Type Of Traumatic Injury Research Articles

Laser photobiomodulation for chemical stomatitis in intensive care patient: Case report

Chemical stomatitis is a type of traumatic injury caused by contact of chemical substances and drugs with oral tissues, resulting in clinically significant damage. This case reports a 14-year-old male patient with chronic kidney disease on renal replacement therapy (peritoneal dialysis) and using calcium carbonate via oral capsules for treatment. Due to peritoneal dialysis complications, the patient developed bacterial peritonitis, requiring intensive care unit admission and alteration of his dialysis therapy mode to hemodialysis. During the hospitalization period, significant oral lesions developed due to inadequate calcium carbonate administration, interfering with the evolution of the patient’s general health and requiring the assistance of a dental team for diagnosis and treatment. The patient was diagnosed with chemical stomatitis. During the clinical examination, ulcerated, bleeding lesions were observed on the lip, jugal mucous membranes, hard palate, and soft palate. Laser photobiomodulation was used as a treatment associated with a topical corticosteroid. Each region received ten 1 J/point, and 60 J of energy were delivered per day/session. In total, 480 J of energy were delivered with a total irradiation time of 4800 s. The patient reported considerable improvement in pain symptoms after the first laser-photobiomodulation session. After 8 sessions, the patient had improved, and laser photobiomodulation proved effective for treating oral lesions.

ANALYSIS OF CLINICAL AND ANATOMICAL CHARACTERISTICS OF TRAFFIC INJURIES IN THE CONDITIONS OF THE REGIONAL CITY. REPORT THREE: SEVERITY OF DAMAGE

Abstract. Road tra ffi c injury, like other types of traumatic injuries, has a rather complex clinical characteristic and is multicomponent. The purpose of the study: To verify and form the clinical characteristics of injuries in victims of tra ffi c accidents in the conditions of a regional city. Material and methods. A retrospective analysis of 242 cases of victims who were injured as a result of a traffi c accident and were treated in the emergency medical hospital of Chernivtsi from 2019 to 2020 was conducted. The research array was formed by the method of irreversible randomization using the methodology of random numbers. The results. As a result of the study, it was found that in the conditions of the regional city, 66.11 % of the victims of road accidents receive an injury with a severity of damage of more than 16 points according to the standardized scoring system NISS, i. e. polytrauma. In the general array of the study, the highest mortality rate was recorded in victims with an injury severity of 45-75 points and 34-45 points (33.34 % and 30.30 %, respectively). Among drivers, damage with a severity of up to 24 points according to the standardized scoring system NISS (light injury) is 76.13 %, among passengers – 67.04 %, and among pedestrians – 51.51 %. Severe (35-44 points) and extremely severe injury (45-75 points) together have the same weight: for drivers – 10.23 %, for passengers – 13.64 %, for pedestrians – 31.82 %, i. e. pedestrians receive more serious injuries, and the sign of participation in traffi c has a probable infl uence on the severity of injuries in victims of tra ffi c accidents. Pedestrian survivors have the highest number of injuries with NISS severity of 16-24 points – 39.62 %, drivers and passengers – up to 16 points (46.83 % and 42.85 %, respectively). In the array of dead pedestrians and passengers, the highest specifi c weight is given to victims with a severity of 45-75 points (38.46 % and 36.37 %, respectively), and drivers with a severity of damage of 35-44 points – 33.34 %, that is, a sign of participation in traffi c and the severity of damage have a probable infl uence on the occurrence of a negative result of the course of the traumatic process. Conclusions. For the victims of road accidents in the conditions of the regional city, in general, a relatively mild injury is characteristic – up to 34 points, 82.65 %, and an injury up to 16 points is 33.89 %. It was established that the severity of damage depends on the sign of participation in tra ffi c: the most severe injuries are sustained by pedestrians (specifi c weight of severe and extremely severe injuries – 31.82 %), the least severe – drivers, 10.23 %. It was established that the severity of damage in victims of traffi c accidents in the conditions of a regional city obviously depends on participation in traffi c and is a signifi cant factor in the occurrence of mortality.

