scholarly journals Conservative Management of Paediatric Clavicle Fractures

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Barry J. O'Neill ◽  
Alan P. Molloy ◽  
William Curtin
Keyword(s):  
Clinical Outcome ◽  
Conservative Management ◽  
Retrospective Review ◽  
Nonoperative Management ◽  
Clinical Symptoms ◽  
Operative Management ◽  
Fractures In Children ◽  
Clavicle Fractures

Paediatric clavicle fractures have traditionally been treated nonoperatively. Recent studies have recommended operative management for displaced midshaft fractures. We conducted a retrospective review of all clavicle fractures in children aged one to sixteen over a two-year period. We classified fractures and evaluated followup and clinical outcome. We identified 190 fractures. There were 135 boys and 55 girls. 65% of fractures were displaced and 35% undisplaced. Mean radiographic and clinical followup was 35 days and 44 days, respectively. Clavicle fractures in children heal with nonoperative management. Radiographs of clavicle fractures in children are unnecessary in the absence of clinical symptoms.

Open sternoclavicular osteophyte debridement in the surgical management of sternoclavicular osteoarthritis: clinical outcome of a new procedure

2020 ◽  
pp. 175857322097209
Author(s):  
Charles I Ayekoloye ◽  
Qi Yin ◽  
Amanda Wood ◽  
Simon Frostick
Keyword(s):  
Clinical Outcome ◽  
Conservative Management ◽  
Operative Management ◽  
Satisfaction Score ◽  
Dash Score ◽  
Patient Satisfaction Score ◽  
Subjective Satisfaction ◽  
Quick Dash ◽  
Non Operative Management

Introduction Symptomatic sternoclavicular osteoarthritis is uncommon but remains the most frequent non-traumatic condition affecting the sternoclavicular joint and tends to have a predilection for middle-aged women. It responds well to conservative management. Surgery is indicated when conservative management fails. We present the clinical outcome of open symptomatic sternoclavicular osteophyte debridement, a new operation for treating recalcitrant symptomatic sternoclavicular osteoarthritis. Methods Five patients (five symptomatic sternoclavicular joints) with symptomatic sternoclavicular osteoarthritis underwent open sternoclavicular debridement following failure of conservative treatment. There were three females and two males. Mean age was 46.6 years (range 37.17–66). Four cases were primary osteoarthritis and one case was secondary to trauma. They were reviewed at mean follow-up at 35.4 months with minimum follow-up of 29 months. Assessment included Quick Disabilities of Arm Shoulder and Hand (DASH) and subjective patient satisfaction score. Results There was no post-operative complication. Mean Quick DASH score 10.9 (range 0–29.5) at mean 35.4-month follow-up (range 29–43 months). Three patients reported excellent and two reported good outcome as per subjective satisfaction score. Conclusions Open sternoclavicular debridement has proved to be a simple, safe and highly effective new surgical treatment for patients with symptomatic sternoclavicular osteoarthritis unresponsive to non-operative management.

scholarly journals Intermediate-Term Outcomes Following Operative and Nonoperative Management of Midshaft Clavicle Fractures in Children and Adolescents

2021 ◽  
Vol 6 (1) ◽  
pp. e20.00036-e20.00036
Author(s):  
Ishaan Swarup ◽  
Bhargavi Maheshwer ◽  
Steven Orr ◽  
Clare Kehoe ◽  
Yi Zhang ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Nonoperative Management ◽  
Fractures In Children ◽  
Clavicle Fractures

Factors Associated with Failure of Nonoperative Management for Complicated Appendicitis

2019 ◽  
Vol 85 (8) ◽  
pp. 865-870
Author(s):  
Charles Walker ◽  
Ali Moosavi ◽  
Katelyn Young ◽  
Marcus Fluck ◽  
Denise Torres ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Nonoperative Management ◽  
Operative Management ◽  
Complicated Appendicitis ◽  
Symptom Duration ◽  
Hospital System ◽  
Duration Of Symptoms ◽  
Failure Group ◽  
Non Operative Management

In recent years, nonoperative management of complicated appendicitis has become more common. Patients managed nonoperatively do well, but there is a paucity of literature on patients who fail nonoperative management. The purpose of this study was to examine the overall failure rate, morbidity associated with failure, and potential predictors of failure in nonop management of appendicitis. This is a descriptive retrospective review of patients from a single hospital system who were diagnosed with advanced appendicitis and underwent nonop management between January 1, 2007, and November of 2017. The data were obtained through review of patient charts from the electronic medical record. Failure was defined as requirement of an operation due to ongoing infection secondary to appendicitis. There were 183 patients initially managed non-operatively, with 70 patients failing nonoperative management. Patients failing nonoperative management experienced longer hospitalization (6.2 vs 2.9 days, P < 0.0001), and more patients in the failure group required admission to the ICU (10.0% vs 1.8%, P = 0.028). Multivariate analysis revealed that longer duration of symptoms reduced the likelihood of failure (odds ratio: 0.77 [0.64–0.92]). In this retrospective review, 38 per cent of patients failed nonop management of appendicitis. Symptom duration could provide insight for clinicians in assessing the role of non-operative management because increasing symptom duration reduced the likelihood of failure.

scholarly journals Splenic Artery Embolization for Patients with High-Grade Splenic Trauma: Indications, Techniques, and Clinical Outcomes

