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At least 1,153 records · Page 64Linked to original sources
PubMed1997

The lumbosacral lucent cleft.

BACKGROUND: The lumbosacral lucent cleft was first described in association with traumatic injuries to the neck. However, we have observed this sign to be present in patients with no precursor of trauma, and we reviewed the incidence of lucent cleft sign in our local population and any characteristic features of the lucent cleft. METHODS: Four-hundred and thirty lumbosacral spine radiographs were examined prospectively over an 8-month period, with correlation with clinical findings. Follow-up radiographs were obtained at 1, 3 and 6 months for patients with the lucent cleft sign. FINDINGS: Nineteen patients (4.4%) were found to have lucent clefts in their lumbosacral spine X-rays. No significant change in the number and features to the lucent clefts was noted even when the symptoms had resolved after 6 months. All the lucent clefts were linear, horizontally oriented and located at the anterior edge of the adjacent vertebral body. CONCLUSION: The lucent cleft sign in the spine, which has so far been described in association with has spinal trauma may be completely innocuous in patients with little or no symptoms.

Adolescent↗
PubMed1995

[Otoneurological syndromes after cervical injuries].

The aim of the work was the examination of vestibular and visual disturbances in patients after whiplash injury of the neck. The authors are of the opinion, that estimation of peripheral and central vestibular disorders are useful for defining of the clinical state of these patients.

Adolescent↗
PubMedDate not supplied

Forces, moments, and acceleration acting on a restrained dummy during simulation of three possible accidents involving a wheelchair negotiating a curb: comparison between lap belt and four-point belt.

The objective of this study was to determine the effect of two types of restraining belts (lap belt and a four-point belt) on an instrumented dummy during three situations: wheelchair hitting straight into curb (SIC); wheelchair falling straight off a curb (SOC); wheelchair falling diagonally off a curb (DOC). A fully instrumented (50th percentile Hybrid III) dummy was seated in a standard wheelchair and restrained with one of the belts. The wheelchair rolled down a ramp reaching a platform at 2.4 miles per hour (comfortable walking speed). Three types of experiments were performed: SIC, SOC, DOC. Each experiment was repeated at least three times. Forces, moments, and acceleration were monitored and recorded via 48 sensors placed at the head, spine, and limbs. All experiments were videotaped and photographed. The data were averaged and compared with standards that have been previously established in car crash testing and with data recently obtained in a similar study using a nonrestrained dummy. Our results showed that in the SIC experiments, low magnitude forces, moments, and acceleration of no clinical significance were recorded with both types of belts. The wheelchair remained upright and the dummy safely seated. In the SOC experiments, the two belts prevented the dummy's ejection from the chair and, thus, have been effective in lowering the forces, moments, and acceleration and preventing significant injuries to the head and neck regions. In the DOC experiments, the lap belt proved to be somewhat more effective than the four-point belt in lowering the extension forces at the upper neck and the moments at the lower neck below injury levels. It also kept the head injury criteria well below injury level. We postulate that the four-point belt was less effective because of its more extensive body fixation, which leads to concentration of moments and forces at the head and lower neck regions. The results of this study show that restraining systems can enhance the safety of wheelchair occupants in certain incidents. It has been demonstrated that the lap belt is as effective as the four-point belt system in SIC and SOC incidents. In DOC falls, neither belt could prevent falls and trauma to the head and neck region. The lap belt, however, was somewhat superior. We recommend that wheelchairs be equipped with a lap belt and patients be encouraged to buckle-up while using the wheelchair outdoors.

Acceleration↗
PubMed2001

Air-gun pellet injuries to the head and neck in children.

Air-gun pellet injuries to the head and neck are seldom reported in pediatric practice, although they typically occur in children. The adult skeleton stops these projectiles, but they can easily transverse the thin bones of children. If unnoticed, these apparently trivial injuries may have catastrophic consequences. We report three children who sustained a central nervous system injury resulting from a shot by a compressed-air gun. The true nature and extent of the lesion in two infants was established only by neuroradiological investigations. We also briefly review the management and prevention of this type of injury.