Epidemiology and outcomes of geriatric trauma patients consulting at the center hospitalier universitaire de Kigali emergency department

BackgroundLife expectancy in low- and middle-income countries (LMIC) continues to rise, resulting in a growing geriatric population. In Rwanda, a sub-Saharan LMIC, traumatic injuries are a common cause of mortality and morbidity. However, little is known about the frequency and type of traumatic injuries among geriatric populations in Rwanda. ObjectiveWe explored the epidemiology and outcomes of trauma for geriatric patients presenting to the emergency department (ED) of the center Hospitalier Universitaire de Kigali (CHUK) in Rwanda. MethodsThis prospective cross-sectional study was conducted from July 2019 to January 2020 at the ED of CHUK. Trauma patients aged 65 and above and alive at the time of evaluation were eligible for inclusion. Demographic characteristics were collected along with triage category, mechanism of injury, transfer status, transport method to CHUK, time spent at the ED, complications, and mortality predictors. ResultsFor the 100 patients enrolled, the most common injury mechanism was falls (63%), followed by road traffic accidents (28%). The majority of patients spent less than 48 h in the ED (63%). The mortality rate was 14%, with most deaths resulting from injury-related complications. Triage category, Kampala Trauma Score, and Glasgow Coma Scale were significant predictors of mortality, with p-values of 0.002, <0.001, and <0.001, respectively. ConclusionsThe epidemiology of geriatric trauma found in this study can inform public health and clinical guidelines. Interventions targeting falls and road traffic accidents would target the most common geriatric trauma mechanisms, and clinical protocols that take into account predictors of mortality could improve outcomes and increase life expectancy for this population.

Unusual causes for meralgia paresthetica: systematic review of the literature and single center experience.

Meralgia paresthetica is often idiopathic, but sometimes symptoms may be caused by traumatic injury to the lateral femoral cutaneous nerve (LFCN) or compression of this nerve by a mass lesion. In this article the literature is reviewed on unusual causes for meralgia paresthetica, including different types of traumatic injury and compression of the LFCN by mass lesions. In addition, the experience from our center with the surgical treatment of unusual causes of meralgia paresthetica is presented. A PubMed search was performed on unusual causes for meralgia paresthetica. Specific attention was paid to factors that may have predisposed to LFCN injury and clues that may have pointed at a mass lesion. Moreover, our own database on all surgically treated cases of meralgia paresthetica between April 2014 and September 2022 was reviewed to identify unusual causes for meralgia paresthetica. A total of 66 articles was identified that reported results on unusual causes for meralgia paresthetica: 37 on traumatic injuries of the LFCN and 29 on compression of the LFCN by mass lesions. Most frequent cause of traumatic injury in the literature was iatrogenic, including different procedures around the anterior superior iliac spine, intra-abdominal procedures and positioning for surgery. In our own surgical database of 187 cases, there were 14 cases of traumatic LFCN injury and 4 cases in which symptoms were related to a mass lesion. It is important to consider traumatic causes or compression by a mass lesion in patients that present with meralgia paresthetica.

Head Injury and Intracranial Hemorrhages: A CT Imaging Study of Trauma Patients

Objective: To find out how frequently patients who have experienced head trauma have intracranial bleeding on computed tomography imaging.&#x0D; Materials and Methods: The study comprised 165 individuals with a history of trauma, all of whom had computed tomography. The brain was imaged using axial plane computed tomography without contrast, with slices 10mm thick from the foramen magnum to the vertex. SPSS version 22 was used for data analysis. All numerical values, including age, were given a mean and standard deviation. All qualitative variables, including gender, head injury, injury type, and cerebral hemorrhage, were calculated using frequencies and percentages.&#x0D; Results: 25 (15.3%) of the 165 head injury patients had traumatic intracranial bleeding visible on a computed tomography scan. In the 25 patients, there were 9 (36%) subdural hemorrhages, 5 (20%) subarachnoid hemorrhages, 7 (28%) epidural hemorrhages, and 4 (16%) intraparenchymal hemorrhages. The 165 patients had 71 (43.1%) road traffic accidents, 39 (23.6%) history of falls, and 55 (33.33%) other types of traumatic injuries. It was found that the age range of 16 to 30 years had the highest frequency of cerebral bleeding. Intracranial hemorrhage was more common in men (72%) than in women.&#x0D; Conclusion: According to this study, a CT scan revealed intracranial hemorrhages in 15.3% of head injury patients. The most frequent type of hemorrhage in this study was subdural. Compared to other traumatic injuries, the presence of cerebral bleeding was most frequently related to traffic accidents.

