Avulsion injury

Source: Wikipedia, the free encyclopedia.
This article is about avulsion injuries other than
Avulsion fractures. For other uses, see Avulsion (disambiguation)
.
Avulsion on a hippopotamus

In

abrasion
but more severe, as body parts such as an eyelid or an ear can be partially or fully detached from the body.

Skin avulsions

The most common avulsion injury, skin avulsion often occurs during motor vehicle collisions. The severity of avulsion ranges from skin flaps (minor) to degloving (moderate) and amputation of a finger or limb (severe). Suprafascial avulsions are those in which the depth of the removed skin reaches the subcutaneous tissue layer, while subfascial avulsions extend deeper than the subcutaneous layer.[2] Small suprafascial avulsions can be repaired by suturing, but most avulsions require skin grafts or reconstructive surgery.

Rock climbing

In rock climbing, a "flapper" is an injury in which parts of the skin are torn off, resulting in a loose flap of skin on the fingers.[3] This is usually the result of friction forces between the climber's fingers and the holds, arising when the climber slips off a hold.

To fix this injury and to be able to continue climbing, many climbers will apply sports tape to the flapped finger to cover up the sensitive area of broken skin. Some climbers may even use super-glue to adhere the loose skin back to the finger.

Ear avulsions

The ear is particularly vulnerable to avulsion injuries because of its position on the side of the head.

anaplastologist
.

Eyelid avulsions

botulinum toxin is injected into the eyelid to paralyze the muscles while the eyelid heals.[13]

Nail avulsions

Trauma to the

dressing, as an ordinary dressing will stick to the nail bed and cause pain upon removal.[19]
In the average person, fingernails require 3 to 6 months to regrow completely, while toenails require 12 to 18 months.

Brachial plexus avulsions

In brachial plexus avulsions, the brachial plexus (a bundle of nerves that communicates signals between the spine and the arms, shoulders, and hands) is torn from its attachment to the spinal cord. One common cause of brachial plexus avulsions is when a baby's shoulders rotate in the birth canal during delivery, which causes the brachial plexus to stretch and tear.[20] It occurs in 1 to 2 out of every 1,000 births.[21] Shoulder trauma during motor vehicle collisions is another common cause of brachial plexus avulsions.[22] Detachment of the nerves can cause pain and loss of function in the arms, shoulders, and hands. Neuropathic pain can be treated with medication, but it is only through surgical reattachment or nerve grafts that function can be restored.[22] For intractable pain, a procedure called dorsal root entry zone (DREZ) lesioning can be effective.[22]

Tooth avulsions

During a

root resorption makes replacement of the tooth impossible.[23] To minimize damage to the root, the tooth should be kept in milk or sterile saline while it is outside the mouth.[23][24]

Periosteal avulsions

During a periosteal avulsion, the

ALPSA
(anterior labral periosteal sleeve avulsion).

Surgical avulsions

An avulsion is sometimes performed surgically to relieve symptoms of a disorder, or to prevent a chronic condition from recurring. Small incision avulsion (also called

botulinum toxin injections have been shown to be more effective than surgical avulsions in treating benign essential blepharospasm, while causing fewer complications.[28]

