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D D Damschen

Publications and source records attributed to D D Damschen.

3 recordsLinked to original sources

Scapulothoracic dissociation caused by blunt trauma.

Scapulothoracic dissociation is an infrequent injury with a potentially devastating outcome. The diagnosis has heretofore relied on the radiographic description of the forequarter disruption. Recent experience with four patients at a single trauma center, along with review of 54 injuries adequately described in the literature, indicates a broader spectrum of injury. Neurologic injuries occurred in 94% and vascular injuries in 88%. A nearly uniform poor outcome with flail extremity in 52% of patients, early amputation in 21%, and death in 10% reflects the severity of injuries reported. Identification of this injury requires clinical suspicion, based upon the injury mechanism and physical findings, to accurately assess the degree of trauma to musculoskeletal, neurologic, and vascular structures. Based upon these clinical findings, a rational approach to diagnostic techniques, injury classification, and appropriate surgical intervention can be achieved. Outcome is dependent on early recognition of the subset of patients with injuries amenable to surgical treatment and rehabilitation.

Acromioclavicular Joint↗

Acute traumatic abdominal hernia: case reports.

Traumatic abdominal hernia is a rare injury with most reports documenting only one or two such cases. We describe five cases that were recognized during a 22-year period at a single trauma center. Physical examination often revealed abdominal wall tenderness and ecchymosis, but confirmation of hernia required additional testing in four of five patients. Two patients sustained muscle avulsion from the iliac crest which was likely a result of obesity and high riding seatbelts. In three of the patients a computed tomographic scan of the abdomen was instrumental in making the diagnosis. Surgical repair of the hernia was accomplished in three patients. The other two patients were managed nonsurgically. This report documents that an individualized approach to these patients is appropriate. Diagnosis may be difficult and immediate surgery does not prevent late sequelae. Management guidelines based upon a review of the English language literature on traumatic abdominal wall hernias are presented.

Adult↗