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PubMed2006

[Psychological comparison of patients with soft tissue injuries in oral and maxillofacial region by different kinds of suturing].

OBJECTIVE: To evaluate the psychological situations of patients with soft tissue injuries in oral and maxillofacial region by different kinds of suturing. METHODS: A total of 200 patients were selected and randomly divided into two groups. Group A received intradermic suture while group B underwent para-position suture. All patients were evaluated by hospital anxiety and depression (HAD) scales pre-suture, after one week, one month and three months. RESULTS: The HAD total scores of group B were significantly high compared with group A (P < 0.05) after one week and one month, while there was no difference between group A and group B pre-suture and three months later. CONCLUSIONS: Intradermic suture results in less psychological influence in patients with soft tissue injuries in oral and maxillofacial region.

Adult↗
PubMed1995

Outcome of tibial shaft fractures with severe soft tissue injury treated by unreamed nailing versus external fixation.

MATERIALS: Between 1987 and 1991, 114 fresh tibial shaft fractures with severe soft tissue injury, which met the inclusion criteria, were treated and retrospectively reviewed. There were 48 cases in the unreamed nail (unreamed tibial nail (UTN)) group and 66 cases in the external fixation (EF) group. METHODS: Soft tissue injury was classified by the Gustilo and Tscherne methods. There were 18 AO type A, 56 type B, and 40 type C fractures. There were no significant difference in fracture type, soft tissue injury, age, and additional injury between the groups. Outcome was assessed using the Karlström score after 28 months. RESULTS: There were a significantly higher number of reoperations in the EF group. Mean time to bony healing was 25.8 weeks. In the EF group, there was a 26% rate of pin tract infection, whereas 19% of cases had bolt breakages in the UTN group. In the UTN group, 40% had good results, compared with 27% in the EF group. In the UTN group, there were significantly fewer ante- and recurvatum deformities of more than five degrees. CONCLUSIONS: Treatment of tibial fractures by UTN, compared with EF, gave a lower reoperation rate and better functional outcome.

External Fixators↗
PubMed1995

MR imaging in evaluation of suspected hip fracture: frequency of unsuspected bone and soft-tissue injury.

PURPOSE: To determine the frequency of unsuspected pelvic fracture and soft-tissue injury in patients referred for magnetic resonance (MR) imaging for possible radiographically occult hip fracture. MATERIALS AND METHODS: Seventy patients with symptoms of possible hip fracture but negative plain radiographs were evaluated with MR imaging. Large-field-of-view T1-weighted coronal images were obtained, and additional T2-weighted or short inversion time inversion recovery (STIR) sequences were used. The number of soft-tissue and bone injuries identified was recorded. RESULTS: Eighty percent of patients had bone or soft-tissue abnormalities. Occult femoral and pelvic fractures were demonstrated in 37% and 23% of patients, respectively. Soft-tissue abnormalities were noted in 74% of patients. When a proximal femoral fracture was not present, MR imaging revealed a 27% frequency of occult pelvic fracture and a 50% frequency of bone or soft-tissue abnormality. CONCLUSION: A high prevalence of occult pelvic fracture and soft-tissue injury may be identified with MR studies designed to evaluate occult hip fracture when large-field-of-view T1-weighted coronal sequences are combined with T2-weighted or STIR sequences.

Adult↗
PubMed1995

Treatment modalities for soft tissue injuries of the ankle: a critical review.

We reviewed the English language medical literature on soft tissue injuries of the ankle published between 1966 and 1993. There were 150 articles reviewed of which 84 dealt substantially with ankle soft tissue injuries. The papers were analyzed for quality and it was found that there were significant weaknesses throughout the literature. This related particularly to randomization, blinded assessment, and outcome measures. The results of the treatment of 32,025 patients were reported in 84 studies. We were unable to gather sufficient data from these studies to perform a statistical analysis of the different forms of treatment. Our conclusions were that nonsteroidal antiinflammatory drugs shortened the time period to recovery and were associated with less pain. Active mobilization appeared to be the treatment of choice. Studies also showed that cryotherapy was of benefit and diapulse may be helpful. There was insufficient evidence to conclude that enzyme treatment, topical gels, ultrasound or diathermy, joint aspiration of injection were of benefit. Overall the literature would substantiate active mobilization following ankle sprains with judicious early use of nonsteroidal antiinflammatory drugs and the use of cryotherapy and diapulse in the treatment of ankle injuries. Our study suggests further investigations need to be carried out into the effectiveness and outcomes following alternative forms of therapy for ankle injuries.

