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Cirugia Y Cirujanos 2024The aim of the study was to investigate the clinical effect of stainless-steel wire fixation on the early mouth-opening movement of an intracapsular fracture involving...
OBJECTIVES
The aim of the study was to investigate the clinical effect of stainless-steel wire fixation on the early mouth-opening movement of an intracapsular fracture involving the condylar process.
MATERIALS AND METHODS
In this study, patients who underwent mandibular condylar intracapsular fracture surgery in our hospital from 2012 to 2020 were selected as research subjects. A total of 44 patients received steel wire internal fixation treatment, 32 patients received titanium plate-and-nail rigid internal fixation, and 28 patients underwent conservative non-surgical treatment.
RESULTS
For the patients in the stainless-steel wire group, the degree of mouth opening reached normal levels of 3.7 cm approximately 10 days after surgery. The recovery time for the patients in the titanium plate-and-nail rigid internal-fixation group was 21 days, while the patients in the conservative treatment group needed 60 days to recover.
CONCLUSION
The treatment of fixation with a stainless-steel wire for intracapsular condylar fracture reduced the time taken to perform mouth-opening exercises and improved the recovery rate of patients.
Topics: Humans; Fracture Fixation, Internal; Mandibular Fractures; Mandibular Condyle; Stainless Steel; Male; Female; Bone Wires; Adult; Bone Plates; Middle Aged; Titanium; Range of Motion, Articular; Bone Nails; Young Adult; Retrospective Studies
PubMed: 38782385
DOI: 10.24875/CIRU.23000093 -
Craniomaxillofacial Trauma &... Jun 2024This retrospective cohort study utilized the National Inpatient Sample (NIS) database for the years 2016-2018. Incidences of street fighting were identified using the...
STUDY DESIGN
This retrospective cohort study utilized the National Inpatient Sample (NIS) database for the years 2016-2018. Incidences of street fighting were identified using the corresponding ICD-10 codes.
OBJECTIVE
To determine whether alcohol use (measured by blood alcohol content (BAC)) in patients sustaining maxillofacial trauma from hand-to-hand fighting influence hospitalization outcomes.
METHODS
The primary predictor variable was BAC stratified into six categories of increasing magnitude. The primary outcome variable was mean length of hospital stay (days). The secondary outcome variable was total hospital charges (US dollars).
RESULTS
Our final sample consisted of 3038 craniomaxillofacial fractures. Each additional year in age added +$545 in hospital charges ( < .01). Non-elective admissions added $14 210 in hospital charges ( < .05). Patients admitted in 2018 experienced approximately $7537 more in hospital charges ( < .01). Le Fort fractures (+$61 921; < .01), mandible fractures (+$13 227, < .01), and skull base fractures (+$22 170; < .05) were all independently associated with increased hospital charges. Skull base fractures added +7.6 days to the hospital stay ( < .01) and each additional year in patient age added +.1 days to the length of the hospital stay ( < .01).
CONCLUSIONS
BAC levels did not increase length of stay or hospitalization charges. Le Fort fractures, mandible fractures, and skull base fracture each independently increased hospital charges. This reflects the necessary care (ie, ICU) and treatment (ie, ORIF) of such fractures. Older adults and elderly patients are associated with increased length of stay and hospital charges-they are likely to struggle in navigating the healthcare system and face socioeconomic barriers to discharge.
PubMed: 38779398
DOI: 10.1177/19433875231164705 -
Ophthalmic Plastic and Reconstructive... May 2024A 6-year-old boy presented with a lateral rectus muscle entrapment in a complex orbital fracture sustained during bicycle riding. He was diagnosed with a skull-base...
A 6-year-old boy presented with a lateral rectus muscle entrapment in a complex orbital fracture sustained during bicycle riding. He was diagnosed with a skull-base fracture with pneumocephalus and zygomatic and inferior orbital wall fractures at another hospital. The zygomatic fracture and pneumocephalus were treated conservatively. Although a detailed ocular motility examination could not be performed due to pain and inability to open the eyelid, the inferior wall fracture was surgically repaired. Postoperatively, persistent extraocular movement limitation prompted a referral to our clinic. Orbital CT imaging demonstrated a fracture at the greater wing of the sphenoid with a hypoattenuated area in the adjacent middle cranial fossa. Orbital MRI taken thereafter revealed lateral rectus and orbital fat prolapse into the middle cranial fossa, indicating entrapment of these structures through the lateral wall fracture. The incarcerated lateral rectus was released using an endoscopic transorbital approach via an upper lid crease, resulting in the recovery of extraocular movement.
PubMed: 38776157
DOI: 10.1097/IOP.0000000000002723 -
Frontiers in Bioengineering and... 2024In this study, we attempted to demonstrate the actual process of orbital floor fracture visually and computationally in anatomically reconstructed structures and to...
