W C Prall, M Rieger, J Fürmetz, F Haasters, H O Mayr, W Böcker, T Kusmenkov
INTRODUCTION: The design of anatomically precontoured locking compression plates (LCP) allows the placement of angular stable screws right underneath the reduced joint surface fragments. To date, there is a lack of evidence supporting the broad utilization of these implants in split depression fractures to the lateral tibial plateau. Thus, aim of the present matched pair retrospective cohort study was to investigate the radiological and clinical outcomes of anatomically precontoured LCP compared to conventional plate and screw osteosynthesis in Schatzker II fractures...
July 5, 2020: Injury
Jennifer T Cone, Elizabeth R Benjamin, Daniel B Alfson, Subarna Biswas, Demetrios Demetriades
INTRODUCTION: Obesity has been described as a significant risk factor for adverse outcomes in hospitalized patients. However, recent literature reports an "obesity paradox", suggesting that obesity may have a protective effect in a subset of surgical and critically ill patients. The present study assesses the effect of body mass index (BMI) on outcomes following severe isolated blunt chest trauma. METHODS: This was a TQIP database study including patients with severe isolated blunt chest injury (chest AIS 3-5, extrathoracic AIS <3)...
July 5, 2020: Injury
Mathieu M E Wijffels, Jonne T H Prins, Eva J Perpetua Alvino, Esther M M Van Lieshout
PURPOSE: Surgical rib stabilization in flail chest is proven to be beneficial over nonoperative treatment in terms of rate of pneumonia, Intensive Care (IC) length of stay (ICLOS) and mechanical ventilation days. The aim of this systematic review and meta-analysis was to evaluate the effect of operative versus nonoperative treatment on the occurrence of pneumonia and other relevant clinical outcomes in patients with multiple simple rib fractures. METHODS: A search was performed in Embase, Medline Ovid, Cochrane Central, Web of Science, and Google Scholar...
July 3, 2020: Injury
Chul-Ho Kim, Ji Wan Kim
BACKGROUND: Whether plate fixation or sacroiliac (SI) screw fixation is the better treatment for posterior pelvic ring disruption is controversial. The aim of this systematic review and meta-analysis was to compare the two fixation methods. MATERIAL AND METHODS: The MEDLINE, Embase, and Cochrane Library databases were systematically searched for studies comparing plate and SI screw fixations in posterior pelvic ring injuries. Intraoperative variables, postoperative complications, and clinical/radiological scores were compared between the techniques...
July 3, 2020: Injury
Huy Le Quang, Werner Schmoelz, Richard A Lindtner, Peter Schwendinger, Michael Blauth, Dietmar Krappinger
OBJECTIVES: To biomechanically compare five different fixation techniques for transverse acetabular fractures using both the single-leg stance (SLS) and the sit-to-stand (STS) loading protocols and to directly compare fracture gap motion (FGM) and relative interfragmentary rotation (RIFR). METHODS: Transtectal transverse acetabular fractures were created on fourth-generation composite hemipelves in a reproducible manner. Five different fixation techniques were biomechanically assessed using both an SLS and STS loading protocol: anterior plate (AP) only, posterior plate (PP) only, anterior plate plus posterior column screw (AP+PCS), posterior plate plus anterior column screw (PP+ACS) and anterior plus posterior plate (AP+PP)...
July 3, 2020: Injury
Qiong He, Jin Tong, Min Jin, Junjie Hua, David C Schwebel, Jing Zhang, Guoqing Hu
OBJECTIVE: To assess the accuracy of injury-related hospitalization diagnoses by physicians in China. METHODS: 62,269 hospitalizations between 2014 and 2016 at a large hospital in Changsha, China were assessed. We considered three types of diagnostic errors: under-reporting, lack of cause specificity, and misclassification across injury causes. Diagnosis and coding of diseases were ascertained by professional coders based on the tenth International Classification of Disease (ICD-10)...
July 3, 2020: Injury
Arvind Kumar, Yawar Haider, Sandeep Kumar, Javed Jameel
No abstract text is available yet for this article.
June 30, 2020: Injury
Nathan N O'Hara, Gerard P Slobogean, Kevin O'Halloran, Renan Castillo, Sheila Sprague, Mohit Bhandari, Robert V O'Toole
BACKGROUND: Predictive models are common in orthopedic research; however, most models are not validated in an external population. The Nonunion Risk Determination (NURD) score was developed using a single-center cohort of 382 patients to reliably predict tibia shaft nonunions at the time of initial intramedullary nail fixation. The purpose of this study was to externally validate the NURD score using data from the SPRINT Trial. METHODS: The SPRINT trial was a multicenter study comparing reamed versus unreamed intramedullary nails in tibial shaft fracture patients...
June 29, 2020: Injury
Mir Mohsin, Haroon Rashid Zargar, Tanveer Ahmed Bhat, Hilal Ahmed Bhat, Farooq Ahmed Mir, Adil Hafeez Wani
BACKGROUND: Open traumatic tendoachilles injuries due to toilet seats are least reported. The exact mechanism of such injuries is debatable. None of the studies have reported associated neurovascular injuries and the need for microvascular tissue transfer. METHODS: It is a 5-year prospective observational study from Sep 2013 - Aug 2018 at a tertiary care center on 26 patients who had sustained foot injuries due to squatting type toilet seats. All the patients were managed by thorough wound irrigation and debridement followed by repair of cut tendoachilles, other tendons and neurovascular structures...
