ORIGINAL_ARTICLE
Occult Laryngeal Foreign Body Mimicking Normal Thyroid Cartilage
Introduction: Foreign body aspiration is common especially in children. The absence of history of choking does not rule out the diagnosis. Diagnosis required high index of suspicion. Case Presentation: Undiagnosed foreign body aspiration mostly occurs in bronchial airway rather than larynx and can cause severe complications. In this article, we report a silent laryngeal foreign body aspiration to show that careful history taking and accurate evaluation of radiography are important factors for diagnosis. Conclusions: The single most significant factor leading to detect of tracheobronchial foreign body aspiration is a high index of suspicion; this case highlights the possibility of a foreign body in the airway in patients who presents with a recent onset of chronic respiratory complaints.
https://www.traumamon.com/article_99933_2d358f1c7310f0d350f3d368abdfaac4.pdf
2015-07-01
10.5812/traumamon.15441
Respiratory Aspiration
Foreign body
Larynx
laryngeal
Foreign Bodies
Laryngoscopy
Farzad
Izadi
1
AUTHOR
Fatemeh
Hassannia
2
AUTHOR
Mojtaba
Maleki
3
AUTHOR
Behzad
Pousti
4
AUTHOR
Ehsan
Shams Koushki
5
AUTHOR
Sedighe
Mirhashemi
6
AUTHOR
ORIGINAL_ARTICLE
A Triage Model for Chemical Warfare Casualties
Context: The main objectives of triage are securing patient safety during the process of emergency diagnosis and treatment, and reduction of waiting time for medical services and transport. To date, there is no triage system for nerve agent victims. Evidence Acquisition: This systematic review proposes a new triage system for patients exposed to nerve agents. Information regarding clinical signs and symptoms of intoxication with nerve agents, primary treatments, and classification of patients were extracted from the literature. All related articles were reviewed. Subsequently, specialists from different disciplines were invited to discuss and draft protocols. Results: Finalized triage tables summarizing the classification methods and required protocols in the field were designed after several meetings. Conclusions: The proposed triage protocol encompasses aspects from most of the existing triage systems to create a single overarching guide for unifying the triage process. The proposed protocol can serve as a base for the designing future guidelines.
https://www.traumamon.com/article_99934_f141d6b2e39e890b08c26dff680daf5b.pdf
2015-07-01
10.5812/traumamon.16211
triage
chemical warfare
Nerve Agents
protocol
Mohammad Ali
Khoshnevis
1
AUTHOR
Yunes
Panahi
2
AUTHOR
Mostafa
Ghanei
3
AUTHOR
Hojat
Borna
4
AUTHOR
Amirhossein
Sahebkar
5
AUTHOR
Jafar
Aslani
6
AUTHOR
ORIGINAL_ARTICLE
Displaced Intra-Articular Fractures of the Distal Radius: Open Reduction With Internal Fixation Versus Bridging External Fixation
Background: Distal radius fracture is common in all ages. Mobility and wrist function is important. The choice of treatment should aim for optimal function with minimal complications. Objectives: In this study we compared two surgical approaches, open reduction and internal fixation (ORIF) and closed reduction with external fixation (CR + EF), for treatment of intra-articular distal radius fractures. Patients and Methods: Ninety-four patients with distal radius fracture (type 3, 4 and 5 Fernandez classification) were treated with two surgical methods (ORIF and CR + EF); 55 were treated with CR + EF and 39 were treated with ORIF by different surgeons. All patients were assessed at the end of the first, third and sixth week; and then after the third, sixth and 12th month. At the end of the follow-up, all patients completed the Michigan hand outcome questionnaire (MHOQ). We compared radiological parameters of distal radius, range of motion (ROM) of the wrist, duration of rehabilitation, complication and patient satisfaction of the methods. Results: In our study, radiological findings for the ORIF group were radial inclination (RI): 19.35, radial length (RL): 10.35, radial tilt (RT): 8.92, and ulnar variance (UV): 1.64, while for the CR + EF group these were RI: 15.13, RL: 8, RT: 4.78, and UV: 0.27. The ROM for ORIF were flexion/ extension (F/E): 137, Radial/Ulnar deviation (R/U): 52, and Supination/Pronation (S/P): 141, while for the CR + EF group these were F/E: 117, R/U: 40 and S/P: 116. Michigan hand outcome score for ORIF was 75% and for Ext. fix was 60%. The rate of complication with the ORIF method was 58% and in Ext. fix this was 69%. The patients in CR + EF had more than the ORIF course of physiotherapy and rehabilitation. Conclusions: In comparison of ORIF and CR + EF, all results including functional score, clinical and radiologic criteria were in favor of the ORIF method while there were less complications with this method. We believe that ORIF is a better method for treatment of these types of fractures.
