Background: Traumatic paediatric arterial injuries are a great challenge due to low incidence and specific characteristics of paediatric anatomy and physiology. The aim of the present study was to investigate their epidemiology, diagnostic and therapeutic options and complications. Furthermore, the prognostic value of the Mangled Extremity Severity Score (MESS) was evaluated.
Methods: In a retrospective clinical study 44 children aged 9.0 +/- 3.2 years treated for traumatic extremity arterial lesions in our Level I trauma center between 1971 and 2006 were enrolled. Exclusion criteria were age > 14, venous and iatrogenic vascular injury. Demographic data, mechanism of injury, severity of arterial lesions (by Vollmar and MESS), diagnostic and therapeutic management, complications and outcome were evaluated.
Results: The most commonly injured vessel was the femoral artery (25%) followed by the brachial artery (22.7%). The mechanism of injury was penetrating (31.8%), isolated severe blunt extremity trauma (29.6%), multiple trauma (25%) and humeral supracondylar fractures (13.6%). In 63.6% no specific vascular diagnostic procedure was performed in favour of emergency surgery. Surgical reconstructive strategies were preferred (68.2%). A MESS < 7 was associated with initial (p < 0.05) and definite limb salvage (p < 0.001) of the lower extremity.
Conclusions: Traumatic paediatric vascular injuries are very rare. The most common situations of vascular lesions in childhood were penetrating injuries and fractures of the extremities either as isolated injuries or in multiply injured patients. In paediatric patients, the MESS could serve as a basis for decision making for limb salvage or amputation.
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http://dx.doi.org/10.1186/1749-799X-5-25 | DOI Listing |
Eur J Trauma Emerg Surg
January 2025
Department of Orthopedic, Trauma and Reconstructive Surgery, Percy Military Hospital, 101 Avenue Henri Barbusse, Clamart, 92140, France.
Introduction: Targeted muscle reinnervation (TMR) is a technique that has proven effective for the treatment and prevention of chronic pain following amputation, though its adoption remains limited. The authors report on their initial experience using TMR.
Methods: A prospective study was conducted in a military trauma center involving traumatic amputees treated with either curative or preemptive TMR.
Clin Orthop Relat Res
January 2025
Department of Rehabilitation, Radboud University Medical Center, Nijmegen, the Netherlands.
Background: Many patients with a lower limb socket-suspended prothesis experience socket-related problems, such as pain, chronic skin conditions, and mechanical problems, and as a result, health-related quality of life (HRQoL) is often negatively affected. A bone-anchored prosthesis can overcome these problems and improve HRQoL, but these prostheses have potential downsides as well. A valid and reliable tool to assess potential candidates for surgery concerning a favorable risk-benefit ratio between potential complications related to bone-anchored prostheses and improvements in HRQoL is not available yet.
View Article and Find Full Text PDFSports (Basel)
January 2025
Institute of Human Movement Science and Health, Chemnitz University of Technology, 09126 Chemnitz, Germany.
Trauma-induced shoulder dislocations and sprains rank among the most common upper extremity injuries, with contact sports accounting for the majority of cases. These injuries often lead to substantial impairments in joint function and long recovery times, requiring targeted therapeutic interventions to restore mobility and prevent recurrent injuries. Given the pivotal role of exercise therapy in restoring shoulder function, this study systematically reviews the literature on the comparative effectiveness of supervised versus self-managed exercise therapy following acute shoulder trauma.
View Article and Find Full Text PDFJ Orthop Trauma
January 2025
The Hand and Upper Extremity Surgery Unit, Department of Orthopaedic Surgery, Yitzhak Shamir Medical Center affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tzrifin, Israel.
Objectives: This study investigates whether the intra-operative administration of intravenous tranexamic acid (TXA), known for its hemostatic and potential anti-inflammatory properties, affects the incidence of heterotopic ossification (HO) following surgery for elbow fracture-dislocations.
Methods: Design: Prospective, randomized clinical trial.
Setting: Hand and Upper Extremity Surgery Unit.
To compare injured and uninjured limb knee extensor and flexor peak torque between youth who experienced a sport-related, traumatic knee joint injury and comparable uninjured youth, at baseline (≤4 months of injury) and semiannually for 2 years. Differences by injury type and sex were also explored. Prospective cohort study.
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