William C H Parr, Tian Wang, Christopher Tan, Michael J Dan, William R Walsh, Per Morberg
OBJECTIVES: - We aimed to investigate how pre-bending affects the mechanical properties, specifically fatigue, of stainless-steel plates. METHODS: - 3.5mm LCP 10-hole plates were pre-bent in 1, 2 and 3 locations to the same overall degree and fatigue testing performed. Finite Element Analysis (FEA) was performed in Strand7 (version 2.4.6) to better understand the failure point of the plates in four-point bending. RESULTS: - Six different plate pre-bending conditions were tested for resistance to fatigue failure...
January 17, 2021: Injury
Nico Maximilian Jandl, Tim Rolvien, Tobias Rupp, Udo Schumacher, Klaus Püschel, Kai-Jonathan Maas, Michael Amling, Frank Oliver Henes, Clemens Spink
INTRODUCTION: Detection of symptomatic foreign bodies (FB) after penetrating hand injuries can be challenging. Multiplanar radiography is most frequently used for FB detection and may be complemented by multislice computed tomography (MSCT) if suspected FBs cannot be identified and clinical symptoms are persisting. Cone beam computed tomography (CBCT) is a promising imaging modality for traumatology aside from fracture detection. The aim of this study was to evaluate the diagnostic yield of CBCT for different small FBs in the hand in comparison with radiography, MSCT and magnetic resonance imaging (MRI)...
January 15, 2021: Injury
Yanshi Liu, Jialin Liu, Xingpeng Zhang, Hong Li, Xuefei Fu, Qixin Liu, Chuang Ma, Aihemaitijiang Yusufu
BACKGROUND: Postoperative malalignment in fractures treated by monolateral external fixation is not uncommon in clinical practice. Accurate reduction without excessive tissue disruption caused by surgical intervention and sequentially manage the fractures using monolateral external fixation for definitive treatment is still a challenge for surgeons. The purpose of our study was to evaluate the feasibility and effectiveness of the temporary application of the hexapod external fixator (HEF) for the postoperative malalignment correction in tibial diaphyseal fractures treated by monolateral external fixation...
January 14, 2021: Injury
John Whitaker, Lindani Chirwa, Boston Munthali, Albert Dube, Abena S Amoah, Andrew J M Leather, Justine Davies
BACKGROUND: It is known that outcomes after injury care in low-and-middle income countries (LMICs) are poorer than those in high income countries. However, little is known about healthcare provider competency to deliver quality injury care in these settings. We developed and used clinical vignettes to evaluate injury care quality in an LMIC setting. METHOD: Four serious injury scenarios, developed from agreed best practice, testing diagnostic and management skills, were piloted with high and low-income setting clinicians...
January 14, 2021: Injury
Khalid Al-Hourani, Oliver Pearce, Michael Kelly
Open fractures of the lower limb remain a potentially devastating group of injuries that are challenging to manage. The primary aims of treatment are to optimise limb function and avoid serious complications such as infection and non-union, which are costly for both the patient and healthcare system. The management of these fractures has evolved significantly, and this is evident following the creation of national open fracture guidelines and a formal trauma system. These have served to standardise care for these injuries in the United Kingdom...
January 13, 2021: Injury
Johannes D Bastian, Seth M Tarrant, Richard Buckley
No abstract text is available yet for this article.
January 13, 2021: Injury
Carlin C Chuck, Thomas J Martin, Roshini Kalagara, Elias Shaaya, Tareq Kheirbek, Deus Cielo
BACKGROUND: Traumatic brain injury (TBI) with acute elevation in intracranial pressure (ICP) is a neurologic emergency associated with significant morbidity and mortality. In addition to indicated trauma resuscitation, emergency department (ED) management includes empiric administration of hyperosmolar agents, rapid diagnostic imaging, anticoagulation reversal, and early neurosurgical consultation. Despite optimization of in-hospital care, patient outcomes may be worsened by variation in prehospital management...
January 10, 2021: Injury
Ippokratis Pountos, Michalis Panteli, Gavin Walters, Peter V Giannoudis
INTRODUCTION & AIMS: Non Steroidal Anti-Inflammatory drugs (NSAIDs) are potent inhibitors of post-traumatic pain. Several studies have highlighted that NSAIDs could exert a negative effect on bone healing process possibly by down-regulating chondrogenesis and endochondral ossification. The aim of the study is to explore the potential mechanism though which NSAIDs can affect chondrogenesis. M&M: Trabecular bone from the fracture site was isolated from 10 patients suffering from long bone fractures...