In this study, we attempted to demonstrate the actual process of orbital floor fracture visually and computationally in anatomically reconstructed structures and to investigate them using finite element analysis. A finite element model of the skull and cervical vertebrae was reconstructed from computed tomography data, and an eyeball surrounded by extraocular adipose was modeled in the orbital cavity. Three-dimensional volume mesh was generated using 173,894 of the 4-node hexahedral solid elements. For the cases where the impactor hit the infraorbital foramen, buckling occurred at the orbital bone as a result of the compressive force, and the von Mises stress exceeded 150 MPa. The range of stress components included inferior orbital rim and orbital floor. For the cases where the impactor hit the eyeball first, the orbital bone experienced less stress and the range of stress components limited in orbital floor. The critical speeds for blowout fracture were 4 m/s and 6 m/s for buckling and hydraulic mechanism. Each mechanism has its own fracture inducing energy and its transmission process, type of force causing the fracture, and fracture pattern. It is possible to determine the mechanism of the fracture based on whether an orbital rim fracture is present.
PubMed: 38774815
DOI: 10.3389/fbioe.2024.1354944 -
PloS One 2024Wild boar trapping has been used as a management tool to control wild boar populations. However, it is increasingly criticized due to animal welfare concerns. While...
Wild boar trapping has been used as a management tool to control wild boar populations. However, it is increasingly criticized due to animal welfare concerns. While cortisol levels have been used to assess trap-related stress in wild boar, data on trap-related injuries and behavioral data are scarce. We aimed to evaluate three different corral-style traps for wild boar according to available mammal trapping standards to investigate and refine animal welfare in wild boar trapping. We examined 138 wild boars captured and killed by head shot in 27 capture events. Traps were closed by remote control only if the complete group were trapped. The behavior of the animals in the trap and during culling was recorded on video. All wild boars were examined and a pathological and radiological examination of the heads for trap- and shot-related injuries followed. Trap-related injuries occurred in 33% of the animals with superficial mild skin defects to skull fractures. One out of three traps met all the set requirements. A wire-meshed trapping system failed all. After installing an incomplete barrier in the center of the trap to slow down trapped animals, the fracture rate in one trap type was significantly reduced by 29% (p < 0.05). Our data showed that the type of trap (p = 0.007) and the number of animals trapped at once (p = 0.002) had a significant influence on the number of escape attempts. Trapping larger groups reduced the escape attempts. We emphasize the importance of an accurate pathological examination to evaluate animal welfare in traps and call for adjusting the injury categories listed in the standards and make a proposal for wild boar live trapping.
Topics: Animals; Animal Welfare; Sus scrofa; Behavior, Animal; Male; Female
PubMed: 38771820
DOI: 10.1371/journal.pone.0303458 -
The Journal of Craniofacial Surgery May 2024In this study, we aimed to compare the efficiency of different osteotomy techniques for Lefort 1 osteotomy in an experimental caprine skull model.
OBJECTIVE
In this study, we aimed to compare the efficiency of different osteotomy techniques for Lefort 1 osteotomy in an experimental caprine skull model.
METHODS
Twelve caprine skulls were used for the study. Skulls were divided into 3 groups: (1) manual chisel group, (2) Lindemann bur group, and (3) piezo osteotomy group. Bilateral osteotomies were performed on each skull. Results were evaluated with three-dimensional computerized tomography scans and macroscopic observations of the mucosal tears and soft tissue.
RESULTS
The mean length of the bone gap in the manual, Lindemann, and piezo groups was 4.8 (±0.7), 3.38 (±1.49), and 1.39 (±0.3) mm, respectively (P < 0.05). The mean number of comminuted fractures in the manual, Lindemann, and piezo groups was 5.5 (±1.4), 1.6 (±0.3), and 0.6 (±0.5), respectively (P < 0.05). Mucosal tearing and soft tissue damage based on subjective inspection observations were negligible in the piezo technique. Soft tissue and mucosal damage were observed significantly more in the manual chisel osteotomy method compared with the other 2 techniques.
CONCLUSION
We anticipate that piezo, which has started to be used in new application areas besides rhinoplasty, will continue to be used more widely, especially in reconstructive orthognathic surgery, due to the minimal damage it causes to tissues. With the long-term results, much healthier interpretations can be made.
PubMed: 38767364
DOI: 10.1097/SCS.0000000000010309 -
Acute Medicine & Surgery 2024Traumatic pneumocephalus is commonly encountered after basal skull fractures and rarely associated with blunt chest trauma. Here, we report a case of pneumocephalus...
BACKGROUND
Traumatic pneumocephalus is commonly encountered after basal skull fractures and rarely associated with blunt chest trauma. Here, we report a case of pneumocephalus caused by traumatic pneumothorax and brachial plexus avulsion.
