scholarly journals Location of Sternal Fractures as a Possible Marker for Associated Injuries

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Max J. Scheyerer ◽  
Stefan M. Zimmermann ◽  
Samy Bouaicha ◽  
Hans-Peter Simmen ◽  
Guido A. Wanner ◽  
...  
Keyword(s):  
Thoracic Spine ◽  
Head Injuries ◽  
Fracture Morphology ◽  
Associated Injuries ◽  
Concomitant Injuries ◽  
Fracture Location ◽  
Chest Injuries ◽  
Severity Of Injury ◽  
Manubrium Sterni ◽  
Sternal Fractures

Introduction. Sternal fractures often occur together with serious and life-threatening additional injuries. This retrospective study was designed to assess concomitant injuries and develop a correlation between fracture location and the severity of injury.Methods.All patients () diagnosed with a fracture of the sternum by means of a CT scan were analysed with respect to accident circumstances, fracture morphology and topography, associated injuries, and outcome.Results. Isolated sternal fractures occurred in 9%. In all other admissions, concomitant injuries were diagnosed: mainly rip fractures (64%), injury to the head (48%), the thoracic spine (38%), lumbar spine (27%), and cervical spine (22%). Predominant fracture location was the manubrium sterni. In these locations, the observed mean ISS was the highest. They were strongly associated with thoracic spine and other chest injuries. Furthermore, the incidence of head injuries was significantly higher. ICU admission was significantly higher in patients with manubrium sterni fractures.Conclusion. Sternal fractures are frequently associated with other injuries. It appears that the fracture location can provide important information regarding concomitant injuries. In particular, in fractures of manubrium sterni, the need for further detailed clinical and radiologic workup is necessary to detect the frequently associated injuries and reduce the increased mortality.

scholarly journals The Need for Multidisciplinary Management of Patients with Upper Thoracic Spine Fractures Caused by High-Velocity Impact: A Review of 32 Surgically Stabilised Cases

2005 ◽  
Vol 13 (1) ◽  
pp. 34-39 ◽  
Author(s):  
JF Quinlan ◽  
JA Harty ◽  
JM O'Byrne
Keyword(s):  
Thoracic Spine ◽  
Neurological Deficit ◽  
High Velocity ◽  
Traffic Accidents ◽  
Spinal Fractures ◽  
Concomitant Injuries ◽  
Upper Thoracic Spine ◽  
Chest Injuries ◽  
Great Force ◽  
Upper Thoracic

Purpose. To analyse the characteristics of patients who underwent surgery for fractures of the upper thoracic spine (T1–T6) in our institution. The thoracic spine is supported by the rib cage and associated ligaments; therefore, displacement and fracture of the upper thoracic spine in healthy young adults require a great force. The relatively narrow spinal canal around the spinal cord in this area could result in severe neurological deficit should fractures occur. Methods. The treatment course of 32 patients (26 men and 6 women) who underwent surgery for fractures of the upper thoracic spine between February 1995 and March 2001 was retrospectively reviewed. Parameters of injuries and treatment methods were evaluated. Results. Of the 32 patients, 29 were injured in traffic accidents (15 motorcycle and 14 vehicle), 2 in falls, and one by a heavy door falling on his back. 29 patients had spinal fractures at more than one level. 23 patients had complete, 7 had incomplete, and 2 had no neurological deficit. 30 patients required multiple modalities of radiological imaging (in addition to plain radiography) for diagnosis. 20 patients sustained other injuries apart from spinal fractures, 15 of them had associated chest injuries. Conclusion. High-velocity fractures of the upper thoracic spine are injuries with devastating consequences, and can result in severe neurological deficit and concomitant injuries. These patients are best treated by a multidisciplinary approach.

Pattern of major injuries after motorcycle accidents in Egypt: The Mansoura Emergency Hospital experience

Trauma ◽  
2016 ◽  
Vol 19 (1) ◽  
pp. 39-45 ◽  
Author(s):  
El Yamani Fouda ◽  
Mohamed Youssef ◽  
Sameh H Emile ◽  
Hossam Elfeki ◽  
Waleed Thabet ◽  
...  
Keyword(s):  
Road Traffic ◽  
Head Injuries ◽  
Age Groups ◽  
Road Traffic Injuries ◽  
Emergency Hospital ◽  
Chest Injuries ◽  
The Common ◽  
Orthopedic Injuries ◽  
Motorcycle Accidents ◽  
Motorcycle Crashes

