Background: Maxillofacial injury may vary from simple soft tissue lacerations to complex fractures of the orofacial region. Soft tissue injuries, whether isolated or in combination with other injuries, form part of th...Background: Maxillofacial injury may vary from simple soft tissue lacerations to complex fractures of the orofacial region. Soft tissue injuries, whether isolated or in combination with other injuries, form part of the frequent traumatic craniofacial injuries seen at the emergency department. The force of impact and the injury type is directly related to the severity of the injury sustained. This study aimed to analyze the etiological factors, prevalence, and management of oral and maxillofacial soft tissue injuries at the Komfo Anokye Teaching Hospital. Methods: This was a prospective study that involved children presenting with oral and maxillofacial injuries at the Accident and Emergency Department and the Oral and Maxillofacial Surgery unit of the Komfo Anokye Teaching Hospital in Kumasi between the period of April to October 2020 (6 months). Patient selection was by convenience sampling targeting all children with injuries who met the inclusion criteria. Inclusion criteria were children below the age of 18 years whose parents or caregivers consent to participation. Children with maxillofacial injuries as a result of burns were excluded from the study. Results: During the study period a total of 134 children were reviewed with oral and maxillofacial injuries at KATH. Of these, 107 (78.9%) were recorded cases of orofacial soft tissue injuries. There were 63 (58.9%) males and 44 (41.1%) females and the male-to-female ratio was 1.5:1. The age range of patients studied was 8 months – 17 years, with mean age ± SD being 9.5 ± 5.3 years. Road Traffic Crash (50.5%) was the most common etiology of which Motor cycle crash constituted 24.3% and Pedestrian knockdown was 19.6%. Falls (42.1%) were the next most common etiology. The lips (19.8%) and the forehead (18.5%) were the most frequently injured sites on the face whiles the tongue (3.3%) had the most injuries intraorally. Laceration (45.7%) was the most frequent injury reviewed, followed by abrasions (35.8%). Most of the soft tissue injuries underwent primary closure (56.3%). A complication rate of 21.2% was recorded in this study and hypertrophic scarring (11.3%) was the most observed.展开更多
Cold therapy has been used regularly as an immediate treatment to induce analgesia following acute soft-tissue injuries,however,a prolonged ice application has proved to delay the start of the healing and lengthen the...Cold therapy has been used regularly as an immediate treatment to induce analgesia following acute soft-tissue injuries,however,a prolonged ice application has proved to delay the start of the healing and lengthen the recovery process.Hyperbaric gaseous cryotherapy,also known as neurocryostimulation,has shown the ability to overcome most of the limitations of traditional cold therapy,and meanwhile promotes the analgesic and anti-inflammatory effects well,but the current existing studies have shown conflicting results on its effects.Traditional cold therapy still has beneficial effect especially when injuries are severe and swelling is the limiting factor for recovery after soft-tissue injuries,and therefore no need to be entirely put out to pasture in the rehabilitation practice.Strong randomized controlled trials with good methodological quality are still needed in the future to evaluate the effects of different cryotherapy modalities.展开更多
BACKGROUND: Pakistan has been hugely struck with massive bomb explosions(car and suicide bombs) resulting in multiple casualties in the past few years. The aim of this study is to present the patterns of skeletal and ...BACKGROUND: Pakistan has been hugely struck with massive bomb explosions(car and suicide bombs) resulting in multiple casualties in the past few years. The aim of this study is to present the patterns of skeletal and soft tissue injuries and to review the outcome of the victims who presented to our hospital.METHODS: This is a retrospective chart review from January 2008 to December 2012. The medical record numbers of patients were obtained from the hospital Health Information and Management Sciences(HIMS) as per the ICD-9 coding.RESULTS: During the study period, more than 100 suicide and implanted bomb blast attacks took place in the public proceedings, government offices, residential areas and other places of the city. Altogether 262 patients were enrolled in the study. The mean age of the patients was 31±14 years. The shrapnel inflicted wounds were present on to the upper limb in 24 patients and the lower limb in 50.CONCLUSION: Long bone fractures were the most common skeletal injuries. The fractures were complicated by penetrating fragments and nails which result in post operative infections and prolonged hospital stay.展开更多
[Objectives]This study was conducted to observe the therapeutic effect of Jipei Dilong Ointment on rats with acute soft tissue injury caused by heavy objects and to explore its action mechanism.[Methods]Thirty six rat...[Objectives]This study was conducted to observe the therapeutic effect of Jipei Dilong Ointment on rats with acute soft tissue injury caused by heavy objects and to explore its action mechanism.[Methods]Thirty six rats were randomly divided into six groups(control group,model group,high-dose Jipei Dilong Ointment group(JP-H),medium-dose Jipei Dilong Ointment group(JP-M),low-dose Jipei Dilong Ointment group(JP-L)and diclofenac group).Except for the Control group,other groups were subjected to modeling of acute soft tissue injury by the weight impact method.All administration was performed once a day for nine consecutive days.The local appearance score and activity disorder score were determined after soft tissue injury in rats.HE staining was used to detect the pathological changes of injured soft tissues in rats.RT-PCR was used to detect the relative mRNA expressions of Bax,Bcl-2,MMP-9 and TIMP-1 in injured soft tissues of rats.Western Blot was used to detect the protein expressions of MMP-9,TIMP-1,TLR4,MyD88 and NF-κB p65 in injured soft tissues of rats.Results were statistically analyzed.