Archives of Trauma Research Archives of Trauma Research Arch Trauma Res http://www.archtrauma.com 2251-953X 2251-9599 10.5812/atr. en jalali 2017 9 20 gregorian 2017 9 20 2 3
en 10.5812/atr.16079 Fall Injuries: An Important Preventable Cause of Trauma Fall Injuries: An Important Preventable Cause of Trauma editorial editorial Fall;Injury;Trauma Fall;Injury;Trauma 101 102 http://www.archtrauma.com/index.php?page=article&article_id=16079 Mehrdad Mahdian Mehrdad Mahdian Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615620634, Fax: +98-3615620634 Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615620634, Fax: +98-3615620634
en 10.5812/atr.13665 Early Rehabilitation in Head Injury; Can We Improve the Outcomes? Early Rehabilitation in Head Injury; Can We Improve the Outcomes? research-article research-article Results

In the first three years, the team managed the care of 812 admissions. Mean age was\n 44.3 years (SD = 24.8) and mean length of hospital stay was 6.1 days (SD = 10.9). Of\n these individuals, 674 attended for 6 month follow-up with 52.2% having a good outcome\n on Extended Glasgow outcome score. Patients and their relatives' feedbacks were\n excellent with an average score of 4.7/5 on overall satisfaction rating. Following\n presentations at national meetings and elsewhere, other centers in the United Kingdom\n are now setting up similar pathways.

Conclusions

A dedicated clinical pathway and head injury team can improve the quality of care for\n all admissions with head injury and enhance the role for rehabilitation medicine input\n at an early stage.

Objectives

To improve the outcomes of all head injury admissions to hospital, including mild and\n moderate, by creating a head injury team to supervise a rehabilitation clinical\n pathway.

Patients and Methods

A head injury team was established to manage the care of all non-neurosurgical\n admissions with head injury to a large teaching hospital. Apart from inpatient care, the\n team coordinates various services involved in the care of head injuries, arranged\n suitable follow-ups, supported relatives and trained healthcare staff on general wards\n in the treatment of head injured patients. Follow-up clinics at 6 weeks and 6 months\n were arranged.

Background

The quality of care after head injury is still very variable with a little coordination\n between different specialties. Acute care dominates, often with little regard to\n rehabilitation needs.

Results

In the first three years, the team managed the care of 812 admissions. Mean age was\n 44.3 years (SD = 24.8) and mean length of hospital stay was 6.1 days (SD = 10.9). Of\n these individuals, 674 attended for 6 month follow-up with 52.2% having a good outcome\n on Extended Glasgow outcome score. Patients and their relatives' feedbacks were\n excellent with an average score of 4.7/5 on overall satisfaction rating. Following\n presentations at national meetings and elsewhere, other centers in the United Kingdom\n are now setting up similar pathways.

Conclusions

A dedicated clinical pathway and head injury team can improve the quality of care for\n all admissions with head injury and enhance the role for rehabilitation medicine input\n at an early stage.

Objectives

To improve the outcomes of all head injury admissions to hospital, including mild and\n moderate, by creating a head injury team to supervise a rehabilitation clinical\n pathway.

Patients and Methods

A head injury team was established to manage the care of all non-neurosurgical\n admissions with head injury to a large teaching hospital. Apart from inpatient care, the\n team coordinates various services involved in the care of head injuries, arranged\n suitable follow-ups, supported relatives and trained healthcare staff on general wards\n in the treatment of head injured patients. Follow-up clinics at 6 weeks and 6 months\n were arranged.

Background

The quality of care after head injury is still very variable with a little coordination\n between different specialties. Acute care dominates, often with little regard to\n rehabilitation needs.

