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Brice Malgras, Olivier Aoun, Ghislain Pauleau, Guillaume Boddaert, Emmanuel Hornez, Renaud Dulou, Jean-Marc Delmas, Pierre Haen, Sophie Laversanne, Anna Crambert, Paul Balandraud
INTRODUCTION: The military operations carried out by the French armed forces, occasionally require the use of the Surgical Life-saving Module (SLM), to ensure the surgical support of its soldiers. Due to its extreme mobility and capacity of fast deployment, SLM is particularly useful in small-scale military operations, such as Special Forces missions. In 2017, the French SLM was for the first time used to ensure surgical support of allied forces, which were lacking forward surgical capabilities...
March 4, 2019: Injury
Giuseppe Toro, Federica Lepore, Giampiero Calabrò, Gabriella Toro, Marco Rossini, Michele Vasso, Alfredo Schiavone Panni
INTRODUCTION: Humeral shaft is a common site of fracture non-union. Biology and bone quality represent some of the problems that the orthopaedic surgeon has to face up in the elderly. The goals of treatment of humeral shaft non-union are the achievement of mechanical stability and creation of a favourable biologic environment. Bone graft and stem cells are some of the augmentation techniques available to reach these goals. PURPOSE: Evaluation of the outcomes of humeral shaft non-union in elderly population treated with cortical allograft and stem cells...
February 27, 2019: Injury
David Gomez, Kristian Larsen, Brian J Burns, Michael Dinh, Jeremy Hsu
INTRODUCTION: Getting the right patient, to the right place, at the right time is dependent on a multitude of modifiable and non-modifiable factors. One potentially modifiable factor is the number and location of trauma centres (TC). Overabundance of TC dilutes volumes and could be associated with worse outcomes. We describe a methodology that evaluates trauma system reconfiguration without reductions in potential access to care. We used the mature trauma system of New South Wales (NSW) as a model given the perceived overabundance of urban major trauma centres (MTC)...
February 27, 2019: Injury
Emir Battaloglu, Marisol Figuero, Christopher Moran, Fiona Lecky, Keith Porter
Urethral injury in major trauma is infrequent, with complex problems of diagnosis and treatment. The aims of this study are to determine the incidence and epidemiological factors relating to urethral injury in major trauma, as well as determine if any additional prognostic factors are evident within this cohort of patients. A retrospective review of patients sustaining urethral injury following major trauma was made over a 6-year period, from 2010 to 2015. Quantitative analysis was made using the national trauma registry for England and Wales, the Trauma Audit and Research Network (TARN) database, identifying all patients with injury codes for urethral injury...
February 22, 2019: Injury
T H Rainer, K K C Hung, J H H Yeung, S K C Cheung, Y K Leung, L Y Leung, W B Goggins, H F Ho, C W Kam, N K Cheung, C A Graham
BACKGROUND: Trauma care systems in Asia have been developing in recent years, but there has been little long-term outcome data from injured survivors. This study aims to evaluate the trajectory of functional outcome and health status up to five years after moderate to major trauma in Hong Kong. METHODS: We report the five year follow up results of a multicentre, prospective cohort from the trauma registries of three regional trauma centres in Hong Kong. The original cohort recruited 400 adult trauma patients with ISS ≥ 9...
February 22, 2019: Injury
K Al-Hourani, M Stoddart, T J S Chesser
OBJECTIVE: To analyse whether early post-operative full weight bearing following syndesmotic ankle fixation affected radiographic outcomes suggestive of diastasis. DESIGN: Retrospective comparative cohort study over a two year period. SETTING: Level 1 trauma centre PATIENTS/PARTICIPANTS: 152 consecutive patients sustaining an unstable ankle fracture requiring syndesmotic stabilisation were included. Exclusions were 49 patients who had trimalleolar fixation without syndesmosis screws, one patient who had concomitant ankle and talar fracture...
February 20, 2019: Injury
Jorge Briceño, Bonnie Chien, Christopher Miller, Brian Velasco, John Y Kwon
The ankle gravity stress view (GSV) is often utilized to elucidate instability in patients with an apparent, isolated lateral malleolus fracture. While this has been demonstrated to have advantages over the manual external rotation stress test, positioning in the lateral decubitus position can be difficult, uncomfortable and time-intensive. We report a simple and safe technique that allows one to obtain a gravity stress view of the ankle with the patient seated.