[Results]Compared with the model group,Jipei Dilong Ointment could significantly improve the appearance symptoms such as swelling and ecchymosis in the injured area and the movement function of the affected limb(P<0.05).It could also improve the infiltration of inflammatory cells and widening of the intermuscular space caused by injury.Among them,the JP-H group and the diclofenac group had more significant curative effects.After 9 d of administration,each administration group could significantly up-regulate the ratio of Bcl-2/Bax mRNA expression level(P<0.05 or P<0.01),and the ratio of MMP-9/TIMP-1 mRNA expression level showed a downward trend(P>0.05).The expression level of NF-κB p65 protein in each administration group was significantly decreased(P<0.01).The protein expression levels of TLR4 and MyD88 and the ratio of MMP-9/TIMP-1 protein expression level in each administration group decreased to varying degrees.Among them,the JP-H group and diclofenac group significantly decreased(P<0.05).[Conclusions]Jipei Dilong Ointment has the functions of relieving pain,swelling and inflammation.It could improve the local appearance,functional activity and tissue morphology of affected limbs in rats,and has a therapeutic effect on acute soft tissue injury in rats.Its mechanism of action might be related to the inhibition of TLR4/MyD88/NF-κB p65 signaling pathway and the regulation of Bcl-2/Bax and MMP-9/TIMP-1 balance.展开更多
Introduction: Pilon fracture in elderly individuals is characterized by senile skin atrophy, poor dermal extensibility, and thin subcutaneous tissue. The use of bulky internal fixation material can thus cause the swel...Introduction: Pilon fracture in elderly individuals is characterized by senile skin atrophy, poor dermal extensibility, and thin subcutaneous tissue. The use of bulky internal fixation material can thus cause the swelling that accompanies the fracture to induce secondary injury to skin tissue. In addition, initiation of postoperative weight-bearing is delayed due to bone fragility and difficulties with partial weight-bearing, causing a tendency toward prolonged hospitalization. Mean duration of hospitalization after pilon fracture for elderly patients in our department was 79.2 days. Case Presentation: An 80-year-old woman with pilon fracture with soft tissue injury and severe osteoporosis was transferred to our department. The fracture was treated using Ilizarov external fixation. Fourteen days postoperatively, walking with full weight-bearing was permitted. The hospital stay was 28 days. The external fixator of the ankle was removed 87 days postoperatively, at which time the patient was anatomically and functionally recovered and able to walk unaided. Conclusion: Ilizarov external fixation may represent a useful option in elderly patients with pilon fracture showing severe soft tissue injury and severe osteoporosis. The present case provides evidence that this procdure can be successfully applied to the management of such pilon fractures in elderly patients.展开更多
High energy bone fractures resulting from impact trauma are often accompanied by subcutaneous soft tissue injuries, even if the skin remains intact. There is evidence that such closed soft tissue injuries affect the h...High energy bone fractures resulting from impact trauma are often accompanied by subcutaneous soft tissue injuries, even if the skin remains intact. There is evidence that such closed soft tissue injuries affect the healing of bone fractures, and vice versa. Despite this knowledge, most impact trauma studies in animals have focussed on bone fractures or soft tissue trauma in isolation. However, given the simultaneous impact on both tissues a better understanding of the interaction between these two injuries is necessary to optimise clinical treatment. The aim of this study was therefore to develop a new experimental model and characterise, for the first time, the healing of a complex fracture with concurrent closed soft tissue trauma in sheep. A pendulum impact device was designed to deliver a defined and standardised impact to the distal thigh of sheep, causing a reproducible contusion injury to the subcutaneous soft tissues. In a subsequent procedure, a reproducible femoral butterfly fracture (AO C3-type) was created at the sheep’s femur, which was initially stabilised for 5 days by an external fixator construct to allow for soft tissue swelling to recede, and ultimately in a bridging construct using locking plates. The combined injuries were applied to twelve sheep and the healing observed for four or eight weeks (six animals per group) until sacrifice. The pendulum impact led to a moderate to severe circumferential soft tissue injury with significant bruising, haematomas and partial muscle disruptions. Posttraumatic measurements showed elevated intra-compartmental pressure and circulatory tissue breakdown markers, with recovery to normal, pre-injury values within four days. Clinically, no neurovascular deficiencies were observed. Bi-weekly radiological analysis of the healing fractures showed progressive callus healing over time, with the average number of callus bridges increasing from 0.4 at two weeks to 4.2 at eight weeks. Biomechanical testing after sacrifice showed in- creasing torsional stiffness between four and eight weeks healing time from 10% to 100%, and increasing ultimate torsional strength from 10% to 64% (relative to the contralateral control limb). Our results demonstrate the robust healing of a complex femur fracture in the presence of a severe soft tissue contusion injury in sheep and demonstrate the establishment of a clinically relevant experimental model, for research aimed at improving the treatment of bone fractures accompanied by closed soft tissue injuries.展开更多