Age Factors↗
PubMed1979

[Soft tissue injuries in compound fractures (author's transl)].

Problems in the management of soft tissue injuries in compound fractures are presented. They usually originate from the initial traumatic force, but may be the result of pitfalls of the primary treatment as well. The management of open fractures--as it is performed in this clinic--is presented in detail. After primary stabilization of the fracture attention is directed to the associated soft tissue injuries, which require utmost care in the further course of treatment. Primary wound closure should never be forcefully obtained, since closure under tension will result in severe secondary tissue damage. In our experience temporary open wound treatment and delayed closure is the method of choice in the initial management of open fractures. For temporary cover we successfully use the synthetic skin substitute Epigard. Since we adopted this policy, the rate of infection declined drastically, and anaerobic infections as well as generalized sepsis could be totally avoided.

Debridement↗
PubMed2006

The use of vacuum assisted closure (VAC) in soft tissue injuries after high energy pelvic trauma.

BACKGROUND: Application of vacuum-assisted closure (VAC) in soft tissue defects after high-energy pelvic trauma is described as a retrospective study in a level one trauma center. MATERIALS AND METHODS: Between 2002 and 2004, 13 patients were treated for severe soft tissue injuries in the pelvic region. All musculoskeletal injuries were treated with multiple irrigation and debridement procedures and broad-spectrum antibiotics. VAC was applied as a temporary coverage for defects and wound conditioning. RESULTS: The injuries included three patients with traumatic hemipelvectomies. Seven patients had pelvic ring fractures with five Morel-Lavallee lesions and two open pelviperineal trauma. One patient suffered from an open iliac crest fracture and a Morel-Lavallee lesion. Two patients sustained near complete pertrochanteric amputations of the lower limb. The average injury severity score was 34.1 +/- 1.4. The application of VAC started in average 3.8 +/- 0.4 days after trauma and was used for 15.5 +/- 1.8 days. The dressing changes were performed in average every 3 days. One patient (8%) with a traumatic hemipelvectomy died in the course of treatment due to septic complications. CONCLUSION: High-energy trauma causing severe soft tissues injuries requires multiple operative debridements to prevent high morbidity and mortality rates. The application of VAC as temporary coverage of large tissue defects in pelvic regions supports wound conditioning and facilitates the definitive wound closure.

Adolescent↗
PubMed1992

Prediction of acute renal failure following soft-tissue injury using the venous bicarbonate concentration.

Sixty-four patients with soft-tissue injuries were studied prospectively to determine whether an initial venous bicarbonate concentration (VBC) of less than 17 mmol/L would predict the development of myoglobin-induced acute renal failure. The VBC was > 17 mmol/L in 59 patients, seven of whom had myoglobinuria. All recovered without renal complications. The remaining five patients all had VBC < 17 mmol/L and four had myoglobinuria. Acute renal failure developed in four patients (p < 0.001). The VBC on hospital arrival was the most accurate predictor of these patients' risk for the development of acute renal failure following soft-tissue injury.

Acute Kidney Injury↗
PubMed1991

Prognostic factors in soft tissue injuries of the cervical spine.

A series of 35 patients presenting with soft tissue injuries of the cervical spine were reviewed clinically and radiographically after an average of 10.8 years. Symptoms persisted in 86 per cent and were intrusive or worse in 23 per cent. On presentation, paraesthesia, thoracolumbar back pain and multiple symptoms were predictive of continuing symptoms and their severity. Degenerative changes of the cervical spine were present in 68 per cent of the patients, of whom 87 per cent were symptomatic. Of those with normal radiographs, 80 per cent were symptom-free. Degenerative changes occurred significantly more frequently in patients who had sustained soft tissue injuries than in a control population.

Adult↗
PubMedDate not supplied

The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials.

