Versatility With Far Forward Damage Control Surgery: Successful Resuscitative Thoracotomy in an HH-60 Black Hawk.

The military conflicts of the past 17 years have taught us many lessons, including the evolution of the tiered trauma system with en route resuscitation. The evolution of the conflict has begun to limit the reach of this standard trauma system. Recent evidence suggests that 95% of early deaths resulting from traumatic injuries may be prevented if the patient can undergo damage control surgery within 23 minutes of injury. US Military Surgical Resuscitation Teams have been developed to shorten this time from injury to surgical care, as illustrated by this case report.

Gallery of uncommon orthopedic implants: a guide for emergency radiologist.

The purpose of this gallery of orthopedic implants was to provide a reference for emergency radiologists to quickly identify uncommon devices in the shoulders, hips, and extremities. The cases presented in this exhibit will include unusual arthroplasties and prostheses as well as bone graft implants (including allograft and autograft). Bone grafts are frequently used for the treatment of bone defects, which may be caused by trauma, infection, or avascularity. Autogenous cancellous, corticocancellous, or cortical bone grafts are often used, either free or vascularized. Alternative bone graft substitutes are also used. An obvious complication of bone grafts is the failure of incorporation. Joint arthroplasty is the most frequently performed orthopedic procedure after fracture fixation. Major indications include degenerative joint disease, inflammatory arthropathy, avascular necrosis, and complicated fractures. Custom orthopedic implants are frequently used for less common indications or for patients with bone tumors. The common hardware complications are infections, loosening, small particle disease/osteolysis, periprosthetic fracture, hardware fracture or dislocation, and recurrent disease, especially in patients with tumors. Many of the devices used by orthopedic surgeons are infrequently seen in everyday radiology practice. With such variations, correct recognition of the prosthetic devices and their complications is very important. The goal of this exhibit was to familiarize the radiologist with both the normal and abnormal appearance of many atypical orthopedic implants. It is important to understand the purpose and proper function of a device, but not necessarily important to describe every device by its proper brand name. Although this exhibit is not meant to be inclusive of every unusual orthopedic implant, we will present multiple examples of orthopedic hardware involving the shoulder, humerus, elbow, forearm, wrist, hand, pelvis, hip, femur, knee, tibia, ankle, and foot that are not likely seen in everyday practice.