Post traumatic stress disorder (PTSD) is well recognised in children having repeated medical/surgical procedures. It has been suggested that it is common in young children undergoing growing rod treatment with ongoing lengthening and the inevitable accompanying complications. We present an index case history, review the literature in order to infer a correlation for the incidence of
Purpose. To examine the management and outcome of patients suffering complex paediatric lower limb injuries with bone and soft tissue loss. Method. A retrospective review was conducted identifying patients from our trauma database. Inclusion criteria were age (4–17 years) and open lower-limb trauma. Outcome measures included time to soft tissue coverage, surgical techniques, trauma impact scores, health-related quality of life, union and complication rates. Results. We identified 26 patients. 24 patients had open tibia fractures including 10 patients with bone loss. In 9 patients primary skin closure was achieved by acute shortening. 17 patients required soft tissue coverage including 14 free vascularised muscle flaps (89% within 48 hours). The surgical techniques applied were: circular fine wire frame (16), external fixateur (5) and open reduction internal fixation (5). Median follow up time was 8 (3–45) months. The trauma impact scores showed one in three patients were at risk of
The purpose of this study was to identify the prevalence of common mental disorders in patients undergoing complex limb reconstruction. Patients undergoing limb reconstruction are vulnerable to mental health problem as they must adapt to significant and prolonged physical disability. Treatment emphasis has been on restoration and rehabilitation of physical health with little or no attention given to spectrum of psychological consequences. IMPARTS (Integrating Mental and Physical healthcare: Research, Training and Services) is a King's Health Partners initiative aiming to develop informatics to improve detection and management of common mental disorders in medical settings. IMPARTS screening in the King's College Hospital limb reconstruction clinic commenced in April 2012. Outpatients attending between April 2012 and November 2013 were screened prior to their appointment. Patients were screened for symptoms of depression, anxiety, post-traumatic stress disorder (PTSD), alcohol dependence and drug use. In total, 298 individual patients were screened. The prevalence of depression was found to be 21.8%, with 6.4% experiencing suicidal thoughts. Probable anxiety disorder was identified in 20.7% of patients. Symptoms of
The cost of claims for personal injury after whiplash injury costs the economy of the United Kingdom some £3 billion per year. The majority of vehicle occupants subjected to rear-end shunt either suffer no effects or make a complete recovery however a minority suffer adverse psychological and social consequences which may be largely unrelated to the severity of the initial physical insult. The early psychological reactions include feelings of being shocked, frightened and angry which are related to the victim’s subjective perception of accident severity. During the days after many victims continue to experience anxiety and distress manifest in physical, emotional, cognitive and social complaints – which may be severe enough to constitute the diagnosis of acute stress disorder which has a high risk of subsequent
The October 2015 Trauma Roundup360 looks at: PCA not the best in resuscitation; Impact of trauma centre care; Quality of life after a hip fracture; Recovery and severity of injury: open tibial fractures in the spotlight; Assessment of the triplane fractures; Signs of an unstable paediatric pelvis; Safe insertion of SI screws: are two views required?; Post-operative delirium under the spotlight; Psychological effects of fractures; K-wires cost effective in DRAFFT