BACKGROUND: There are wide variations in the clinical use of cryotherapy, and guidelines continue to be made on an empirical basis. STUDY DESIGN: Systematic review assessing the evidence base for cryotherapy in the treatment of acute soft-tissue injuries. METHODS: A computerized literature search, citation tracking, and hand searching were carried out up to April 2002. Eligible studies were randomized-controlled trials describing human subjects recovering from acute soft-tissue injuries and employing a cryotherapy treatment in isolation or in combination with other therapies. Two reviewers independently assessed the validity of included trials using the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Twenty-two trials met the inclusion criteria. There was a mean PEDro score of 3.4 out of of 10. There was marginal evidence that ice plus exercise is most effective, after ankle sprain and postsurgery. There was little evidence to suggest that the addition of ice to compression had any significant effect, but this was restricted to treatment of hospital inpatients. Few studies assessed the effectiveness of ice on closed soft-tissue injury, and there was no evidence of an optimal mode or duration of treatment. CONCLUSION: Many more high-quality trials are needed to provide evidence-based guidelines in the treatment of acute soft-tissue injuries.

Athletic Injuries↗
PubMed2002

Pattern of soft tissue injuries to the oro-facial region in Nigerian children attending a teaching hospital.

OBJECTIVE: This study was designed to determine the aetiological factors and pattern of oro-facial soft tissue injuries among children in a suburban Nigerian population. The problems encountered in the management of the patients are also highlighted. SETTING: Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife, Osun State Nigeria. SAMPLE AND METHODS: This prospective study was carried out in children aged < or = 15 years who presented with oro-facial soft tissue injuries between July 1996 and December 1997. Data was collected from a clinical examination of the child and a questionnaire completed by the parent or carer. RESULTS: During the study period, 174 children were managed for oro-facial soft tissue injuries, an incidence of 1.1%, out of a total of 15 582 child admissions. A male preponderance was found (1 : 0.74). The mean age +/- SD was 7.3 +/- 4.2 years and the range was 9 months-15 years. Falls were the most common aetiology followed by road traffic accident. The forehead was the most frequently injured site. A mortality of 3.4% was found. Although animal bites and burns accounted for only 13.8% of all injuries, all the deaths were a result of these aetiologies. Road traffic accidents and burn victims had the longest hospital stay. CONCLUSION: Although falls and road traffic accidents are frequent causes of oro-facial soft tissue injuries, less common causes, like burns and dog bites are more likely to result in death.

Accidental Falls↗
PubMed1997

[Soft tissue injuries, burns and scars].

The principles of diagnosis and therapy of soft tissue injuries, burns and scars that have been established in the course of many years' experience of facial and plastic surgery are expounded. The goal of early definitive management cannot always be achieved, particularly in the case of burns. Possible consequences are outlined. Recommendations are given, based on analysis of the authors' own case material and taking recent developments into account.

Adult↗
PubMed2000

Epidemiology of musculoskeletal and soft tissue injuries aboard a U.S. Navy ship.

OBJECTIVE: The objective of this study was to characterize injuries occurring to crew members aboard a U.S. Navy ship. METHODS: A retrospective review of crew member medical records was conducted covering a 90-day period during which the ship was intermittently at sea. Data on new injuries were collected and sorted. Injuries were classified as soft tissue or musculoskeletal, acute or overuse, and occurring with the ship at sea or in port. RESULTS: There was a total incidence of 16.5 injuries per 100 man-months. Acute musculoskeletal injuries contributed 2.6 injuries per 100 man-months and resulted in 79 lost and 192.5 modified work days. Overuse musculoskeletal injuries were responsible for 9.3 injuries per 100 man-months and caused 1 lost and 255.5 modified work days. Soft tissue injuries had an incidence of 4.6 injuries per 100 man-months and resulted in no lost and only 106 modified work days. The relative risk of sustaining a soft tissue injury in port compared with at sea was 1.1, but this was not statistically significant. The relative risk of sustaining an acute musculoskeletal injury in port compared with at sea was 3.5 (p = 0.01). CONCLUSIONS: Overuse musculoskeletal injuries occurred with the greatest incidence, but acute musculoskeletal injuries were responsible for the greatest morbidity. Soft tissue injuries occurred with an intermediate incidence but had the lowest overall morbidity. The safest place for crew members assigned to this Navy ship was aboard that ship at sea. Further studies of this nature could help guide medical efforts at injury treatment and prevention for shipboard personnel.

