoms, BAG was more excellent than NBAG on the whols grade. 5. In the result of treatment due to duration of admission, the duration of admission was not in proportion to the results of treatment. 6. In the change of lumber flexion, the improvement above $80^{\circ}$ was 50% in BAG and 21.7% in NBAG 7. In the stability of treatment, the BAG and NBAG did't show any detrimental change in GOT, GPT, r-GTP, BUN, creatinine. Conclusions : In the treatment of thoracolumbar compression fracture, the Bee Venom Acupuncture can be regarded as more effective treatment than Filiform Acupuncture in the clinical practice. This is expected to be available for clinical use.
Choi, Kyunghak;Jung, Kwang-Hwan;Keum, Min Ae;Kim, Sungjeep;Kim, Jihoon T;Kyoung, Kyu-Hyouck
Journal of Trauma and Injury
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v.33
no.1
/
pp.18-22
/
2020
Purpose: Damage control laparotomy has contributed to improved survival rates for severe abdominal injuries. A large part of severe abdominal injury occurs with a concomitant pelvic bone fracture. The safety and effectiveness of internal fixation of pelvic bone fracture(s) has not been established. The aim of the present study was to evaluate infection risk in the pelvic surgical site in patients who underwent emergent abdominal surgery. Methods: This single-center retrospective observational study was based on data collected from a prospectively maintained registry between January 2015 and June 2019. Patients who underwent laparotomy and pelvic internal fixation were included. Individuals <18 and ≥80 years of age, those with no microbiological investigations, and those who underwent one-stage abdominal surgery were excluded. Comprehensive statistical comparative analysis was not performed due to the small number of enrolled patients. Results: A total of six patients met the inclusion criteria, and the most common injury mechanism was anterior-posterior compression (67%). The average duration of open abdomen was 98 hours (range, 44-98), and the time interval between abdominal closure and pelvic surgery was 98 hours. One patient (16.7%) died due to multi-organ dysfunction syndrome. Micro-organisms were identified in the abdominal surgical site in five patients (83%), with no micro-organisms in pelvic surgical sites. There was no unplanned implant removal. Conclusions: Internal fixation of pelvic bone fracture(s) could be performed in the state of open abdomen, and the advantages of early fixation may countervail the risks for cross contamination.
Repetitive overhead throwing exerts significant mechanical stress on the elbow joint. Pitching in baseball, serving in tennis, spiking in volleyball, passing in American football and launching in javelin-throwing can all produce elbow pathology by forceful valgus stress, with medial stretching, lateral compression and posterior impingement. This stress can lead to developmental anatomic changes in the young thrower. Asymptomatic pathology in the shoulder and elbow joint is prevalent and, with overuse, can progress to disabling injury. Joint injury occurs as a result of the body's inability to properly coordinate motion segments during the pitching delivery, leading to further structural damage. The implications of acute and overuse injuries and the possibility of permanent damage should be understood by parents, coaches and the athletes. Proper understanding of the intrinsic and extrinsic risk factors that could lead to elbow injuries is thus required. Measures to prevent elbow injuries should include proper coaching, warm-up, medical expertise and protective gear. Injury prevention and rehabilitation should center on optimizing pitching mechanics, core strength, scapular control, and joint range of motion.
Objective: Valproic acid (VPA), as known as histone deacetylase inhibitor, has neuroprotective effects. This study investigated the histological changes and functional recovery from spinal cord injury (SCI) associated with VPA treatment in a rat model. Methods: Locomotor function was assessed according to the Basso-Beatlie-Bresnahan scale for 2 weeks in rats after receiving twice daily intraperitoneal injections of 200 mg/kg VPA or the equivalent volume of normal saline for 7 days following SCI. The injured spinal cord was then examined histologically, including quantification of cavitation. Results: Basso-Beatlie-Bresnahan scale scores in rats receiving VPA were significantly higher than in the saline group (p<0.05). The cavity volume in the VPA group was Significantly reduced compared with the control (saline-injected) group (p<0.05). The level of histone acetylation recovered in the VPA group, while it was significantly decreased in the control rats (p<0.05). The macrophage level was significantly decreased in the VPA group (p<0.05). Conclusion: VPA influences the restoration of hyperacetylation and reduction of the inflammatory reaction resulting from SCI, and is effective for histology and motor function recovery.
Objective : This study investigates the effect of valproic acid (VPA) on expression of neural stem/progenitor cells (NSPCs) in a rat spinal cord injury (SCI) model. Methods : Adult male rats (n=24) were randomly and blindly allocated into three groups. Laminectomy at T9 was performed in all three groups. In group 1 (sham), only laminectomy was performed. In group 2 (SCI-VPA), the animals received a dose of 200 mg/kg of VPA. In group 3 (SCI-saline), animals received 1.0 mL of the saline vehicle solution. A modified aneurysm clip with a closing force of 30 grams was applied extradurally around the spinal cord at T9, and then rapidly released with cord compression persisting for 2 minutes. The rats were sacrificed and the spinal cord were collected one week after SCI. Immunohistochemistry (IHC) and western blotting sample were obtained from 5 mm rostral region to the lesion and prepared. We analyzed the nestin immunoreactivity from the white matter of ventral cord and the ependyma of central canal. Nestin and SOX2 were used for markers for NSPCs and analyzed by IHC and western blotting, respectively. Results : Nestin and SOX2 were expressed significantly in the SCI groups but not in the sham group. Comparing SCI groups, nestin and SOX2 expression were much stronger in SCI-VPA group than in SCI-saline group. Conclusion : Nestin and SOX2 as markers for NSPCs showed increased expression in SCI-VPA group in comparison with SCI-saline group. This result suggests VPA increases expression of spinal NSPCs in SCI.
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