Cases reported "Facial Injuries"

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1/59. diabetes insipidus caused by craniofacial trauma.

    A patient is presented with diabetes insipidus secondary to craniofacial trauma. diabetes insipidus can occur in any patient within ten days of craniofacial trauma. Even the masked disease in the unconscious patient can be diagnosed by observation of intake and output, urinary specific gravities, and appropriate chemical studies. The disease can recur following operative reduction of facial fractures. diabetes insipidus can be successfully treated by intramuscular Pitressin and appropriate fluid intake.
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keywords = fracture
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2/59. death due to concussion and alcohol.

    We encountered 5 deaths following blunt trauma to the face and head in which the injuries were predominantly soft tissue in nature with absence of skull fractures, intracranial bleeding, or detectable injury to the brain. All individuals were intoxicated, with blood ethanol levels ranging from 0.22 to 0.33 g/dl. We feel that in these deaths, ethanol augmentation of the effects of concussive brain injury, with resultant posttraumatic apnea, was the mechanism of death.
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3/59. Extensive facial damage caused by a blast injury arising from a 6 volt lead accumulator.

    Low-voltage electrical injuries are relatively uncommon. Injury caused by flow of heavy current due to short-circuiting a low-voltage battery has not been described in the English literature. A 9-year-old boy connected two thin household electrical wires to the two terminals of a 6 volt (lead accumulator) battery and pressed the other two ends between his teeth. This resulted in a blast causing a compound comminuted fracture of the mandible and extensive tissue damage in the oral cavity. The low internal resistance of a lead accumulator (approximately 0.03 ohms) permits the flow of a heavy current (approximately 200 amps) when short-circuited. This instantaneously vaporises a minuscule portion of wire at approximately 2000 K resulting in a sudden rise of intraoral pressure to 30 kg cm-2 leading to tissue damage.
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keywords = fracture
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4/59. Management of a gunshot wound to the face resulting in a mandibular body fracture with burying of a bicuspid crown into the tongue.

    Gunshot wounds to the maxillofacial region are unpredictable and run the gamut from minor injuries to severe mutilating and life threatening injuries. This patient although unfortunate to have been the victim of mistaken identify resulting in the gunshot wound, was fortunate that the bullet hit his bicuspid, which probably served to deflect its path away from vital structures, thus saving his life. This accounts for the buried bicuspid crown found in the midline of the body of the tongue. Rigid internal fixation of maxillofacial fractures minimizes risks to the airway that may occur if patients are in post-operative maxillo-mandibular fixation during the post-anesthetic recovery phase. In addition, the use of rigid internal fixation speeds up the recovery and the patient's ability to return to function after surgery. Above, we presented an interesting case of a mandibular anterior body fracture resulting from a gunshot wound in the face and resulting in the burying of a bicuspid crown in the substance of the tongue, treated under general nasoendotracheal anesthesia and the use of rigid internal fixation (EDCP).
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ranking = 6
keywords = fracture
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5/59. Mandibular fracture resulting from dog bite: report of a case.

    The diagnosis and management of a fractured mandible of a 4-year old child has been presented. A brief review of the literature is given. The remarkable aspect of the case is its reported cause of dog bite. The patient was managed conservatively by closed reduction, and use of Oliver loops. The maxillomandibular fixation was lost on the 11th postoperative day. At that time, no mandibular deviation or limitation of movement was noted. Further immobilization was not deemed necessary. During a three-month follow-up period, no complications occurred.
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ranking = 5
keywords = fracture
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6/59. Sevoflurane mask anesthesia for urgent tracheostomy in an uncooperative trauma patient with a difficult airway.

