Keyvan Eghbal; Abbas Rakhsha; Arash Saffarrian; Abdolkarim Rahmanian; Hamid Reza Abdollahpour; Fariborz Ghaffarpasand
Volume 6, Issue 4 , October 2018, , Pages 367-371
Abstract
Atlantoaxial rotatory subluxation (AARS) is rarely occurred in adults with trauma as the most common cause. In type A and B it is usually managed with close reduction and external brace; however, in nonresponsive cases, surgical interventions might be needed. Our patient is a 21-year-old man with neck ...
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Atlantoaxial rotatory subluxation (AARS) is rarely occurred in adults with trauma as the most common cause. In type A and B it is usually managed with close reduction and external brace; however, in nonresponsive cases, surgical interventions might be needed. Our patient is a 21-year-old man with neck pain and torticollis after a car turn- over. There was C1-C2 rotatory subluxation with left side locked facet and C1 rotation about 40 degrees relative to C2 on computed tomography without evident of ligamentous injury in magnetic resonance imaging (MRI). However, during the first 48 hours, two tries of close reduction using Gardner cervical traction under fluoroscopy were failed. Thus, the patient underwent open reduction of the subluxation and atlantoaxial fixation (Harm’s technique) with subsequent relief of pain and torticollis. This a rare case of traumatic AARS type A with unilateral locked facet joint in an adult patient which needed surgical manipulation for reduction. The management of the AARS in adults should be individualized in each patient.
Mehdi Ayaz; Abdolkhalegh Keshavarzi; Hamid Bahadoran; Peyman Arasteh; Sam Moslemi
Volume 5, Issue 3 , July 2017, , Pages 179-183
Abstract
Objectives: To compare the outcomes of early excision and grafting between pediatric and adult patients with deep burns of less than 40% total body surface area burns (TBSA).Methods: This is a prospective comparative study. Overall, 106 patients admitted to Ghotbodin Burn Center in Shiraz, Iran ...
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Objectives: To compare the outcomes of early excision and grafting between pediatric and adult patients with deep burns of less than 40% total body surface area burns (TBSA).Methods: This is a prospective comparative study. Overall, 106 patients admitted to Ghotbodin Burn Center in Shiraz, Iran from September 2012 to September 2013, were included in the study. All patients had less than 40% TBSA burn and had excision and grafting under 14 days from their injury. Patients were divided into two age groups of younger than 14 (n=49) and older than 14 (14-65) years old (n=57). During a 6-month follow-up period, the two groups were compared regarding mean percentage of graft take, total scar score, duration of hospital stay and itching score.Results: During follow-up, the two groups did not show a significant difference in graft take, total scar score and itching score (p=0.461, p=0.363 and p=0.637, respectively). Clinically, the pediatric group showed less hospital stay (12.25±9.1 vs. 16±12.9), however this was not statistically significant (p=0.091). Conclusion: Adults and elderly patients (14–65 years old) compared to pediatric patients (less than 14 years old) with less than 40% TBSA burns, can expect similar results regarding scar score, graft take, itch score and hospital stay, after excision and grafting performed less than two weeks from their initial injury.