Craniocerebral Trauma;Critical Pathways;Healthcare Quality;Physical and Rehabilitation Medicine Craniocerebral Trauma;Critical Pathways;Healthcare Quality;Physical and Rehabilitation Medicine 103 107 http://www.archtrauma.com/index.php?page=article&article_id=13665 Rajiv Singh Rajiv Singh Osborn Neurorehabilitation Unit, Northern General Hospital, UK; Osborn Neurorehabilitation Unit, Northern General Hospital, UK. Tel.: +44-114215651, Fax: +44-1142715649 Osborn Neurorehabilitation Unit, Northern General Hospital, UK; Osborn Neurorehabilitation Unit, Northern General Hospital, UK. Tel.: +44-114215651, Fax: +44-1142715649 Guruprasad Venkateshwara Guruprasad Venkateshwara Osborn Neurorehabilitation Unit, Northern General Hospital, UK Osborn Neurorehabilitation Unit, Northern General Hospital, UK Julie Batterley Julie Batterley Osborn Neurorehabilitation Unit, Northern General Hospital, UK Osborn Neurorehabilitation Unit, Northern General Hospital, UK Sarah Bruce Sarah Bruce Osborn Neurorehabilitation Unit, Northern General Hospital, UK Osborn Neurorehabilitation Unit, Northern General Hospital, UK
en 10.5812/atr.13826 Treatment of Open Pediatric Tibial Fractures by External Fixation Versus Flexible Intramedullary Nailing: A Comparative Study Treatment of Open Pediatric Tibial Fractures by External Fixation Versus Flexible Intramedullary Nailing: A Comparative Study research-article research-article Conclusions

Although external fixation in open pediatric fractures and severe injuries is recommended, intramedullary nailing is also an effective method with low complications. Combining pins and flexible intramedullary nails is effective in developing more stability and is not associated with more complications.

Background

Tibial fractures are the third most common pediatric long-bone fracture after forearm and femoral fractures. Approximately 50% of pediatric tibial fractures occur in the distal third of the tibia. This is followed by midshaft tibial fractures (39%), and least commonly, the proximal third of the tibia is involved. Tibial fractures in the skeletally immature patient can usually be treated without surgery but tibial fractures resulting from high energy traumas are of special importance considering type of the selected treatment method affecting the children future. Manipulation and casting are regarded as definite treatments for children tibia fractures. They are used following compartment syndrome in poly-trauma, neurovascular damages, open fractures, and fasciotomy cases.

Results

Mean time required for fracture union was 12.5 (11-14) and 11.8 (10-12) weeks for the external fixator and TEN groups, respectively. There was no statistical difference in time of union between the two methods. The main complications in external fixation were infection around the pin 4 (22.2%), leg-length discrepancy 2 (11.1%) and re-fracture 4 (22.2%). In the TEN group, 2 cases (14.2%) of painful bursitis were observed at the entry point of TEN and the pin was removed earlier. There was not any report of mal-union requiring correction in the groups. No complication was seen in 6 patients treated with a combined method of pin and flexible intramedullary nails.

Materials and Methods

In this descriptive analytical study, 32 patients with open tibial fractures were treated with either fixator (n = 18) or TEN nails (n=14) during 2006-2011. Some patients were treated with a combination method of TEN and pin. The results were evaluated considering infection, union, mal-union, and re-fracture and the patients were followed up for two years.

Objectives

In children, most open fractures occur due to high energy traumas and inappropriate treatment of the fractures may result in several complications. Flexible intramedullary nailing is one of the popular options as an effective method of treating long-bone fractures in children. The external fixator is used in cases with severe injuries and open fractures. The present study aims at comparing results of these two treatment methods in the pediatric tibial open fractures.

Conclusions

Although external fixation in open pediatric fractures and severe injuries is recommended, intramedullary nailing is also an effective method with low complications. Combining pins and flexible intramedullary nails is effective in developing more stability and is not associated with more complications.

Background

Tibial fractures are the third most common pediatric long-bone fracture after forearm and femoral fractures. Approximately 50% of pediatric tibial fractures occur in the distal third of the tibia. This is followed by midshaft tibial fractures (39%), and least commonly, the proximal third of the tibia is involved. Tibial fractures in the skeletally immature patient can usually be treated without surgery but tibial fractures resulting from high energy traumas are of special importance considering type of the selected treatment method affecting the children future. Manipulation and casting are regarded as definite treatments for children tibia fractures. They are used following compartment syndrome in poly-trauma, neurovascular damages, open fractures, and fasciotomy cases.

