Traumatology Research Papers - Academia.edu (original) (raw)

Nowadays, fracture management is an essential part of everyday clinical decisionmaking prior to any fracture-related surgery. The way to carry out such preoperative planning involves tracing the bones over paper using the X-Rays, and then... more

Nowadays, fracture management is an essential part of everyday clinical decisionmaking prior to any fracture-related surgery. The way to carry out such preoperative planning involves tracing the bones over paper using the X-Rays, and then placing the resulting drawings together as if reconstructing the fractured bones. This action, although proven eective, is quite rudimentary and time consuming. In recent years,

We previously (1997) demonstrated superior clinical but similar cognitive performance after the new interactive compared to the old ATLS course. The present study is aimed at determining whether this difference was short term or... more

We previously (1997) demonstrated superior clinical but similar cognitive performance after the new interactive compared to the old ATLS course. The present study is aimed at determining whether this difference was short term or maintained over time (2 years). Two groups of 13 physicians out of the original 32 physicians were available for the study which compared performance in a 40-item MCQ examination on trauma topics and clinical performance in 4 trauma OSCE stations consisting of simulated trauma patients. Paired and unpaired t tests were used for within- and between-group comparisons, respectively, with P < 0.05 being considered statistically significant. Overall OSCE scores (maximum standard 20), adherence to priority scores (Priority, scale 1 to 7), and overall approach (Approach, scale 1 to 5) scores were analyzed. Values are means +/- SD; (+)-P < 0.05 compared to 1999; *P < 0.05 compared to old group [table in text]. Although knowledge base decreases similarly with time after both courses, the new interactive course participants maintained a consistently higher clinical skill performance level at 2 years.

Points essentiels • Toute plaie pénétrante du cou doit faire l’objet d’une médicalisation préhospitalière • La correction d’une détresse respiratoire et/ou d’un choc hémorragique sont les priorités de la prise en charge initiale •... more

Points essentiels
• Toute plaie pénétrante du cou doit faire l’objet d’une médicalisation préhospitalière
• La correction d’une détresse respiratoire et/ou d’un choc hémorragique sont les priorités de la prise en charge initiale
• L’examen clinique a une valeur prédictive positive de 100 % et une valeur prédictive négative de 98 %. Il détermine l’orientation hospitalière
• Les lésions à rechercher sont artérielles, veineuses, des voies aériennes, du tube digestif, du rachis, de la moelle et des plèvres
• L’admission directe au bloc opératoire doit être la règle devant une hémorragie extériorisée incontrôlable
• L’angio-scanner crânio-cervico-thoracique a remplacé l’exploration chirurgicale systématique chez les patients non instables.
• Il est préférable d’admettre les patients symptomatiques à chaque fois que possible en centres spécialisés

Goal: To provide healthcare professionals with comprehensive multidisciplinary expert recommenda- tions for the acute care of severe limb trauma patients, both during the prehospital phase and after admission to a Trauma Centre. Design: A... more

Goal: To provide healthcare professionals with comprehensive multidisciplinary expert recommenda-
tions for the acute care of severe limb trauma patients, both during the prehospital phase and after admission to a Trauma Centre.
Design: A consensus committee of 21 experts was formed. A formal conflict-of-interest (COI) policy was
developed at the onset of the process and enforced throughout. The entire guidelines process was
conducted independently of any industrial funding (i.e., pharmaceutical, medical devices). The authors
were advised to follow the rules of the Grading of Recommendations Assessment, Development and
Evaluation (GRADE1) system to guide assessment of the quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasised. Few recommendations remained non-graded.
Methods: The committee addressed eleven questions relevant to the patient suffering severe limb trauma: 1) What are the key findings derived from medical history and clinical examination which lead to the patient’s prompt referral to a Level 1 or Level 2 Trauma Centre? 2) What are the medical devices that must be implemented in the prehospital setting to reduce blood loss? 3) Which are the clinical findings prompting the performance of injected X-ray examinations? 4) What are the ideal timing and modalities for performing fracture fixation? 5) What are the clinical and operative findings which steer
the surgical approach in case of vascular compromise and/or major musculoskeletal attrition? 6) How to
best prevent infection? 7) How to best prevent thromboembolic complications? 8) What is the best
strategy to precociously detect and treat limb compartment syndrome? 9) How to best and precociously
detect post-traumatic rhabdomyolysis and prevent rhabdomyolysis-induced acute kidney injury? 10)
What is the best strategy to reduce the incidence of fat emboli syndrome and post-traumatic systemic
inflammatory response? 11) What is the best therapeutic strategy to treat acute trauma-induced pain?
Every question was formulated in a PICO (Patient Intervention Comparison Outcome) format and the
evidence profiles were produced. The literature review and recommendations were made according to the GRADE1 methodology.
Results: The experts’ synthesis work and the application of the GRADE method resulted in 19 recommendations. Among the formalised recommendations, 4 had a high level of evidence (GRADE 1+/) and 12 had a low level of evidence (GRADE 2+/). For 3 recommendations, the GRADE method could not be applied, resulting in an expert advice. After two rounds of scoring and one amendment,
strong agreement was reached on all the recommendations.
Conclusions: There was significant agreement among experts on strong recommendations to improve
practices for severe limb trauma patients.