MICROSCOPIC CHANGES IN THE LIVER OF RATS IN MODELED BLUNT ABDOMINAL TRAUMA COMPLICATED BY EXTERNAL AND INTERNAL BLEEDING AND UNDER CONDITIONS OF CORRECTION

Abdominal trauma is a type of traumatic injury that occurs in the abdomen and is divided into open and closed. Closed abdominal trauma involves damage to the parenchymal organs, in particular the organs of the hepatobiliary system. Histological changes in the liver can vary depending on the level of damage and traumatic mechanism. In case of signifi cant damage to the parenchyma and stroma of the organ, processes such as hypoxia, hypertrophy and hemorrhage occur.Objective. To determine the morphological changes in the liver of rats under conditions of closed abdominal trauma complicated by external and internal bleeding and correction with arminids. Material and Methods. The experimental study was performed on 132 sexually mature white male rats. Blunt abdominal trauma (BAT) was infl icted by a solid object with a fl at nozzle and energy of 0.7 J under general anesthesia with thiopental sodium. The experimental animals were divided into 4 groups: 1 – intact group, 2 – BAT and where extensive external bleeding was caused by transection of the femoral vein, 3 – BAT where bleeding was caused from the femoral vein, then blood from the wound in the volume of 20 % of the circulating blood was taken into a syringe and injected intraperitoneally, 4 – group with correction with arminide. For microscopic studies, the liver was sampled in accordance with the generally accepted methodology. Histological slides of liver that were examined from laboratory rats of the control group showed a typical lobular structure of the organ. In the second experimental group, signifi cant vascular disorders in the liver, central vein hemorrhage, disorganization of hepatic lining, hepatocyte dystrophy occurred after 7 days, and after 14 days, alternative changes in hepatocytes in peripheral areas of portal tracts, dilated lumens of central arteries were detected. Under the conditions of application of the correction factor, after 7 days, destructive changes in hepatocytes, vascular disorders, macrophage reaction were established, and on day 14, remodeling of the organ’s vessels was less than in the previous period, the manifestations of discomplexity of the beams of hepatocytes of the liver lobe, their dystrophy were partially reduced, binuclear hepatocytes and cells with mitotic fi gures were more often detected, indicating the activation of regenerative processes.Conclusions. The histoarchitectonics of the liver of experimental animals modeled with blunt abdominal trauma, external and internal bleeding after 7 days of experiment underwent the most prominent dystrophic and necrotic changes in hepatocytes among all groups of observations, extensive histoleukocyte clusters and macrophages in the portal tracts, against the background of deep circulatory disorders with the formation of hemorrhages on 14th day. In the group of animals modeled with blunt abdominal trauma, external and internal bleeding and under the conditions of the corrective drug administration both on 7th day and to a greater extent on day 14th, a lesser degree of dystrophic- necrotic changes in hepatocytes was found, the macrophage reaction decreased, hemodynamics of the organ and the integrity of the vessel wall were partially restored, indicating the activation of the regenerative potential of the organ.

The Burden of Geriatric Trauma at the University College Hospital, Ibadan Nigeria.

Geriatric populations presently account for 9% of the world population and this is expected to increase. Injuries to the elderly accounted for 5.8 million accident and emergency visits in the US as well as 4% of patients treated for traumatic injuries in Abuja, Nigeria. Traumatic injury is therefore a major cause of morbidity in the elderly as such the need for the study in our environment. The aim of this study was to review the incidence and types of traumatic injury among the elderly population that presented at the University College Hospital Ibadan and to determine the causes of traumatic injury involving the geriatric age group in our environment. A retrospective hospital-based study involving the records of geriatric patients that presented with traumatic injuries between January 2014 and June 2021 at the geriatric center and the accident and emergency department of the hospital. The record was retrieved from the Total Quality Management Unit of the hospital. Approximately 7.61% of the traumatic injury that presented at the accident and emergency department within the study period involved geriatric patients with a male-to-female ratio of 1:1.08, whereas 0.3% of the patients for inpatient care at the geriatric center had a traumatic injury. Fall was the most common cause of traumatic injury observed and fracture was the most common traumatic injury observed. Less than 10% of the patients with the traumatic injury that presented at the University College Hospital Ibadan are in the geriatric age group. Most of the traumatic injury involving geriatric patients in our environment is due to low energy falls and fracture is the most common injury observed with the femur being the most affected bone. Therefore, interventions directed at reducing the incidence of falls in our environment will hopefully help in reducing the incidence of traumatic injuries in older person.

