scholarly journals The severity degree estimation for the lower extremity blast injury

2019 ◽  
Vol 21 (2) ◽  
pp. 215-218
Author(s):  
A V Anisin ◽  
A V Denisov ◽  
V M Shapovalov
Keyword(s):  
Lower Extremity ◽  
Medical Care ◽  
Blast Injury ◽  
Clinical Findings ◽  
Unbiased Estimation ◽  
Technological Disasters ◽  
Combat Injuries ◽  
Limb Injuries ◽  
Blast Trauma ◽  
Severity Degree

The present review is concerned with the modern state of the problem connected with the severity degree estimation of the lower extremity blast injury. The specific character of modern combat activity is considered to be the prevalence of the blast trauma in the structure of casualties, this trauma amounting up to 69% of all the combat injuries. The problem of the adequate unbiased estimation of the severity degree for this kind of trauma appears to be critical, because it is important for the appraisal of the necessary volume of medical care provided for the casualties and optimal assignment of the casualties to the medical evacuation stages beginning from the combat zone up to the specialized trauma center. The combat blast trauma is distinguished from the civilian trauma, it also differs from blast injuries occurring during technological disasters. In this regard, the use of traditional estimation parameters for the lower extremity trauma severity, based on clinical findings of civilian injuries, seems not possible. The development of appropriate severity estimation technique for the lower extremity blast trauma is essential not only for the medical care, but also for the adequate experimental modeling processes using human cadavers and biomorphic models, and the development of virtual “mathematical” simulators. Currently, investigators are involved in developing specific severity degree estimation scales for the lower extremity blast injury, based on the case histories analysis and casualties’ follow-up. Foreign experts have proposed a number of assessment classifications of mine-explosive injury, allowing to formulate a diagnosis and determine the severity of the injured explosive limb injuries. In our country, there is currently no generally accepted classification developed in relation to the explosive injury of the lower extremities, but the methods proposed by domestic military field surgeons and traumatologists allow us to effectively assess the severity of this injury and make a certain sorting decision.

scholarly journals Features of medical care in patientswith elbow joint gunshot wounds

2021 ◽  
pp. 5-8
Author(s):  
Aleksandr Loskutov ◽  
Andriy Domanskyi ◽  
Ivan Zherdev ◽  
Svyatoslav Lushnya
Keyword(s):  
Medical Care ◽  
Elbow Joint ◽  
Damage Control ◽  
Soft Tissue Injuries ◽  
Gunshot Wounds ◽  
Shoulder Injuries ◽  
Combat Injuries ◽  
Limb Injuries ◽  
Two Stages ◽  
Favorable Conditions

Gunshot wounds of the elbow joint are the third most common after knee and shoulder injuries. Features of the anatomical and functional structure of the elbow joint, the close location of the vascular and nervous formations, favorable conditions for the development of infection determine the severity of gunshot wounds and cause the complexity of its treatment. Objective. To evaluate the frequency and nature of the elbow joint gunshot wounds in the structure of the general combat injuries, as well as to determine the volume of medical care and direction of treatment of such injuries in the conditions of the regional hospital as a stage of care. Methods. A retrospective study included 1 809 patients (96.0 % of men, mean age (33.7 ± 0.2) years). Firearms limb injuries were detected in 1 013 (56.0 %) of all victims, of which the elbow joint — 25 (2.47 %). Mines and explosives injuries were in 22 (88 %) of the patients, bullet — in 3 (12 %). Results. Tactics of treatment of elbow joint gunshot wounds depended on the severity of the condition of the victims and the nature of concomitant traumatic injuries. In the structure of combat injury of the elbow joint the majority was combined (52 %) and multiple (40 %) injuries and was accompanied by gunshot fractures in 60 %. In patients who were in severe state, applied the tactics of Damage control in two stages. At the first stage the fractures were fixed with plaster splints or external fixation devices (EF), the wounds were not subjected to full surgical debridment (SD), but only washed with antiseptics and the visible foreign bodies were removed. In patients with soft tissue injuries wounds the primary SD was performed according to general principles, injured nerves were not restored. In the second stage, after patient is stabilized, the repeated SD of the wound was performed. After their uncomplicated healing the EF was removed and the method of fixation was changed to internal osteosyntesis. Conclusions. It is recommended to perform stabilization of intra-articular gunshot fractures of the elbow joint with EF and after uncomplicated wound healing go to the internal osteosynthesis. Key words. Elbow joint, gunshot wounds, treatment.