BACKGROUND: Although scaphoid fractures are treated uneventfully with cast treatment, immobilization with cast is associated with complication like wrist stiffness and functional morbidity to the patient. Fixation with Herbert Screw... more

BACKGROUND: Although scaphoid fractures are treated uneventfully with cast treatment, immobilization with cast is associated with complication like wrist stiffness and functional morbidity to the patient. Fixation with Herbert Screw though technically demanding procedure can yield excellent results and prevents complication like non-union and loss of wrist function in fracture of fractures. OBJECTIVES: To assess the outcome of scaphoid fracture after operative management following Herbert screw fixation in patient attending Institute of Orthopaedics & Traumatology, Rajiv Gandhi Government General Hospital & Madras Medical College between March 2017 – August 2018. MATERIALS & METHODS: All scaphoid fracture, treated between the above period and those previously treated patients were followed up retrospectively. Ten patients with scaphoid fractures were treated with Herbert screw. All of them were male. Serial radiographs were taken to assess radiographic union and functional outcome was assessed using Modified Mayo wrist score. RESULTS: Out of 10 patients, 7 scaphoid had waist fractures and two had proximal pole factures and one with distal pole fracture. 8/10 scaphoid fractures were treated with open reduction and Herbert screw fixation either by volar approach or by dorsal approach and rest two by percutaneous approach. All fractures maintained good alignment post operatively. Seven (70%) patients had excellent results with normal wrist range of motion, two (20%) patients had good results and one (10%) patient had fair outcome. Radiological union was seen in all cases with average duration to union noted in the study was 7.2 weeks (range: 6-10 weeks). We encountered complications like scar sensitivity in 2 cases and wrist pain in 2 and stiffness in 3 cases. CONCLUSION: Our study has shown that internal fixation using the Herbert screw results in rapid symptomatic relief and functional recovery with sufficient stability to allow normal use of the wrist. Orientation of the screw and length of the screw plays a major role in preventing the late complications like arthritis and wrist pain.

Background The aim of this study was to evaluate the available resources for trauma care at health centers (HCs) and referral hospitals (RHs) in rural Cambodia and to examine whether the resources at HCs are allocated on the basis of... more

Background The aim of this study was to evaluate the available resources for trauma care at health centers (HCs) and referral hospitals (RHs) in rural Cambodia and to examine whether the resources at HCs are allocated on the basis of actual need based on the referral distance and number of severely injured patients referred to RHs. Methods We conducted a cross-sectional facility survey by phone interview or mail using structured questionnaires at nationally representative samples of 85 HCs and 17 RHs from December 2006 to April 2007. The questionnaire included a modified checklist of the guidelines for essential trauma care as well as questions on distance for referral and the number of injured patients received and referred during the last 3 months. We analyzed the association between resource availability at HCs and their need using multivariate linear regression. Results Median (interquartile range) numbers of available resources at HCs and RHs were 25.5 (22.0–27.5) and 35 (28–41) among 37 and 62 essential items, respectively. Basic equipment, including both consumable supplies and durable devices and life-saving knowledge/skills, were not satisfactory at either HCs or RHs. A longer distance to the RH was associated with more knowledge/skills but not with equipment supplies; the number of referred patients was not associated with equipment or knowledge/skills. Conclusions Staff training emphasizing life-saving knowledge/skills and better organization and planning to supply physical resources are needed. There is a gap between resource allocation and need, which should be addressed through clear policies to prioritize remote areas and to allocate resources based on reliable injury data.