A medicolegal evaluation of geriatric cases with traumatic injuries.

The morbidity and mortality of traumatic injuries are higher in individuals aged >65 years, which are a population group showing an increase worldwide, compared to other age groups. The aim of this study was to compare the medicolegal aspects, such as abuse of the elderly with the morbidity and mortality rates of injuries resulting from trauma by examining the age, gender, trauma history, type of traumatic injury, clinical progress following injury, elderly abuse, and the care environment of the person in cases aged 65 years and older. In this cross-sectional and descriptive study, a retrospective examination was made of the electronic and physical patient files of patients aged 65 years and older who presented at the Emergency Department of Blacksea Tecnical Univercity Medical Faculty Farabi Hospital between 2019 and 2020. Of the 647 patients who presented because of trauma, 384 (59.4%) were male and 263 (40.6%) were female. The leading cause of trauma was a same-level fall in 244 (37.7%) cases, followed by piercing or cutting injuries in 123 (19.0%), and a fall from height in 80 (12.4%) cases. Same-level falls and burns injuries were determined at a statistically significantly higher rate in females (p<0.001). Abuse of the elderly and the mechanisms of all traumas, primarily falls as the most common cause of geriatric trauma, are a subject that should be addressed in terms of forensic medicine. Preventative measures against trauma should be implemented and reviewed for the elderly, and health-care personnel should take responsibility for the legal reporting of forensic traumatic injuries.

Pathological Mechanisms and Additional Factors Involved in Complex Neck Traumatology

Background. Cervical trauma can be closed or open, have different degrees of severity, incidence rates, prevalence, or mortality, with variations in the presence of demographic factors. The different types of traumatic injuries have a certain pattern of occurrence depending on criteria related to sex, age, alcohol consumption, and socio-demographic factors. Increasing the rate of trauma is becoming a public health problem and it is necessary to study their epidemiology and implement control strategies. Aims. The objectives of the study are to establish the particularities of epidemiological, morphopathological, and pathophysiological factors involved in complex neck traumatology. Methods. The study group consisted of 384 patients, representative for the population of Moldova, who presented at the ENT Clinic, Hospital “St. Spiridon” Iași and the Institute of Forensic Medicine, Iași during 2012–2016, with complex cervical trauma pathology, produced by various mechanisms, such as car accidents, domestic accidents, aggressions, ballistic trauma, self-inflicted attempts, hanging or strangulation. Data were collected from autopsy reports and medical records. Results. Complex cervical trauma occurs with a predisposition in males, with an average age of 43 years, from rural areas. The mechanism of cervical trauma is predominantly self-inflicted—hanging in 78.4% of the total number of cases, followed by 14.8% of stabbing aggression. The majority of neck injuries, both open and closed, are located in anatomical zone II (73.6%), vascular and pharyngeal are produced by stabbing. Psychiatric disorders and blood alcohol levels are correlated with complex cervical trauma caused by self-inflicted mechanism—hanging and can be considered a predictive factor of suicide attempts. Conclusions. Overall, the vast majority of closed neck injuries were caused by the self-inflicted mechanism, attempted suicide by hanging, followed by the accidental mechanism. Regarding the penetrating complex aero-digestive cervical traumas, they were mostly produced by stabbing both in aggression and self-inflicted circumstances. Aggravating addictive factors such as alcoholism and mental disorders require a competent assessment in terms of the indication of institutionalized treatment, prevention of repeated self-inflicted attempts, or social reintegration.

