Greg Vigna, MD, JD, an academic rehabilitation physician serving a Level 1 Trauma Center in Indianapolis states, “Removable Inferior Vena Cava Filters (IVC) that are placed in traumatic brain injury, spinal cord injury and complex pelvic fracture patients are rarely removed within the FDA recommended time frame. The FDA states these filters should be removed […]
Traumatic SI Joint Pain: Often Overlooked, Often Disabling
Medical studies have determined that the sacral iliac joint (SIJ) is the primary cause of 20% of all patients who suffer with chronic low back pain. The SIJ connects the sacrum, which is the lowest segment of the spinal column, to the pelvis. Injuries to the SIJ occur by several different mechanisms including falls, motor […]
Severe TBI: Riding Out the Sympathetic Storm
There is a normal bodily response to severe injury called the ‘sympathetic response’ that produces increased heart rate, increased respiratory rate, sweating, and elevated blood pressure. Up to one third of patients with severe traumatic brain injuries suffer from an exaggerated ‘sympathetic response’ some times referred to as ‘Sympathetic Storming’. Patients with sympathetic storming have […]
Flail Chest Injuries: Acute Then Chronic Respiratory Impairment
A flail chest is a severe injury to the chest wall caused by multiple rib fractures and sternal injuries that may occur as a result of high-speed motor vehicle accidents or motorcycle accidents. It is caused from a high impact force to the chest wall when the injured person is hurled into the ground or […]
Childhood Chest Injuries: Pulmonary Contusions
Trauma related pediatric thoracic injury admitted to trauma hospitals carries a mortality rate of five percent. This refers to injuries to the chest wall and any structure within. Pediatric trauma surgeons understand the anatomy of the growing child and how injury patterns change with age. Unique to pediatric trauma is the effect of the growing […]
Frontal Sinus Fractures: Acute Management for a Life Time
Over half of all patients hospitalized with severe brain injuries and cervical spinal cord injuries following high-velocity accidents have associated facial fractures. Frontal sinus fractures are not uncommon since this structure is located in the forehead, an area at risk to direct blunt trauma. Sinus fractures complicate the care of the catastrophically injured patient both […]
Traumatic Optic Nerve Damage: Academic Physician Life Care Planning Perspective
Traumatic optic nerve damage, also referred to as traumatic optic neuropathy (TON), is the result of high-speed collision type injuries that cause closed head injuries and facial trauma and is a significant cause of vision loss in the trauma patient population. Motorcycle and bicycle accidents account for over 60% of cases of TON. Approximately 1 […]
Academic Physician Life Care Planner Greg Vigna Helps Understand Cauda Equina Syndrome: Red Flag Warning
Patients with the red flag warnings of low back pain, bilateral leg symptoms, and urinary retention require urgent help. Cauda Equina Syndrome (CES) is a rare diagnosis that represents a true neurosurgical emergency. A regrettable failure to diagnose and surgically treat CES leads to permanent bowel and bladder dysfunction, sexual impairment, weakness in the bilateral […]
Lifetime Issues: Midfoot Fracture-Dislocations and Metatarsal Fractures
Midfoot fracture-dislocations are difficult to treat, often lead to multiple procedures, and lifetime functional impairment and disability. These injuries are often the product of high-speed motor vehicle accidents and associated with multiple life threatening injuries in a ‘polytrauma patient’. The two most described midfoot injuries in the literature are the Lisfranc fracture-dislocation and Chopart fracture- […]
