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Spinal trauma in children and adolescents: mechanisms of injury, anatomical characteristics and principles of treatment 儿童和青少年脊柱创伤：损伤机制、解剖特点和治疗原则
Orthopaedics and Trauma Pub Date : 2024-08-27 DOI: 10.1016/j.mporth.2024.07.009
Maryem-Fama Ismael Aguirre, Athanasios I Tsirikos
{"title":"Spinal trauma in children and adolescents: mechanisms of injury, anatomical characteristics and principles of treatment","authors":"Maryem-Fama Ismael Aguirre,&nbsp;Athanasios I Tsirikos","doi":"10.1016/j.mporth.2024.07.009","DOIUrl":"10.1016/j.mporth.2024.07.009","url":null,"abstract":"<div><div>Spinal trauma in children and adolescents, including spinal cord injury, fractures and dislocations, is relatively uncommon, but represents the highest risk of morbidity and mortality of all paediatric injuries. Motor vehicle accidents, falls from heights and sport accidents resulting in blunt trauma are the most frequent mechanisms of injury. The average age of presentation is approximately 12 years old. Injury following spinal trauma differs according to age-specific biomechanical characteristics of the developing spine. The most common site of injury in younger children is the cervical spine, whereas injury to the thoracolumbar spine is more common in adolescents. Differential diagnosis following trauma should include physiological particularities of the developing spine. Search for concomitant lesions is mandatory as patients frequently present with more than one vertebral fracture. Injury in this population can significantly affect the developing spine leading to neurological trauma and progressive deformity.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 5","pages":"Pages 320-324"},"PeriodicalIF":0.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spinopelvic dissociation: aetiology, presentation and principles of treatment 脊柱骨盆分离：病因、表现和治疗原则
Orthopaedics and Trauma Pub Date : 2024-08-26 DOI: 10.1016/j.mporth.2024.07.007
Michael J Price, Paul Lambton Rodham, Athanasios I Tsirikos, Tristan E McMillan
{"title":"Spinopelvic dissociation: aetiology, presentation and principles of treatment","authors":"Michael J Price,&nbsp;Paul Lambton Rodham,&nbsp;Athanasios I Tsirikos,&nbsp;Tristan E McMillan","doi":"10.1016/j.mporth.2024.07.007","DOIUrl":"10.1016/j.mporth.2024.07.007","url":null,"abstract":"<div><div>Spinopelvic dissociation describes the traumatic separation of the axial and appendicular skeleton, commonly involving bilateral vertical sacral fractures which may be linked by a transverse fracture line. This injury may occur in patients with osteoporosis, in which there may be relative stability with minimal displacement; or result from high-energy trauma with extensive associated injuries and an increased risk of complications. Operative intervention forms the mainstay of treatment for high-energy injuries, although the heterogenous nature and relative rarity of this phenomenon renders a comprehensive treatment strategy difficult to define.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 5","pages":"Pages 304-310"},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trauma of the upper cervical spine and cranio-vertebral junction in adults 成人上颈椎和颅椎交界处的创伤
Orthopaedics and Trauma Pub Date : 2024-08-26 DOI: 10.1016/j.mporth.2024.07.004
Himanshu Shekhar, Andreas K Demetriades
{"title":"Trauma of the upper cervical spine and cranio-vertebral junction in adults","authors":"Himanshu Shekhar,&nbsp;Andreas K Demetriades","doi":"10.1016/j.mporth.2024.07.004","DOIUrl":"10.1016/j.mporth.2024.07.004","url":null,"abstract":"<div><div>The upper cervical spine is responsible for a significant portion of the flexion, extension and rotation movements of the whole cervical spine. It is a complex region with anatomical and biomechanical relationships between the occipital condyles, atlas, axis and their joints. These make this a region of special interest in the context of trauma. In this article we review the anatomy of the cranio-vertebral junction, the clinical patterns of injury, and the options in their clinical management.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 5","pages":"Pages 279-288"},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142314160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spinal trauma related to military combat: characteristics, mechanisms of injury and principles of management 与军事战斗有关的脊柱创伤：特点、损伤机制和处理原则
Orthopaedics and Trauma Pub Date : 2024-08-26 DOI: 10.1016/j.mporth.2024.07.010
Louise Robiati, Edward Spurrier, Athanasios I. Tsirikos
{"title":"Spinal trauma related to military combat: characteristics, mechanisms of injury and principles of management","authors":"Louise Robiati,&nbsp;Edward Spurrier,&nbsp;Athanasios I. Tsirikos","doi":"10.1016/j.mporth.2024.07.010","DOIUrl":"10.1016/j.mporth.2024.07.010","url":null,"abstract":"<div><div>Trauma-related spinal injuries have been reported as far back as Egyptian times when their severity was recognized but treatment limited and outcomes poor. Advances in the knowledge and management of these injuries have arisen due to increased periods of conflict in the 20th and 21st centuries. With terrorist activity increasing globally, clinicians working in the civilian environment are increasingly being called upon to manage severe, high-energy injuries of the sort usually seen in conflict. This review considers the differences in the mechanism, pattern, and management of spinal trauma in a military combat setting to allow translation to a civilian setting.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 5","pages":"Pages 325-330"},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spinal cord injury: pathophysiology and principles of management 脊髓损伤：病理生理学和处理原则
Orthopaedics and Trauma Pub Date : 2024-08-26 DOI: 10.1016/j.mporth.2024.07.002