Dental Trauma at a University Dental Clinic in Milan including the SARS-CoV-2 Period.

The aim of this study i.e., is to present the distribution of traumatic dental injuries (TDI) in 306 patients registered at the Unit of Dental Emergencies at a University Dental Clinic in Milan, Italy, between June 2019 and May 2021. This time frame includes the beginning of the SARS-CoV-2 pandemic. Information regarding age, gender, number and type of injured teeth, type of traumatic injury, and data on where or how the injury happened were recorded. Seventy-nine percent of patients can be classified as pediatric (under 14 years old), and in all age groups, male patients were found to be more susceptible (1.6:1). A total of 480 teeth were involved, 59% of which were deciduous, and 41% permanent. The most affected teeth in both dentitions were upper central incisors. In deciduous teeth, periodontal lesions were more common, whereas in permanent dentitions, dental fractures were diagnosed more often. Most data found in this study confirms the results found in the literature. The biggest difference, due to changes in daily routine during the SARS-CoV-2 pandemic, can be found by analyzing the incidence and etiology. As a matter of fact, there was a decrease in school accidents, whereas domestic falls remained constant.

Retrospective medico-social analisys of the results of treatment patients with the concequences of long bone fractures

The problem of long bones fractures treatment remains actual, despite a significant number of studies carried out on this topic. Such fractures of the musculoskeletal system occur more often and are accompanied by various complications, significantly compromise the quality of patients life and often lead to the disability. Objective. To analyze different types of traumatic injuries in patients with the consequences of long bone fractures, to evaluate the effectiveness of diagnostics, treatment and to analyze the state of disability. Methods. A retrospective medical and social analysis of the results of treatment of 333 patients (232 (69.6 %) men, 101 (30.4 %) women) with the consequences of long bone fractures, based on the obtained study group in the Kharkiv Regional Center for Medical and Social Expertise № 2, for the period 2018–2019. Results. Three main methods of surgical treatment were analyzed: internal fixation (ORIF), blocking intramedullary nailing (IMN) and treatment with external fixation devices (EF). They were applied in the following rate: ORIF — 204 (61.3 %) cases, IMN — 98 (29.4 %), EF — 31 (9.3 %). The most typical complications of the treatment of patients with fractures of the long bones were delayed union or nonunion, neuropathies of the treated extrimities, joint contractures, osteoarthritis of adjacent joints, deformities of affected extrimities, osteomyelitis. Causes of disability were: 63 % — severity of injuries, 46 % — different posttraumatic complications, 6.5 % — iatrogenic complications. Among the latter, the most common were: diagnostic — 7.1 %, incorrect method of treatment — 29.7 %, iatrogenic incorrect surgery methods — 45 %. Conclusions. The data obtained showed that the improvement of organization measures for the prevention of complications and disability in patients with consequences of long bones fractures could help to increase the efficiency and quality of specialized medical help. Key words. Fractures, long bones, limbs, consequences, complications, disability.

The classifications of subaxial cervical spine traumatic injuries. Part 6. Ben L. Allen biomechanical classification

Traumatic injuries of subaxial cervical spine are characterized by a wide range of possible pathomorphological changes that depend not only on the direction and intensity of the traumatic force impact, but also on the initial position of cervical spine at the moment of exposure. One of the most detailed classifications of cervical spine traumatic injuries, in which the integrated approach to assessing the type of injury considering the mechanism of injury is used, is the system developed by Ben L. Allen and published with co-authors in 1982. It is also known as the Allen-Ferguson classification and despite long history of existence, still has not lost its relevance. In the classification when characterizing the type of traumatic injury, not only visually detected signs, but also inevitably accompanying changes are given. In total, 6 types of damage were classified: compression-flexion, vertical compression, distraction-flexion, compression-extension, distraction-extension and lateral-flexion, which were divided into stages depending on the severity of pathomorphological changes. The authors of the classification note a pronounced correlation between the nature of damage to anatomical structures and neurological disorders in all patterns of damage. When writing this review, a detailed analysis of the original publication was carried out, highlighting the basic biomechanical aspects that underlie the classification and still have not lost their relevance . It is noted that the schematic images of damages found in modern literature often do not correspond to the description proposed by Ben L. Allen et al., Therefore, when preparing the illustrative material, we relied solely on the data of the original article. Along with the description of morphology, for each type and stage of injury, modern data on possible methods of treatment, both conservative and surgical are given. The complex analysis suggests that the classification developed by Ben L. Allen is a convenient tool for assessing pathomorphological changes and allows choosing the optimal method of treating the patients in each specific clinical situation.

