The Experts below are selected from a list of 99 Experts worldwide ranked by ideXlab platform
Michael A. Carron - One of the best experts on this subject based on the ideXlab platform.
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stability of Midface Fracture repair using absorbable plate and screw system pilot holes drilled and pin placement at angles other than 90
JAMA Facial Plastic Surgery, 2014Co-Authors: Michael A. Carron, Lucio Pereira, Giancarlo Zuliani, Maher Abuhamdan, Adrianna Thibault, Nathan Dau, Cynthia BirAbstract:ImportanceConventional plating systems use titanium plates for fixation of Fractures, with benefits of strength and biocompatibility. However, titanium plates require that screws be placed at a 90°...
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Stability of Midface Fracture Repair Using Absorbable Plates
Otolaryngology–Head and Neck Surgery, 2011Co-Authors: Lucio Pereira, Giancarlo Zuliani, Maher Abu-hamdan, Michael A. CarronAbstract:Objective: Determine if the KLS Martin Sonic Weld system provides plate-screw construct stability in human skulls even when placed at acute angles at the Midface buttresses. The strength of the construct will be compared with absorbable miniplates with screws placed at 90-degree angles.Method: Ten skulls will be prepared by creating Midface osteotomies bilaterally. All screws will be placed at 90 degrees on the control side. The contralateral side will be plated with the absorbable system at more acute angles. The data will be compared as matched pairs within each specimen and statistically analyzed.Results: Fractures fixated with the ultrasonic absorbable plating system placed with screws at all tested angles will fail at similar to our control plates placed at 90 degrees. This will allow the surgeon to successfully reduce Fractures in the Midface fragments in difficult to reach areas and possibly cut down on operative time and improve the chance of achieving a long lasting adequate reduction.Conclusion:...
George C. Velmahos - One of the best experts on this subject based on the ideXlab platform.
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frequency of cervical spine injuries in patients with Midface Fractures
International Journal of Oral and Maxillofacial Surgery, 2020Co-Authors: Esa M Farkkila, George C. Velmahos, Zachary S Peacock, R J Tannyhill, Laurie Petrovick, Alice Gervasini, Leonard B KabanAbstract:Abstract The aim of this retrospective cohort study was to determine the frequency and risk factors for cervical spine injury (CSI) in patients with Midface Fractures. Patients ≥18 years of age entered in the Massachusetts General Hospital Trauma Registry from 2007 to 2017 were identified. Those with a Midface Fracture, computed tomography and/or magnetic resonance imaging of the cervical spine, and complete medical records were included. There were 23,394 patients in the registry; 3950 (16.9%) had craniomaxillofacial Fractures and 1822 (7.8%) had a CSI. Craniomaxillofacial Fractures included Fractures of the Midface (n = 2803, 71.0%), mandible (n = 873, 22.1%), and Midface plus mandible (n = 274, 6.9%). The overall frequency of CSI in patients with Midface Fractures was 11.4% (350/3077). Patients with Midface Fractures had a higher risk for CSI compared to patients without a Midface Fracture (odds ratio 2.4, 95% confidence interval 2.1–2.4, P
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risk factors for cervical spine injury in patients with mandibular Fractures
Journal of Oral and Maxillofacial Surgery, 2019Co-Authors: Esa M Farkkila, George C. Velmahos, Zachary S Peacock, Laurie Petrovick, Alice Gervasini, John R Tannyhill, Leonard B KabanAbstract:Purpose Patients with mandibular Fractures are known to be at risk of concomitant cervical spine injuries (CSIs). The purpose of this study was to determine the incidence of and risk factors for CSIs in these patients. Patients and Methods We conducted a retrospective cohort study of adult trauma patients with mandibular Fractures from June 1, 2007, through June 30, 2017. Patients were identified through the Massachusetts General Hospital trauma registry and were included as study patients if they had a mandibular Fracture and computed tomography or magnetic resonance imaging of the cervical spine. The primary predictor variable was the site of the mandibular Fracture; the primary outcome variables were the presence of CSIs and death. The other variables were demographic characteristics (age, gender, alcohol use, and drug use), Injury Severity Score, Glasgow Coma Scale, presence of Midface and extra-craniofacial injuries, and etiology. Data analysis consisted of univariate correlations and construction of a multivariate model to determine independent risk factors for CSIs. Results Of 23,394 patients in the trauma registry, 3,950 (17%) had craniomaxillofacial Fractures and 1,822 (7.7%) had CSIs. The frequency of CSIs in the overall cohort of mandibular Fracture patients (n = 1,147) was 4.4%, and for admitted patients (n = 495), it was 10%. The mean age of patients with mandibular Fractures plus CSIs was 40 years (range, 19 to 93 years); 84% were men. Patients with a ramus-condyle unit Fracture, mandibular Fracture plus any Midface Fracture, non–craniomaxillofacial injury, and motor vehicle crash etiology had the highest frequency of CSIs. Ramus-condyle unit Fractures and chest injuries were independent risk factors for CSIs in the multivariate model (P = .0334 and P = .0013, respectively). The mortality rate was 4-fold higher in patients with CSIs versus those without CSIs. Conclusions The presence of ramus-condyle unit Fractures and the presence of chest injuries were independent risk factors for CSIs. Oral and maxillofacial surgeons should be diligent in ruling out CSIs in mandibular Fracture patients.
