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Limb Trauma (limb + trauma)
Selected AbstractsPulsed Signal Therapy® for the treatment of musculoskeletal conditions: a millennium paradigmINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 3 2004Richard MARKOLL Abstract Reports and reviews from various sources, including the World Health Organization and United Nations Population Division, confirm the general increasing trend in the ageing population groups worldwide. There are over 150 types of musculoskeletal conditions, with rheumatoid arthritis, osteoarthritis, osteoporosis, low back pain and limb trauma, accounting for the greatest impact on the population at large. Osteoarthritis (OA) is predicted to become the fourth leading cause of disability by the year 2020. The most common medication prescribed for OA is non-steroidal anti-inflammatory drugs (NSAIDs). These have long been associated with numerous adverse effects, are costly and short-term in their ,therapeutic' effect. Pulsed Signal Therapy® (PSTÔ) is an innovative treatment modality for musculoskeletal conditions. It has been commercially available since 1992, is currently employed in at least 800 clinics and/or medical institutes, and to-date, no adverse effects have been reported. Furthermore, it is non-invasive, non-pharmacological, painless, with long-term follow-up, and sustained efficacy. When connective tissue is injured and physiological signalling is disturbed or absent, PSTÔ, as the external, biophysical signal (stimulus) of physiological energy parameters and waveform, passively induces ,fluid flow' in the injured area, creating ,streaming potentials', that induce biophysical-biochemical coupling, subsequent signal transduction, to activate repair and regenerative processes. In doing so, it restores the innate, physiological signalling to enable these regenerative and repair processes to continue naturally. [source] Spontaneous cecum perforation following rectus abdominis free flap transfer for isolated lower limb traumaMICROSURGERY, Issue 3 2009Ch.B., Roger J. G. Stevens M.Sc. A case of a 32-year-old motorcyclist, who sustained an open comminuted fracture of the left tibia and subsequently developed spontaneous cecal perforation following successful fixation of the fracture and reconstruction of the soft tissue defect with a rectus abdominis free flap, is reported. Although benign cecal perforation has been described in patients with thermal burns and blunt trauma of the abdomen or pelvis, our association has not been reported previously in the medical literature. It is important to recognize cecal perforation early as it is associated with a high mortality from peritonitis and septicaemia. © 2009 Wiley-Liss, Inc. Microsurgery, 2009. [source] Clinical practice guidelines for the management of acute limb compartment syndrome following traumaANZ JOURNAL OF SURGERY, Issue 3 2010Christopher J. Wall Abstract Background:, Acute compartment syndrome is a serious and not uncommon complication of limb trauma. The condition is a surgical emergency, and is associated with significant morbidity if not managed appropriately. There is variation in management of acute limb compartment syndrome in Australia. Methods:, Clinical practice guidelines for the management of acute limb compartment syndrome following trauma were developed in accordance with Australian National Health and Medical Research Council recommendations. The guidelines were based on critically appraised literature evidence and the consensus opinion of a multidisciplinary team involved in trauma management who met in a nominal panel process. Results:, Recommendations were developed for key decision nodes in the patient care pathway, including methods of diagnosis in alert and unconscious patients, appropriate assessment of compartment pressure, timing and technique of fasciotomy, fasciotomy wound management, and prevention of compartment syndrome in patients with limb injuries. The recommendations were largely consensus based in the absence of well-designed clinical trial evidence. Conclusions:, Clinical practice guidelines for the management of acute limb compartment syndrome following trauma have been developed that will support consistency in management and optimize patient health outcomes. [source] SURVEY OF MANAGEMENT OF ACUTE, TRAUMATIC COMPARTMENT SYNDROME OF THE LEG IN AUSTRALIAANZ JOURNAL OF SURGERY, Issue 9 2007Christopher J. Wall Background: Acute compartment syndrome is a serious and not uncommon complication of limb trauma. The condition is a surgical emergency and is associated with significant morbidity if not diagnosed promptly and treated effectively. Despite the urgency of effective management to minimize the risk of adverse outcomes, there is currently little consensus in the published reports as to what constitutes best practice in the management of acute limb compartment syndrome. Methods: A structured survey was sent to all currently practising orthopaedic surgeons and accredited orthopaedic registrars in Australia to assess their current practice in the management of acute, traumatic compartment syndrome of the leg. Questions were related to key decision nodes in the management process, as identified in a literature review. These included identification of patients at high risk, diagnosis of the condition in alert and unconscious patients, optimal timeframe and technique for carrying out a fasciotomy and management of fasciotomy wounds. Results: A total of 264 valid responses were received, a response rate of 29% of all eligible respondents. The results indicated considerable variation in management of acute compartment syndrome of the leg, in particular in the utilization of compartment pressure measurement and the appropriate pressure threshold for fasciotomy. Of the 78% of respondents who regularly measured compartment pressure, 33% used an absolute pressure threshold, 28% used a differential pressure threshold and 39% took both into consideration. Conclusions: There is variation in the management of acute, traumatic compartment syndrome of the leg in Australia. The development of evidence-based clinical practice guidelines may be beneficial. [source] Lower limb replantations: Indications and a new scoring systemMICROSURGERY, Issue 5 2002Bruno Battiston M.D. The need for reconstruction of lower limb amputations is increasing, due to high-energy trauma in road accidents and work-related injuries. The indication for lower limb replantation is still controversial. Compared with upper limb replantations, indications are more select due to the frequent complications in lower limb salvage procedures, such as severe general complications or local complications such as necrosis, infections, nonunions, the need for secondary lengthening, or other reconstructive procedures. The satisfactory results given by artificial prosthesis, such as quicker recovery time and fewer secondary procedures, also contribute to the higher degree of selection for lower limb replantation candidates. Since 1993, we have replanted 14 amputations of the lower limb in 12 patients, including 2 bilateral cases. Although survival of the replanted segment was obtained in all patients, 5 cases were subsequently amputated for severe secondary complications. Of the remaining 9 cases, evaluated by means of Chen criteria, 7 had good results (3 Chen I and 4 Chen II), 1 sufficient (Chen III), and 1 poor (Chen IV). The best results were obtained in young patients. Our experience led us to examine the necessity for careful, objective patient selection. We developed a score evaluation system by modifying the international classifying method for severe limb traumas (mangled extremity severity score, or MESS system). This relatively simple system, based on the retrospective study of our cases, considers several parameters (patient's age, general conditions, level and type of lesion, time of injury, and associated lesions), giving each one a score. The total score gives the indication for replantation, predicts the functional outcome, and facilitates decision-making. © 2002 Wiley Liss, Inc. MICROSURGERY 22:187,192 2002 [source] |