Spinal Impairment Evaluation: Fifth Edition Changes

2001 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Robert H. Haralson
Keyword(s):  
Spinal Cord ◽  
Lower Extremity ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Spinal Cord Injuries ◽  
Clinical Findings ◽  
Fourth Edition ◽  
Treatment Results ◽  
Standard Terminology ◽  
Made In

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, was published in November 2000 and contains major changes from its predecessor. In the Fourth Edition, all musculoskeletal evaluation and rating was described in a single chapter. In the Fifth Edition, this information has been divided into three separate chapters: Upper Extremity (13), Lower Extremity (14), and Spine (15). This article discusses changes in the spine chapter. The Models for rating spinal impairment now are called Methods. The AMA Guides, Fifth Edition, has reverted to standard terminology for spinal regions in the Diagnosis-related estimates (DRE) Method, and both it and the Range of Motion (ROM) Method now reference cervical, thoracic, and lumbar. Also, the language requiring the use of the DRE, rather than the ROM Method has been strengthened. The biggest change in the DRE Method is that evaluation should include the treatment results. Unfortunately, the Fourth Edition's philosophy regarding when and how to rate impairment using the DRE Model led to a number of problems, including the same rating of all patients with radiculopathy despite some true differences in outcomes. The term differentiator was abandoned and replaced with clinical findings. Significant changes were made in evaluation of patients with spinal cord injuries, and evaluators should become familiar with these and other changes in the Fifth Edition.

scholarly journals Emergency Medical Care and Management of Sports Injuries on the Football Court

2021 ◽  
Vol 5 (1) ◽  
pp. 773-777
Author(s):  
Basri Lenjani ◽  
Premtim Rashiti ◽  
Gani Shabani ◽  
Arber Demiri ◽  
Besarta Pelaj ◽  
...  
Keyword(s):  
Medical Care ◽  
Health Care Professionals ◽  
Sports Medicine ◽  
Sports Injuries ◽  
Multiple Injuries ◽  
Emergency Medical Care ◽  
Treatment And Prevention ◽  
Emergency Medical ◽  
Limb Injuries ◽  
Football Field

Introduction; Sports medicine is a clinical subspecialty that deals with the examination, monitoring, diagnosis, treatment, and prevention of injuries that occur during sports events, training and physical activities in pre-hospital settings. Managing dramatic situations with minor and multiple injuries is a challenge that requires a quick approach to a dramatic event in managing minor and multiple injuries on the football field and in other sports in support of SHME at pre-hospital and hospital level. Purpose of the paper. Providing emergency medical care at all basic stages of managing minor and multiple injuries on the football field and in other sports in order to implement BLS, ACLS, BTLS, PTLS, ATLS care measures reducing morbidity, disability, and mortality. Material and methods. The research is of retrospective, descriptive, qualitative type. The material was taken from the archive of the Emergency Clinic of UCCK for the period January-December 2019. Only the sick or injured in sports matches were taken in the research; Age, gender, type of illness and injury and type of medical care, equipment available, and training and education. Result. Sports injuries are very costly, and according to the pathology with diseases were 15 cases or 21.4 %, injuries were 55 cases or 78/6 %. Injured by age. The largest number of injured with injuries in the field of football sports the most affected age was the age of 21-25 years with 28 cases or 40.00%, over 25 years were 27 cases or 38.58% and with a smaller number were aged 15-20 years15 cases or 21.42%. Discussion and conclusions. A very important factor in sports injuries is the provision of optimal medical care for footballers and other sports in head, neck, spine, chest, abdomen, and pelvis and limb injuries and with a joint communication with the cooperation of health care professionals in the selection of priority cases. Education of medical staff, nurses, paramedics with courses, use of medical equipment, BLS, ACLS, BTLS, PTLS, ATLS as well as standard procedures for providing and transporting medical care to the hospital.