Objective The objective of this study was to screen the therapeutic target of olibanum and myrrha on acute soft tissue injury(ASTI)by network pharmacology and to clarify their mechanisms.Methods The main chemical cons...Objective The objective of this study was to screen the therapeutic target of olibanum and myrrha on acute soft tissue injury(ASTI)by network pharmacology and to clarify their mechanisms.Methods The main chemical constituents and the targets of olibanum and myrrha were obtained by using traditional Chinese medicine systems pharmacology database and analysis platform database.The disease targets of ASTI were searched by GeneCards.The intersection targets of herbs and diseases were selected for protein interaction analysis,protein–protein interaction network was constructed,and potential protein functional modules in the network were explored.A compound–target–disease network was constructed using Cytoscape3.8.2 software.The targets were analyzed by gene ontology analysis and Kyoto Encyclopedia of Genes and Genomes enrichment analysis based on the Metascape database.Results The core active components of olibanum and myrrha were quercetin,β-sitosterol,and stigmasterol.The core targets were PGR,NCOA2,PTGS2,PRKCA,and NR3C2.Pathways in cancer,AGE-RAGE signaling pathway in diabetic complications might play a potential role in olibanum and myrrha in the treatment of ASTI.Conclusion Olibanum and myrrha have the characteristics of multiple components,multiple targets,and overall regulation in the treatment of ASTI.展开更多
Contralateral needling method is a common and effective one of acupuncture analgesicmethods.It is used to treat a local pain in the limbs and trunk with a short course of disease,pain and swelling will disappear or be...Contralateral needling method is a common and effective one of acupuncture analgesicmethods.It is used to treat a local pain in the limbs and trunk with a short course of disease,pain and swelling will disappear or be relieved immediately for one or two treatments.Really,there isan effect of relieving pain as soon as the needle is inserted.When the local contralateral needlingmethod is used,the key to improving the effectiveness lies in determining the pain position and its correspondingpoint correctly,the more correct the pain position and its corresponding point are determined,the better the effectiveness will be.In this group,80 cases soft tissue injury were treatedwith local contralateral needling method,the cure rate was 82％,and the total effective rate was100％.展开更多
The left cheek of 8 adult male mongrel dogs was shot with M1935.56mm bul-let fired through an US-made M16 rifle to result in a perforating soft tissue defect.Pri-mary debridement was performed immediately and the seco...The left cheek of 8 adult male mongrel dogs was shot with M1935.56mm bul-let fired through an US-made M16 rifle to result in a perforating soft tissue defect.Pri-mary debridement was performed immediately and the secondary debridement 72h alter in-jury.After the secondary thorough debridement,the cutaneous side of the defect was re-paired with a saphenous artery-vein free skin(muscular)flap using microvascularanastomosis,and the oral side of the defect was repaired by drawing the surroundingmucosa together and fixing with sutures or with a local sliding mucous membrane flap.All the animals were kept under observation for 2～6 months.It was believed that the pri-mary debridement and secondary thorough debridement were both essential. The survivalrate of the free tissue flap was 75%(6/8).These facts suggest that early repair ofthe oromaxillofacial perforating soft tissue defect due to gunshot is practicable.展开更多
Assessment of muscle damage relies commonly on subjective sensation of pain. The purpose of this research was to test thevalidity of microcurrent conductance on skin over injured tissue to quantify soft tissue injury ...Assessment of muscle damage relies commonly on subjective sensation of pain. The purpose of this research was to test thevalidity of microcurrent conductance on skin over injured tissue to quantify soft tissue injury and recovery following heavy exercisecompared to other indexes of muscle soreness. A randomized, controlled, single-blinded, 1-week trial on 60 subjects.Setting-University Interventions： Subjects did 3 sets of squats for 5 min each. There were 3 groups of 20 subjects. One did nothing andone had heat applied for 8 h post exercise. The final group had heat 24 h after exercise. Tissue resistance and muscle strength force tomove the knee, analog visual pain scale. In the control group, microcurrent continually decreased, eventually decreasing 32% by thethird day post exercise. When heat was given immediately following exercise, microcurrent was 26% greater （P 〈 0.001）. The painscale rose to 3.1/10 as opposed to 5.4/10 for controls. Strength and muscle elasticity stayed mostly constant after heat as opposed to a28% decrease in strength and increase in stiffness in the control subjects. For 24 h delayed heat, microcurrent was 14% greater（P 〈 0.02）, and was unchanged for the first 24 h when no therapy was given. Pain scale rose to 4.8/10. Stiffness was unchanged whilemuscle strength decreased the same as controls. Microcurrent shows agreement with loss of strength, and stiffness from DOMS but notthe subjective pain measure. It appears that microcurrent is a good measure of muscle damage.展开更多
Objective: To observe the therapeutic effect of acupuncture of "Xi" (Cleft) points in treatment of soft tissue injury. Methods: 335 cases of soft tissue injury patients were divided into Cleft point group (2...Objective: To observe the therapeutic effect of acupuncture of "Xi" (Cleft) points in treatment of soft tissue injury. Methods: 335 cases of soft tissue injury patients were divided into Cleft point group (264 cases) and Ashi point group (control group, 71 cases) randomly. In Cleft point group, the 16 Cleft points were used in combination with Ahshi points. In control group, only local Ahshi points were punctured. The treatment was conducted once every day, with 5 sessions being a therapeutic course. After 2 courses of treatment, the therapeutic effect was analyzed. Results: Results showed that the therapeutic effect of cleft point group was significantly better than that of control group (P<0.05), particularly in treatment of acute soft tissue. Conclusion: Cleft point acupuncture has a better therapeutic effect in treatment of soft tissue injury in comparison with Ashi point.展开更多