Optimal care of the injured patient requires an organized approach, dedicated resources and clinical expertise. Victims of major trauma, however, frequently present to rural and suburban hospitals regardless of whether a dedicated trauma... more

Optimal care of the injured patient requires an organized approach, dedicated resources and clinical expertise. Victims of major trauma, however, frequently present to rural and suburban hospitals regardless of whether a dedicated trauma system in place. Immediate consultation by a trauma expert could potentially expedite effective evaluation and management of trauma victims, reducing the occurrence of unnecessary transport and leading to efficient stabilization and transport when needed. Remote assessment of trauma patients must be assesses for feasibility, safety and efficacy before widespread implementation. This project represents the initial steps towards the development of a functional telemedicine system for trauma care.

Chpt in R. Kunzendorf (Ed.) Imagery: Recent Developments, NY: Plenum Press, 1991, p. 101-112.

Weaver A.J., Flannelly, L.T., Garbarino, J., Figley, C. and Flannelly, K.J. (2003). A Review of the Research on Religion and Spirituality. The Journal of Traumatic Stress: 1990-1999. Mental Health, Religion and Culture, 6:3, 215-228.

September 11th for the US and comparable dates of national trauma in other countries are drawing attention to psychological trauma and its treatment more than ever before. The new field traumatology, expanded far beyond medical trauma,... more

September 11th for the US and comparable dates of national trauma in other countries are drawing attention to psychological trauma and its treatment more than ever before. The new field traumatology, expanded far beyond medical trauma, enjoys more than 20,000 articles about traumatic stress alone, as noted in the first chapter of this important book ed- ited by leading experts in the field.

Les maladies psychosomatiques présentent des symptômes d’ordre physique dont l’origine est au moins en partie liée à l’état psychique. Elles apparaissent donc comme l’expression corporelle de tensions psychologiques. Comme disait Freud... more

Les maladies psychosomatiques présentent des symptômes d’ordre physique dont l’origine est au moins en partie liée à l’état psychique. Elles apparaissent donc comme l’expression corporelle de tensions psychologiques.
Comme disait Freud “le psychique fait alors un saut dans l’organique”.

Opekline su vrlo zahtjevne i nimalo ugodne ozljede po djeteta. Dolazi do narušavanja integriteta kože koja je ujedno i najveći organ tijela. Kod djeteta, koža je osjetljivija i svojim integritetom još uvijek nedostatno razvijena kao kod... more

Doctor Enrique Galindo Andújar Cirujano Ortopédico, Cirujano Traumatológico, Traumatólogo. Madrid España Consulta de Traumatologia (patologia de cadera, rodilla, hombro, tobillo, pie y muñeca) - Artroscopia - Cirujia Ortopédica - Aporte... more

Doctor Enrique Galindo Andújar
Cirujano Ortopédico, Cirujano Traumatológico, Traumatólogo.
Madrid España Consulta de Traumatologia (patologia de cadera, rodilla, hombro, tobillo, pie y muñeca) - Artroscopia - Cirujia Ortopédica - Aporte de Factores de Crecimiento autólogos de origen plaquetario en patologías de traumatología. - Rehabilitación de Traumatologia. Fisioterapia. - Radiología convencional - Resonancia Magnetica abierta (RMN abierta) - Cámara Hiperbárica - Consulta de Odontología - Consulta de Psicólogo - Consulta antiedad (anti-aging) - Aporte de Células madre (Stem cells) - Rehabilitación avanzada.

The present study aimed to investigate the relationship between exposure to traumatised complainants and secondary traumatic stress. It also established the occurrence of secondary traumatic stress and the degree to which police detective... more

The present study aimed to investigate the relationship between exposure to traumatised complainants and secondary traumatic stress. It also established the occurrence of secondary traumatic stress and the degree to which police detective officers reported secondary traumatic stress symptoms. Data were obtained on 51 police detective officers working in the Family Violence, Child Protection and Sexual Offences unit of the South African Police Service. A quantitative, correlational research design was employed to achieve the aim of the study. The sample was obtained using a combination of convenience and purposive sampling techniques.

Una presentación de mis dias de estudiante :v