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C Endress

Publications and source records attributed to C Endress.

8 recordsLinked to original sources

Facial fracture classification according to skeletal support mechanisms.

OBJECTIVE: To construct, propose, and evaluate the usefulness of a new clinical facial fracture classification scheme to accurately denote, communicate, and compare facial fractures. DESIGN: A retrospective, consecutive sample study with application of the proposed classification scheme to denote maxillary and zygomatic fractures with computed tomography. SETTING: Metropolitan tertiary care trauma center. PATIENTS: A total of 213 consecutive adult patients with facial fractures evaluated by means of 2-dimensional computed tomography. RESULTS: The classification scheme is defined according to fractures of vertical buttresses and horizontal beams. The scheme uses 3 primary descriptors of laterality and support sites to denote the clinical pattern of the fractures. This scheme was accurately applied and sufficient to describe 87 midfacial fracture patterns in this study. In addition, 118 (98%) of 120 mock fracture patterns were correctly transcribed and reproducibly communicated among 12 participating physicians. CONCLUSIONS: This newly proposed facial fracture classification scheme provides a convenient, specific, descriptive, and reproducible method of denoting fracture patterns. This scheme may be used to accurately communicate and compare, in greater detail than permitted using current independent classification schemes, the essential site and degree-of-severity characteristics of facial fractures critical to their surgical reduction and reconstruction. The usefulness of this classification scheme in determining optimal methods and subsequent outcomes in midfacial fracture reduction requires further investigation.

Adolescent↗

The "fallen lung with absent hilum" signs of complete bronchial transection.

A 19-year-old pedestrian who was the victim of a motor vehicle accident had a left pneumothorax with a large air leak. Despite a well-placed chest tube, a chest radiograph showed that the left lung had fallen down and away from the mediastinum and that no hilar structures were visible. This "fallen lung with an absent hilum" is considered virtually diagnostic of complete mainstem bronchus transection.

Adult↗

Cervical osteomyelitis due to i.v. heroin use: radiologic findings in 14 patients.

We reviewed the radiographs of 14 patients who had cervical osteomyelitis and were IV heroin users. Eleven were men and three were women. Their age range was 33-48 years (mean, 39 years). Eleven regularly used the jugular vein access, and three alternated between the jugular and femoral veins. Initial radiographs of the cervical spine in 13 patients showed destruction of two or more vertebral bodies and the adjacent intervertebral disk, as well as a prevertebral soft-tissue mass. In one patient, findings on initial radiographs were normal, but marked destruction at two contiguous intervertebral levels and a large prevertebral abscess were identified 2 weeks later. All the patients had positive results on cultures of joint aspirates or bone biopsy materials (10 patients) or blood (four patients). Ten grew Staphylococcus aureus; two, Staphylococcus epidermidis; one, Streptococcus viridans; and one, Pseudomonas aeruginosa. CT in nine patients showed inflammatory reaction adjacent to the carotid sheath resulting from the repeated jugular injections and delineated the extent of prevertebral abscess and bone destruction. Scintigrams were of minimal value in establishing the diagnosis. Advanced vertebral body destruction, disk space infection, prevertebral abscess, and anterior cervical inflammatory reaction appear to be typical findings on radiographs in heroin abusers with cervical osteomyelitis.

Adult↗