June 29, 2020: Injury
Yung-Chuan Hsiao, Tung-Yi Lin, Ying-Chih Wang, Chia-Wei Chang, Hao-Che Tang, Chien-Hao Chen, Chun-Yi Su
OBJECTIVES: This study aimed to evaluate the prognostic factors of reoperation after plate fixation for midshaft clavicle fracture and compare outcomes of dynamic compression plates (DCP) and pre-contoured locking plates. DESIGN: Retrospective comparative study. SETTING: Level I trauma center. PATIENTS/PARTICIPANTS: We recruited 274 consecutive patients who underwent plate fixation for midshaft clavicle fracture from 2007 to 2017 and completed at least 1 year of follow-up...
June 29, 2020: Injury
Arvind Kumar, Rizwan Khan, Javed Jameel, Owais Ahmed Qureshi, Mukesh Kumar
No abstract text is available yet for this article.
June 29, 2020: Injury
Andrew L Foster, T Fintan Moriarty, Charalampos Zalavras, Mario Morgenstern, Anjali Jaiprakash, Ross Crawford, Marc-Antoine Burch, Willemijn Boot, Kevin Tetsworth, Theodore Miclau, Peter Ochsner, Michael A Schuetz, R Geoff Richards, Willem-Jan Metsemakers
Bone healing is a complicated process of tissue regeneration that is influenced by multiple biological and biomechanical processes. In a minority of cases, these physiological processes are complicated by issues such as nonunion and/or fracture-related infection (FRI). Based on a select few in vivo experimental animal studies, construct stability is considered an important factor influencing both prevention and treatment of FRI. Stephan Perren played a pivotal role in the evolution of our current understanding of the critical relationship between biomechanics, fracture healing and infection...
June 26, 2020: Injury
Matthew Benns, Matthew Ruther, Nicholas Nash, Matthew Bozeman, Brian Harbrecht, Keith Miller
BACKGROUND: The Home Owner's Loan Corporation (HOLC) was created in 1933 to provide government backing of troubled mortgages during the Great Depression. Residential security maps were created to guide investment in over 200 US cities. Neighborhoods were assigned grades of 'A' through 'D' (with corresponding color coding of green, blue, yellow and red) to indicate desirability for investment. Neighborhoods with a high percentage of African Americans or other minorities were frequently assigned grades of 'C' or 'D'...
June 25, 2020: Injury
Vaibhav Sahni
The oral & maxillofacial region and by that virtue surgery of the same is correlated to an increased risk of the transfer of the SARS CoV-2. In times of a pandemic it is imperative to institute a protocol based management of maxillofacial injuries based on currently available literature which is suggestive, simplistic, executable and amenable to modifications should the rapidly changing situation demand the same. The author, in the present study conducted a review of literature to undertake the task of forming a simplistic protocol which is readily applicable for the management of maxillofacial injuries which would not only provide the clinician guidance on what to do now but caution towards the future implications of his/her present decision...
June 25, 2020: Injury
Kai-Lan Hsu, Fa-Chuan Kuan, Hao-Chun Chuang, Ming-Long Yeh, Wei-Ren Su
No abstract text is available yet for this article.
June 25, 2020: Injury
Liv Riisager Wahlsten, Lærke Smedegaard, Stig Brorson, Gunnar Gislason, Henrik Palm
INTRODUCTION: Sustaining a hip fracture is a life changing event for many elderlies. While doctors and researchers tend to be preoccupied with mortality and complication rates, patients are more concerned by other aspects e.g. loss of independence and ability to remain in their own home. This study aimed to i) determine age-stratified one-year event rates of admission to nursing home after discharge, and ii) identify risk factors associated with nursing home admission. METHODS: Community dwelling patients aged 60-100 years undergoing their first hip fracture surgery in 2005 - 2015 were identified in nationwide administrative registries...
June 25, 2020: Injury
Andrew M Schwartz, Christopher A Staley, Jacob M Wilson, William M Reisman, Mara L Schenker
BACKGROUND: There is a select number of massive-volume, high-acuity trauma centers (HACs) in the United States. Expertise in polytrauma care has been associated with improved mortality in general surgery trauma, though has not been investigated in orthopaedic trauma. With complex polytrauma proficiency comes the inherent risk of intensive care, complications, and prolonged inpatient stays, without a commensurate increase in allocated resources. The purpose of this study was to compare mortality, complications, and length of stay in polytraumatized orthopaedic patients treated at HACs vs...
June 25, 2020: Injury
Chong Li, Yi-Jun Gao, Ke Lu
No abstract text is available yet for this article.
June 25, 2020: Injury
Sachin Mathur, Chung Fai Jeremy Ng, Fangju Koh, Mingzhe Cai, Gautham Palaniappan, Yun Le Linn, Huiling Linda Lim, Ramu Lakshman, Xiao Shuang Ling, Sock Teng Chin, Hiang Khoon Tan
BACKGROUND: As the COVID-19 pandemic sweeps across the world, healthcare departments must adapt to meet the challenges of service provision and staff/patient protection. Unlike elective surgery, acute care surgery (ACS) workloads cannot be artificially reduced providing a unique challenge for administrators to balance healthcare resources between the COVID-19 surge and regular patient admissions. METHODS: An enhanced ACS (eACS) model of care is described with the aim of limiting COVID-19 healthcare worker and patient cross-infection as well as providing 24/7 management of emergency general surgical (GS) and trauma patients...
June 25, 2020: Injury
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