Objective To explore the research hotspots and main content of the treatment of soft tissue injury with traditional Chinese medicine(TCM)in CNIK in the past 20 years,and to provide reference for the formulation of rel...Objective To explore the research hotspots and main content of the treatment of soft tissue injury with traditional Chinese medicine(TCM)in CNIK in the past 20 years,and to provide reference for the formulation of relevant policies and further research.Methods Based on CNKI,relevant literature was retrieved through subject terms.CiteSpace software was used for visualization analysis of authors,institutions and keywords.Finally,correlation analysis was carried out based on specific content.Results and Conclusion The cooperation networks between authors and research institutions were scattered,and most of them were independent studies.The establishment of cooperation network of research institutions is obviously limited by region.Based on keywords collinear,cluster and emergent analysis,during the sample statistical period,the research content of the treatment for soft tissue injury with TCM focused on clinical trials,especially the clinical therapeutic effects of different treatment schemes.The keywords cluster map mainly forms 10 clusters which are effective and can be analyzed.The treatment for soft tissue injury with TCM focuses more on the external application.展开更多
Background:Following combat-related,extensive soft tissue injury from gunshot wounds or blasts,prolonged duration from injury to full wound closure is associated with infection,increased morbidity and mortality,failur...Background:Following combat-related,extensive soft tissue injury from gunshot wounds or blasts,prolonged duration from injury to full wound closure is associated with infection,increased morbidity and mortality,failure to mobilize,poor functional outcome and increased cost.The purpose of this study was to evaluate a novel treatment enabling early primary closure of combat wounds.Methods:This was a retrospective study of 10 soldiers and civilians with extensive combat-related soft tissue limb injuries(5 gunshot wounds,5 blasts)treated using the TopClosure^(■)Tension Relief System(TRS)with simultaneous administration of regulated oxygen-enriched and irrigation negative pressure-assisted wound therapy(ROINPT)via the Vcareα^(■)device.Results:Nine patients were treated during the acute phase of injury and one was treated following removal of a flap due to deep infection 20 years after injury and flap reconstruction.Two patients had upper limb injury and the rest lower limb injury.With the aid of the TRS and/or ROINPT,immediate primary closure during reconstruction was achieved in 6 patients and delayed primary closure in three.Only one patient required a skin graft to close a small area of the wound after most of the wound had been closed by delayed primary closure.Wound closure was achieved within 0–37 days(median:12.5 days,interquartile range:2.75–19.75)from injury.Conclusions:The TRS is a novel device for effective,early skin stretching and secure wound closure through the application of stress relaxation and mechanical creep,achieving primary closure of large defects using a simplified surgical technique and reducing the need for closure using skin grafts and flaps and the use of tissue expanders.Delivering supplemental oxygen to the wound by ROINPT reverses the reduced oxygen levels inherent in conventional negative pressure-assisted wound therapy,mitigating anaerobic contamination and reducing infection.Irrigation may accelerate the evacuation of infectious material from the wound and provide a novel method for antibiotic administration.The combination of TRS and ROINPT devices allow for early primary closure with improved functionality of combat-related limb injuries.展开更多
Objective： To compare the therapeutic effects between the needling method by identification of deficient and excessive patterns and the needling method by routine meridian differentiation in the treatment of soft tis...Objective： To compare the therapeutic effects between the needling method by identification of deficient and excessive patterns and the needling method by routine meridian differentiation in the treatment of soft tissue injuries. Methods. 380 cases of the patients with soft tissue injuries were randomly divided into pattern identification group （200 cases, with the needling method by identification of deficient and excessive patterns） and meridian identification group （180 cases, with the needling method by routine meridian differentiation）, to observe and compare the therapeutic effects in the two groups. Results： The curative effect was 86% in the pattern identification group and 31.11% in the meridian identification group, with a significant difference （P〈 0.01）. In comparison with the total average treatment times in the cured and improved cases, the pattern identification group was 8.8 days and the meridian identification group was 15.6 days, with a remarkable significant difference （P〈 0.01）. The pattern identification group was better than the meridian identification group. Conclusion： In the treatment of soft tissue injuries, the needling method by identification of deficient and excessive patterns was better than the needling method by routine meridian differentiation.展开更多
Objective: To investigate the immediate analgesic effect of sinew acupuncture for patients with soft-tissue injuries (STIs). Methods: Two hundreds eligible adult patients suffering from STIs were recruited and receive...Objective: To investigate the immediate analgesic effect of sinew acupuncture for patients with soft-tissue injuries (STIs). Methods: Two hundreds eligible adult patients suffering from STIs were recruited and received sinew acupuncture with flexible treatment schedules. The number of treatment sessions was pragmatically decided by each patient on the basis of their pain relief. The outcome measurement was the change of pain rating in the Visual Analogue Scale (VAS) during the first 5 sessions. The adverse effect was also observed. Results: Of the 200 patients recruited, 7 were excluded due to incomplete data. In total, 888 sinew acupuncture treatments were administered to patients at 14 injury sites (including head, neck, shoulder, arm, chest, elbow, wrist, hand, waist and hip, knee, thigh, calf, ankle, and foot) where pain was felt. Compared with the baseline, the VAS rating after the first and last treatments were both significantly reduced at all the injury sites (P<0.01). The VAS rating was also significantly reduced after each session of treatment in the first five sessions (P<0.01). No serious adverse effect was observed. Conclusion: Sinew acupuncture had not only an immediate analgesic effect for STIs, but also an accumulated analgesic effect during the first 5 treatment sessions.展开更多