January 10, 2021: Injury
Huy Le Quang, Werner Schmoelz, Richard A Lindtner, Dietmar Dammerer, Peter Schwendinger, Dietmar Krappinger
OBJECTIVES: Open reduction and internal fixation of both columns is considered the treatment of choice for displaced anterior column with posterior hemitransverse (ACPHT) fractures in non-geriatric patients. Plate fixation of one column combined with lag screw fixation of the other column allows to decrease operative time and approach-related morbidity compared to conventional both column plating. The aim of this biomechanical study was to evaluate whether single column plate plus other column lag screw fixation confers similar stability to both column plate fixation...
January 8, 2021: Injury
R Mason Curtis, Kelly Vogt, Neil Parry, Fran Priestap, W Robert Leeper, Amol Mujoomdar, Stewart Kribs, Ian M Ball
OBJECTIVE: To determine if insertion of rIVCF for PE prophylaxis in high risk trauma patients could result in a clinically meaningful reduction (>24 h) in time that patients are left unprotected from PEs SUMMARY AND BACKGROUND DATA: Trauma patients are at high risk for the development of pulmonary embolism (PE). Early pharmacologic PE prophylaxis is ideal, however many patients are unable to receive prophylaxis due to concomitant injuries. Current guidelines are conflicting on the role of prophylactic retrievable inferior vena cava filters (rIVCF) for PE prevention in this patient population, and robust data to guide clinicians is lacking...
January 8, 2021: Injury
Kessiena Aya, Connor S Johnson, Uchechukwu Emili, Daniel C Jupiter, Ronald W Lindsey
OBJECTIVES: Acute compartment syndrome (CS) is a common complication of tibia shaft fractures (TSFs), and occurs when the pressure inside a myofascial compartment rises and impairs tissue perfusion. If treatment is delayed due to a missed diagnosis, amputation or permanent loss of function can result. This study aims to determine the incidence, clinical associations, and risk factors for missed CS following surgical stabilization of tibia shaft fractures (TSFs) using data from the National Trauma Data Bank (NTDB)...
January 7, 2021: Injury
Henk Jan Schuijt, Matthew Lamar Morin, Elizabeth Allen, Michael John Weaver
INTRODUCTION: Many geriatric hip fracture patients utilize significant healthcare resources and require an extensive recovery period after surgery. There is an increasing awareness that measuring frailty in geriatric patients may be useful in predicting mortality and perioperative complications and may be useful in helping guide treatment decisions. The primary purpose of the study is to investigate whether the frailty index predicts discharge disposition from the hospital and discharge facility and length of stay...
January 7, 2021: Injury
Jun-Feng Liu, Zi-Fei Zhou, Xiao-Dong Hou, Yi-Xing Chen, Long-Po Zheng
OBJECTIVES: Dual plate fixation has been reported to be effective in the treatment of comminuted distal femur fractures (DFFs). However, optimized use of the medial plate and screws is less studied. This study aimed to evaluate the effect of a hybrid configuration of the medial plate in dual plate fixation of comminuted DFFs in promoting fracture healing. MATERIALS AND METHODS: We retrospectively analyzed 62 patients with comminuted DFFs (AO/OTA 33-A3/33-C2/33-C3) from January 2015 to March 2020, who were either fixed with lateral locked plating augmented with hybrid locked medial plating (LP-HLMP, n = 32) or lateral locked plating (LLP, n = 30) alone...
January 7, 2021: Injury
Hyung-Gon Ryu, Young Ju Roh, Kwang-Jun Oh, Ji-Hyo Hwang, Yeesuk Kim, Hyun-Woo Cho, Sang-Min Kim
PURPOSE: Neuromuscular disease is well known to be at increased risk of complications following hip replacement surgeries. This study is prospectively conducted to investigate clinical performance and survivorship of total hip arthroplasty (THA) using dual mobility articulation in femoral neck fractures of elderly with neuromuscular disease. MATERIALS AND METHODS: We prospectively enrolled 162 patients (162 hips) with displaced femoral neck fracture who gave informed consent for dual mobility articulation THA...