    PURPOSE: Proper care of the trauma patient often includes tracheal intubation to insure adequate ventilation and oxygenation, protect the airway from aspiration, and facilitate surgery. airway management can be particularly complex when there are facial bone fractures, head injury and cervical spine instability. CLINICAL FEATURES: A 29-yr-old intoxicated woman suffered a motor vehicle accident. Injuries consisted of multiple abrasions to her head, forehead, and face, right temporal lobe hemorrhage, and complex mandibular fractures with displacement. mouth opening was <10 mm. blood pressure was 106/71 mm Hg, pulse 109, respirations 18, temperature 37.3 degrees C, SpO2 100%. Chest and pelvic radiographs were normal and the there was increased anterior angulation of C4-C5 on the cervical spine film. Drug screen was positive for cocaine and alcohol. The initial plan was to perform awake tracheostomy with local anesthesia. However, the patient was uncooperative despite sedation and infiltration of local anesthesia. Sevoflurane, 1%, inspired in oxygen 100%, was administered via face mask. The concentration of sevoflurane was gradually increased to 4%, and loss of consciousness occurred within one minute. The patient breathed spontaneously and required gentle chin lift and jaw thrust. A cuffed tracheostomy tube was surgically inserted without complication. Blood gas showed pH 7.40, PCO2 35 mm Hg, PO2 396 mm Hg, hematocrit 33.6%. Diagnostic peritoneal lavage was negative. Pulmonary aspiration did not occur. Oxygenation and ventilation were maintained throughout the procedure. CONCLUSION: Continuous mask ventilation with sevoflurane is an appropriate technique when confronted with an uncooperative trauma patient with a difficult airway.
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ranking = 2
keywords = fracture
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7/59. Traumatic pneumomediastinum caused by isolated blunt facial trauma: a case report.

    Traumatic pneumomediastinum is most often identified as an incidental finding in the setting of blunt or penetrating neck, chest, or abdominal trauma. There are only a few cases in the medical literature of a pneumomediastinum following isolated facial trauma. We present a patient who sustained fractures of the lateral and anterior walls of the right maxillary sinus, floor of the right orbit, and right zygomatic arch. subcutaneous emphysema overlaid the right facial region and extended to the left side of the neck and into the mediastinum. We describe this unusual complication with respect to the anatomic relations of the facial and cervical fascial planes and spaces with the mediastinum.
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ranking = 1
keywords = fracture
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8/59. Field hospital treatment of blast wounds of the musculoskeletal system during the Yugoslav civil war.

    The spectrum of wounding and treatment of forty-one patients with musculoskeletal blast injuries at a U.S. military field hospital in the former yugoslavia was reviewed. patients underwent wound exploration, irrigation, debridement, broad-spectrum antibiotic therapy, early fracture stabilization, and appropriate reconstructive surgery. Four patients developed wound infections. Two patients died as a result of their injuries (overall mortality 5 percent). There were three below-knee amputations and five other amputations (above-knee, ankle, midtarsal, partial forefoot, and finger). Three patients sustained lumbar burst fractures from mines that exploded under their vehicles, resulting in paraplegia in one case. Our patients underwent 112 surgical procedures, an average of 2.1 per patient. Twenty-two patients (54 percent) had other injuries or conditions in addition to their orthopaedic wounds. There were wide variations in the bone and soft tissue injuries caused by detonating ordnance, and the tissue damage was qualitatively different from that caused by gunshot wounds. Early debridement, leaving wounds open, and treatment with broad-spectrum antibiotics were important factors in wound healing to allow subsequent successful reconstructive surgery in an austere field setting.
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ranking = 2
keywords = fracture
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9/59. Bilateral facial nerve paralysis with craniofacial trauma.

    Bilateral facial paralysis (BFP) is a very rare condition, unlike its unilateral counterpart. Causes of BNP include a wide variety of diseases and its differential diagnosis can be challenging. We report a case of BFP secondary to craniofacial trauma, with unilateral orbitozygomatic and bilateral temporal bone fractures.
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ranking = 1
keywords = fracture
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10/59. The use of the C-arm in reduction of isolated zygomatic arch fractures: a technical overview.

    Isolated zygomatic arch fractures account for approximately 10% of all zygoma fractures. Numerous techniques have been described to reduce these fractures using a variety of approaches. Successful reductions are often difficult to evaluate clinically because of the great amount of swelling that often accompanies these fractures. Postoperative radiographs are often the only way to assess the adequacy of the reduction. This article describes a technique that uses the C-arm to quickly and accurately evaluate the reduction intraoperatively so that appropriate corrections can be made. A case report of a patient who suffered multiple orthopedic injuries and a w-shaped depressed fracture of the left zygomatic arch is presented. The C-arm can obviate the need for intraoperative radiographs that, due to technician and film processing delays, add significantly to operative time.
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ranking = 9
keywords = fracture
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