Impact of COVID-19 and Shelter in Place on Volume and Type of Traumatic Injuries.

IntroductionVery little is known about the effects of the novel coronavirus (COVID-19) pandemic and its associated social distancing practices on trauma presentations to the emergency department (ED). This study aims to assess the impact of a city-wide stay at home order on the volume, type, and outcomes of traumatic injuries at urban EDs.MethodsThe study was a retrospective chart review of all patients who presented to the ED of an urban Level I Trauma Center and its urban community affiliate in the time period during the 30 days before the institution of city-wide shelter-in-place (preSIP) order and 60 days after the shelter-in-place (SIP) order and the date-matched time periods in the preceding year. Volume and mechanism of traumatic injuries were compared using paired T-tests.ResultsThere was a significant decrease in overall ED volume. The volume of certain blunt trauma presentations (motor vehicle collisions) during the first 60 days of SIP compared to the same period from the year prior also significantly decreased. Importantly, the volume of penetrating injuries, including gunshot wounds and stab wounds, did not differ for the preSIP and SIP periods when compared to the prior year. The mortality of traumatic injuries was also unchanged during the SIP comparison period.ConclusionWhile there were significant decreases in visits to the ED and overall trauma volume, penetrating trauma, including gun violence, and other severe traumatic injuries remain a public health crisis that affects urban communities despite social distancing recommendations enacted during the COVID-19 pandemic.

The Burden of Geriatric Trauma at the University College Hospital, Ibadan, Nigeria.

Background:Geriatric populations presently account for 9% of the world population and this is expected to increase. Injuries to the elderly accounted for 5.8 million accident and emergency visits in the USA as well as 4% of patients treated for traumatic injuries in Abuja, Nigeria. Traumatic injury is therefore a major cause of morbidity in the elderly as such the need for the study in our environment.Aims and Objectives:The aim(s) of this article is to review the incidence and types of traumatic injury among elderly population who presented at the University College Hospital, Ibadan, Nigeria and to determine the causes of traumatic injury involving the geriatric age group in our environment.Materials and Methods:A retrospective hospital-based study involving the records of geriatric patients who presented with traumatic injuries between January 2014 and June 2021 at the geriatric center and the accident and emergency department of the hospital. The record was retrieved from the Total Quality Management Unit of the hospital.Results:About 7.61% of the traumatic injury that presented at the accident and emergency department within the study period involved geriatric patients with a male-to-female ratio of 1:1.08, whereas 0.3% of the patients for inpatient care at the geriatric center had traumatic injury. Fall was the most common cause of traumatic injury observed and fracture the most common traumatic injury observed.Conclusion:Less than 10% of the patients with traumatic injury who presented at the University College Hospital, Ibadan, Nigeria are in the geriatric age group. Most of the traumatic injury involving geriatric patients in our environment is due to low energy falls, and fracture is the most common injury observed, with the femur being the most affected bone. Therefore, interventions directed at reducing the incidence of falls in our environment will hopefully help in reducing the incidence of traumatic injuries in the older population.

Surgical management of traumatic irreducible spondyloptosis of thoracolumbar junction