https://www.traumamon.com/article_99935_d0a97218edfdd1284b308e413d7fca86.pdf
2015-07-01
10.5812/traumamon.17631v2
Open Reduction
Internal Fixation
Closed Reduction
External Fixation
outcome
Distal Radius Fractures
Mohammad
Fakoor
1
AUTHOR
Morteza
Fakoor
2
AUTHOR
Payam
Mohammadhoseini
3
AUTHOR
ORIGINAL_ARTICLE
A Study to Analyses Pattern and Treatment of Upper Cervical Spine Injuries Experience From Developing World
Background: The literature regarding the different patterns of upper cervical spine injuries, their appropriate management, and management development of such injuries is scarce in the world. Objectives: The current study aimed to present the experience regarding the high velocity trauma of upper cervical spine injuries. Patients and Methods: Thirty patients (22 males, 8 females) with upper cervical spine injuries were treated and followed-up for an average of 24 months. The corresponding data were analyzed with respect to various types of injuries and different treatment modalities used to treat such patients keeping the basic healthcare facilities in view. Results: The clinical as well as radiological outcomes of the treatment of such injuries were mostly achievable with minimum facilities in India, with only few complications. Conclusions: Managing such patients needs a proper transport facility, proper care during transport, appropriate evaluation in the hospital and prompt conservative or operative treatment. Treatment is usually safe and effective by well trained professionals with good clinical and radiological outcomes.
https://www.traumamon.com/article_99936_bb4785a06a200c2cd3dc80ab41cb6ac2.pdf
2015-07-01
10.5812/traumamon.19174
Upper Cervical Spine Injury
Dense Fracture
Hangamans Fracture
Younis
Kamal
1
AUTHOR
Hayat
Ahmad Khan
2
AUTHOR
Naseemul
Gani
3
AUTHOR
Anil
Gupta
4
AUTHOR
Dara
Singh
5
AUTHOR
Snobar
Gul
6
AUTHOR
ORIGINAL_ARTICLE
Presentation of a Humeral Shaft Fracture Treated by Locked Intramedullary Nailing With Unlocked Technique
Introduction: Although intramedullary nailing (IMN) is used in a reamed or unreamed fashion for treatment of long bone fractures, the locked nails may also be used in the unlocked form if so decided by the orthopedic surgeon. Case Presentation: We describe a 50-year-old man who had a shaft fracture of his right humerus. The fracture was treated with a reamed, locked IMN using unlocked technique. Conclusions: The functional outcome 22 months post injury showed that although primary treatment method uses locked IMN in humeral shaft fractures, unlocked IMN can be used in appropriate cases. Less injury risk to the axillary and radial nerve, short period of surgery, and less radiation can be considered as advantages of this technique.