Adolescent↗
PubMed2001

Soft tissue injuries to face and neck: early assessment and repair.

The principles of assessment and repair of soft tissue trauma of the face are outlined. The importance of an adequate preoperative evaluation is emphasized. Recognizing lesions in the deep vital structures is extremely important in the initial approach to these patients. The postoperative care and the best management of the sequelae are described.

Facial Injuries↗
PubMed2006

Predictors of persistent neck pain after whiplash injury.

OBJECTIVE: To establish the aetiological influences of persistent neck pain following a motor vehicle collision and to construct a model for use in the emergency department for identifying patients at high risk of persistent symptoms. DESIGN: Prospective cohort study. Patients recruited from hospital emergency departments were sent a questionnaire to gather information on various exposures. They were followed up at 1, 3, and 12 months to identify those with persistent symptoms. MAIN OUTCOME MEASURE: Persistent neck pain (pain at 1, 3, and 12 months after collision). RESULTS: The baseline survey included 765 patients. Subsequently, 480 completed a questionnaire at each follow up time point, of whom 128 (27%) reported neck pain on each occasion. Few collision specific factors predicted persistent neck pain. In contrast, a high level of general psychological distress, pre-collision history of widespread body pain, type of vehicle, whiplash associated symptoms, and initial neck disability best predicted the persistence of symptoms. Furthermore, these factors, in combination, accounted for more than a fivefold increase in the risk of persistent neck pain. CONCLUSION: The greatest predictors of persistent neck pain following a motor vehicle collision relate to psychological distress and aspects of pre-collision health rather than to various attributes of the collision itself. With these factors, and those relating to initial injury severity, it is possible to identify a subgroup of patients presenting with neck pain with the highest risk of persistent symptoms. Thus, it is possible to identify whiplash patients with a poor prognosis and to provide closer follow up and specific attention to management in these individuals.

Accidents, Traffic↗
PubMedDate not supplied

Bilateral femoral neck fractures after electrical injury: a case report and literature review.

Simultaneous bilateral fractures of the femoral necks are rare injuries, especially when there is no underlying pathologic condition. A review of the literature revealed only 10 cases of this injury as a result of trauma, only one of which was due to accidental electric shock. A second case in which such an injury was caused by accidental electric shock is presented here. It is important to be aware of this injury and to diagnose it early to avoid the increased risk of complications after a delay in diagnosis or treatment.

Adult↗
PubMed1997

Air-gun pellet injuries to the head and neck.

BACKGROUND: Air-gun pellet injuries (AgPI) of the central nervous system (CNS) are rare but catastrophic events. They occur mostly in children and young adults. The entrance is usually either through the orbit or through the neck and the entry wound is so small that it may be disregarded on physical examination in the emergency room. Early recognition and correct management of the possible complications of AgPIs is important and may prevent a poor outcome. METHODS We intend to present our experience with 16 cases of AgPIs of the head and neck referred to the department of neurosurgery during the last 15 years. The characteristic findings on physical examination of the cases and the imaging studies performed are described. Special management undertaken for the rare complications are mentioned and a short literature review is performed on each entity. RESULTS All our cases happened in the first and second decades of life and only in boys playing with toy guns. There were 12 head and face and four neck wounds. Damaged globe that had to be exenterated was the earliest complication, handled by ophthalmologists (four cases). Cerebrospinal fluid (CSF) leakage, meningitis, brain abscess formation, development of traumatic aneurysm (TA), carotid-cavernous sinus fistula (CCF), wandering intracerebral and intraventricular pellet, and splitting of the pellet after striking hard bone were the complications noted. In addition to plain X-ray films, computed tomography (CT) scanning and angiography were diagnostic procedures of choice. CONCLUSIONS The present series of patients is the largest collection of AgPIs to the head and neck reported in the literature in which nearly all the possible complications of such injuries have been reviewed. Early recognition and awareness of the possible cumbersome complications of such a minor penetrating wound can prevent major catastrophies in this young group of victims.