Clinical correlation of anatomical location of non-thrombotic iliac vein lesion

Vascular ◽  
2016 ◽  
Vol 25 (4) ◽  
pp. 359-363 ◽  
Author(s):  
Afsha Aurshina ◽  
Borislav Kheyson ◽  
Justin Eisenberg ◽  
Anil Hingorani ◽  
Arkady Ganelin ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Intravascular Ultrasound ◽  
Iliac Vein ◽  
Clinical Findings ◽  
Common Iliac Vein ◽  
Anatomical Location ◽  
Clinical Correlation ◽  
Common Site ◽  
External Iliac Vein ◽  
Left Lower Extremity

Objective Treatment of non-thrombotic iliac vein lesions is an active area of research. Intravascular ultrasound allows its localization. We chose intravascular ultrasound to clarify the exact anatomical location of non-thrombotic iliac vein lesions and correlate it with clinical findings. Materials and methods Over seven months, we performed ilio-femoral intravascular ultrasound studies on 217 patients, in 141 women and 76 men. The average age ± standard deviation was 68 ± 14 years. We used intravascular ultrasound intraoperatively to measure the ilio-femoral veins and compared it with adjacent non-stenotic ilio-femoral veins. If more than 50% area or diameter reduction was found, it was treated with appropriate balloon and stent. Results We identified 244 lesions, 124 in left lower extremity and 120 in the right lower extremity. The most common site was the proximal common iliac vein 38.7% (22.5% females and 16.12% males) in left lower extremity and middle external iliac vein 29.16% (18.33% females and 10.83% males) in right lower extremity. The least common site was the distal external iliac vein in 3.2% (all 3.2% females) and the distal external iliac vein 7.5% (5% females and 2.5% males) in right lower extremity. Clinical correlation was noted between laterality and location of the NIVL lesion ( p < 0.0001). Conclusion This analysis gives an insight into understanding the exact anatomical locations of the non-thrombotic iliac vein lesions helping clinicians and researchers guide their treatment and research.

Extremity Injuries in Children: Predictive Value of Clinical Findings

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 803-807
Author(s):  
Frederick P. Rivara ◽  
Ruth Ann Parish ◽  
Beth A. Mueller
Keyword(s):  
Lower Extremity ◽  
Physical Examination ◽  
Clinical Findings ◽  
Clinical Predictors ◽  
Lower Extremity Fracture ◽  
Extremity Fracture ◽  
Extremity Injuries ◽  
Physical Findings ◽  
Upper Extremity Fracture ◽  
Point Tenderness

This study sought to identify clinical predictors of extremity fracture in children with trauma. There were 189 children 1 to 15 years of age with 209 extremity injuries seen during a 9-month period. Gross deformity and point tenderness were the best predictors of upper extremity fracture; these two findings correctly identified 81% of children with fractures and 82% of these without fractures. Gross deformity and pain on motion best predicted lower extremity fracture, with 97% of children with fractures correctly identified. The study showed that physical examination is predictive of fractures in extremity injuries of children, regardless of age. In the absence of the specific physical findings identified by the study, the probability of diagnosing a fracture by roentgenographic findings is low.