See also

References

  1. ^ "Avulsion". The Free Dictionary. Retrieved 14 March 2013.
  2. ^ Jeng, S.F., & Wei, F.C. (1997, May). Classification and reconstructive options in foot plantar skin avulsion injuries. Plastic And Reconstructive Surgery, 99(6), 1695-1703.
  3. ^ Flapper - n. a superficial injury resulting in a loose flap of skin. Archived 2016-12-27 at the Wayback Machine, Climbing Dictionary, Rockclimbing.com
  4. ^ a b Davison, S. P., & Bosley, B. N. (2008). Ear, Reconstruction and Salvage. Retrieved January 15, 2009, from [1].
  5. ^ Nahai, F., Hayhurst, J. W., & Salibian, A. H. (1978, July). Microvascular surgery in avulsive trauma to the external ear. Clinics in Plastic Surgery, 5(3), 423-426.
  6. ^ Fleming, J. P., & Cotlar, S. W. (1979, July). Successful reattachment of an almost totally avulsed ear: Use of the fluorescein test. Plastic and Reconstructive Surgery, 64, 94-96.
  7. ^ Pennington, D. G., Lai, M. F., & Pelly, A.D. (1980, June). Successful replantation of a completely avulsed ear by microvascular anastomosis. Plastic and Reconstructive Surgery, 65(6), 820-823.
  8. ^ Tanaka, Y., & Tajima, S. (1989, October). Plastic and Reconstructive Surgery, 84(4), 665-668.
  9. ^ Talbi, M., Stussi, J. D., & Meley, M. Microsurgical replantation of a totally amputated ear without venous repair. (2001, August). Journal of Reconstructive Microsurgery, 17(6), 417-420.
  10. ^ a b Saad Ibrahim, S. M., Zidan, A., & Madani, S. (2008). Totally avulsed ear: New technique of immediate ear reconstruction. Journal of Plastic, Reconstructive & Aesthetic Surgery, 61, S29-36.
  11. ^ O'Toole, G., Bhatti, K., & Masood, S. (2008). Replantation of an avulsed ear, using a single arterial anastamosis. Journal of Plastic, Reconstructive & Aesthetic Surgery, 61(3), 326-329.
  12. ^ Goldberg, S.H., Bullock, J.D., & Connelly, P.J. (1992). Eyelid avulsion: A clinical and experimental study. Ophthalmic Plastic And Reconstructive Surgery, 8(4), 256-261.
  13. ^ a b c Huerva, V., Mateo, A.J., & Espinet, R. (2008, January). Isolated medial rectus muscle rupture after a traffic accident. Strabismus, 16(1), 33-37.
  14. ^ a b Avram, D.R., Hurwitz, J.J., & Kratky, V. (1991, October). Dog and human bites of the eyelid repaired with retrieved autogenous tissue. Canadian Journal of Ophthalmology, 26(6), 334-337.
  15. ^ a b Soueid, N.E., & Khoobehi, K. (2006, January). Microsurgical replantation of total upper eyelid avulsion. Annals of Plastic Surgery, 56(1), 99-102.
  16. ^ deSousa, J.L., Leibovitch, I., Malhotra, R., O'Donnell, B., Sullivan, T., & Selva, D. (2007, December). Techniques and outcomes of total upper and lower eyelid reconstruction. Archives of Ophthalmology, 125(12), 1601-1609.
  17. ^ Nail Avulsions
  18. ^ Rischer, C.E., & Easton, T.A. (1995). Focus on human biology (2nd ed.). New York: Harper Collins College Publishers.
  19. ^ National Center for Emergency Medicine Informatics. Nail Off. Retrieved January 16, 2009, from [2] Archived 2016-08-14 at the Wayback Machine.
  20. ^ National Institute of Neurological Disorders and Stroke. NINDS Erb-Duchenne and Dejerine-Klumpke Palsies Information Page. Retrieved January 15, 2009, from [3] Archived 2016-12-02 at the Wayback Machine.
  21. ^ American Academy of Orthopaedic Surgeons. Erb's Palsy (Brachial Plexus Birth Injury). Retrieved January 15, 2009, from [4].
  22. ^ a b c Binder, D. K., Lu, D. C., & Barbaro, N. M. (2005, October). Multiple root avulsions from the brachial plexus. Neurosurgical Focus, 19(3).
  23. ^ a b c d e Merck Manual Online. Fractured and Avulsed Teeth. Retrieved January 15, 2009, from [5].
  24. ^ Kidd, P. S., Sturt, P. A., & Fultz, J. (2000). Mosby's emergency nursing reference (2nd ed.). St. Louis: Mosby, Inc.
  25. ^ Society for Vascular Surgery. VascularWeb: Chronic Venous Insufficiency. Retrieved January 15, 2009, from [6] Archived 2009-01-21 at the Wayback Machine.
  26. ^ American Academy of Orthopaedic Surgeons. Ingrown Toenail. Retrieved January 15, 2009, from [7].
  27. ^ a b McCord, C.D. Jr., Coles, W.H., Shore, J.W., Spector, R., & Putnam, J.R. (1984, February). Treatment of essential blepharospasm: Comparison of facial nerve avulsion and eyebrow-eyelid muscle stripping procedure. Archives Of Ophthalmology, 102(2), 266-268.
  28. ^ a b Grandas, F., Elston, J., Quinn, N., & Marsden, C.D. (1988, June). Blepharospasm: A review of 264 patients. Journal of Neurology, Neurosurgery, and Psychiatry, 51(6), 767-772.

External links

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