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blunt carotid artery injury the futility of aggressive screening and diagnosis
Archives of Surgery, 2004Co-Authors: John C Mayberry, Erwin R Thal, Edward T Peter, Ashraf M Mansour, David H. Wisner, Carlos V R Brown, Richard J. Mullins, Thomas V Berne, George C. Velmahos, Gregory J JurkovichAbstract:Background Blunt carotid artery injury (BCI) remains a rare but potentially lethal condition. Recent studies recommend that aggressive screening based on broad criteria (hyperextension-hyperflexion mechanism of injury, basilar skull Fracture, cervical spine injury, Midface Fracture, mandibular Fracture, diffuse axonal brain injury, and neck seat-belt sign) increases the rate of diagnosis of BCI by 9-fold. If this recommendation becomes a standard of care, it will require a major consumption of resources and may give rise to liability claims. The benefits of aggressive screening are unclear because the natural history of asymptomatic BCI is unknown and the existing treatments are controversial. Hypothesis The lack of an aggressive angiographic screening protocol does not result in delayed BCI diagnosis or BCI-related neurologic deficits. Methods A 10-year medical record review of patients with BCI was undertaken in 2 level I academic trauma centers. In both centers, urgent screening for BCI was performed in patients with focal neurologic signs or neurologic symptoms unexplainable by results of computed tomography of the brain as well as in selected patients undergoing angiography for another reason. Results Of 35 212 blunt trauma admissions, 17 patients (0.05%) were diagnosed as having BCI. Six showed no evidence of BCI-related neurologic symptoms during hospitalization or prior to death as a result of associated injuries. Eleven sustained a BCI-related stroke, 9 of whom had it within 2 hours of injury. The remaining 2 had a delayed diagnosis (9 and 12 hours after injury) and received only anticoagulation because the lesions were surgically inaccessible. Just 1 of these 2 patients met the criteria for BCI screening and could have been offered earlier treatment, of uncertain benefit, if we had adopted an aggressive screening policy. Conclusions Of the few patients with BCI, most remain asymptomatic or develop neurologic deficits shortly after injury. Although a widely applied, resource-consuming screening program may increase the rate of early diagnosis of BCI, an improvement in outcome is uncertain. A cost-effectiveness analysis should be done before trauma surgeons accept an aggressive screening protocol as the standard of care.
Lucio Pereira - One of the best experts on this subject based on the ideXlab platform.
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stability of Midface Fracture repair using absorbable plate and screw system pilot holes drilled and pin placement at angles other than 90
JAMA Facial Plastic Surgery, 2014Co-Authors: Michael A. Carron, Lucio Pereira, Giancarlo Zuliani, Maher Abuhamdan, Adrianna Thibault, Nathan Dau, Cynthia BirAbstract:ImportanceConventional plating systems use titanium plates for fixation of Fractures, with benefits of strength and biocompatibility. However, titanium plates require that screws be placed at a 90°...
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Stability of Midface Fracture Repair Using Absorbable Plates
Otolaryngology–Head and Neck Surgery, 2011Co-Authors: Lucio Pereira, Giancarlo Zuliani, Maher Abu-hamdan, Michael A. CarronAbstract:Objective: Determine if the KLS Martin Sonic Weld system provides plate-screw construct stability in human skulls even when placed at acute angles at the Midface buttresses. The strength of the construct will be compared with absorbable miniplates with screws placed at 90-degree angles.Method: Ten skulls will be prepared by creating Midface osteotomies bilaterally. All screws will be placed at 90 degrees on the control side. The contralateral side will be plated with the absorbable system at more acute angles. The data will be compared as matched pairs within each specimen and statistically analyzed.Results: Fractures fixated with the ultrasonic absorbable plating system placed with screws at all tested angles will fail at similar to our control plates placed at 90 degrees. This will allow the surgeon to successfully reduce Fractures in the Midface fragments in difficult to reach areas and possibly cut down on operative time and improve the chance of achieving a long lasting adequate reduction.Conclusion:...
Leonard B Kaban - One of the best experts on this subject based on the ideXlab platform.