CASE PRESENTATION
A 20-year-old male was admitted to our hospital following a motorcycle accident with complete paralysis of the right upper limb. 2 days later, follow-up computed tomography revealed a slight right pneumothorax, pneumomediastinum around the neck, and intracranial air without skull fracture. Air migrates into the subarachnoid space through a dural tear caused by a brachial plexus avulsion. The pneumocephalus immediately improved after the insertion of a chest drain.
CONCLUSION
Pneumothorax combined with brachial plexus avulsion could lead to pneumocephalus. Immediate chest drainage might be the best way to stop the migration of air; however, care should be taken to not worsen cerebrospinal fluid leakage.
PubMed: 38765777
DOI: 10.1002/ams2.956 -
The British Journal of Oral &... Jun 2024
Topics: Humans; Mandibular Fractures
PubMed: 38755038
DOI: 10.1016/j.bjoms.2024.03.005 -
Journal of Plastic, Reconstructive &... Jul 2024To present the demographics and clinical characteristics of pure (rim-sparing) orbital roof fractures. (Observational Study)
Observational Study
PURPOSE
To present the demographics and clinical characteristics of pure (rim-sparing) orbital roof fractures.
METHODS
This retrospective observational study used 10 years of data from a single institution. Patient age, sex, laterality, field of binocular single vision, associated injuries, and radiologic features were analyzed. Orbital roof fractures were categorized into four groups: comminuted/open, hinged, trapdoor, and linear. These were further subdivided into blow-in (-down) and blow-out (-up) fractures. Injury etiology was classified into fall, traffic accidents, sports injuries, assault, work-related, and others.
RESULTS
Data documented a low incidence rate of 2.5% (27 patients) in 1074 patients. Most patients were male (81%). The most common cause of injury was fall (48%), followed by traffic accidents (22%). Comminuted/open fractures constituted the bulk of fracture types (54%), followed by hinged, and linear fractures. Blow-in and blow-out fractures had an incidence rate of 50% each. Concomitant fractures of the medial and inferior orbital walls were predominant. Low surgical intervention was noted owing to acceptable field of binocular single vision outcomes, and the field of binocular single vision included the primary position of gaze in 88% of patients.
CONCLUSION
Pure orbital roof fractures occurred in 2.5% of patients with pure orbital fractures. Patients were predominantly male with trauma caused by high energy forces, which regularly caused comminution of the roof and fractures of the medial and inferior orbital walls. Most patients were managed conservatively.
Topics: Humans; Orbital Fractures; Male; Retrospective Studies; Female; Adult; Middle Aged; Aged; Adolescent; Young Adult; Incidence; Accidents, Traffic; Accidental Falls; Child
PubMed: 38754270
DOI: 10.1016/j.bjps.2024.04.063 -
Child Abuse & Neglect Jul 2024There is limited understanding of the hypothesized association between the Ehlers-Danlos Syndromes (EDS), hypermobility and fractures in children. Despite this, EDS and...
BACKGROUND
There is limited understanding of the hypothesized association between the Ehlers-Danlos Syndromes (EDS), hypermobility and fractures in children. Despite this, EDS and hypermobility continue to be raised in the legal setting as possible causes of unexplained fractures in infants where there is a concern for physical abuse. Further understanding is needed regarding fractures in children with EDS and hypermobility.
OBJECTIVE
This study assessed fracture prevalence and characteristics in children diagnosed with EDS and Generalized Joint Hypermobility (GJH). The secondary outcome was fracture prevalence in infants <1 year of age.
PARTICIPANTS AND SETTING
Children aged <18 years with EDS or GJH seen in a single-center EDS clinic from April 2017 to December 2021 were included. Diagnoses were based on the 2017 international classification. Exclusion criteria were concurrent medical conditions associated with bone fragility.
METHODS
This retrospective descriptive study examined variables including fracture history, fracture location, fracture type, age of sustaining fracture, and injury mechanism. Descriptive statistics were used for analysis.
RESULTS
Fracture prevalence was 34.6 % (9/26, 95 % CI [16.3, 52.9]) in the EDS population and 25.4 % (15/59, 95 % CI [14.3, 36.5]) in the GJH population. No fractures occurred in infancy. Most fractures occurred in the limbs. There were no rib or skull fractures. Most fractures were the result of an identifiable injury event.
CONCLUSION
In a cohort of children with formally diagnosed EDS or GJH, fractures occurred commonly in ambulatory children and generally in the limbs from identifiable events. This study does not support EDS or GJH as a cause of fractures in infancy.
Topics: Humans; Ehlers-Danlos Syndrome; Joint Instability; Male; Female; Prevalence; Retrospective Studies; Child, Preschool; Child; Infant; Fractures, Bone; Adolescent
PubMed: 38749147
DOI: 10.1016/j.chiabu.2024.106828