Ankle–foot orthosis alignment affects running mechanics in individuals with lower limb injuries

2019 ◽  
Vol 43 (3) ◽  
pp. 316-324
Author(s):  
Kelly A Schmidtbauer ◽  
E Russell Esposito ◽  
Jason M Wilken
Keyword(s):  
Lower Extremity ◽  
Lower Limb ◽  
Knee Extensor ◽  
Design Parameters ◽  
Foot Orthoses ◽  
Lower Limb Injury ◽  
Limb Injuries ◽  
Peak Knee ◽  
Ankle Foot Orthoses ◽  
Running Mechanics

Background: Individuals with severe lower extremity injuries often require ankle–foot orthoses to return to normal activities. Ankle–foot orthoses alignment is a key consideration during the clinical fitting process and may be particularly important during dynamic activities such as running. Objective: To investigate how 3° changes in sagittal plane ankle–foot orthoses alignment affect running mechanics. Study design: Controlled laboratory study. Methods: Twelve participants with unilateral lower limb injury ran overground and lower extremity running mechanics were assessed. Participants wore their passive-dynamic ankle–foot orthoses in three alignments: clinically fit neutral, 3° plantarflexed from clinically fit neutral, and 3° dorsiflexed from clinically fit neutral. Results: The 3° changes in sagittal alignment significantly influenced ankle mechanics during running. The plantarflexed alignment significantly decreased the peak ankle plantarflexor moment, peak knee extensor moment, and peak ankle and knee power absorption and generation compared to more dorsiflexed alignments. Alignment also altered footstrike angle, with dorsiflexed alignments associated with a more dorsiflexed footstrike pattern and plantarflexed alignments toward a more plantarflexed footstrike pattern. However, alignment did not influence loading rate. Conclusion: Small changes in ankle–foot orthoses alignment significantly altered running mechanics, including footstrike angle, and knee extensor moments. Understanding how ankle–foot orthoses design parameters affect running mechanics may aid the development of evidence-based prescription guidelines and improve function for ankle–foot orthoses users who perform high-impact activities. Clinical relevance Understanding how ankle–foot orthoses alignment impacts biomechanics should be a consideration when fitting passive-dynamic devices for higher impact activities, such as running. Individual running styles, including footstrike patterns, may be affected by small changes in alignment.

scholarly journals Risk factors for lower extremity injuries in young badminton players

2018 ◽  
Vol 28 (2) ◽  
pp. 28939
Author(s):  
Ang Lin Kang ◽  
Vinodhkumar Ramalingam
Keyword(s):  
Risk Factors ◽  
Lower Extremity ◽  
Limb Length Discrepancy ◽  
Ankle Injuries ◽  
Case Group ◽  
Lower Limb Injuries ◽  
Lower Extremity Injuries ◽  
Younger Age ◽  
Limb Injuries ◽  
Extremity Injuries

AIMS: Based on the limited evidence available about the intrinsic factors causing lower extremity injuries among Malaysian badminton players, this study was aimed to determine the relationship of demographic and physical characteristics to lower extremity injuries in young badminton players.METHODS: A cross-sectional study included badminton players between 14 and 24 years of age, categorized into case and control groups. Participants diagnosed with lower limb injuries were designated as cases, and those with no reported injuries were designated as controls. Personal information including demographic data, level of athlete and injury history was collected using a questionnaire. Independent t-test was used to analyze the differences between intrinsic characteristics in cases and controls. Pearson's χ2 was applied to evaluate the association between risk factors and general lower limb injuries, knee injuries and ankle injuries, with 95% confidence interval (CI). A p value of ≤0.05 was considered significant.RESULTS: A total of 106 young badminton players (83 males, 23 females) were recruited, of whom 42 participants were allocated as the case group, and 64 participants were allocated as the control group. A total of 60 lower extremity injuries were reported among the 42 players of the case group. The overall mean age of the sample was 18.7±5 years (minimum 14 years and maximum 24 years). Mean age of the participants in the case group was 16.92±2.99 years. The most common injuries reported were ankle joint injuries, followed by knee and hip injuries. Participants of the younger age group (14-19 years old) were found to have a higher risk for lower extremity injures compared to those of the older age group (20-24 years old) (odds ratio [OR], 3.39; 95%CI, 1.15-10.01; p=0.023). Increased true limb length discrepancy was identified among the participants with lower extremity injuries (OR, 4.57, 95%CI, 1.2-17.24; p=0.016) and this discrepancy was strongly associated with ankle injuries (OR, 7.25; 95%CI, 1.85-28.57; p=0.002). There was no significant relationship between lower extremity injuries and gender, limb dominance or Q-angle.CONCLUSIONS: Lower extremity injuries in young badminton players were predominantly located in ankle and knee joints. Younger age and increase in true limb length discrepancy were identified as risk factors for lower extremity injuries in the study sample.