Results

Mean time required for fracture union was 12.5 (11-14) and 11.8 (10-12) weeks for the external fixator and TEN groups, respectively. There was no statistical difference in time of union between the two methods. The main complications in external fixation were infection around the pin 4 (22.2%), leg-length discrepancy 2 (11.1%) and re-fracture 4 (22.2%). In the TEN group, 2 cases (14.2%) of painful bursitis were observed at the entry point of TEN and the pin was removed earlier. There was not any report of mal-union requiring correction in the groups. No complication was seen in 6 patients treated with a combined method of pin and flexible intramedullary nails.

Materials and Methods

In this descriptive analytical study, 32 patients with open tibial fractures were treated with either fixator (n = 18) or TEN nails (n=14) during 2006-2011. Some patients were treated with a combination method of TEN and pin. The results were evaluated considering infection, union, mal-union, and re-fracture and the patients were followed up for two years.

Objectives

In children, most open fractures occur due to high energy traumas and inappropriate treatment of the fractures may result in several complications. Flexible intramedullary nailing is one of the popular options as an effective method of treating long-bone fractures in children. The external fixator is used in cases with severe injuries and open fractures. The present study aims at comparing results of these two treatment methods in the pediatric tibial open fractures.

Fractures, Open;External Fixator;Fracture Fixation;Child Fractures, Open;External Fixator;Fracture Fixation;Child 108 112 http://www.archtrauma.com/index.php?page=article&article_id=13826 Hossein Aslani Hossein Aslani Pediatric Orthopedic, Tehran University of Medical Sciences,Tehran, IR Iran Pediatric Orthopedic, Tehran University of Medical Sciences,Tehran, IR Iran Ali Tabrizi Ali Tabrizi Orthopedic Surgery, Shohada Educational Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran; Orthopedic Surgery, Shohada Educational Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel:+98-9148883851 Orthopedic Surgery, Shohada Educational Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran; Orthopedic Surgery, Shohada Educational Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel:+98-9148883851 Ali Sadighi Ali Sadighi Shohada Educational Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran Shohada Educational Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran Ahmad Reza Mirblok Ahmad Reza Mirblok Orthopedic Surgery, Poursina Educational Hospital, Guilan University of Medical Sciences, Rasht, IR Iran Orthopedic Surgery, Poursina Educational Hospital, Guilan University of Medical Sciences, Rasht, IR Iran
en 10.5812/atr.8382 Epidemiology of Accidents and Traumas in Qom Province in 2010 Epidemiology of Accidents and Traumas in Qom Province in 2010 research-article research-article Conclusions

Most traumas in Qom province occurred among younger age-groups and strikes and falls\n are the main causes of such traumas. Therefore, safeties to prevent falls and traffic\n regulations to reduce strikes can be effective strategies.

Patients and Methods

A cross–sectional study was conducted on 29426 injured people referred to Qom\n province hospitals in 2010. Information about place, time, type of accidents and traumas\n and demographic variables had been collected in a veteran hospital. Data were analyzed\n by SPSS (version 16) software, using chi-square test and logistic regression.

Results

The incidence of accidents was about 27/1000 per year. The incidences of traffic\n accidents, motorcycle accidents, violence, burns, poisoning and suicides were 3, 1.6,\n 1.2, 0.3, 0.8, 0.37 cases per 1000 people respectively. Strikes (65%) and falls (12%)\n were the main causes of traumas. Forty-six percent of all injuries had occurred in 16 -\n 30 years groups. Most frequent accidents were as follows: fall (97%) and strike (50%) in\n < 12, violence (46%) in 20 - 29, suicide (71%) in 15 - 29, poisoning (34%) and burns\n (20%) among < 5 years old. Pedestrian and motorcycle accidents among +60 years old\n people were significantly higher than other (P = 0.000). Odds ratio for suicide among\n female was about 3.36 and in 16 - 30 age-group was 15.7 more than +60 years old group (P\n = 0.000).