Adolescent↗
PubMed1989

Management of maxillofacial and neck soft-tissue injuries.

Maxillofacial injuries sustained during sporting events may involve any variety of soft-tissue or bony injuries. As in any traumatized patient, more extensive injuries must be excluded and the basic principles of maintaining an airway and restoration of circulation maintained. The face and neck take on a particular significance when one considers the complexity of function and significant aesthetic value of the structures of the face and neck. Careful inspection, palpation, and examination of function assure the accurate diagnosis of injuries. Specific injuries to the specialized areas of the face and neck are discussed with particular attention to the potential underlying injuries to the facial nerves, parotid duct, and lacrimal systems. The importance of recognizing septal nasal hematomas and external ear hematomas are discussed.

Athletic Injuries↗
PubMed2005

Factors predicting outcome after whiplash injury in subjects pursuing litigation.

Records of 277 patients presenting for medicolegal reporting following isolated whiplash injury were studied retrospectively. A range of pre-accident, accident and response variables were recorded. Multivariate analysis was used to determine the main factors that predict physical and psychological outcome after whiplash injury. The factors that showed significant association with poor outcome on both physical and psychological outcome scales were pre-injury back pain, high frequency of General Practitioner attendance, evidence of pre-injury depression or anxiety symptoms, front position in the vehicle and pain radiating away from the neck after injury. The strongest associations were with factors that are present before impact. In this selected cohort of patients, there is a physical and a psychological vulnerability that may explain the widely varied response to low violence indirect neck injury.

Accidents, Traffic↗
PubMed2002

On field evaluation and management of head and neck injured athletes.

Cervical spine injuries, although relatively uncommon, can be devastating. Proper and prompt management is absolutely essential, even though the complexity of the brain and the lack of objective signs and symptoms make injury assessment difficult. Being prepared for head and neck injury is key to its on-field management. In the event of an injury, the equipment needed to evaluate, and if necessary, to transport the injured athlete must be available. The most important objective of on-field management of head and neck injuries is to prevent further damage and recurrent injury.

Athletic Injuries↗
PubMed2004

Injuries among skiers and snowboarders in Quebec.

BACKGROUND: Snow sports such as skiing and snowboarding are recognized as hazardous, but population-based injury rates or specific risk factors have been difficult to estimate as a result of a lack of complete data for both numerator and denominator. METHODS: We used data from 3 surveys to estimate the number of participants and annual number of outings in Quebec by age, sex, activity, and calendar year. Injuries reported by ski patrollers were used to estimate injury rates among skiers and snowboarders for the head and neck, trunk, upper extremity, and lower extremity. RESULTS: Head-neck and trunk injury rates increased over time from 1995-1996 to 1999-2000. There was a steady increase in the rate of injury with younger age for all body regions. The rate of head-neck injury was 50% higher in snowboarders than in skiers (adjusted rate ratio [ARR] = 1.5; 95% confidence interval = 1.3-1.8). Women and girls had a lower rate of head-neck injury (0.73; 0.62-0.87). Snowboarders were twice as likely as skiers to have injuries of the trunk (2.1; 1.7-2.6), and more than 3 times as likely to have injuries of the upper extremities (3.4; 2.9-4.1). Snowboarders had a lower rate of injury only of the lower extremities (0.79; 0.66-0.95). Snowboarder collision-related injury rates increased substantially over time. CONCLUSIONS: Except for lower extremity injuries, snowboarders have a higher rate of injuries than skiers. Furthermore, collision-related injury rates have increased over time for snowboarders. Targeted injury prevention strategies in this group seem justified.

Adolescent↗