Biomedical subjects

Jorge E Alonso

Publications and source records attributed to Jorge E Alonso.

21 records · Page 2Linked to original sources

PubMed2002

Analysis of the incidence of pelvic trauma in fatal automobile accidents.

Pelvic fractures are frequent complications of motor vehicle accidents, and motor vehicle accidents are the most common cause of pelvic fracture. Although pelvic fractures are associated with considerable morbidity and mortality, there has traditionally been no attempt to grade or classify pelvic fractures during postmortem examination. The authors performed a retrospective study of cases examined at the Jefferson County Coroner/Medical Examiner Office from 1994 to 1996, reviewing investigative reports and autopsy findings. Radiographs were examined for the presence and Tile type of pelvic fracture. Pelvic fractures were identified in 88 of 392 cases (23%). In most (89%), the pelvic fracture was readily classified according to Tile type on the basis of radiographs and the inferred mechanism of injury. This study indicates that current estimates of the mortality of pelvic fractures are low because of the exclusion of individuals who do not survive to hospitalization. Furthermore, pelvic fractures in rapidly fatal motor vehicle accidents tend to be more severe than fractures in individuals who have a significant interval of survival. The presence and classification of pelvic fractures may be readily determined by radiographs in most cases. The Tile classification scheme is easy to apply and has important implications in the comparison of study groups.

Accidents, Traffic↗

PubMed2002

Fixation failure in femoral neck fractures.

Fixation of femoral neck fractures is associated with a higher incidence of complications than any other fracture. The rates of nonunion and avascular necrosis with open reduction and internal fixation continue to be unacceptably high. These complications are the main reason for resorting to primary endoprosthetic replacement of the femoral head in the presence of displaced fractures in elderly patients. However, with the increasing life span of the patients with these prostheses, late complications of endoprosthetic replacement of the femoral head are becoming significant. With these complications, it may be argued that the most cost-effective solution to the femoral neck fracture in the majority of patients is open reduction and internal fixation, with elective conversion, when necessary, to total hip arthroplasty in patients who have a complication. Because the literature does not contain a systematic review of reasons for failure of internal fixation, the authors will attempt to review the common means of failure of internal fixation in young and older patients in an attempt to better understand and prevent these complications.

Adult↗

PubMedDate not supplied

Use of a hinged external knee fixator after surgery for knee dislocation.

PURPOSE: This study documents short-term clinical outcomes in patients with knee dislocations after blunt trauma and evaluates the compass knee hinge (CKH) external fixator for their treatment. TYPE OF STUDY: Nonrandomized prospective functional outcome study. METHODS: Forty patients with 43 knee dislocations were evaluated. Twelve knees underwent ligament reconstruction followed by placement of a CKH; this was group A. Group B included 27 knees that underwent the same treatment and rehabilitation protocol except that an external brace was used rather than a CKH. RESULTS: Thirty-six patients with 39 knee dislocations underwent follow-up ranging from 14 to 41 months (mean, 24). Four patients with 4 knee dislocations were lost to follow-up (1 group A, 3 group B). Group A underwent 27 knee ligament procedures with 2 (7%) failures based on clinical examination. Group B underwent 102 ligament procedures with 30 (29%) failures (P <.05). Anterior cruciate ligament (ACL) reconstruction revealed that 7 group A patients experienced 1 (14%) failure and 25 Group B patients experienced 7 (28%) failures. Posterior cruciate ligament (PCL) reconstruction in 7 group A patients included no failures, and 20 PCL reconstructions in group B included 1 failure. Reconstruction of the posterolateral corner (PLC) yielded no failures in 2 group A patients and 5 (25%) of 20 in group B. Repair of 8 PLCs in group A yielded 1 (12.5%) failure and 26 PLC repairs in group B had 14 (54%; P =.05). SF-36 data revealed low mean values with no significant differences between groups with current enrollment. CONCLUSIONS: Knee dislocation after blunt trauma requires aggressive surgical treatment and physical therapy. In the short-term evaluation, the CKH allows aggressive physical therapy without placing repaired or reconstructed ligaments under high stresses that can result in failure.

Accidents, Traffic↗