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41.
Thomas Ruffing Tilmann Rückauer Frederic Bludau Alexander Hofmann Markus Muhm Arnold J Suda 《Injury》2019,50(2):607-612
Introduction
Compression fractures of the cuboid bone in children and adolescents are rare. Fracture morphology, associated lesions, treatment options and long-term outcomes of this very rare injury are published in a few case reports. This study with review of the literature aims to support the understanding of fracture pattern and optimize pathways of decision making.Material and Methods
A retrospective two-center study was performed in a patient cohort treated between 2001 and 2016. All patients aged less than 18 years who sustained a cuboid fracture were included. Age, gender, mechanism of injury, fracture morphology, amount of displacement, associated injuries, and therapy were analyzed. In the follow-up (FU), the AOFAS Midfoot Scale was investigated.Results
Fractures of the cuboid bone were diagnosed in 7 boys and 9 girls. The mean age of the patients was 10 years (range: 2.2–16.1 years). According to the classification of Fenton we detected 11 (69%) type 2, 2 (12%) type 3 and 3 (19%) type 5b fractures. Other fracture types according to Fenton were not observed. All children under 10 years sustained a type 2 fracture. Open reduction and internal fixation was performed in 5 (31%) patients. Bone grafting was not necessary. FU was performed in 14/16 patients on average after 9 years (mean; range: 1.4–16.2 years). The mean AOFAS Midfoot Scale at FU for extra-articular type 2 fractures was 100 points, whereas in intra-articular fractures (Type 3) and fractures associated with mid-tarsal disruption (type 5b) worse results were found (95 and 66 points, accordingly).Conclusion
This rare injury shows inhomogenous morphologies and offers different treatment approaches. Extra-articular Fenton type 2 lesions are the most common type of cuboid fracture in children (69%). A potential loss of length of the lateral column must be considered. In contrast to adults, type 1, 4, and 5a fractures were not found in our cohort of children and adolescents. Lower scores of the AOFAS Midfoot Scale were found with either intra-articular involvement or associated midfoot lesions. 相似文献42.
Ángel Becerra Héctor Trujillo Lucía Valencia Aurelio Rodríguez‐Pérez 《Brazilian Journal of Anesthesiology》2019,69(2):200-203
Background and objectives
A prompt and effective management of trauma patient is necessary. The aim of this case report is to highlight the importance of intraoperative echocardiography as a useful tool in patients suffering from refractory hemodynamic instability no otherwise explained.Case report
A 41 year‐old woman suffered a car accident. At the emergency department, no abnormalities were found in ECG or chest X‐ray. Abdominal ultrasound revealed the presence of abdominal free liquid and the patient was submitted to urgent exploratory laparotomy. Nevertheless, she persisted suffering arterial hypotension and metabolic acidosis. Looking for the reason of her hemodynamic instability, intraoperative transthoracic echocardiography was performed, finding out the presence of pericardial effusion. Once the cardiac surgeon extracted pericardial clots, patient's situation improved clinically and analytically.Conclusion
Every anesthesiologist should be able to use the intraoperative echocardiography as an effective tool in order to establish the appropriate measures to promote the survival of patients suffering severe trauma. 相似文献43.
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Notfall + Rettungsmedizin - 相似文献
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B Maybury A Powell-Chandler N Kumar 《Annals of the Royal College of Surgeons of England》2015,97(3):e37-e38
We report two British cases of liver abscess, due to Klebsiella pneumoniae and associated with synchronous infection elsewhere, which required liver resection for definitive treatment. They illustrate the geographic spread of aggressive K pneumoniae liver infection and demonstrate the importance of early aggressive treatment. 相似文献
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