Introduction. The thoracolumbar junction is the most common location of traumatic spinal injuries. It accounts for 50-60% of all thoracic and lumbar spine injuries. Spondyloptosis is rather rare, but one of the most severe types of traumatic injury, that is characterized by a severe damage of spinal axis in one or more planes. Traumatic spondyloptosis is classified as reducible and irreducible, depending on the possibility of intraoperative restoration of the spinal axis without resection of the damaged vertebra. Objective. To determine the optimal surgical technique for traumatic irreducible spondyloptosis of thoracolumbar junction. Materials and methods. A retrospective analysis of the patients’ database treated at the Romodanov Neurosurgery Institute, Ukraine was performed over the past 4 years (2017 to 2020) to identify all cases with traumatic irreducible spondyloptosis of the thoracolumbar junction. Results. Treatment outcomes of five patients aged 18 to 52 years (mean age 31.2 years) were analyzed. The minimum period from the moment of injury to surgery was 14 days, the maximum was 3 months and 2 days (on average 42.2 days). At the time of admission all patients had a neurological deficit that corresponds to the functional class A on the American spine injury associatin ASIA scale of severity of spinal cord injury. The TLICS (Thoracolumbar injury classification and severity) score was 8 points. All the patients had the injury of lateral spondyloptosis: in three cases as an isolated displacement only in the coronal plane, in two – as a combined one - in the coronal and sagittal plane. Surgical intervention in all cases was performed from the posterior approach. As a body replacement system in 2 patients, a vertical cylindrical implant (Mesh) was used, in 3 patients - a telescopic body replacing implant. The method of bicortical implantation of pedicle screws was applied. The transpedicular system was strengthened by two cross links of the rod-to-rod type. In all cases the restoration of spinal axis was achieved in both the coronal and sagittal planes. Follow-up examinations were carried out 2, 6 and 12-18 months of the postoperative period. Regression of neurological disorders was registered in two patients, in one case to ASIA B, in the other to ASIA C. Conclusions. Isolated posterior approach has demonstrated high efficacy in the surgical management of traumatic irreducible spondyloptosis of the thoracolumbar junction both in restoring the axis of the spine and in ensuring the stability of fusion.

ROLE OF ULTRASOUND SCANNING IN DIAGNOSIS OF CONDITIONS OF KNEE JOINT SOFT TISSUES IN ACUTE AND CHRONIC INJURY IN FOOTBALL PLAYERS

Traumatic injuries of the knee joint are one of the main factors resulting in the loss of mobility among football players. According to the reports of many researchers, the damage to the soft tissues predominates in the structure of traumatic injuries of the knee joint; therefore, such diagnostic technique as ultrasound scanning is very helpful in determining the nature and extent of injuries and in making decision on the necessity of the surgical intervention. The aim of this study is to investigate and systematize ultrasound criteria for various types of traumatic injuries of the soft tissues of the knee joint in acute and chronic trauma in football players. The analysis of the findings of ultrasound scan of the knee joints in 36 football players with sports injury was carried out. The following echographic data were assessed: homogeneity, echogenicity, integrity of the tendon contours, the presence of effusion in the bursae and tendon sheaths, the number of vascular signals in the affected area. In the first group of patients, the analysis of ultrasound signs revealed the following structural changes: separate meniscus ruptures were diagnosed in 6 (27, 3%) athletes; combined lesions of the menisci and ligamentous apparatus – in 9 (40, 9%) with signs of damage to the menisci and ligaments characteristic of acute trauma; separate ligament ruptures were diagnosed in 7 (31, 8%) athletes. In the second group of the patients, sonography confirmed suffered meniscus tears in 3 (21, 4%) athletes; combined lesions of the menisci and ligaments in 7 (50,1%) footballers; rupture of the ligamentous apparatus in 4 (28,5%) individuals. Fresh injuries to the menisci and ligaments against the background of previous ruptures were not diagnosed during past ultrasound examinations and resulted in the impairment of the ratio of the load distribution on the limb that could provoke repeated trauma to the menisci and ligaments. Ultrasound scanning for acute and chronic injury of the knee joint in football players can be considered a reliable informative imaging technique, which allows assessing the severity of damage to the menisci, ligaments, soft tissues and makes it possible to choose the proper tactics of further treatment.

MENISCUS TRANSPLANT: IS STILL A STEP FORWARD FOR GOOD RESULTS IN CARTILAGE LESION PROGRESSION AND KNEE PAIN?

