Articles Tagged with blunt force trauma

Microsurgery is one of the latest types of surgery to develop. It involves doing surgery to blood vessels and nerves underneath a microscope. It is the type of surgery that makes doing replantation of amputated body parts possible. Vessels and nerves of around one millimeter in diameter have been reattached successfully. Microsurgery is used in trauma surgery as well as in plastic surgery, general surgery, ophthalmology, orthopedic surgery, neurosurgery, pediatric surgery, maxillofacial surgery, and otolaryngology.

Microsurgery was first used by otolaryngologists in about 1921. The first monocular surgical microscope was built and was eventually used in people who had fistulae. Binocular microscopes were then used starting in 1922. Other ear operations were done using a binocular microscope soon after.

Children have a higher likelihood of being injured or killed from trains than adults. They like to play on train tracks and have a lesser ability to detect the speed of a train coming towards them. Their bodies are more frail than adult bodies and the forces on the bodies from the train are great.

One study looked at the pattern of sustained injuries in kids who are injured in train tracks and train accidents. It was a retrospective review of those patients who showed up on two different trauma registries for the years 1984 through 1994. The patients attended a level I trauma center in a single metropolitan area. A total of 17 patients were treated for injuries at the level I trauma center. Those who were injured in a car that was struck by a train and those that were pronounced deceased at the scene were excluded from the study.

Approximately every 115 minutes, someone or something is struck by a train; almost 50 % of all collisions happen at railroad crossings when the automatic warning lights and automatic warning gates are working correctly. The big problem is that people think that even if their car gets stuck on the tracks, the train will be able to stop. In reality, a 150-car train going at fifty miles per hour will need at least a mile to stop.

The fact of the matter is that a car weighs only about 3000 pounds and it must come up against a several hundred ton train. The car almost always loses. These types of accidents cause about 600 deaths per year and injure about 2300 people per year in the US. About 75 percent of automobile/train crashes involve the train hitting the car in the daytime. At night, half of the collisions happen when the car does not see the train at a poorly lit intersection and strikes the train.

Traumatic hemipelvectomies are rare traumatic injuries with a forty percent mortality rate. It happens when half of the pelvis from the pubic symphysis to the sacroiliac joint is pulled away from the rest of the body in an open or closed injury. Because this is a situation that often results in death, it is important for the trauma team to do angiography to assess the circulation to the area, x-rays to determine the extent of the fracture and possibly a CT scan of the pelvis to determine what the injury looks like in three dimensions. Only aggressive surgical treatment can save the person’s life.

Because prehospital care has gotten so good, more and more people are arriving to the trauma centers alive rather than dead. This is a very unstable fracture with ligamentous injury and bony injury with external bleeding in some cases. The pelvic neurovascular bundle is usually destroyed, affecting sensation to the affected, partially-amputated leg.

Unfortunately, kids can be involved in motor vehicle accidents. Hopefully, they are properly restrained and have no problems following an accident. However, some accidents are so severe or if the child is unrestrained, the result can be serious injury, including head injuries in these kids. Head injury happens to be the most common fatality or cause of death in children who are occupants in cars, trucks or other vehicles. There is a great deal of morbidity of death. There are nonlethal injuries related to motor vehicle accidents and they are of great importance clinically. Doctors and researchers want to know the best way to manage these situations so children survive these injuries with a minimum of damage to their body and brains.

The purpose of a recent study was to identify the risk factors for and frequency of significant injury to children who are occupants in a motor vehicle crash. A large surveillance system was established with regard to crashes that was linked to insurance claims information in automobile accidents. A telephone survey was done to obtain the data. Incidents that qualified for the survey were those involving 1990-year cars or newer involved in crashes that had at least one child involved in the crash. The individual needed to be aged 4 to 15 years and the crash had to happen in one of fifteen total states. Data were collected between March of 2000 and December of 2007. A sampling of crashes was collected to undergo the telephone interview which was done with the driver of the car that was the insured vehicle.

Motorcyclists are in a unique position as riders on the road. They ride on two wheels, which is an inherently unstable position. They ride without the benefit of any protective metal around them, which makes direct vehicle to patient contact likely. Road to victim contact is almost inevitable and these riders often suffer from significant injuries. Many motorcyclists use performance enhancing equipment, which makes the chances of severe injury or death quite likely.

One recent review study looked at the patterns of injury, particularly major ones, seen in motorcycle riders following their injuries. There are unique aspects of their care, including airway management, circulatory status and the management of the spine.

Head injuries are a common cause of death in motor vehicle accidents. They often result from unbelted drivers or passengers who are ejected from the vehicle. These head injuries also occur to seat-belted passengers or even the driver when stuck directly, usually with a bigger vehicle such as an SUV or truck. Pedestrians can be struck by a motor vehicle and this can also lead to a head injury.

In the US, someone sustains a traumatic brain injury every 23 seconds. This is about 2 million people per year. Three hundred thousand people will need to be hospitalized because of head injuries and 99,000 will have a long lasting disability. A total of 56,000 people will die in the US per year. About 34 percent of all injuries resulting in death are due to a head injury.

Some patients with traumatic brain injury secondary to a motor vehicle accident will recover to the point where they wish to drive again. It is the job of doctors and other health practitioners to make challenging decisions as to whether or not the individual should be able to drive again. In order to do this, doctors need to perform reliable psychometric testing batteries so that unreliable and unsafe drivers can be detected.

Some researchers have looked into five different driving-associated personality traits that predict whether or not a driver can resume driving after a traumatic brain injury. It also helps when evaluating the post-stroke patient who wants to drive again. About 178 patients who suffered from traumatic brain injury or stroke were evaluated for their ability to drive after their medical incident. Each participant took a standardized psychometric test battery and also took a specific standardized driving test. The two tests were combined to see how the individual fared in being able to drive again.

Car surfing is the dangerous practice of standing on the hood or top of a car, “surfing” the car as if it were a surfboard. Some youths consider this a ‘sport.’ It is a practice usually performed by teenagers, some of whom are intoxicated and have poor coordination. Obviously, this is a practice that is fraught with the potential for injury and death.

Trauma from car surfing includes head and spine injuries. A recent study has looked at the neurological injuries resulting from car surfing. The study also addressed why this is a growing ‘trend’ in the nation. For starters, it is portrayed in the media as a “cool thing” to do. Additionally, many teens do not seem to think it is dangerous.

Traumatic brain injury is a common cause of permanent disability in patients who have had a serious automobile accident. The injury can affect mood, speech, mobility, vision and hearing. The part of the brain affected by trauma determines what kind of injury the patient has.

Some people have serious problems with agitation and aggression following a severe traumatic brain injury. The part of the brain affected can be the frontal lobe or the limbic system deeper in the brain. The trauma causes the damaged areas of the brain to make too many or too few neurotransmitters, resulting in changes in behavior.