https://www.traumamon.com/article_99937_007f1db7a8ab15c6b911fce6b0104b58.pdf
2015-07-01
10.5812/traumamon.19452v2
Intramedullary Nailing
Bone Screw
humerus
Sermet
Inal
1
AUTHOR
Canan
Inal
2
AUTHOR
Betul
Taspinar
3
AUTHOR
ORIGINAL_ARTICLE
Perception From Barrier and Facilitator for Providing of Early Rehabilitation Care for RTI Victims
Background: Road traffic injuries (RTIs) are a major public health problem and the most important cause of disability, morbidity and mortality worldwide. Early rehabilitation can play a significant role in minimizing complications, morbidity and mortality. Objectives: The aim of this study was to describe perceptions of barriers precluding provision of early rehabilitation care for RTI victims. Patients and Methods: A qualitative content analysis was carried out on 15 nurses with at least one year experience caring for RTI victims. The nurses were selected from various wards (emergency, orthopedic, neurosurgery, and clinic) of Sina and Imam Khomeini Hospitals via targeted sampling. Data were collected through semi-structured interviews and targeted sampling until data saturation. Data were analyzed and assessed. Results: After continuous analysis and comparison of data, major causes precluding nurses from early rehabilitation of RTI patients were retrieved. These barriers included: (a) lack of insight, (b) lack of comprehensive care (c) excessive costs; facilitating factors included (d) training for cooperation and (e) support for coping. Conclusions: The findings of this study show that the need for early rehabilitation in the hospital phase of care for RTI victims is needed. Knowledge about the barriers precluding nurses from early rehabiltiation of RTI patients and facilitators that can help health care workers and policy makers eliminate the barriers precluding early rehabilitation can help health care workers, especially nurses enable patients get over their disability and gain social and family support.
https://www.traumamon.com/article_99938_08979d420b6bf1dd9217cada4a2b7604.pdf
2015-07-01
10.5812/traumamon.21621v2
Road traffic injuries
Early Rehabilitation
Nurses
Fatemeh
Pashaei Sabet
1
AUTHOR
Kian
Norouzi Tabrizi
2
AUTHOR
Soheil
Saadat
3
AUTHOR
Hamid Reza
Khankeh
4
AUTHOR
Heidar Ali
Abedi
5
AUTHOR
ORIGINAL_ARTICLE
Mechanism of Injury, Glasgow Coma Scale, Age, and Systolic Blood Pressure: A New Trauma Scoring System to Predict Mortality in Trauma Patients
Background: Trauma is the most common cause of death in people aged 1 - 44 years and the third leading cause of death regardless of age. Early diagnosis can expedite emergency care and thus patients can be transferred more quickly to a treatment center. Objectives: The purpose of this study was to evaluate the mechanism of injury, Glasgow coma scale, age, and arterial pressure (MGAP) scoring system in predicting mortality in trauma patients. Patients and Methods: In this cross-sectional study, 5,484 victims over 12 years of age referred to a trauma referral hospital and were evaluated. The MGAP score was assessed based on type of injury, Glasgow coma scale (GCS), systolic blood pressure (BP) and patient’s age. The area under the receiver operating characteristic (AUROC) curve was used as a measure of predictive performance. Data were analyzed using SPSS software version 16. Results: Patients were divided into three groups : scores of less than 18, 18 - 22 and greater than 22; in which the mortality rates were 75.2%, 9.5% and 0.1%, respectively (P < 0.0001). The best cut-off point was 22 in our study, and the MGAP scoring system had 93.7% sensitivity and 91.3% specificity. Conclusions: The MGAP scoring system can be used as an appropriate scoring system to predict mortality in triage trauma patients
https://www.traumamon.com/article_99939_9f27e0a1c227f3e6becf9b372e4f442a.pdf
2015-07-01
10.5812/traumamon.24473
scoring system
Injury
Trauma
mortality
MGAP
Glasgow coma scale
Iraj
Baghi
1
AUTHOR
Leila
Shokrgozar
2
AUTHOR
Mohamad Rasoul
Herfatkar
3
AUTHOR
Kazem
Nezhad Ehsan
4
AUTHOR
Zahra
Mohtasham Amiri
5
AUTHOR
ORIGINAL_ARTICLE
A Case of Slipped Capital Femoral Epiphysis in Association With Craniopharyngioma
Introduction: Slipped capital femoral epiphysis is characterized by the slippage of the proximal femoral epiphysis on the metaphysis, which is sometimes associated with an underlying endocrine disorder. Panhypopituitarism due to craniopharyngioma has been reported several times. We report a case of craniopharyngioma recurrence leading to slipped capital femoral epiphysis. Case Presentation: A 28-year-old man diagnosed with recurrent craniopharyngioma presented with slipped capital femoral epiphysis. He was treated with gentle manipulation, capsulotomy, and placement of one screw as fixation per side. No complications showed up in a follow-up duration of 4 months. Conclusions: We underscored the importance of endocrinologic disorders in craniopharyngioma cases. Such disorders should be taken into consideration and be followed up.