Simon B Roberts, Athanasios I Tsirikos
{"title":"Spinal cord injury: pathophysiology and principles of management","authors":"Simon B Roberts,&nbsp;Athanasios I Tsirikos","doi":"10.1016/j.mporth.2024.07.002","DOIUrl":"10.1016/j.mporth.2024.07.002","url":null,"abstract":"<div><div>Spinal cord injury (SCI) is a catastrophic neurological condition resulting in increased physical dependency, medical comorbidity, psychological distress and economic burden. New SCI affects 250,000–500,000 individuals globally each year. The pathophysiological mechanisms following SCI are incompletely understood, and the management of patients following SCI is challenging. Understanding the evolution of pathophysiological changes following SCI is fundamental to delivering and developing appropriate management strategies. Timely interventions following acute SCI can prevent secondary neurological deterioration and improve potential for neurological recovery. A bespoke, multidisciplinary and holistic approach to the management and rehabilitation of SCI patients can optimize physical and mental wellbeing and maximize patient's neurological recovery and functional capabilities. Current therapeutic options following SCI are limited and do not overcome the debilitating effects of SCI. Current knowledge of the pathophysiological mechanism following SCI, management strategies and novel therapies for adult and paediatric SCI patients are reviewed.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 5","pages":"Pages 264-272"},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Biomechanics of the spine and the implications for spinal injuries 脊柱的生物力学及其对脊柱损伤的影响
Orthopaedics and Trauma Pub Date : 2024-08-26 DOI: 10.1016/j.mporth.2024.07.001
Simon B Roberts, Athanasios I Tsirikos
{"title":"Biomechanics of the spine and the implications for spinal injuries","authors":"Simon B Roberts,&nbsp;Athanasios I Tsirikos","doi":"10.1016/j.mporth.2024.07.001","DOIUrl":"10.1016/j.mporth.2024.07.001","url":null,"abstract":"<div><div>Biomechanics is the application of principles of engineering and computers to biological problems. Clinical biomechanics of the spine is the understanding of normal and pathological functions of the human vertebral column in response to mechanical insult, which may include traumatic, degenerative, pathological, or slowly applied loads to the spine. Spinal biomechanics involves the regional features of the vertebrae, intervertebral discs, ligaments, facet joints and muscles. The role of these structures individually and in concert in relation to spinal injuries is discussed. Regional spinal biomechanics, maintenance of spinal stability and assessment of spinal instability following injury are described. Finally, the biomechanical principles, individual structural components, mechanisms of injury and principles specific to the adult and paediatric spine are reviewed.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 5","pages":"Pages 258-263"},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Answers to the CME questions on The Elbow 关于肘部的继续医学教育问题解答
Orthopaedics and Trauma Pub Date : 2024-08-24 DOI: 10.1016/j.mporth.2024.07.012
{"title":"Answers to the CME questions on The Elbow","authors":"","doi":"10.1016/j.mporth.2024.07.012","DOIUrl":"10.1016/j.mporth.2024.07.012","url":null,"abstract":"","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 5","pages":"Page 333"},"PeriodicalIF":0.0,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CME questions on Spinal Trauma 关于脊柱创伤的继续医学教育问题
Orthopaedics and Trauma Pub Date : 2024-08-24 DOI: 10.1016/j.mporth.2024.07.011
{"title":"CME questions on Spinal Trauma","authors":"","doi":"10.1016/j.mporth.2024.07.011","DOIUrl":"10.1016/j.mporth.2024.07.011","url":null,"abstract":"","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 5","pages":"Pages 331-332"},"PeriodicalIF":0.0,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Revision total elbow arthroplasty: a primer for exam candidates 翻修型全肘关节置换术：考生入门指南
Orthopaedics and Trauma Pub Date : 2024-08-01 DOI: 10.1016/j.mporth.2024.05.007
Alistair Ian Eyre-Brook, Lawrence Majkowski, Margo Dirckx, Amjid Ali, Simon Booker
{"title":"Revision total elbow arthroplasty: a primer for exam candidates","authors":"Alistair Ian Eyre-Brook,&nbsp;Lawrence Majkowski,&nbsp;Margo Dirckx,&nbsp;Amjid Ali,&nbsp;Simon Booker","doi":"10.1016/j.mporth.2024.05.007","DOIUrl":"10.1016/j.mporth.2024.05.007","url":null,"abstract":"<div><p>Total elbow arthroplasty (TEA) has a relatively high revision rate compared to conventional joint arthroplasties (4–7% at 5 years). The cause for revision is most commonly implant loosening. A thorough work-up with history, examination, bloods, radiographs and joint tissue or fluid samples are all required to rule out peri-prosthetic infection. Patient factors and soft tissue management must be considered before revising a TEA to ensure the best outcome and longevity of the revised implant. Surgical strategies for TEA revision include single or two-stage revision, bearing exchange, bone windows and strut grafts.</p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 4","pages":"Pages 245-252"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141954489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Answers to the CME questions on Principles of Orthopaedics 骨科原理》继续医学教育问题解答
Orthopaedics and Trauma Pub Date : 2024-08-01 DOI: 10.1016/j.mporth.2024.05.008
{"title":"Answers to the CME questions on Principles of Orthopaedics","authors":"","doi":"10.1016/j.mporth.2024.05.008","DOIUrl":"10.1016/j.mporth.2024.05.008","url":null,"abstract":"","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 4","pages":"Page 255"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141954491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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