Objectives

This study was conducted to reveal the epidemiological features of accidents and their\n casualties in Qom province in 2010.

Background

Accidents are the most important public health challenges in our society. To prevent\n the accidents, the identification of their epidemiological features seems necessary.

Conclusions

Most traumas in Qom province occurred among younger age-groups and strikes and falls\n are the main causes of such traumas. Therefore, safeties to prevent falls and traffic\n regulations to reduce strikes can be effective strategies.

Patients and Methods

A cross–sectional study was conducted on 29426 injured people referred to Qom\n province hospitals in 2010. Information about place, time, type of accidents and traumas\n and demographic variables had been collected in a veteran hospital. Data were analyzed\n by SPSS (version 16) software, using chi-square test and logistic regression.

Results

The incidence of accidents was about 27/1000 per year. The incidences of traffic\n accidents, motorcycle accidents, violence, burns, poisoning and suicides were 3, 1.6,\n 1.2, 0.3, 0.8, 0.37 cases per 1000 people respectively. Strikes (65%) and falls (12%)\n were the main causes of traumas. Forty-six percent of all injuries had occurred in 16 -\n 30 years groups. Most frequent accidents were as follows: fall (97%) and strike (50%) in\n < 12, violence (46%) in 20 - 29, suicide (71%) in 15 - 29, poisoning (34%) and burns\n (20%) among < 5 years old. Pedestrian and motorcycle accidents among +60 years old\n people were significantly higher than other (P = 0.000). Odds ratio for suicide among\n female was about 3.36 and in 16 - 30 age-group was 15.7 more than +60 years old group (P\n = 0.000).

Objectives

This study was conducted to reveal the epidemiological features of accidents and their\n casualties in Qom province in 2010.

Background

Accidents are the most important public health challenges in our society. To prevent\n the accidents, the identification of their epidemiological features seems necessary.

Trauma;Epidemiology;Injury;Qom Trauma;Epidemiology;Injury;Qom 113 117 http://www.archtrauma.com/index.php?page=article&article_id=8382 Moharram Karami Joushin Moharram Karami Joushin Health Deputy, Qom University of Medical Sciences, Qom, IR Iran Health Deputy, Qom University of Medical Sciences, Qom, IR Iran Abedin Saghafipour Abedin Saghafipour Health Deputy, Qom University of Medical Sciences, Qom, IR Iran; Health Deputy, Qom University of Medical Sciences, Qom, IR Iran. Tel.: +98- 2518619757 Health Deputy, Qom University of Medical Sciences, Qom, IR Iran; Health Deputy, Qom University of Medical Sciences, Qom, IR Iran. Tel.: +98- 2518619757 Mehdi Noroozi Mehdi Noroozi Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Hamid Soori Hamid Soori Department of Health Education, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Health Education, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Esmaeil Khedmati Morasae Esmaeil Khedmati Morasae Health Deputy, Qom University of Medical Sciences, Qom, IR Iran; Center for Community Based Participatory Research, Tehran University of Medical Sciences, Tehran, IR Iran Health Deputy, Qom University of Medical Sciences, Qom, IR Iran; Center for Community Based Participatory Research, Tehran University of Medical Sciences, Tehran, IR Iran Mahmoud Khodadoust Mahmoud Khodadoust Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
en 10.5812/atr.11146 Electrophysiological Assessment of Injury to the Infra-patellar Branch(es) of the Saphenous Nerve during Anterior Cruciate Ligament Reconstruction Using Medial Hamstring Auto-grafts: Vertical versus Oblique Harvest Site Incisions Electrophysiological Assessment of Injury to the Infra-patellar Branch(es) of the Saphenous Nerve during Anterior Cruciate Ligament Reconstruction Using Medial Hamstring Auto-grafts: Vertical versus Oblique Harvest Site Incisions research-article research-article Conclusions

IPBSN injury is a common complication following arthroscopically-assisted ACLR and, if\n not significant, oblique direction of the incision is associated with decreased\n incidence of the injury. IPBSN injury has no effect on the function but because of the\n disturbance with patients' satisfaction, authors believe the oblique incision is\n preferable to avoid the nerve injury during medial hamstring tendons harvesting.