January 7, 2021: Injury
Seung Hun Woo, Tae-Sik Goh, Tae-Young Ahn, Jun Sang You, Su-Young Bae, Hyung-Jin Chung
BACKGROUND: This study aims to analyze the outcomes of subtalar distraction arthrodesis (SDA) for calcaneal malunion using structural freeze-dried iliac allograft (FDIA) compared to using autologous iliac bone (AIB). METHODS: We retrospectively evaluated 57 consecutive cases (51 patients) of calcaneal malunion between March 2006 and December 2017. All patients were followed for an average of 22.8 months. All cases were treated by SDA using structural FDIA (17 cases, group 1), or AIB (40 cases, group 2)...
January 7, 2021: Injury
Nushin Moussavi, Hamidreza Talari, Masoumeh Abedzadeh-Kalahroudi, Neda Khalili, Razie Eqtesadi, Mojtaba Sehat, Mohammd-Javad Azadchehr, Abdoulhossein Davoodabadi
PURPOSE: Due to the low sensitivity of chest radiography, chest CT-scan is usually recommended for the evaluation of high-risk blunt trauma patients. Considering the radiation exposure and costs accompanying routine CT-scan, the aim of this study was to design and implement an evidence-based institutional algorithm for selective chest imaging in high energy blunt trauma patients and evaluate its effect on patient outcome and resource utilization. METHODS: For this field trial, an institutional evidence-based algorithm for chest trauma imaging was designed according to existing data and expert panel...
January 6, 2021: Injury
Dhawal Patel, Christopher Talbot, Weisang Luo, Shirley Mulvaney, Eileen Byrne
The purpose of this study is to assess the use of esketamine as procedural sedation for the reduction of paediatric forearm fractures in the emergency department (ED). A retrospective analysis was undertaken of forearm fractures between 1st January 2012 to 31st December 2016 which were treated with manipulation in ED using esketamine sedation. Patient demographics and fracture configuration were collected. Patient radiographs were evaluated and cast index calculated. 151 patients (103 male, 48 female) were included (average age of 8...
January 5, 2021: Injury
Olivera Djuric, Marina Andjelkovic, Misa Vreca, Anita Skakic, Sonja Pavlovic, Ivana Novakovic, Bojan Jovanovic, Vesna Skodric-Trifunovic, Ljiljana Markovic-Denic
INTRODUCTION: Single nucleotide variants (SNVs) represent important genetic risk factors for susceptibility to posttraumatic sepsis and a potential target for immunotherapy. We aimed to evaluate the association between 8 different SNVs within tumor necrosis factor alpha (TNFA), lymphotoxin alpha (LTA) and Toll-like receptor (TLR2 and TLR4) genes and the risk of posttraumatic sepsis. METHODS: Nested case-control study was conducted in the emergency department of the Clinical Centre of Serbia including 228 traumatized patients (44 with sepsis and 184 without sepsis)...
January 5, 2021: Injury
Lily Tung, Jennifer Leonard, Ryan A Lawless, Alexis Cralley, Richard Betzold, Jason D Pasley, Kenji Inaba, Jennie S Kim, Dennis Y Kim, Kwang Kim, Bradley M Dennis, Michael C Smith, Margaret Moore, Christina Tran, Joshua P Hazelton, Atlee Melillo, Tejal S Brahmbhatt, Stephanie Talutis, Noelle N Saillant, Jae Moo Lee, Mark J Seamon
INTRODUCTION: We sought to determine the impact of the indication for shunt placement on shunt-related outcomes after major arterial injuries. We hypothesized that a shunt placed for damage control indications would be associated with an increase in shunt-related complications including shunt dislodgement, thrombosis, or distal ischemia. PATIENTS & METHODS: A prospective, multicenter study (eleven level one US trauma centers) of all adult trauma patients undergoing temporary intravascular shunts (TIVS) after arterial injury was undertaken (January 2017-May 2019)...
January 3, 2021: Injury
Hikaru Hayakawa, Megumi Hanaka, Kousuke Iba, Kenta Kiyomoto, Makoto Emori, Atsushi Teramoto, Toshihiko Yamashita
BACKGROUND: Pathological conditions after skeletal tissue injury such as trauma and surgical intervention are often accompanied with regional osteoporotic changes, which are recognized to be mainly caused by limb immobility after injury. However, the mechanisms for the progression of regional osteoporotic changes related to the injury remains unknown. Previous studies reported that the pathophysiological conditions related to tissue injury include the acidic micro-environment formation and increased ATP levels...
January 3, 2021: Injury
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