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frequency of cervical spine injuries in patients with Midface Fractures
International Journal of Oral and Maxillofacial Surgery, 2020Co-Authors: Esa M Farkkila, George C. Velmahos, Zachary S Peacock, R J Tannyhill, Laurie Petrovick, Alice Gervasini, Leonard B KabanAbstract:Abstract The aim of this retrospective cohort study was to determine the frequency and risk factors for cervical spine injury (CSI) in patients with Midface Fractures. Patients ≥18 years of age entered in the Massachusetts General Hospital Trauma Registry from 2007 to 2017 were identified. Those with a Midface Fracture, computed tomography and/or magnetic resonance imaging of the cervical spine, and complete medical records were included. There were 23,394 patients in the registry; 3950 (16.9%) had craniomaxillofacial Fractures and 1822 (7.8%) had a CSI. Craniomaxillofacial Fractures included Fractures of the Midface (n = 2803, 71.0%), mandible (n = 873, 22.1%), and Midface plus mandible (n = 274, 6.9%). The overall frequency of CSI in patients with Midface Fractures was 11.4% (350/3077). Patients with Midface Fractures had a higher risk for CSI compared to patients without a Midface Fracture (odds ratio 2.4, 95% confidence interval 2.1–2.4, P
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risk factors for cervical spine injury in patients with mandibular Fractures
Journal of Oral and Maxillofacial Surgery, 2019Co-Authors: Esa M Farkkila, George C. Velmahos, Zachary S Peacock, Laurie Petrovick, Alice Gervasini, John R Tannyhill, Leonard B KabanAbstract:Purpose Patients with mandibular Fractures are known to be at risk of concomitant cervical spine injuries (CSIs). The purpose of this study was to determine the incidence of and risk factors for CSIs in these patients. Patients and Methods We conducted a retrospective cohort study of adult trauma patients with mandibular Fractures from June 1, 2007, through June 30, 2017. Patients were identified through the Massachusetts General Hospital trauma registry and were included as study patients if they had a mandibular Fracture and computed tomography or magnetic resonance imaging of the cervical spine. The primary predictor variable was the site of the mandibular Fracture; the primary outcome variables were the presence of CSIs and death. The other variables were demographic characteristics (age, gender, alcohol use, and drug use), Injury Severity Score, Glasgow Coma Scale, presence of Midface and extra-craniofacial injuries, and etiology. Data analysis consisted of univariate correlations and construction of a multivariate model to determine independent risk factors for CSIs. Results Of 23,394 patients in the trauma registry, 3,950 (17%) had craniomaxillofacial Fractures and 1,822 (7.7%) had CSIs. The frequency of CSIs in the overall cohort of mandibular Fracture patients (n = 1,147) was 4.4%, and for admitted patients (n = 495), it was 10%. The mean age of patients with mandibular Fractures plus CSIs was 40 years (range, 19 to 93 years); 84% were men. Patients with a ramus-condyle unit Fracture, mandibular Fracture plus any Midface Fracture, non–craniomaxillofacial injury, and motor vehicle crash etiology had the highest frequency of CSIs. Ramus-condyle unit Fractures and chest injuries were independent risk factors for CSIs in the multivariate model (P = .0334 and P = .0013, respectively). The mortality rate was 4-fold higher in patients with CSIs versus those without CSIs. Conclusions The presence of ramus-condyle unit Fractures and the presence of chest injuries were independent risk factors for CSIs. Oral and maxillofacial surgeons should be diligent in ruling out CSIs in mandibular Fracture patients.
Maher Abu-hamdan - One of the best experts on this subject based on the ideXlab platform.
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Stability of Midface Fracture Repair Using Absorbable Plates
Otolaryngology–Head and Neck Surgery, 2011Co-Authors: Lucio Pereira, Giancarlo Zuliani, Maher Abu-hamdan, Michael A. CarronAbstract:Objective: Determine if the KLS Martin Sonic Weld system provides plate-screw construct stability in human skulls even when placed at acute angles at the Midface buttresses. The strength of the construct will be compared with absorbable miniplates with screws placed at 90-degree angles.Method: Ten skulls will be prepared by creating Midface osteotomies bilaterally. All screws will be placed at 90 degrees on the control side. The contralateral side will be plated with the absorbable system at more acute angles. The data will be compared as matched pairs within each specimen and statistically analyzed.Results: Fractures fixated with the ultrasonic absorbable plating system placed with screws at all tested angles will fail at similar to our control plates placed at 90 degrees. This will allow the surgeon to successfully reduce Fractures in the Midface fragments in difficult to reach areas and possibly cut down on operative time and improve the chance of achieving a long lasting adequate reduction.Conclusion:...