Introduction:Hemorrhage control is the essence of trauma care.Conventional teaching is 1 on the floor(ie,external bleeding)and 4 more(thoracic cavity,abdomen,retroperitoneum,and long bones).In this case report,we pres...Introduction:Hemorrhage control is the essence of trauma care.Conventional teaching is 1 on the floor(ie,external bleeding)and 4 more(thoracic cavity,abdomen,retroperitoneum,and long bones).In this case report,we present a unique case with concealed bleeding into the soft tissue compartment leading to shock.This case triggered to consider the soft tissue compartment as the sixth potential bleeding site in trauma patients in hemorrhagic shock.Case presentation:We present the case with concealed bleeding into the soft tissue compartment posing a challenge in management.On presentation,he had a pulse rate of 117 beats/min,a blood pressure of 90/60mmHg,and a Glasgow Coma Scale(GCS)score of 9.During resuscitation,the patient's blood pressure dropped to 70/46 mmHg with a GCS of 7 of 15.He was then intubated and reevaluated.Contrast-enhanced computed tomography of the torso revealed a right scapular fracture with a large soft tissue hematoma along the right side of the neck and chest wall,extending up to the right lumbar region.Conclusion:We suggest that the soft tissue compartment is the sixth potential site of internal bleeding in trauma patients,which should not be overlooked after having ruled out the other 5 sites.展开更多
文摘Background: Maxillofacial injury may vary from simple soft tissue lacerations to complex fractures of the orofacial region. Soft tissue injuries, whether isolated or in combination with other injuries, form part of the frequent traumatic craniofacial injuries seen at the emergency department. The force of impact and the injury type is directly related to the severity of the injury sustained. This study aimed to analyze the etiological factors, prevalence, and management of oral and maxillofacial soft tissue injuries at the Komfo Anokye Teaching Hospital. Methods: This was a prospective study that involved children presenting with oral and maxillofacial injuries at the Accident and Emergency Department and the Oral and Maxillofacial Surgery unit of the Komfo Anokye Teaching Hospital in Kumasi between the period of April to October 2020 (6 months). Patient selection was by convenience sampling targeting all children with injuries who met the inclusion criteria. Inclusion criteria were children below the age of 18 years whose parents or caregivers consent to participation. Children with maxillofacial injuries as a result of burns were excluded from the study. Results: During the study period a total of 134 children were reviewed with oral and maxillofacial injuries at KATH. Of these, 107 (78.9%) were recorded cases of orofacial soft tissue injuries. There were 63 (58.9%) males and 44 (41.1%) females and the male-to-female ratio was 1.5:1. The age range of patients studied was 8 months – 17 years, with mean age ± SD being 9.5 ± 5.3 years. Road Traffic Crash (50.5%) was the most common etiology of which Motor cycle crash constituted 24.3% and Pedestrian knockdown was 19.6%. Falls (42.1%) were the next most common etiology. The lips (19.8%) and the forehead (18.5%) were the most frequently injured sites on the face whiles the tongue (3.3%) had the most injuries intraorally. Laceration (45.7%) was the most frequent injury reviewed, followed by abrasions (35.8%). Most of the soft tissue injuries underwent primary closure (56.3%). A complication rate of 21.2% was recorded in this study and hypertrophic scarring (11.3%) was the most observed.
文摘Cold therapy has been used regularly as an immediate treatment to induce analgesia following acute soft-tissue injuries,however,a prolonged ice application has proved to delay the start of the healing and lengthen the recovery process.Hyperbaric gaseous cryotherapy,also known as neurocryostimulation,has shown the ability to overcome most of the limitations of traditional cold therapy,and meanwhile promotes the analgesic and anti-inflammatory effects well,but the current existing studies have shown conflicting results on its effects.Traditional cold therapy still has beneficial effect especially when injuries are severe and swelling is the limiting factor for recovery after soft-tissue injuries,and therefore no need to be entirely put out to pasture in the rehabilitation practice.Strong randomized controlled trials with good methodological quality are still needed in the future to evaluate the effects of different cryotherapy modalities.
文摘BACKGROUND: Pakistan has been hugely struck with massive bomb explosions(car and suicide bombs) resulting in multiple casualties in the past few years. The aim of this study is to present the patterns of skeletal and soft tissue injuries and to review the outcome of the victims who presented to our hospital.METHODS: This is a retrospective chart review from January 2008 to December 2012. The medical record numbers of patients were obtained from the hospital Health Information and Management Sciences(HIMS) as per the ICD-9 coding.RESULTS: During the study period, more than 100 suicide and implanted bomb blast attacks took place in the public proceedings, government offices, residential areas and other places of the city. Altogether 262 patients were enrolled in the study. The mean age of the patients was 31±14 years. The shrapnel inflicted wounds were present on to the upper limb in 24 patients and the lower limb in 50.CONCLUSION: Long bone fractures were the most common skeletal injuries. The fractures were complicated by penetrating fragments and nails which result in post operative infections and prolonged hospital stay.
基金Supported by National Key R&D Plan(2019YFC1712500)Guizhou Provincial Science and Technology Planning Project(QKHHBZ[2020]3003)On-campus Project of Guizhou University of Traditional Chinese Medicine(2018YFC170810520).