Background

It was suggested that the direction of incision for medial hamstring tendons harvesting\n influences the incidence of injury to the infrapatellar branch of the saphenous nerve\n (IPBSN), a common complication following arthroscopically-assisted anterior cruciate\n ligament reconstruction (ACLR).

Results

The incidence of IPBSN injury was higher in the vertical group (4 patients vs. 10\n patients), but the difference was not statistically significant. The mean of Lysholm and\n VAS scores were the same. Also, the mean of Lysholm score was the same in patients with\n and without IPBSN injury. However, patients without IPBSN injury were more satisfied\n (8.9 ± 9 vs. 7.4 ± 1.1; P < 0.001).

Patients and Methods

There were 60 patients underwent arthroscopically-assisted ACLR assigned to two equal\n vertical or oblique incision groups, randomly. One year postoperatively, the patients\n were electrophysiologically examined to detect whether IPBSN is injured. The Lysholm\n score was completed. The patients' satisfaction with surgical outcomes determined\n utilizing visual analogue scale (VAS). Finally, two groups were compared and the effect\n of IPBSN injury on function and satisfaction was investigated.

Objectives

The main purpose of current study was to compare the incidence of IPBSN injury between\n vertical and oblique incisions utilizing electrophysiological evaluation.

Conclusions

IPBSN injury is a common complication following arthroscopically-assisted ACLR and, if\n not significant, oblique direction of the incision is associated with decreased\n incidence of the injury. IPBSN injury has no effect on the function but because of the\n disturbance with patients' satisfaction, authors believe the oblique incision is\n preferable to avoid the nerve injury during medial hamstring tendons harvesting.

Background

It was suggested that the direction of incision for medial hamstring tendons harvesting\n influences the incidence of injury to the infrapatellar branch of the saphenous nerve\n (IPBSN), a common complication following arthroscopically-assisted anterior cruciate\n ligament reconstruction (ACLR).

Results

The incidence of IPBSN injury was higher in the vertical group (4 patients vs. 10\n patients), but the difference was not statistically significant. The mean of Lysholm and\n VAS scores were the same. Also, the mean of Lysholm score was the same in patients with\n and without IPBSN injury. However, patients without IPBSN injury were more satisfied\n (8.9 ± 9 vs. 7.4 ± 1.1; P < 0.001).

Patients and Methods

There were 60 patients underwent arthroscopically-assisted ACLR assigned to two equal\n vertical or oblique incision groups, randomly. One year postoperatively, the patients\n were electrophysiologically examined to detect whether IPBSN is injured. The Lysholm\n score was completed. The patients' satisfaction with surgical outcomes determined\n utilizing visual analogue scale (VAS). Finally, two groups were compared and the effect\n of IPBSN injury on function and satisfaction was investigated.

Objectives

The main purpose of current study was to compare the incidence of IPBSN injury between\n vertical and oblique incisions utilizing electrophysiological evaluation.