scholarly journals Magnetic Resonance Imaging versus Electrophysiologic Tests in Clinical Diagnosis of Lower Extremity Radicular Pain

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
E. G. Hasankhani ◽  
F. Omidi-Kashani
Keyword(s):  
Lower Extremity ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Radicular Pain ◽  
Clinical Findings ◽  
Lower Limbs ◽  
Medical Problems ◽  
Cross Sectional ◽  
Physical Examinations ◽  
Comprehensive History

Introduction. Radicular low back pain is one of the most common medical problems. The aim of this study was to evaluate the diagnostic accuracy of MRI and electrodiagnosis in lower extremity radicular pain in relation to history and clinical findings. Methods. In this cross-sectional study, we studied 165 sciatalgic subjects. A comprehensive history and physical examinations were taken from the subjects and recorded, and then MRI scanning and electrodiagnostic (nerve conduction velocity and electromyography) tests were performed. Results. From 152 subjects who remained in the study, 67 cases (44.1%) had radicular pain in left lower limb, 46 (30.3%) in right, and 39 (25.6%) in both lower limbs. 104 cases (68.4%) had shown some type of abnormalities in both MRI and electrodiagnosis, 30 (19.7%) had shown this abnormality only in MRI, and 21 (13.8%) only in electrodiagnosis, while 10 cases (6.5%) had both normal MRI and electrodiagnostic studies. Coordination rates of MRI and electrodiagnosis with clinical findings were 58.6% and 89.5%, respectively. Conclusion. In many MRI negative but symptomatic subjects, electrodiagnosis has an important diagnostic value.

Strategies for Managing Massive Defects of the Foot in High-Energy Combat Injuries of the Lower Extremity

2010 ◽  
Vol 15 (1) ◽  
pp. 139-149 ◽  
Author(s):  
John J. Keeling ◽  
Joseph R. Hsu ◽  
Scott B. Shawen ◽  
Romney C. Andersen
Keyword(s):  
Lower Extremity ◽  
High Energy ◽  
Combat Injuries

Effect of podiatric medical care on rates of lower-extremity amputation in a Medicare population

1999 ◽  
Vol 89 (6) ◽  
pp. 312-317 ◽  
Author(s):  
RD Sowell ◽  
WB Mangel ◽  
CJ Kilczewski ◽  
JM Normington
Keyword(s):  
At Risk ◽  
Lower Extremity ◽  
Medical Care ◽  
Health Care Financing ◽  
Lower Extremity Amputation ◽  
Coding System ◽  
Common Procedure ◽  
Medicare Part B ◽  
Patients At Risk ◽  
Extremity Amputation

The purpose of this study was to determine whether Medicare patients at risk for lower-extremity amputation due to complications from diabetes, peripheral vascular disease, and/or gangrene who receive the services classified under Level II code M0101 of the Health Care Financing Administration's Common Procedure Coding System (cutting or removal of corns, calluses, and/or trimming of nails, application of skin creams and other hygienic and preventive maintenance care) have lower rates of lower-extremity amputation than those who do not receive such services. Analysis of the data suggests that those at-risk beneficiaries who received these services were nearly four times less likely to experience lower-extremity amputation than those who did not receive such services. The study has both methodologic limitations (the study considers only one variable, receipt or nonreceipt of certain types of podiatric medical care, while other variables may affect rates of lower-extremity amputation) and technological limitations (attempts to link the 2 years of per case Medicare Part B data were unsuccessful, limiting the length of the study to 1 year). Further research on this topic is encouraged.

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