文摘[Objectives]This study was conducted to observe the therapeutic effect of Jipei Dilong Ointment on rats with acute soft tissue injury caused by heavy objects and to explore its action mechanism.[Methods]Thirty six rats were randomly divided into six groups(control group,model group,high-dose Jipei Dilong Ointment group(JP-H),medium-dose Jipei Dilong Ointment group(JP-M),low-dose Jipei Dilong Ointment group(JP-L)and diclofenac group).Except for the Control group,other groups were subjected to modeling of acute soft tissue injury by the weight impact method.All administration was performed once a day for nine consecutive days.The local appearance score and activity disorder score were determined after soft tissue injury in rats.HE staining was used to detect the pathological changes of injured soft tissues in rats.RT-PCR was used to detect the relative mRNA expressions of Bax,Bcl-2,MMP-9 and TIMP-1 in injured soft tissues of rats.Western Blot was used to detect the protein expressions of MMP-9,TIMP-1,TLR4,MyD88 and NF-κB p65 in injured soft tissues of rats.Results were statistically analyzed.[Results]Compared with the model group,Jipei Dilong Ointment could significantly improve the appearance symptoms such as swelling and ecchymosis in the injured area and the movement function of the affected limb(P<0.05).It could also improve the infiltration of inflammatory cells and widening of the intermuscular space caused by injury.Among them,the JP-H group and the diclofenac group had more significant curative effects.After 9 d of administration,each administration group could significantly up-regulate the ratio of Bcl-2/Bax mRNA expression level(P<0.05 or P<0.01),and the ratio of MMP-9/TIMP-1 mRNA expression level showed a downward trend(P>0.05).The expression level of NF-κB p65 protein in each administration group was significantly decreased(P<0.01).The protein expression levels of TLR4 and MyD88 and the ratio of MMP-9/TIMP-1 protein expression level in each administration group decreased to varying degrees.Among them,the JP-H group and diclofenac group significantly decreased(P<0.05).[Conclusions]Jipei Dilong Ointment has the functions of relieving pain,swelling and inflammation.It could improve the local appearance,functional activity and tissue morphology of affected limbs in rats,and has a therapeutic effect on acute soft tissue injury in rats.Its mechanism of action might be related to the inhibition of TLR4/MyD88/NF-κB p65 signaling pathway and the regulation of Bcl-2/Bax and MMP-9/TIMP-1 balance.
文摘Introduction: Pilon fracture in elderly individuals is characterized by senile skin atrophy, poor dermal extensibility, and thin subcutaneous tissue. The use of bulky internal fixation material can thus cause the swelling that accompanies the fracture to induce secondary injury to skin tissue. In addition, initiation of postoperative weight-bearing is delayed due to bone fragility and difficulties with partial weight-bearing, causing a tendency toward prolonged hospitalization. Mean duration of hospitalization after pilon fracture for elderly patients in our department was 79.2 days. Case Presentation: An 80-year-old woman with pilon fracture with soft tissue injury and severe osteoporosis was transferred to our department. The fracture was treated using Ilizarov external fixation. Fourteen days postoperatively, walking with full weight-bearing was permitted. The hospital stay was 28 days. The external fixator of the ankle was removed 87 days postoperatively, at which time the patient was anatomically and functionally recovered and able to walk unaided. Conclusion: Ilizarov external fixation may represent a useful option in elderly patients with pilon fracture showing severe soft tissue injury and severe osteoporosis. The present case provides evidence that this procdure can be successfully applied to the management of such pilon fractures in elderly patients.
文摘High energy bone fractures resulting from impact trauma are often accompanied by subcutaneous soft tissue injuries, even if the skin remains intact. There is evidence that such closed soft tissue injuries affect the healing of bone fractures, and vice versa. Despite this knowledge, most impact trauma studies in animals have focussed on bone fractures or soft tissue trauma in isolation. However, given the simultaneous impact on both tissues a better understanding of the interaction between these two injuries is necessary to optimise clinical treatment. The aim of this study was therefore to develop a new experimental model and characterise, for the first time, the healing of a complex fracture with concurrent closed soft tissue trauma in sheep. A pendulum impact device was designed to deliver a defined and standardised impact to the distal thigh of sheep, causing a reproducible contusion injury to the subcutaneous soft tissues. In a subsequent procedure, a reproducible femoral butterfly fracture (AO C3-type) was created at the sheep’s femur, which was initially stabilised for 5 days by an external fixator construct to allow for soft tissue swelling to recede, and ultimately in a bridging construct using locking plates. The combined injuries were applied to twelve sheep and the healing observed for four or eight weeks (six animals per group) until sacrifice. The pendulum impact led to a moderate to severe circumferential soft tissue injury with significant bruising, haematomas and partial muscle disruptions. Posttraumatic measurements showed elevated intra-compartmental pressure and circulatory tissue breakdown markers, with recovery to normal, pre-injury values within four days. Clinically, no neurovascular deficiencies were observed. Bi-weekly radiological analysis of the healing fractures showed progressive callus healing over time, with the average number of callus bridges increasing from 0.4 at two weeks to 4.2 at eight weeks. Biomechanical testing after sacrifice showed in- creasing torsional stiffness between four and eight weeks healing time from 10% to 100%, and increasing ultimate torsional strength from 10% to 64% (relative to the contralateral control limb). Our results demonstrate the robust healing of a complex femur fracture in the presence of a severe soft tissue contusion injury in sheep and demonstrate the establishment of a clinically relevant experimental model, for research aimed at improving the treatment of bone fractures accompanied by closed soft tissue injuries.