February 18, 2019: Injury
Pietro Persiani, Lorena Martini, Filippo Maria Ranaldi, Anna Zambrano, Mauro Celli, Luca Celli, Patrizia D'Eufemia, Ciro Villani
INTRODUCTION: Patients with Osteogenesis Imperfecta (OI) Type 3 may exhibit both primitive deformities and secondary fracture malunions on a femoral level. The orthopaedic surgeon's objective is to cure the deformities in order to prevent fractures and to treat the fractures in order to prevent deformities, by using telescopic nails as the gold standard method of fixation. However, the titanium elastic nail (TEN) is indicated as a possible alternative in certain selected cases. MATERIALS AND METHODS: The Centre for Congenital Osteodystrophy of the Sapienza University of Rome follows 485 patients with osteogenesis imperfecta...
February 15, 2019: Injury
Giovanni Vicenti, Giuseppe Solarino, Massimiliano Carrozzo, Silvana De Giorgi, Lorenzo Moretti, Angelo De Crescenzo, Biagio Moretti
PURPOSE: The purpose of this systematic review was to address the treatment of multiligament knee injuries in three major aspects, specifically (1) surgical versus nonoperative treatment, (2) repair versus reconstruction of injured ligamentous structures, and (3) early versus late surgery of damaged ligaments. METHODS: Two independent reviewers performed a search on PubMed from 1966 to March 2016 using Levy's review as a starting-point, and the same terms "knee dislocation," "multiple ligament-injured knee," and "multiligament knee reconstruction...
February 15, 2019: Injury
Elizabeth Benjamin, Alberto Aiolfi, Gustavo Recinos, Kenji Inaba, Demetrios Demetriades
INTRODUCTION: Optimal timing of pharmacological thromboprophylaxis (VTEp) in patients with severe pelvic fractures remains unclear. The high risk of venous thromboembolic (VTE) complications after severe pelvic fractures supports early VTEp however concern for fracture-associated hemorrhage can delay initiation. Patients with pelvic fractures also frequently have additional injuries that complicate the interpretation of the VTEp safety profiles. To minimize this problem, the study included only patients with isolated severe pelvic fractures...
February 14, 2019: Injury
Chien-Hua Wu, Shih-Wei Huang, Yen-Nung Lin, Chyan-Yeong Wang, Tsan-Hon Liou, Kwang-Hwa Chang
BACKGROUND: Having motor impairment since childhood and being at risk of osteoporosis and falls, adults with polio would be more likely to suffer a hip fracture (HF) and may experience different epidemiological characteristics from the general population. OBJECTIVE: To estimate the risk and incidence of HF in adults with polio. DESIGN: Using a national database, we conducted a population-based cohort study. We identified patients with polio using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code of 138...
February 14, 2019: Injury
Michal Bartnikowski, Nicole Bartnikowski, Anna Woloszyk, Romano Matthys, Vaida Glatt
The purpose of this study was to determine whether differences in structural and material properties of bone between different mouse strains influence the fracture patterns produced under experimental fracture conditions. Femurs of C57BL/6 (B6), C3H/HeJ (C3H), and DBA/2 (DBA) strains were evaluated using micro-computed tomography (μCT), measurements derived from radiographic images and mechanical testing to determine differences in the geometry and mechanical properties. A fracture device was used to create femoral fractures on freshly sacrificed animals using a range of kinetic energies (∼20-80mJ) which were classified as transverse, oblique, or comminuted...
February 13, 2019: Injury
Ruipeng Zhang, Yingchao Yin, Shilun Li, Jialiang Guo, Zhiyong Hou, Yingze Zhang
OBJECTIVE: Fracture line of the sacrum always involves the Zone II region because sacral foramina are anatomically and physiologically weak regions of the sacrum. The purpose of this study is to compare the therapeutic effects of a sacroiliac screw and a minimally invasive adjustable plate (MIAP) for Zone II sacral fractures. METHODS: Patients with unilateral Zone II sacral fractures fixed with a unilateral sacroiliac screw or MIAP from August 2009 to January 2016 were recruited into this study and were divided into two groups: group A (sacroiliac screw) and group B (MIAP)...
