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Jared Gallaher, Malcolm Jefferson, Carlos Varela, Rebecca Maine, Bruce Cairns, Anthony Charles
BACKGROUND: Globally, traumatic injury is a leading cause of morbidity and mortality in low-income countries. Current tools for predicting trauma-associated mortality are often not applicable in low-resource environments due to a lack of diagnostic adjuncts. This study sought to derive and validate a model for predicting mortality that requires only a history and physical exam. METHODS: We conducted a retrospective analysis of all patients recorded in the Kamuzu Central Hospital trauma surveillance registry in Lilongwe, Malawi from 2011 through 2014...
July 9, 2019: Injury
B Kool, P Reid
No abstract text is available yet for this article.
July 7, 2019: Injury
Zhe-Ming Cao, Wei Du, Li-Ming Qing, Zheng-Bing Zhou, Pan-Feng Wu, Fang Yu, Ding Pan, Yong-Bing Xiao, Xiao-Yang Pang, Rui Liu, Ju-Yu Tang
BACKGROUNDS: Due to the delicate tissue, small blood vessels and incomplete development of interarticular ligaments, skin and soft-tissue defects of the foot and ankle in pediatric patients remain a challenge for orthopedic and plastic surgeons. Anterolateral thigh perforator (ALTP) flap and deep inferior epigastric perforator (DIEP) flap are the most commonly used flaps for the repair of lower-extremity soft-tissue defects. The literature contains a shortage of evidence involving the differences between ALTP and DIEP flaps in the reconstruction of young patients with complex foot and ankle defects...
July 6, 2019: Injury
Peta L Hitchens, Kelly Ryan, Stephen I Koch, Mary C Scollay, Michael L Peterson
Jockey injuries in North American racing are not well understood. The types and severity of injuries as well as exposure need to be better characterized in order to reduce risk. We consider existing data sources and the opportunity to combine this data with a new data collection effort to better understand and potentially reduce risk to riders. Using a two-phase approach, data appears to be available which would allow useful information on jockey injuries that could inform efforts for risk reduction quickly and with modest resources...
July 5, 2019: Injury
Weisi Xia, Ahmed W H Barazanchi, Wiremu S MacFater, Andrew G Hill
INTRODUCTION: Sarcopenia is the progressive loss of skeletal muscle mass, strength and general decline in function associated with age, and has previously been shown to be a predictor of poor outcomes following surgery. Computed tomography (CT)-assessed sarcopenia has been proposed to be an independent predictor of outcomes for trauma patients. This systematic review aims to determine the impact of CT-assessed sarcopenia on patient mortality following trauma. MATERIALS AND METHODS: A systematic review and meta-analysis of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
July 2, 2019: Injury
Kyeong-Hyeon Park, Chang-Wug Oh, Il-Hyung Park, Joon-Woo Kim, Jin-Han Lee, Hee-June Kim
INTRODUCTION: Lateral locked plating is a standard treatment option for distal femur fractures. However, the unstable conditions after lateral locked plating are increasing. The objective of this study was to investigate the biomechanical strength of additional medial plate fixation over the unstable lateral locked plating of distal femur fractures. MATERIALS AND METHODS: A distal femur fracture model (AO/OTA 33-A3) was created with osteotomies in the composite femur...
June 30, 2019: Injury
Adriana König, Ludwig Oberkircher, Frank J P Beeres, Reto Babst, Steffen Ruchholtz, Björn-Christian Link
BACKGROUND: Fragility fractures of the pelvis (FFP) show a notable rise in prevalence. Minimally invasive surgical fixation of FFP is increasingly advocated for its obvious advantages with reference to early mobilization and weight bearing. Concerns regarding the holding power of osteosynthetic materials in osteoporotic bone led to the development of cementing techniques. However, the role of cement augmentation in the surgical treatment of FFP has yet to be defined. Therefore, the aim of this study was to conduct a systematic review of the current literature concerning studies that are comparing the performance of cement augmented versus non-augmented sacroiliac (SI) screws...