基金supported by the Science and Technology Project of Xi 'an Science and Technology Bureau [201805093YX1SF27(16)]Scientific Research Project of Shaanxi Provincial Administration of Traditional Chinese Medicine (15-JC014).
文摘Objective The objective of this study was to screen the therapeutic target of olibanum and myrrha on acute soft tissue injury(ASTI)by network pharmacology and to clarify their mechanisms.Methods The main chemical constituents and the targets of olibanum and myrrha were obtained by using traditional Chinese medicine systems pharmacology database and analysis platform database.The disease targets of ASTI were searched by GeneCards.The intersection targets of herbs and diseases were selected for protein interaction analysis,protein–protein interaction network was constructed,and potential protein functional modules in the network were explored.A compound–target–disease network was constructed using Cytoscape3.8.2 software.The targets were analyzed by gene ontology analysis and Kyoto Encyclopedia of Genes and Genomes enrichment analysis based on the Metascape database.Results The core active components of olibanum and myrrha were quercetin,β-sitosterol,and stigmasterol.The core targets were PGR,NCOA2,PTGS2,PRKCA,and NR3C2.Pathways in cancer,AGE-RAGE signaling pathway in diabetic complications might play a potential role in olibanum and myrrha in the treatment of ASTI.Conclusion Olibanum and myrrha have the characteristics of multiple components,multiple targets,and overall regulation in the treatment of ASTI.
文摘Contralateral needling method is a common and effective one of acupuncture analgesicmethods.It is used to treat a local pain in the limbs and trunk with a short course of disease,pain and swelling will disappear or be relieved immediately for one or two treatments.Really,there isan effect of relieving pain as soon as the needle is inserted.When the local contralateral needlingmethod is used,the key to improving the effectiveness lies in determining the pain position and its correspondingpoint correctly,the more correct the pain position and its corresponding point are determined,the better the effectiveness will be.In this group,80 cases soft tissue injury were treatedwith local contralateral needling method,the cure rate was 82％,and the total effective rate was100％.
文摘The left cheek of 8 adult male mongrel dogs was shot with M1935.56mm bul-let fired through an US-made M16 rifle to result in a perforating soft tissue defect.Pri-mary debridement was performed immediately and the secondary debridement 72h alter in-jury.After the secondary thorough debridement,the cutaneous side of the defect was re-paired with a saphenous artery-vein free skin(muscular)flap using microvascularanastomosis,and the oral side of the defect was repaired by drawing the surroundingmucosa together and fixing with sutures or with a local sliding mucous membrane flap.All the animals were kept under observation for 2～6 months.It was believed that the pri-mary debridement and secondary thorough debridement were both essential. The survivalrate of the free tissue flap was 75%(6/8).These facts suggest that early repair ofthe oromaxillofacial perforating soft tissue defect due to gunshot is practicable.
文摘Assessment of muscle damage relies commonly on subjective sensation of pain. The purpose of this research was to test thevalidity of microcurrent conductance on skin over injured tissue to quantify soft tissue injury and recovery following heavy exercisecompared to other indexes of muscle soreness. A randomized, controlled, single-blinded, 1-week trial on 60 subjects.Setting-University Interventions： Subjects did 3 sets of squats for 5 min each. There were 3 groups of 20 subjects. One did nothing andone had heat applied for 8 h post exercise. The final group had heat 24 h after exercise. Tissue resistance and muscle strength force tomove the knee, analog visual pain scale. In the control group, microcurrent continually decreased, eventually decreasing 32% by thethird day post exercise. When heat was given immediately following exercise, microcurrent was 26% greater （P 〈 0.001）. The painscale rose to 3.1/10 as opposed to 5.4/10 for controls. Strength and muscle elasticity stayed mostly constant after heat as opposed to a28% decrease in strength and increase in stiffness in the control subjects. For 24 h delayed heat, microcurrent was 14% greater（P 〈 0.02）, and was unchanged for the first 24 h when no therapy was given. Pain scale rose to 4.8/10. Stiffness was unchanged whilemuscle strength decreased the same as controls. Microcurrent shows agreement with loss of strength, and stiffness from DOMS but notthe subjective pain measure. It appears that microcurrent is a good measure of muscle damage.
文摘Objective: To observe the therapeutic effect of acupuncture of "Xi" (Cleft) points in treatment of soft tissue injury. Methods: 335 cases of soft tissue injury patients were divided into Cleft point group (264 cases) and Ashi point group (control group, 71 cases) randomly. In Cleft point group, the 16 Cleft points were used in combination with Ahshi points. In control group, only local Ahshi points were punctured. The treatment was conducted once every day, with 5 sessions being a therapeutic course. After 2 courses of treatment, the therapeutic effect was analyzed. Results: Results showed that the therapeutic effect of cleft point group was significantly better than that of control group (P<0.05), particularly in treatment of acute soft tissue. Conclusion: Cleft point acupuncture has a better therapeutic effect in treatment of soft tissue injury in comparison with Ashi point.
文摘Objective To explore the research hotspots and main content of the treatment of soft tissue injury with traditional Chinese medicine(TCM)in CNIK in the past 20 years,and to provide reference for the formulation of relevant policies and further research.Methods Based on CNKI,relevant literature was retrieved through subject terms.CiteSpace software was used for visualization analysis of authors,institutions and keywords.Finally,correlation analysis was carried out based on specific content.Results and Conclusion The cooperation networks between authors and research institutions were scattered,and most of them were independent studies.The establishment of cooperation network of research institutions is obviously limited by region.Based on keywords collinear,cluster and emergent analysis,during the sample statistical period,the research content of the treatment for soft tissue injury with TCM focused on clinical trials,especially the clinical therapeutic effects of different treatment schemes.The keywords cluster map mainly forms 10 clusters which are effective and can be analyzed.The treatment for soft tissue injury with TCM focuses more on the external application.