Arthroscopy;Anterior Cruciate Ligament Reconstruction;Medial Hamstring Tendons;Infrapatellar Branch of the Saphenous Nerve Arthroscopy;Anterior Cruciate Ligament Reconstruction;Medial Hamstring Tendons;Infrapatellar Branch of the Saphenous Nerve 118 123 http://www.archtrauma.com/index.php?page=article&article_id=11146 Reza Tavakoli Darestani Reza Tavakoli Darestani Orthopedics Surgery Department, Beheshti University of Medical Sciences , Tehran , IR Iran Orthopedics Surgery Department, Beheshti University of Medical Sciences , Tehran , IR Iran Mohammad Mehdi Bagherian Lemraski Mohammad Mehdi Bagherian Lemraski Orthopedics Surgery Department, Beheshti University of Medical Sciences , Tehran , IR Iran Orthopedics Surgery Department, Beheshti University of Medical Sciences , Tehran , IR Iran Mehrdad Hosseinpour Mehrdad Hosseinpour Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3112335547, Fax: +98-3615620634 Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3112335547, Fax: +98-3615620634 Amin Kamrani-Rad Amin Kamrani-Rad Orthopedics Surgery Department, Beheshti University of Medical Sciences , Tehran , IR Iran Orthopedics Surgery Department, Beheshti University of Medical Sciences , Tehran , IR Iran
en 10.5812/atr.10240 Morphology of Rat Hippocampal CA1 Neurons Following Modified Two and Four-Vessels Global Ischemia Models Morphology of Rat Hippocampal CA1 Neurons Following Modified Two and Four-Vessels Global Ischemia Models research-article research-article Results

In all groups ischemic changes were apparently observed in hippocampus CA1 neurons. In two-vessel occlusion model, after 3 and 24 hours of reperfusions, ischemic cells accounted for 14.9% and 23.2%, respectively. In four-vessel occlusion model, after 3 and 24 hours of reperfusions, ischemic cells accounted for 7.6% and 44.9% (P < 0.0001), respectively.

Background

An appropriate animal model of ischemia stroke is essential for evaluation of different therapeutic methods. Two and four-vessel global ischemia models are one of the most common types of transient cerebral ischemia.

Objectives

In this study, the morphology of rat hippocampal CA1 neurons in modified models of two and four-vessel ischemia and reperfusion were evaluated.

Materials and Methods

In this study, 20 Wistar rats were randomly divided into five groups. In group 2 and 3, both common carotid arteries were occluded for 10 minutes in either 3 or 24 hours of reperfusions, respectively. In group 4 and 5, both common carotid and vertebral arteries were occluded for 10 minutes in either 3 or 24 hours of reperfusions, respectively. Group 1 as control, underwent the whole surgery without any arteries occlusion. Hippocampi of the rats in all groups were processed and tissue sections were stained using the Nissl method. The morphology of CA1 neurons were studied under a light microscope and compared different groups.

Conclusions

Modified four-vessel occlusion model resulted in significant ischemic changes after 24 hours of reperfusion in CA1 neurons of rat hippocampus.

Results

In all groups ischemic changes were apparently observed in hippocampus CA1 neurons. In two-vessel occlusion model, after 3 and 24 hours of reperfusions, ischemic cells accounted for 14.9% and 23.2%, respectively. In four-vessel occlusion model, after 3 and 24 hours of reperfusions, ischemic cells accounted for 7.6% and 44.9% (P < 0.0001), respectively.

Background

An appropriate animal model of ischemia stroke is essential for evaluation of different therapeutic methods. Two and four-vessel global ischemia models are one of the most common types of transient cerebral ischemia.

Objectives

In this study, the morphology of rat hippocampal CA1 neurons in modified models of two and four-vessel ischemia and reperfusion were evaluated.

Materials and Methods

In this study, 20 Wistar rats were randomly divided into five groups. In group 2 and 3, both common carotid arteries were occluded for 10 minutes in either 3 or 24 hours of reperfusions, respectively. In group 4 and 5, both common carotid and vertebral arteries were occluded for 10 minutes in either 3 or 24 hours of reperfusions, respectively. Group 1 as control, underwent the whole surgery without any arteries occlusion. Hippocampi of the rats in all groups were processed and tissue sections were stained using the Nissl method. The morphology of CA1 neurons were studied under a light microscope and compared different groups.

Conclusions

Modified four-vessel occlusion model resulted in significant ischemic changes after 24 hours of reperfusion in CA1 neurons of rat hippocampus.

