RESUMO
BACKGROUND: Open reduction and internal fixation of unstable pelvic fractures has been advocated to minimize complications and avoid further injury. We have recently performed CT guided percutaneous fixation of sacroiliac joints as an alternative to open repair. METHODS: From May 1, 1998 to April 30, 1999, our Level II trauma center admitted 76 patients with pelvic fractures, all due to blunt trauma. Twenty patients with unstable sacroiliac fracture-distractions underwent 22 percutaneous fixation procedures under general anesthesia in the radiology department by the third hospital day. Procedure times averaged 82 minutes. Localization with CT guidance was performed by the radiologist using 3-D images followed by percutaneous screw placement by the orthopaedic surgeon. RESULTS: There was minimal procedural blood loss and no post-procedural wound complications. There was one operative delay due to respiratory difficulties and one postoperative death unrelated to the pelvic fracture. All patients were mobilized on the first post-procedural day. CONCLUSION: CT guided fixation of unstable pelvic fractures minimizes blood loss during a short procedure with few subsequent complications and allows early mobilization of the patients.
Assuntos
Fixação de Fratura/métodos , Fraturas Ósseas , Articulação Sacroilíaca/lesões , Tomografia Computadorizada por Raios X/métodos , Acidentes de Trânsito , Administração Cutânea , Adulto , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Centros de TraumatologiaRESUMO
The neuroradiology of visual deficits has advanced dramatically in recent years. Plain film evaluation of the orbit and face remains useful in the emergency room for the evaluation of trauma. High-resolution coronal CT remains the method of choice in the assessment of serious injury to the orbit and in cases of penetrating metallic foreign body. The contrast-enhanced orbital CT provides useful information in cases of tumor and infection and when the bones of the face or skull are involved. MRI has largely replaced CT in the search for brain infarct, brain tumor, and cerebral inflammatory and demyelinating processes. MRI is the study of choice in all cases of sellar and parasellar disease. It offers high-resolution images in any plane. GTPA enhancement has provided additional information from MRI without significant risk. The final selection of an imaging modality should be based upon the clinical presentation and any physical limitations of the patient.
Assuntos
Imageamento por Ressonância Magnética , Órbita/anatomia & histologia , Tomografia Computadorizada por Raios X , Transtornos da Visão/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Humanos , Neurorradiografia/métodos , Músculos Oculomotores/anatomia & histologia , Músculos Oculomotores/patologia , Nervo Óptico/anatomia & histologia , Nervo Óptico/patologia , Órbita/patologia , Neoplasias Orbitárias/patologia , Colículos Superiores/anatomia & histologia , Colículos Superiores/patologia , Transtornos da Visão/diagnósticoRESUMO
In two cases of intramuscular hemangioma of the paraspinous muscles, the tumors were treated with arteriographic embolization followed by immediate local excision. We found that this technique creates a hypovascular surgical field and facilitates the dissection. We believe this approach will decrease morbidity and potential mortality.
Assuntos
Hemangioma , Doenças Musculares , Adulto , Embolização Terapêutica , Feminino , Hemangioma/irrigação sanguínea , Hemangioma/diagnóstico por imagem , Hemangioma/cirurgia , Humanos , Masculino , Músculos/irrigação sanguínea , Músculos/cirurgia , Doenças Musculares/cirurgia , Coluna Vertebral , Tomografia Computadorizada por Raios XAssuntos
Aneurisma Infectado/diagnóstico por imagem , Artéria Femoral , Neoplasias Femorais/diagnóstico por imagem , Aneurisma Infectado/complicações , Aneurisma Infectado/patologia , Reabsorção Óssea/etiologia , Diagnóstico Diferencial , Feminino , Artéria Femoral/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Osteogênese , RadiografiaRESUMO
The utility of gray scale ultrasonography in evaluation of extrathyroid masses of the head and neck is demonstrated by correlating ultrasonic data with clinical and histologic findings in 40 cases. This technique is valuable in differentiating cystic from noncystic masses in determining the nature of inflammatory masses, and in many cases allows determination of the margins of a mass and its relationship to adjacent structures.