https://www.traumamon.com/article_99940_0f5ea7348ea3498519d2a8a4854150e9.pdf
2015-07-01
10.5812/traumamon.25633
Slipped Capital
Femoral Epiphysis
Craniopharyngioma
Mehran
Soleymanha
1
AUTHOR
Ali
Karimi
2
AUTHOR
Seyed Mojtaba
Mehrdad
3
AUTHOR
ORIGINAL_ARTICLE
Treatment of Humeral Shaft Fractures: Minimally Invasive Plate Osteosynthesis Versus Open Reduction and Internal Fixation
Background: The optimal technique for operative fixation of humeral shaft fractures remains controversial and warrants research. Objectives: The purpose of the current study was to compare the functional and clinical outcomes of conventional open reduction and internal fixation (ORIF) with minimally invasive plate osteosynthesis (MIPO) in patients with fractures in two-third distal humeral shaft. Patients and Methods: In the current prospective case-control study, 65 patients with humeral shaft fractures were treated using ORIF (33 patients) or MIPO (32 patients). Time of surgery, time of union, incidence of varus deformity and complications were compared between the two groups. Also, the university of California-Los Angeles (UCLA) shoulder rating scale and Mayo Elbow performance score (MEPS) were used to compare the functional outcomes between the two groups. Results: The median of union time was shorter in the MIPO group (4 months versus 5 months). The time of surgery and functional outcomes based on the UCLA and MEPS scores were the same. The incidence of varus deformity was more than 5° and was higher and the incidence of nonunion, infection and iatrogenic radial nerve injury were lower in the MIPO group; however, the differences were not significant. Conclusions: Due to the shorter union time, to some extent less complication rate and comparable functional and clinical results, the authors recommend to use the MIPO technique in treating the mid-distal humeral shaft fracture.
https://www.traumamon.com/article_99941_9ffa5ba267de2217037986496ed89c8c.pdf
2015-07-01
10.5812/traumamon.26271v2
Humeral Shaft
Minimally Invasive Surgical Procedures
humerus
Internal Fracture Fixation
Ali Akbar
Esmailiejah
1
AUTHOR
Mohammad Reza
Abbasian
2
AUTHOR
Farshad
Safdari
3
AUTHOR
Keyqobad
Ashoori
4
AUTHOR
ORIGINAL_ARTICLE
National Getaways for the Weary Trauma Surgeon; Part 4: The Silk Road Trip
https://www.traumamon.com/article_99942_89aca083fde9c57a7f513dee6d3e3936.pdf
2015-07-01
10.5812/traumamon.29439v2
Vacation
fatigue
psychological stress
Holiday
Shahram
Nazerani
1
AUTHOR
ORIGINAL_ARTICLE
Management of Neglected Traumatic Bilateral Cervical Facet Dislocations Without Neurological Deficit
Introduction: Sub axial cervical spine dislocations are common and managing these cases by closed reduction is successful in the majority of cases. However, treatment of old and neglected cases is difficult and the results may vary in terms of neurological and functional outcomes. Case Presentation: We present two cases of traumatic bilateral cervical facet dislocation with no neurological deficit (ND) who referred four months after the injury. They were managed via single stage anterior discectomy, posterior facet reduction, instrumentation, and then anterior reconstruction with bone graft and cervical plate. The patients had no ND in the postoperative period and returned to work. Discussion: Patients presenting with neck pain after a history of trauma should be evaluated thoroughly with radiographs and computed tomography. The management of old neglected facet dislocations is difficult, lengthy, and fraught with potential neurological complications; operative intervention can substantially improve the quality of life in these patients
https://www.traumamon.com/article_99943_b2501a1d4a811d1188c46ef8a528b551.pdf
2015-07-01
10.5812/traumamon.18385
Dislocations
Facet Joint
cervical
Neck
Kamran
Farooque
1
AUTHOR
Kavin
Khatri
2
AUTHOR
Babita
Gupta
3
AUTHOR
Vijay
Sharma
4
AUTHOR