Hippocampus;Brain Ischemia;Global;Rat Hippocampus;Brain Ischemia;Global;Rat 124 128 http://www.archtrauma.com/index.php?page=article&article_id=10240 Mohammad Ali Atlasi Mohammad Ali Atlasi Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Anatomical Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-9131615603, Fax: +98-3615551112 Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Anatomical Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-9131615603, Fax: +98-3615551112 Homayoun Naderian Homayoun Naderian Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Mahdi Noureddini Mahdi Noureddini Physiology Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Physiology Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Esmaeil Fakharian Esmaeil Fakharian Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Abolfazl Azami Abolfazl Azami Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
en 10.5812/atr.9332 Wandering Spleen in an Adult Man Associated With the Horseshoe Kidney Wandering Spleen in an Adult Man Associated With the Horseshoe Kidney case-report case-report Conclusions

The association of horseshoe kidney with a wandering spleen in this case may be due to an embryological anomaly.

Introduction

A wandering spleen occurs when there is a laxity of the ligaments that fix the spleen in its normal anatomical position.

Case Presentation

This is a case report of a wandering spleen with horseshoe kidney in a 29-year-old male admitted with acute lower abdominal pain and vomiting to emergency department of Shariati hospital in Isfahan province. Sonographic examination showed a homogeneous 21 × 15 × 8 cm mass in the lower part of the abdomen and pelvis associated with a horseshoe kidney. Laparotomy confirmed the clinical and ultrasound findings.

Conclusions

The association of horseshoe kidney with a wandering spleen in this case may be due to an embryological anomaly.

Introduction

A wandering spleen occurs when there is a laxity of the ligaments that fix the spleen in its normal anatomical position.

Case Presentation

This is a case report of a wandering spleen with horseshoe kidney in a 29-year-old male admitted with acute lower abdominal pain and vomiting to emergency department of Shariati hospital in Isfahan province. Sonographic examination showed a homogeneous 21 × 15 × 8 cm mass in the lower part of the abdomen and pelvis associated with a horseshoe kidney. Laparotomy confirmed the clinical and ultrasound findings.

Adult;Horseshoe Kidney;Splenectomy;Wandering Spleen Adult;Horseshoe Kidney;Splenectomy;Wandering Spleen 129 132 http://www.archtrauma.com/index.php?page=article&article_id=9332 Mohammadreza Memari Mohammadreza Memari Najafabad Azad University, Najafabad, IR Iran Najafabad Azad University, Najafabad, IR Iran Mohsen Nikzad Mohsen Nikzad Faculty of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran Faculty of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran Hossein Nikzad Hossein Nikzad Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615550480, Fax: +98-3615550480 Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, IR Iran; Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3615550480, Fax: +98-3615550480 Aliakbar Taherian Aliakbar Taherian Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, IR Iran Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
en 10.5812/atr.11005 Innovative Technique of Vascular Repair in Intra-Operative IVC Rupture During Lumbar Microdiscectomy: A Case Report Innovative Technique of Vascular Repair in Intra-Operative IVC Rupture During Lumbar Microdiscectomy: A Case Report case-report case-report Background

Major vascular injury during a spinal surgery is a rare but most dreaded complication.

Case Presentation

A 39 years old female undergoing microscopic lumbar discectomy suddenly developed severe hypotension on table. The procedure was abandoned and the patient turned supine. It was diagnosed to be a major vessel tear and the patient was taken up for immediate successful vascular repair. To best of our knowledge such a repair procedure has not been described in literature.

Conclusions

Majority of such vascular injuries are dealt with primary repair of the defect by a vascular surgeon; however in our case the rent was big and placed on the undersurface making it very difficult for the vascular surgeon to approach or repair it primarily.

Background

Major vascular injury during a spinal surgery is a rare but most dreaded complication.

Case Presentation

A 39 years old female undergoing microscopic lumbar discectomy suddenly developed severe hypotension on table. The procedure was abandoned and the patient turned supine. It was diagnosed to be a major vessel tear and the patient was taken up for immediate successful vascular repair. To best of our knowledge such a repair procedure has not been described in literature.

Conclusions

Majority of such vascular injuries are dealt with primary repair of the defect by a vascular surgeon; however in our case the rent was big and placed on the undersurface making it very difficult for the vascular surgeon to approach or repair it primarily.