June 28, 2019: Injury
A P A Greeven, J Van Groningen, N W L Schep, E M M Van Lieshout, M H J Verhofstad
PURPOSE: Open reduction and internal fixation (ORIF) of Bennett fractures is increasingly preferred over closed reduction and percutaneous fixation (CRIF) in an attempt to prevent the development of post-traumatic arthrosis. The aim of this systematic review was to determine whether the preference for ORIF is justified based on the available literature regarding functional outcome and complications after surgery. METHODS: A systematic review was performed in Medline, Embase, Cochrane CENTRAL, Web of science, and Google scholar...
June 28, 2019: Injury
Kristina Radinovic, Ljiljana Markovic Denic, Zoka Milan, Andja Cirkovic, Marko Baralic, Vesna Bumbasirevic
AIM: Postoperative delirium (PD) is a frequent complication of hip fracture surgery, but its pathophysiology remains poorly understood. We investigated the impact of a single episode of intraoperative hyper/hypotension, blood pressure (BP) fluctuation (ΔMAP), and pulse pressure (PP) on hyper/hypoactive PD in elderly patients undergoing surgery for hip fracture. We also assessed the effect of PD on clinical outcomes. METHODS: This was a prospective 1-year follow-up study of patients over 60 years of age with a primary diagnosis of acute low-energy hip fracture...
June 28, 2019: Injury
S Karhof, F Hietbrink, R Boot, K J P van Wessem, L P H Leenen, R K J Simmermacher
INTRODUCTION: Traumatic abdominal wall defects (TAWDs) following blunt trauma are uncommon injuries with an incidence reported less than 1%. Improved diagnostics and subsequent early detection of otherwise rare injuries raise more questions concerning their treatment. There is lack of consensus on treatment and timing of TAWD. The aim of this study was to analyse the management strategy and outcomes of these injuries in our level I trauma centre. METHODS: All trauma patients who presented with a TAWD at our trauma centre between 2007 and 2016 were retrospectively reviewed...
June 26, 2019: Injury
Rob de Vries, Inge H F Reininga, Max W de Graaf, Erik Heineman, Mostafa El Moumni, Klaus W Wendt
INTRODUCTION: Older adults enduring a polytrauma have an increased mortality risk. Apart from age, the role of other predisposing factors on mortality are mainly described for the total polytrauma population. This study aimed to describe the mortality pattern of older polytrauma patients, its associated risk factors, and the role and etiology of in-hospital complications. METHODS: An eight-year retrospective cohort was constructed from 380 polytrauma patients aged ≥65 in a Dutch level 1 trauma center and linked to the national trauma database (DTR)...
June 25, 2019: Injury
Bernard Youkhana, Frank Tavassol, Heiko Johannsen, Simon Spalthoff, Nils-Claudius Gellrich, Rebecca Stier
BACKGROUND: Many studies have investigated the issue of facial injuries caused by car accidents, but only a few have addressed the technical and clinical aspects of such accidents and injuries in depth. The aim of this study was to identify risk factors and protective elements for facial injuries in car accidents. METHODS: We analysed the technical and clinical data of patients with facial injuries caused by car accidents over a 16-year period (2000-2016) and investigated the following factors: sitting position, sex, age, accident time, use of a seatbelt, deployment of the front airbag, direction of impact, speed at the time of collision, and occurrence and location of facial injuries...
June 25, 2019: Injury
C M Court-Brown, A D Duckworth, S Ralston, M M McQueen
There has been very limited analysis of the relationship between obesity and fractures in the orthopaedic literature. It has been established for some years that underweight individuals are at greater risk of proximal femoral fractures but recently there has been interest in the susceptibility of obese post-menopausal females to fracture. We have undertaken an analysis of 4886 adult patients who presented with a fracture and had their BMI assessed. Analysis has confirmed the relationship between underweight individuals and proximal femoral fractures but there is also a negative association between obesity and clavicle fractures in males and females and with calcaneal fractures in females...
