Biomedical subjects

Howard R Epps

Publications and source records attributed to Howard R Epps.

4 recordsLinked to original sources

PubMed2005

Compartment syndrome in children and adolescents.

BACKGROUND: The authors performed a computerized search of the National Pediatric Trauma Registry for all patients who had compartment syndrome during a 51-month period. METHODS: One hundred thirty-three cases were identified. Boys outnumbered girls 4 to 1. The median age was 12 years and the peak incidence was in the 10- to 14-year-old age group. RESULTS: The most common mechanisms of injury were pedestrians struck by motor vehicles, falls, sports, and occupants in motor vehicle crashes. Eighty-five percent of the cases were the sequelae of fractures. Forearm fractures were the most common cause in the upper extremity, and tibia and/or fibula fractures were most common in the lower extremity. CONCLUSIONS: Open fractures significantly increased the risk of developing a compartment syndrome for both forearm and leg fractures. Sixty percent of the patients went directly from the emergency room to the operating room, suggesting that the others developed the compartment syndrome after admission, or had delayed diagnosis.

Accidents↗

PubMed2005

Communication skills.

Surveys of American Academy of Orthopaedic Surgeons members and patients indicate that orthopaedic surgeons are "high tech, low touch." According to patients and colleagues surveyed, orthopaedic surgeons are given high ratings by patients and colleagues for their skills in the operating room, but their listening and communication skills can be improved upon; they could listen better and show more empathy for their patients. Communication affects patient satisfaction, adherence to treatment, and physician satisfaction. Communication problems have also been cited as the most common factor in the initiation of malpractice suits. All orthopaedic surgeons can benefit from improving their communication skills.

Communication↗

PubMed2004

Bilateral femoral neck fractures after pelvic irradiation.

Our patient, who had no history of trauma, developed bilateral femoral neck fractures several years after pelvic irradiation. The well-documented sequelae of femoral neck fractures include avascular necrosis, nonunion, and malunion. Postirradiation pelvic pain, particularly in the absence of trauma, should be aggressively evaluated. With high clinical suspicion and normal plain radiographs, MRI can be used to exclude potentially serious fractures.

Aged↗

PubMedDate not supplied

Mangled extremity severity score in children.

Treatment of the severely traumatized or mangled lower extremity poses significant challenges. The Mangled Extremity Severity Score (MESS) is a scale that uses objective criteria to assist with acute management decisions. Most research on the MESS has been in adults or combined series with few children. The study was performed to investigate the MESS in children exclusively. The MESS was applied retrospectively to 36 patients with grades IIIB and IIIC open lower extremity fractures collected from two level 1 pediatric trauma centers. Patients were divided into limb salvage and primary amputation groups based on the decision of the treating surgeon. In the salvage group there were 18 grade IIIB fractures and 10 grade IIIC fractures. The MESS prediction was accurate in 93% of the injured limbs. In the amputation group eight limbs met the inclusion criteria; the MESS agreed with the treating surgeon in 63% of cases. These findings suggest the MESS should be considered when managing a child with severe lower extremity trauma.

Amputation, Surgical↗