February 13, 2019: Injury
Jan Herzog, Robert Wendlandt, Sebastian Hillbricht, Rainer Burgkart, Arndt-Peter Schulz
INTRODUCTION: The annual incidence of proximal femoral fractures is 100-150/100,000 and continues to increase with an aging population. Cut-out of hip screws after fracture fixation has been quoted as 8% in the literature. The tip-apex distance (TAD) is the strongest predictor for cut-out after operative fracture stabilisation. The aim of this study was to evaluate the novel ADAPT system (Adaptive Positioning Technology, Stryker, USA), a navigation device for intramedullary nailing of trochanteric fractures and its effect on optimising the TAD...
February 13, 2019: Injury
Jiantao Li, Lin Han, Hao Zhang, Zhe Zhao, Xiuyun Su, Jianfeng Zhou, Chen Li, Peng Yin, Ming Hao, Kun Wang, Gaoxiang Xu, Lihai Zhang, Licheng Zhang, Peifu Tang
OBJECTIVES: Using finite element analysis and biomechanical tests, the biomechanical behaviors of Medial Sustainable Nail (MSN) and Proximal Femoral Nail Antirotation (PFNA) were compared for the fixation of fracture type of AO/OTA 31-A2.3. METHODS: Finite element software Abaqus 6.14 was used to conduct axial loading of 2100 N and we analyzed the von Mises stress distribution and the model displacement of two implant models. Biomechanical tests were separately conducted in the axial stiffness test and axial cyclical loading test on a mechanical testing machine...
February 12, 2019: Injury
F Greve, M Beirer, M Zyskowski, M Crönlein, M Müller, S Pesch, S Felix, P Biberthaler, A Buchholz, C Kirchhoff
BACKGROUND: Fractures of the proximal humerus are often associated with lesions of the long head of the biceps (LHB) tendon. This often leads to prolonged shoulder pain. Hence, many surgeons decide to perform a tenodesis of the LHB tendon simultaneous to ORIF. The purpose of this study was to evaluate the postoperative outcome after interlocking plate fixation and biceps tenodesis for treating proximal humerus fractures. METHODS: 56 patients (38 females, 18 male) suffering from proximal humerus fractures who underwent surgery were retrospectively included...
February 10, 2019: Injury
Peter Kaiser, David Sailer, Anna Spicher, Rohit Arora, Michael Zegg
INTRODUCTION: "Blobbing" is a modern outdoor activity where a participant sits on the end of a partially inflated air bag ("blobber") and is launched into the water when another participant jumps onto the air bag from a platform on the opposite side ("jumper"). This is the first study to evaluate the injury patterns associated with blobbing. PATIENTS AND METHODS: A retrospective data analysis was conducted based on 86 patients who sustained blobbing injuries between January 2011 and December 2016...
February 8, 2019: Injury
Roberto Buzzi, Niccolò Sermi, Felicia Soviero, Stefano Bianco, Domenico A Campanacci
INTRODUCTION: Displaced intra-articular calcaneal fractures (DIACF) represent a challenging and controversial issue in traumatology. Conservative treatment has been recommended to avoid surgical problems and complications. The final result, however, is often a painful malunioun of the calcaneus with peroneal impingement. Surgical treatment is gaining acceptance since it offers a chance to restore bone anatomy improving function as long as complications are avoided. MATERIAL AND METHOD: We reviewed a series of 59 DIACF treated by a single surgeon during a 9 years period...
February 8, 2019: Injury
James Haddon, Robert Buciuto, Lars G Johnsen
BACKGROUND AND PURPOSE: To compare the radiological and clinical results of sliding hip screw (SHS) fixation with or without a Trochanteric Support Plate (TSP) on unstable three-or-more-part trochanteric fractures. METHODS: A randomized prospective non blinded study of one hundred patients with trochanteric fractures; Evans-Jensen type 3, 4 and 5, reduced and fixed with SHS. Patients were randomized into two study groups; with or without TSP supplementation ('TSP' and 'NoTSP' groups)...
February 7, 2019: Injury
A Memeo, E Panuccio, R D D'Amato, M Colombo, S Boero, A Andreacchio, C Origo, L Pedretti
INTRODUCTION: Femoral shaft fractures are the commonest major pediatric fractures. For generations, traction and casting were the standard method of treatment for children. However, over the past two decades there has been growing recognition of the advantages of fixation and rapid mobilization. METHODS: A prospective multicenter study was conducted at four Italian centers of reference for pediatric fractures (January 2005 to December 2014). The study involved 62 patients of both sexes, between 6 and 14 years of age, with closed femoral shaft fractures...
February 7, 2019: Injury
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