Meniscus injuries are the most common traumatic conditions of the knee. If until the early 2000s, menisci were considered structures of no major importance in the knee joint, subsequent studies have shown their importance in the biomechanics of the knee. Their role is not only for the natural suspension of the joint, but also for the protection of the cartilage or the achievement of the efficient and uniform circulation of the synovial fluid. Therefore, disruption of this joint balance can lead, in the absence of a well-conducted treatment, to premature knee wear. Most of the time, these meniscal tears are accompanied by associated lessions, ligaments or more severely cartilaginous lessions, creating a real challenge for the physician, specially for young pacients. There are many conservative treatments of the damaged meniscus, imagined precisely in the idea of preserving the menisci as much as possible. However, this is not always possible, especially due to the type of traumatic injury.

Evaluation of pediatric high-energy trauma patients with whole-body computed tomography.

We aimed to evaluate the findings of whole-body computed tomography (WBCT) in pediatric high-energy trauma patients and to determine the distribution of injuries. The WBCT images of 1132 pediatric patients who were admitted to emergency department between 2013 and 2018 for high-energy trauma were evaluated retrospectively. Six hundred and twenty patients with abdominal, chest, head, and skeletal injuries were included. Using the WBCT images, we detected skeletal injuries in 557 pediatric patients; spinal, rib, extremity, and pelvic fractures were detected in 113, 57, 51, and 37 patients, respectively. Craniofacial fractures were viewed in 299 patients. We detected intracranial hemorrhage, pulmonary contusion, pneumothorax, and solid organ injuries in 102, 115, 45, and 55 pediatric patients, respectively. The frequency and distribution of injuries in trauma cases vary between adults and children. While there are many studies about whole-body CT findings of adult trauma, there are only a few studies about pediatric high-energy trauma patients. The traumatic injury types also differ in pediatric age groups. WBCT scan (with pediatric radiation dose) is the fast and accurate diagnostic tool in high-energy trauma cases and therefore is associated with low mortality rates.

An Open-Globe Porcine Injury Platform for Assessing Therapeutics and Characterizing Biological Effects.

Open-globe injuries can result in permanent vision loss, partly due to extended delays between injury and medical intervention. Even with early intervention, the management of open-globe injuries remains a challenge for ophthalmologists, mostly due to inadequate or suboptimal current therapies. To aid in the development of novel therapeutics and track toxicological and pathophysiological changes, this article details an open-globe injury platform capable of inducing injuries in enucleated porcine eyes. The injury platform relies on a high-speed solenoid device to mimic explosive injury scenarios, allowing for large, complex injury shapes and sizes that are often observed in casualties and are more difficult to treat. The system can be implemented with precise computer control of the injury mechanism to allow for more complex setups. Also, the system can make use of real-time intraocular pressure measurement to track changes during injury induction and to assess therapeutic efficacy for restoring intraocular pressure and the integrity of the eye. These protocols will assist with implementation of the injury model in prospective laboratories seeking to develop therapeutics or studying biological changes that occur from this type of traumatic injury. Published 2020. U.S. Government. Basic Protocol 1: Preparing gelatin molds and porcine eye tissue Basic Protocol 2: Creating an open-globe injury using a solenoid device Alternate Protocol 1: Constructing a computer-controlled system for open-globe injury Alternate Protocol 2: Constructing a pressure measurement system for tracking intraocular pressure Support Protocol 1: Assessing ocular compliance in porcine eyes Support Protocol 2: Assessing outflow rate from the anterior chamber Support Protocol 3: Assessing burst pressure in porcine eyes.

Pathological Responses of Cardiac Mitochondria to Burn Trauma.

Despite advances in treatment and care, burn trauma remains the fourth most common type of traumatic injury. Burn-induced cardiac failure is a key factor for patient mortality, especially during the initial post-burn period (the first 24 to 48 h). Mitochondria, among the most important subcellular organelles in cardiomyocytes, are a central player in determining the severity of myocardial damage. Defects in mitochondrial function and structure are involved in pathogenesis of numerous myocardial injuries and cardiovascular diseases. In this article, we comprehensively review the current findings on cardiac mitochondrial pathological changes and summarize burn-impaired mitochondrial respiration capacity and energy supply, induced mitochondrial oxidative stress, and increased cell death. The molecular mechanisms underlying these alterations are discussed, along with the possible influence of other biological variables. We hope this review will provide useful information to explore potential therapeutic approaches that target mitochondria for cardiac protection following burn injury.