June 22, 2019: Injury
Jotaro Tachino, Kouji Yamamoto, Kentaro Shimizu, Ayumi Shintani, Akio Kimura, Hiroshi Ogura, Takeshi Shimazu
OBJECTIVE: The Risk Assessment Profile (RAP) score is used as a tool of risk prediction in post-traumatic venous thromboembolism (VTE), but this scoring system is complicated to use in clinical settings due to its many variables. The objective of this study was to validate the utility of the RAP model and to develop a simpler risk prediction model for post-traumatic VTE. METHODS: We conducted an observational study at two emergency and critical care centres in Japan between 2013 and 2016...
June 21, 2019: Injury
Ian A Harris, Peter V Giannoudis
No abstract text is available yet for this article.
June 20, 2019: Injury
Joshua C Y Ong, James R Gill, Martyn J Parker
AIMS: The aim of this study was to determine if different patient groups have superior mobility regain following intertrochanteric hip fracture fixation with a cephomedullary nail compared to a sliding hip screw (SHS). PATIENTS AND METHODS: The present study is a subgroup analysis of patients which were enrolled into a randomized controlled trial which randomized 1000 patients with an intertrochanteric hip fracture to fixation with either a short cephomedullary nail (Targon® PF or PFT) or a SHS...
June 19, 2019: Injury
Jill G Putnam, Lauren Nowak, David Sanders, Melanie MacNevin, Abdel-Rahman Lawendy, Clifford Jones, Michael McKee, Emil Schemitsch
INTRODUCTION: This study was designed to measure early postoperative outcomes of plate vs. nail fixation for humeral shaft fractures. PATIENTS AND METHODS: Patients ≥18 years who underwent plate or nail fixation for low-energy humeral shaft fractures between 2005-2016 were identified from the National Surgical Quality Improvement Program (NSQIP). Multivariable regression was used to compare postoperative outcomes using propensity score adjustment to account for differences between fixation groups...
June 14, 2019: Injury
Sandesh S Rao, J Gregory Mawn, Gilberto O Lobaton, Varun Puvanesarajah, Raj M Amin, Casey Jo Humbyrd, Robert S Sterling
INTRODUCTION: Opioid-related compartment syndrome (ORCS) is an understudied complication related to opioid overdose. We hypothesized that ORCS would be associated with worse clinical outcomes, including higher amputation rates, need for multiple surgical procedures, and rhabdomyolysis on admission, compared with nonopioid-related compartment syndrome (NORCS). METHODS: We used Current Procedural Terminology codes for fasciotomy as a proxy marker for cases of compartment syndrome treated at 1 health system from January 1, 2016, to December 21, 2018...
June 13, 2019: Injury
Matthew S Dunn, Ben Beck, Pam M Simpson, Peter A Cameron, Marcus Kennedy, Matthew Maiden, Rodney Judson, Belinda J Gabbe
BACKGROUND: The incidence of older adult traumatic brain injury (TBI) is increasing in both high and middle to low-income countries. It is unknown whether older adults with isolated, serious TBI can be safely managed outside of major trauma centres. This registry based cohort study aimed to compare mortality and functional outcomes of older adults with isolated, serious TBI who were managed at specialised Major Trauma Services (MTS) and Metropolitan Neurosurgical Services (MNS). METHOD: Older adults (65 years and over) who sustained an isolated, serious TBI following a low fall (from standing or ≤ 1 m) were extracted from the Victorian State Trauma Registry from 2007 to 2016...
June 10, 2019: Injury
Eliza E Moskowitz, Lucin Garabedian, Kimberly Harden, Emily Perkins-Pride, Menilik Asfaw, Candice Preslaski, Kiara N Liasia, Ryan Lawless, Clay Cothren Burlew, Fredric Pieracci
No abstract text is available yet for this article.
June 10, 2019: Injury
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