Background and aim Motorcycle accidents are one of the leading causes of road traffic injuries and mortality. The aim of this study was to determine the common patterns of major injuries associated with motorcycle accidents in patients attending Mansoura University Emergency Hospital in Egypt, and to measure the magnitude of the problem in our community. Patients and methods Patients involved in motorcycle crashes who were admitted to the hospital during August 2014 to April 2015 were retrospectively reviewed. All age groups and both genders were included. Results Two hundred patients (181 males) with a mean age of 30.7 ± 10.5 years were included with the majority of patients aged 20–40 years. Head injuries were the most frequent fatal injuries (9/61) patients; orthopedic injuries were the most common injuries, occurring in 78.5% of victims. Multisystem injuries occurred in 28% of patients. None of the motorcyclists involved in accidents wore helmets. Conclusion Motorcycle accidents are a common cause of road traffic injuries and mortalities in Egypt, occurring mainly in males aged 20–40 years. The majority of victims had an isolated trauma to single body system. Orthopedic injuries were the most common and least fatal type of injuries. The highest fatalities were among patients with chest injuries then patients with head injuries. None of the victims wore protective clothing or helmets at the time of accident.

Management of Sternal Fractures: 239 Cases

2002 ◽  
Vol 10 (2) ◽  
pp. 145-149 ◽  
Author(s):  
Konstantinos Potaris ◽  
John Gakidis ◽  
Peter Mihos ◽  
Valsamakis Voutsinas ◽  
Anastasios Deligeorgis ◽  
...  
Keyword(s):  
Trauma Center ◽  
Motor Vehicle ◽  
Morbidity And Mortality ◽  
Cardiac Complications ◽  
Seat Belts ◽  
Motor Vehicle Collisions ◽  
Concomitant Injuries ◽  
Vehicle Collisions ◽  
Car Accident ◽  
Sternal Fractures

A review of the management of 239 patients with sternal fractures in a busy trauma center between October 1989 and May 2000 was undertaken to determine the incidence, significance, morbidity, and mortality of this injury. There were 140 men and 99 women with a mean age of 50.3 years (range, 15 to 93 years). Sternal fractures accounted for 8% of admissions for thoracic trauma. The causes were motor vehicle collisions in 215 patients (90%) and falls or direct blows in 24 (10%). Only 64 of 204 car accident patients (31%), 28 men and 36 women, were restrained by seat belts. Complications developed in 13 patients (5.4%). Mortality rate was 0.8%. Mean length of stay in the ward was 6.4 days (range, 1 to 32 days). Four patients (1.7%) underwent surgery. The results show that isolated sternal fractures have low associated morbidity and mortality. Admission is justified for the management of pain and treatment of cardiac complications and concomitant injuries.

Multiple and combined injuries of the musculoskeletal system

1982 ◽  
Vol 63 (6) ◽  
pp. 46-49
Author(s):  
U. Ya. Bogdanovich
Keyword(s):  
Musculoskeletal System ◽  
Traffic Accidents ◽  
Trauma Patients ◽  
Urgent Problem ◽  
Associated Injuries ◽  
Concomitant Injuries ◽  
Number Of Patients ◽  
Combined Injuries

Treatment of multiple and associated injuries is the most urgent problem of modern traumatology. The number of patients admitted to trauma hospitals with similar injuries is steadily increasing every year and ranges from 7 to 25.1% of all inpatient trauma patients. Most often, multiple and concomitant injuries occur in traffic accidents - up to 50-70%.

Sledging is still a seasonal source of serious injury in Scottish children

2011 ◽  
Vol 56 (4) ◽  
pp. 188-190
Author(s):  
L A Regan ◽  
J G Cooper
Keyword(s):  
Emergency Department ◽  
Retrospective Study ◽  
Head Injuries ◽  
Ground Cover ◽  
Paediatric Population ◽  
Stationary Object ◽  
Safety Measures ◽  
Severity Of Injury ◽  
Serious Injury ◽  
Serious Injuries

In 2002 it was highlighted that sledging results in serious injuries in the paediatric population and safety recommendations were made. The aim of this study was to re-examine the number, severity and aetiology of sledging-related trauma. This was a retrospective study performed in the Paediatric Emergency Department (PED) of the Royal Aberdeen Children's Hospital (RACH) during two periods totalling 12 days, when there was continuous snow ground cover. Records of all attendances were scrutinized to identify patients with sledging injuries. The nature, mechanism and severity of injury, and subsequent management were then analysed. Of 403 PED attendances, 45 (11%) were sledging related with 16 (36%) fractures and 13 (29%) head injuries. Eight patients (18%) were admitted to hospital and three (7%) required an operation. Collision with a stationary object was the most common reason for injury (51%), followed by the adoption of a dangerous sledging position or use of a stationary jump. No patients were wearing a helmet. In conclusion, there has been little change in the epidemiology and aetiology of paediatric sledging injuries since 2002. Work is needed to inform parents of the previously recommended safety measures that could reduce the morbidity of this activity without detracting from the enjoyment.