Accidents, Occupational↗
PubMed1985

Fenoprofen calcium versus aspirin in the treatment of acute inflammatory soft-tissue injuries.

The efficacy and safety of fenoprofen calcium (Nalfon, Dista, Indianapolis, IN) and aspirin for treating acute inflammatory soft tissue injuries were compared in a 3 to 10-day randomized, double-blind, parallel study of 100 patients with bruise (1), bursitis (33), ligamentous strain (8), myofascitis (43), and tendinitis (15). Forty-seven of the 50 aspirin-treated and 48 of the 50 fenoprofen-treated patients were evaluable. Results of the study showed that fenoprofen calcium and aspirin were equally effective in treating acute inflammatory soft-tissue injuries; however, adverse experiences occurred in fewer patients and at a lower frequency with fenoprofen calcium therapy. In global assessments, 73% of the patients rated fenoprofen therapy as very good or good compared to 64% of the patients who received aspirin therapy. There were no significant differences in the clinician's and the patients' global assessments of therapy. The study suggests that fenoprofen calcium is effective for use in treating soft-tissue injuries since it is better tolerated than aspirin when given in equally effective doses.

Adult↗
PubMed1975

The significance of soft tissue injury in the roentgen diagnosis of trauma.

Soft tissue damage is an integral part of trauma. This basic fact is commonly ignored in the evaluation of roentgenograms obtained because of trauma. The soft tissue component of the traumatic lesion may produce the most obvious roentgen sing of injury and is, in these instances, fundamental to the correct roentgen diagnosis. In many instances, the soft tissue lesion is frequently of greater clinical significance that the more obvious skeletal injury. An awareness of the roentgen signs that signal soft tissue injury, and of those skeletal lesions that are commonly associated with radiographically silent, but clinically more significant, soft tissue damage, leads to prompt institution of appropriate additional diagnostic studies or therapeutic measures. Thus, the soft tissue injury in the roentgen diagnosis of trauma has both diagnostic and therapeutic significance. Each will be discussed in this article.

Abdominal Injuries↗
PubMed2005

[Clinical observation on Ashi points Sihua needling method for treatment of acute soft tissue injury].

OBJECTIVE: To observe therapeutic effect of Ashi points Sihua needling method for treatment of acute soft tissue injury. METHODS: The patients were randomly divided into a treatment group (n = 105) and a control group (n = 108). They were treated respectively with Ashi points Sihua needling method and routine needling method. Their therapeutic effects and safety were assessed. RESULTS: The cured rate was 79.0% in the treatment group, better than 65.7% in the control group (P < 0.05); after treatment, the improvement degrees of pain, dysfunction and the total cumulative score in the treatment group were better than those in the control group (P < 0.05 or P < 0.01); the treatment group produced more quickly the effect with a shorter cured period as compared with the control group (P < 0.05 or P < 0.01). CONCLUSION: Ashi points Sihua needling method is safe and effective for acute soft tissue injury.

Acupuncture Points↗
PubMed2005

Facial soft tissue injuries as an aid to ordering a combination head and facial computed tomography in trauma patients.

PURPOSE: While the trauma computed tomography (CT) head scan is frequently ordered during resuscitation of multiply injured patients, determining when also to order facial CT in these situations can be difficult. Consequently, facial fractures are commonly missed on initial imaging evaluation. In acute trauma situations, facial soft tissue injury markers are often used to aid in this decision. A study was undertaken to identify exactly which facial soft tissue injuries correlate with facial fractures and which did not. The aim of our research was to compare the facial soft tissue injury patterns of patients receiving a combination head and facial CT who had facial fractures versus those who had no facial fractures. PATIENTS AND METHODS: A retrospective trauma registry review was performed for a 5-year period at Legacy Emanuel Hospital, a level 1 trauma center. The trauma team saw a total of 9,871 trauma patients and 49.9% required head CT as part of their initial evaluation. A total of 777 (15.7%) patients had a combination head and facial CT in which 477 (61.4%) had a facial fracture and 300 (38.6%) had no facial fracture. Statistical significance was established using Bonferroni corrected P values less than .05. RESULTS: Lacerations occurring in areas of the lips, nose, and intraorally, as well as wounds leading to periorbital contusion and subconjunctival hemorrhage, were significantly prevalent in the fracture group. Conversely, scalp lacerations and scalp contusions were significantly higher in the nonfracture group. Other injuries such as lacerations of the tongue, chin, forehead, cheek, ear, eyelid, and eyebrow were indistinguishable between both groups. CONCLUSIONS: Our data demonstrate that there are certain facial soft tissue injury zones that correlate with facial fractures in trauma patients who obtain head CT. We would like to propose that the acronym LIPS-N (Lip laceration, Intraoral laceration, Periorbital contusion, Subconjunctival hemorrhage, and Nasal laceration) be used in conjunction with a physical examination when assessing if a trauma patient who is getting head CT should also get facial CT.

