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Desaturating Patient with Long Bone Fractures
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
Devendra Kumar Chouhan, Narendra Chouhan
Timing – Definitive fixation of the long bone fracture should be attempted in a safe period within the first 24 h after trauma or wait for 5–7 days. Damage control or external fixator should be the preferred method of fracture stabilization to prevent further fracture movement and embolization of the fat globules in between the safe period.
Hands
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Bone – fractures should be described according to location, type (oblique, transverse, comminuted, etc.) and deformity (angulation by direction of apex and rotational by distal segment relative to proximal). Rotational deformities can be detected by looking for an overlap of the finger cascade (and comparing with the other side). AP and oblique X-rays of the hands are needed as normal examination does not rule out fractures (see below).
Ear trauma
Published in S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague, ENT Head & Neck Emergencies, 2018
Falls, assaults and road traffic accidents may cause a temporal bone fracture. Fractures are classified as longitudinal or transverse, but most tend to be mixed. Longitudinal fractures comprise 80% of all temporal bone fractures and are frequently caused by a blow to the temporo-parietal region; the fracture line is parallel to the long axis of the petrous temporal bone. Transverse fractures comprise 20% of all temporal bone fractures. They are usually secondary to a blow to the frontal or occipital region; the fracture line runs at a right angle to the long axis of the petrous pyramid and may also run through the otic capsule. A temporal bone fracture should be suspected in the presence of Battle’s sign (Figure 16.2a), peri-orbital ecchymosis (racoon sign), blood in the EAC, haemotympanum (Figure 16.2b), TM perforation, CSF otorrhoea and a lower motor neurone facial nerve palsy.
A head-to-head comparison of EQ-5D-5L and SF-6D in Dutch patients with fractures visiting a Fracture Liaison Service
Published in Journal of Medical Economics, 2022
Nannan Li, Annelies Boonen, Joop P. van den Bergh, Sander M. J. van Kuijk, Caroline E. Wyers, Marsha van Oostwaard, Lisanne Vranken, Sandrine P. G. Bours, Mickaël Hiligsmann
Patients with prior fractures are at high risk of a subsequent fracture in their remaining lifetime, by up to 86%1. This risk is particularly elevated in the first 2 years after an initial fracture2,3. Bone fractures can result in acute as well as chronic health physical impairments4. The high incidence and morbidity imposed by fractures are associated with physical, psychological, and social consequences that can further affect health-related quality-of-life (HRQoL)5. Fracture Liaison Services (FLSs) as a coordinated, multi-disciplinary model of care, are advocated as the best practice for secondary fracture prevention. We recently reported significant improvements in HRQoL within 12 months following the initial fracture of patients attending FLS in the Netherlands6.
Defining readmissions among patients undergoing open reduction and internal fixation (ORIF) in claims database analyses
Published in Current Medical Research and Opinion, 2020
Abhishek S. Chitnis, Piyush Nandwani, Jill Ruppenkamp, Mollie Vanderkarr, Chantal E. Holy
Long bones, including the femur, tibia, and fibula, are the most commonly fractured bones in the human body1. The current methods used for surgical treatment of long bone fractures include casting, plate fixation, external fixation, and intramedullary nailing2. Despite the lack of consensus on the best treatment method for long bone fractures, surgical realignment and repair with open reduction and internal fixation (ORIF) is a popular and standard treatment option for fractures of the femur, tibia, and fibula3. In ORIF, the broken bone is surgically reduced or put back into place. Once the bone is reduced, an internal fixation device (e.g. screw, plate, rod, or pin) is placed on and/or inside the bone to ensure that the bone is stabilized for optimal healing.
Racing weight and resistance training: perceptions and practices in trained male cyclists
Published in The Physician and Sportsmedicine, 2019
Matthew W. Hoon, Eric C. Haakonssen, Paolo Menaspà, Louise M. Burke
As discussed, the restriction of energy availability may have significant health implications, with a chief issue being compromised bone health [7]. While the link between low energy availability, menstrual function and bone health for women has been previously highlighted under the Female Athlete Triad framework [8], several estrogen-independent mechanisms by which low energy availability affects bone mineral density (BMD) have been more recently identified [7]. These findings have led to the recognition that male endurance athletes are also at risk of osteoporosis from persistent energy deficit [3]. Poor bone health is of concern for this community not only for the impact of osteoporosis on quality of life [9] but also due to the sizeable risk of a high-impact collision that is inherent with cycling. The combination of fast traveling speeds and close proximity to other competitors makes crashes commonplace within the sport [10]. It is perhaps unsurprising then that bone fractures commonly result from a crash [11]. It may be reasoned that improving bone health in this population would see the incidence of fracture injuries reduce and may also have implications for bone health in later life.