Microdiscectomy Complications;Vascular Injury;Inferior Vena Cava Rupture;Anastomosis;Vascular Bypass Microdiscectomy Complications;Vascular Injury;Inferior Vena Cava Rupture;Anastomosis;Vascular Bypass 133 135 http://www.archtrauma.com/index.php?page=article&article_id=11005 Sandeep Singh Sandeep Singh Primus Super Specialty Hospital, Chankayapuri, New Delhi, India; Primus Super Specialty Hospital, Chankayapuri, New Delhi, India. Tel: +91-9818504323, Fax: +91-1166206650 Primus Super Specialty Hospital, Chankayapuri, New Delhi, India; Primus Super Specialty Hospital, Chankayapuri, New Delhi, India. Tel: +91-9818504323, Fax: +91-1166206650 Arun Bhanot Arun Bhanot Primus Super Specialty Hospital, Chankayapuri, New Delhi, India Primus Super Specialty Hospital, Chankayapuri, New Delhi, India Nipun Bajaj Nipun Bajaj Primus Super Specialty Hospital, Chankayapuri, New Delhi, India Primus Super Specialty Hospital, Chankayapuri, New Delhi, India Pooja Rustagi Pooja Rustagi Primus Super Specialty Hospital, Chankayapuri, New Delhi, India Primus Super Specialty Hospital, Chankayapuri, New Delhi, India
en 10.5812/atr.11376 Application of Queuing Analytic Theory to Decrease Waiting Times in Emergency Department: Does it Make Sense? Application of Queuing Analytic Theory to Decrease Waiting Times in Emergency Department: Does it Make Sense? letter letter Emergency Department;Operations Research;Simulation;Quality Improvement Emergency Department;Operations Research;Simulation;Quality Improvement 136 137 http://www.archtrauma.com/index.php?page=article&article_id=11376 Sean Shao Wei Lam Sean Shao Wei Lam Health Services Research Unit, Singapore General Hospital, Singapore Health Services Research Unit, Singapore General Hospital, Singapore Marcus Eng Hock Ong Marcus Eng Hock Ong Department of Emergency Medicine, Singapore General Hospital, Singapore; Department of Emergency Medicine, Singapore General Hospital, Singapore. Tel: +65-63213590, Fax: +65-63214873 Department of Emergency Medicine, Singapore General Hospital, Singapore; Department of Emergency Medicine, Singapore General Hospital, Singapore. Tel: +65-63213590, Fax: +65-63214873
en 10.5812/atr.10441 Comparison of Analgesic Effect between Gabapentin and Diclofenac on Post-Operative Pain in Patients Undergoing Tonsillectomy Comparison of Analgesic Effect between Gabapentin and Diclofenac on Post-Operative Pain in Patients Undergoing Tonsillectomy letter letter Gabapentin;Diclofenac Gabapentin;Diclofenac 138 139 http://www.archtrauma.com/index.php?page=article&article_id=10441 Mario I Ortiz Mario I Ortiz Medicine Academic Area, Health Sciences Institute at the Autonomous University of Hidalgo State, Pachuca, Hidalgo, Mexico; Medicine Academic Area, Health Sciences Institute at the Autonomous University of Hidalgo State, Pachuca, Hidalgo, Mexico. Tel: +52-7717172000, Fax: +52-7717172000 Medicine Academic Area, Health Sciences Institute at the Autonomous University of Hidalgo State, Pachuca, Hidalgo, Mexico; Medicine Academic Area, Health Sciences Institute at the Autonomous University of Hidalgo State, Pachuca, Hidalgo, Mexico. Tel: +52-7717172000, Fax: +52-7717172000 Luis C Romero-Quezada Luis C Romero-Quezada Medicine Academic Area, Health Sciences Institute at the Autonomous University of Hidalgo State, Pachuca, Hidalgo, Mexico Medicine Academic Area, Health Sciences Institute at the Autonomous University of Hidalgo State, Pachuca, Hidalgo, Mexico