A prospective study of children with head injuries: II. Cognitive sequelae

1981 ◽  
Vol 11 (1) ◽  
pp. 49-61 ◽  
Author(s):  
Oliver Chadwick ◽  
Michael Rutter ◽  
Gillian Brown ◽  
David Shaffer ◽  
Michael Traub
Keyword(s):  
Head Injury ◽  
Prospective Study ◽  
Reading Ability ◽  
Head Injuries ◽  
Specific Pattern ◽  
Control Group ◽  
Severe Injuries ◽  
Injury Group ◽  
Severity Of Injury ◽  
Cognitive Sequelae

SYNOPSISA 2¼-year prospective study of children suffering head injury is described. Three groups of children were studied: (a) 31 children with ‘severe’ head injuries resulting in a post-traumatic amnesia (PTA) of at least 7 days; (b) an individually matched control group of 28 children with hospital treated orthopaedic injuries; and (c) 29 children with ‘mild’ head injuries resulting in a PTA exceeding 1 hour but less than 1 week. Individual psychological testing was carried out as soon as the child recovered from PTA, and then again 4 months, 1 year, and 2¼ years after the injury. A shortened version of the Wechsler Intelligence Scale for Children (WISC), the Neale Analysis of Reading Ability and a battery of tests of specific cognitive functions were employed. The mild head injury group had a mean level of cognitive functioning below the control group, but the lack of any recovery during the follow-up period indicated that the intellectual impairment was not a consequence of the injury. In the severe head injury group, the presence of cognitive recovery and a ‘dose—response’ relationship with the degree of brain injury showed that the intellectual deficits were caused by brain damage. Some degree of cognitive impairment was common following head injuries giving rise to a PTA of at least 2 weeks. Conversely no cognitive sequelae, transient or persistent, could be detected when the PTA was less than 24 hours. The results were less consistent in the 1-day to 2-week PTA range, but the evidence suggested that a broadly defined threshold for impairment operated at about that level of severity of injury. Timed measures of visuo-spatial and visuo-motor skills tended to show more impairment than verbal skills but otherwise there was no suggestion of a specific pattern of cognitive deficit. Recovery was most rapid in the early months after injury, but substantial recovery continued for 1 year with some improvement continuing in the second year in some children, especially those with the most severe injuries. Age, sex and social class showed no significant effects on the course of recovery.

scholarly journals Direct Causes of Death in Road Traffic Accident Victims and Evaluation of the Efficacy of Three-Level Trauma Centers Activity in Chelyabinsk Region

2014 ◽  
pp. 5-9
Author(s):  
M. G. Moskvichyova ◽  
E. V. Shishkin
Keyword(s):  
Medical Care ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Causes Of Death ◽  
Road Traffic ◽  
Trauma Centers ◽  
Concomitant Injuries ◽  
Chest Injuries ◽  
Chelyabinsk Region

Data on direct causes of death in road traffic accident (RTA) victims for Chelyabinsk region is presented for 2 periods, i.e. before (2008-2010) and after (2011-2013) organization of trauma center. Comparison of the level and structure of RTA death causes in two three-year periods showed no significant differences. Evaluation of the efficacy of trauma centers activity (2011 - 2013) that render medical care to RTA victims with multiple and concomitant injuries is performed. During three-year period of trauma centers activity the number of road traffic deaths resulted from multiple and concomitant injuries increased by 17.22%. No statistically significant changes in the rate of three main causes of RTA related death (multiple and concomitant injuries, head and chest injuries) were noted during the study period. Achieved results confirm the necessity to elaborate and introduce the monitoring that will enable to evaluate the efficacy and quality of trauma centers activity at all steps of medical care rendering including patients’ transportation.

The critically ill patient

2016 ◽  
Author(s):  
Jerry Nolan
Keyword(s):  
Critically Ill ◽  
Head Injuries ◽  
Anaesthetic Management ◽  
Pelvic Fractures ◽  
Critically Ill Patient ◽  
Abdominal Injuries ◽  
Chest Injuries ◽  
Life Threatening Illness ◽  
Limb Injuries ◽  
Life Threatening

This chapter discusses the anaesthetic management of the critically ill patient suffering from trauma or life-threatening illness. It begins by describing the principles of immediate trauma care, and the primary and secondary surveys. It then goes into more detail about head injuries, chest injuries, abdominal injuries, pelvic fractures, spinal injuries, limb injuries, burns, multiple trauma, post-cardiac arrest resuscitation care, and septic shock. It concludes by describing the transfer of the critically ill patient to the operating theatre or to another unit.

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