2021 ◽  
Vol 38 (01) ◽  
pp. 105-112
Author(s):  
Majd Habash ◽  
Darrel Ceballos ◽  
Andrew J. Gunn
Keyword(s):  
Clinical Outcomes ◽  
Splenic Artery ◽  
Splenic Injury ◽  
Nonoperative Management ◽  
Operative Management ◽  
Splenic Trauma ◽  
Trauma Patients ◽  
High Grade ◽  
Artery Embolization ◽  
Splenic Artery Embolization

AbstractThe spleen is the most commonly injured organ in blunt abdominal trauma. Patients who are hemodynamically unstable due to splenic trauma undergo definitive operative management. Interventional radiology plays an important role in the multidisciplinary management of the hemodynamically stable trauma patient with splenic injury. Hemodynamically stable patients selected for nonoperative management have improved clinical outcomes when splenic artery embolization is utilized. The purpose of this article is to review the indications, technical aspects, and clinical outcomes of splenic artery embolization for patients with high-grade splenic injuries.

scholarly journals Comparative Results of External Fixation, Plating, or Nonoperative Management for Diaphyseal Clavicle Fractures

2017 ◽  
Vol 26 (5) ◽  
pp. 458-463
Author(s):  
Barış Özkul ◽  
Mehmet Selçuk Saygılı ◽  
Yaşar Mahsut Dinçel ◽  
Ilhan Avni Bayhan ◽  
Deniz Akbulut ◽  
...  
Keyword(s):  
External Fixation ◽  
Nonoperative Management ◽  
Clavicle Fractures ◽  
Comparative Results

scholarly journals Neonatal Gastric Lactobezoar: Management with N-Acetylcysteine

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Sarah Bajorek ◽  
Roel Basaldua ◽  
Katherine McGoogan ◽  
Charla Miller ◽  
Craig B. Sussman
Keyword(s):  
Treatment Regimen ◽  
Conservative Management ◽  
Clinical Symptoms ◽  
Unusual Presentation ◽  
Intravenous Fluids ◽  
Surgical Measures ◽  
Abdominal Symptoms ◽  
Bowel Rest

Gastric lactobezoars (GLBs) are the most common form of bezoars in neonates and consist of aggregations of undigested milk constituents. GLB can present with a variety of intra-abdominal clinical symptoms, and occasionally, extra-abdominal symptoms. Conservative management, with a period of bowel rest and intravenous fluids, is the most common treatment regimen for uncomplicated GLB. Surgical measures are reserved for the rare complications of obstruction and/or perforation. Although limited, utilization of the protein-cleaving enzyme N-acetylcysteine has been described for the disintegration of GLB in toddlers. In this paper, we discuss the first documented use of N-acetylcysteine for a neonatal GLB. Supporting literature, the infant’s unusual presentation, and details of the treatment regimen are discussed.

Trends in the volume of operative treatment of midshaft clavicle fractures in children and adolescents

2016 ◽  
Vol 25 (4) ◽  
pp. 305-309 ◽  
Author(s):  
Catherine A. Suppan ◽  
Donald S. Bae ◽  
Kyna S. Donohue ◽  
Patricia E. Miller ◽  
Mininder S. Kocher ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Operative Treatment ◽  
Fractures In Children ◽  
Clavicle Fractures

1305 Ureteral Stenting in Conservative Management of Grade IV Blunt Renal Injury

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A. Mukhtar A Mukhtar ◽  
M. Gareeballah Yousif Hijazi ◽  
B.A. Abdalaziz Alshareif ◽  
M. Yahia Ibrahim
Keyword(s):  
Ct Scan ◽  
Conservative Management ◽  
Renal Injury ◽  
Motor Vehicle ◽  
Nonoperative Management ◽  
Fluid Collection ◽  
Dramatic Improvement ◽  
Ureteric Stenting ◽  
Delayed Hemorrhage ◽  
The Right

Abstract Post-traumatic urinomas are well-described complications associated with the nonoperative management of major blunt renal injuries. A 16-year-old male sustained a motor vehicle accident. Brought after 30 minutes to emergency department, upon arrival he was fully conscious, complaining of severe right hypochondrial and loin pain, abdomen was tender and guarded over the right side, urinary catheter inserted revealed gross haematuria, the patient was resuscitated accordingly, fast ultrasound scan showed minimal fluid collection in the Morison's pouch, the right kidney was swollen with perinephric fluid collection and poor cortico-medullary differentiation. Urgent CT scan findings were deep avulsion of the right kidney. The Patient was planned for conservative management, admitted to high dependency ward, CT scan repeated, and the size of urinoma increased compared to the initial CT, so he was planned for retrograde pyelography and ureteric stenting. Intra-operatively the right ureter was canulated, contrast injected. The pelvi-ureteric junction was intact, extravasation of contrast in the upper pole of the kidney. The right ureter was stented using a size 6 multiloop stent, with the tip directed into the upper pole calyx. The Patient showed dramatic improvement, haematuria cleared and the patient was discharged well after 12 days and the stent was removed after 6 weeks. Despite the improvements with nonoperative management, complications are described and include delayed hemorrhage, delayed massive hematuria and renal scaring with loss of function. Ureteric stenting is playing a major part in the conservative management of high-grade renal injury particularly grade IV type.

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