文摘Background:Following combat-related,extensive soft tissue injury from gunshot wounds or blasts,prolonged duration from injury to full wound closure is associated with infection,increased morbidity and mortality,failure to mobilize,poor functional outcome and increased cost.The purpose of this study was to evaluate a novel treatment enabling early primary closure of combat wounds.Methods:This was a retrospective study of 10 soldiers and civilians with extensive combat-related soft tissue limb injuries(5 gunshot wounds,5 blasts)treated using the TopClosure^(■)Tension Relief System(TRS)with simultaneous administration of regulated oxygen-enriched and irrigation negative pressure-assisted wound therapy(ROINPT)via the Vcareα^(■)device.Results:Nine patients were treated during the acute phase of injury and one was treated following removal of a flap due to deep infection 20 years after injury and flap reconstruction.Two patients had upper limb injury and the rest lower limb injury.With the aid of the TRS and/or ROINPT,immediate primary closure during reconstruction was achieved in 6 patients and delayed primary closure in three.Only one patient required a skin graft to close a small area of the wound after most of the wound had been closed by delayed primary closure.Wound closure was achieved within 0–37 days(median:12.5 days,interquartile range:2.75–19.75)from injury.Conclusions:The TRS is a novel device for effective,early skin stretching and secure wound closure through the application of stress relaxation and mechanical creep,achieving primary closure of large defects using a simplified surgical technique and reducing the need for closure using skin grafts and flaps and the use of tissue expanders.Delivering supplemental oxygen to the wound by ROINPT reverses the reduced oxygen levels inherent in conventional negative pressure-assisted wound therapy,mitigating anaerobic contamination and reducing infection.Irrigation may accelerate the evacuation of infectious material from the wound and provide a novel method for antibiotic administration.The combination of TRS and ROINPT devices allow for early primary closure with improved functionality of combat-related limb injuries.
文摘Objective： To compare the therapeutic effects between the needling method by identification of deficient and excessive patterns and the needling method by routine meridian differentiation in the treatment of soft tissue injuries. Methods. 380 cases of the patients with soft tissue injuries were randomly divided into pattern identification group （200 cases, with the needling method by identification of deficient and excessive patterns） and meridian identification group （180 cases, with the needling method by routine meridian differentiation）, to observe and compare the therapeutic effects in the two groups. Results： The curative effect was 86% in the pattern identification group and 31.11% in the meridian identification group, with a significant difference （P〈 0.01）. In comparison with the total average treatment times in the cured and improved cases, the pattern identification group was 8.8 days and the meridian identification group was 15.6 days, with a remarkable significant difference （P〈 0.01）. The pattern identification group was better than the meridian identification group. Conclusion： In the treatment of soft tissue injuries, the needling method by identification of deficient and excessive patterns was better than the needling method by routine meridian differentiation.
文摘Objective: To investigate the immediate analgesic effect of sinew acupuncture for patients with soft-tissue injuries (STIs). Methods: Two hundreds eligible adult patients suffering from STIs were recruited and received sinew acupuncture with flexible treatment schedules. The number of treatment sessions was pragmatically decided by each patient on the basis of their pain relief. The outcome measurement was the change of pain rating in the Visual Analogue Scale (VAS) during the first 5 sessions. The adverse effect was also observed. Results: Of the 200 patients recruited, 7 were excluded due to incomplete data. In total, 888 sinew acupuncture treatments were administered to patients at 14 injury sites (including head, neck, shoulder, arm, chest, elbow, wrist, hand, waist and hip, knee, thigh, calf, ankle, and foot) where pain was felt. Compared with the baseline, the VAS rating after the first and last treatments were both significantly reduced at all the injury sites (P<0.01). The VAS rating was also significantly reduced after each session of treatment in the first five sessions (P<0.01). No serious adverse effect was observed. Conclusion: Sinew acupuncture had not only an immediate analgesic effect for STIs, but also an accumulated analgesic effect during the first 5 treatment sessions.
文摘Introduction:Hemorrhage control is the essence of trauma care.Conventional teaching is 1 on the floor(ie,external bleeding)and 4 more(thoracic cavity,abdomen,retroperitoneum,and long bones).In this case report,we present a unique case with concealed bleeding into the soft tissue compartment leading to shock.This case triggered to consider the soft tissue compartment as the sixth potential bleeding site in trauma patients in hemorrhagic shock.Case presentation:We present the case with concealed bleeding into the soft tissue compartment posing a challenge in management.On presentation,he had a pulse rate of 117 beats/min,a blood pressure of 90/60mmHg,and a Glasgow Coma Scale(GCS)score of 9.During resuscitation,the patient's blood pressure dropped to 70/46 mmHg with a GCS of 7 of 15.He was then intubated and reevaluated.Contrast-enhanced computed tomography of the torso revealed a right scapular fracture with a large soft tissue hematoma along the right side of the neck and chest wall,extending up to the right lumbar region.Conclusion:We suggest that the soft tissue compartment is the sixth potential site of internal bleeding in trauma patients,which should not be overlooked after having ruled out the other 5 sites.