Abbreviations as Topic↗
PubMed1977

Management of soft tissue injury.

The fate of a surgical wound is held in a delicate balance between the host's resistance to infection and the causal factors of infection. Considerable insight into this relationship between the host and pathogen can be gained from the results of quantitative bacteriologic measurements. Newer rapid slide techniques have been developed which provide the surgeon with this information within 20 minutes. In most soft tissue injuries, the wound bacterial count gives an accurate prediction of subsequent infection. Wounds combining greater than 10(5) bacteria per gram of tissue are destined to develop infection. When the bacterial count is below that level, the wounds will usually heal per primam without infection. This large number of bacteria required to elicit infection reflects the remarkable ability of soft tissues to resist infection. This state of high resistance to infection can be reduced by several factors which include circulatory embarrassment, tissue injury, dead space, and the presence of foreign bodies (dirt, sutures, drains, etc.). When treating soft tissue injuries, the surgeon must employ specific therapeutic modalities that allow the wound to heal per primam without infection. On the basis of experimental studies supported by clinical experience, the following treatment protocol for soft tissue injuries is recommended. Using strict aseptic technique, the wound must be first anesthetized with 1 per cent Xylocaine to permit painless sound cleansing. All wounds should be subjected to high pressure syringe irrigation to remove bacteria, foreign bodies, and blood clots. When necessary, debridement of all devitalized tissue should be performed with a stainless steel scalpel. Many wounds caused by sharp wounding agents contain no foreign bodies and few bacteria and exhibit considerable resistance to infection. In these wounds, primary closure can be initiated after irrigation without the development of infection. Wounds resulting from impact forces have a diminished resistance to infection and are susceptible to infection by low level of bacterial contamination. Immediate antibiotic treatment of patients with impact injuries subjected to meticulous debridement and cleansing will permit a safe primary closure. In wounds contacted by pus or feces, open wound management followed by delayed primary closure is usually indicated. Antimicrobial prophylaxis is also recommended for patients with such wounds. Ideal postoperative care of all traumatic wounds includes a surgical dressing and immobilization and elevation of the site of injury.

Anesthesia, Local↗
PubMed1994

Tibial plateau fractures: a study of associated soft tissue injuries.

Tibial plateau fractures can occur concomitant with injuries to the collateral and cruciate ligaments, menisci, and surrounding nerves and arteries. The purpose of this article is to record the frequency of these soft tissue injuries with tibial plateau fractures. Patients with plateau fractures were entered into a prospective protocol consisting of radiographic evaluation, Schatzker classification, pre- and postfixation stress testing, and diagnostic arthroscopy. Thirty tibial plateau fractures were evaluated in this study. There was a 56% (17 of 30) frequency of associated soft tissue injuries in this series of tibial plateau fractures. The medial collateral ligaments were injured in 20% (six of 30), the lateral collateral ligaments in 3% (one in 30), the menisci in 20% (six in 30), the peroneal nerve in 3% (one in 30), and the anterior cruciate ligaments in 10% (three in 30). Schatzker type IV and type II fracture patterns were associated with the highest frequency of soft tissue injuries. Medical collateral ligament injuries were most commonly associated with Schatzker type II fracture patterns. Menisci were most commonly injured with Schatzker type IV fracture patterns. Based on the findings, routine arthroscopy should be indicated in nondisplaced Schatzker type I fractures. Pre- and postfixation stress testing should be performed to diagnose collateral and cruciate ligament injuries.

Adult↗