An analysis of 214 cases of rib fractures

INTRODUCTION: Rib fractures are the most common type of injury associated with trauma to the thorax. In this study, we investigated whether morbidity and mortality rates increased in correlation with the number of fractured ribs. MATERIALS AND METHODS: Data from 214 patients with rib fractures who applied or were referred to our clinic between January 2007 and December 2008 were retrospectively evaluated. The patients were allocated into three groups according to the number of fractures: 1) patients with an isolated rib fracture (RF1) (n = 50, 23.4%), 2) patients with two rib fractures (RF2) (n = 53, 24.8%), and 3) patients with more than two rib fractures (RF3) (n = 111, 51.9%). The patients were evaluated and compared according to the number of rib fractures, mean age, associated chest injuries (hemothorax, pneumothorax, and/or pulmonary contusion), and co-existing injuries to other systems. FINDINGS: The mean age of the patients was 51.5 years. The distribution of associated chest injuries was 30% in group RF1, 24.6% in group RF2, and 75.6% in group RF3 (

An analysis of 214 cases of rib fractures

INTRODUCTION: Rib fractures are the most common type of injury associated with trauma to the thorax. In this study, we investigated whether morbidity and mortality rates increased in correlation with the number of fractured ribs. MATERIALS AND METHODS: Data from 214 patients with rib fractures who applied or were referred to our clinic between January 2007 and December 2008 were retrospectively evaluated. The patients were allocated into three groups according to the number of fractures: 1) patients with an isolated rib fracture (RF1) (n = 50, 23.4%), 2) patients with two rib fractures (RF2) (n = 53, 24.8%), and 3) patients with more than two rib fractures (RF3) (n = 111, 51.9%). The patients were evaluated and compared according to the number of rib fractures, mean age, associated chest injuries (hemothorax, pneumothorax, and/or pulmonary contusion), and co-existing injuries to other systems. FINDINGS: The mean age of the patients was 51.5 years. The distribution of associated chest injuries was 30% in group RF1, 24.6% in group RF2, and 75.6% in group RF3 (p<0.05). Co-existing injuries to other systems were 24% in group RF1, 23.2% in group RF2, and 52.6% in group RF3 (p<0.05). Two patients (4%) in group RF1, 2 patients (3.8%) in group RF2, and 5 patients (4.5%) in group RF3 (total n = 9; 4.2%) died. CONCLUSION: Patients with any number of rib fractures should be carefully screened for co-existing injuries in other body systems and hospitalized to receive proper treatment

Post-thoracotomy wound separation (DEHISCENCE): a disturbing complication

OBJECTIVES: We described the treatment of dehiscence of thoracotomy incisions in patients who underwent thoracic surgery in the present study. METHODS: Twenty-four patients with either partial or complete dehiscence of their thoracotomy incisions were included in the study from 2005 to 2010. The patients were evaluated regarding their age, sex, indication for thoracotomy, and surgical approaches. We also described our method of re-closure. RESULTS: The male/female ratio was 17/7. The youngest and oldest patients were 15 and 75 years old, respectively, and the mean age was 43 years. Among the indications for thoracotomy, empyema was the most common reason (determined in eight &#91;33%&#93; patients), followed by vertebral surgery (determined in six &#91;25%&#93; patients). Bacterial growth was detected in the wound site cultures from 13 (54%) patients. For the patients with dehiscence of their thoracotomy incisions, an en block approximation technique with debridement was performed under general or local anesthesia in 16 (66%) and eight (33%) of the cases, respectively. Three patients exhibited an open thorax with dehiscence of the thoracotomy incision. Thoracoplasty was required in two patients. Using this method, successful closure was obtained in 91.7% (n = 22) of the patients with dehiscence of their thoracotomy incisions. CONCLUSION: Dehiscence of the thoracotomy incision is an important complication that causes concern in patients and their thoracic surgeons and strongly affects the success of the surgery. An en block approximation technique with significant debridement that enables removal of the necrotic tissues from the wound site can successfully be applied to patients with dehiscence of their thoracotomy incisions

An Interactional Resource For Creating Opportunities For Student Participation: Designedly Incomplete Utterances

This study examines social studies course classroom interaction in a primary school and describes an interactional resource deployed by the teacher for creating opportunities for student participation. Social studies classrooms are multidisciplinary settings that require teaching of rich content, which is only possible through ensuring student participation. However, there is no study to our knowledge that documents such resources in social studies classrooms by focusing on the micro moments of classroom interaction. This study investigates 17 hours of social studies classroom interactions using Conversation Analysis as the research methodology and present findings on a specific interactional resource deployed repeatedly by the teacher for encouraging learner initiatives and creating opportunities for student participation. This resource has been referred to in previous literature as Designedly Incomplete Utterance (DIU) that is mainly used for creating opportunities for student participation by leaving an utterance designedly incomplete so that it can be completed by the students. Our study has shown how designedly incomplete utterance (DIU) is used as an interactional resource (i.e. as hints, for eliciting an extension or repetition of prior talk, and for prompting the continuation of an action) by the teacher, which provides evidence for that the teacher creates opportunities both for student initiations and student participation in an observable way. Our study contributes to the field of social studies education with the first research to examine social studies classroom interaction and also by presenting an innovative research methodology and providing the teachers and teacher candidates with a rich interactional resource to encourage, create opportunities for, and maintain student participation.Wo

Is the Abramson technique effective in pectus carinatum repair?

Background: The minimally invasive pectus carinatum (PC) surgery described by Abramson has been performed in many centers. We have been using this technique since 2011. This article describes our experience with PC correction. Methods: Between 2011 and 2016, 32 patients at our institution underwent minimally invasive repair of a PC deformity. All patients presented with cosmetic complaints. The deformity involved the lower sternum (all had chondrogladiolar type PC), and three patients had asymmetrical deformities. All operations followed the principles defined by Abramson. Results: Satisfactory esthetic results were achieved in our patients. The hospital stay averaged 5.3 days (range 4–7 days). The most common early complication was pneumothorax, and the most common late complication was wire suture breakage. Conclusion: The Abramson technique is an effective, minimally invasive procedure for PC with shorter operating and hospitalization times and low morbidity rates