journal
https://read.qxmd.com/read/37268532/why-treatment-of-proximal-humeral-fractures-remains-unresolved-despite-randomized-trials
#1
JOURNAL ARTICLE
Leendert Ht Nugteren, Esther Mm Van Lieshout, Dennis Den Hartog
Most proximal humeral fractures can be treated nonoperatively, but there are specific indications to perform surgery for some of these fractures. Optimal treatment remains subject to debate, since no consensus has been reached for the best therapy for these fractures. This review provides an overview of randomized controlled trials (RCTs) comparing treatment for proximal humeral fractures. Fourteen RCTs comparing different operative and nonoperative types of treatment for PHF are included. Different RCTs comparing the same interventions for PHF have drawn different conclusions...
May 29, 2023: Injury
https://read.qxmd.com/read/37263869/clinical-data-or-scoring-system-for-predicting-mortality-in-elderly-patients-with-hip-fracture-a-prospective-study
#2
JOURNAL ARTICLE
Ricardo Machado Castanheira de Souza, Renan Dias Frassei, Luiza de Campos Moreira da Silva, Miguel Antonio Rahal, Jorge Dos Santos Silva, Kodi Edson Kojima
INTRODUCTION: Hip fracture in elderly individuals is frequent and is related to a high rate of mortality. Finding the best predictor of death will help to develop better patient care. Aim - To analyze the reliability of the clinical data and assessment scores to predict mortality in acute hip fracture in elderly patients. PATIENT AND METHODS: Prospective data were collected from all patients > 65 years with acute hip fracture from May to October 2020. The clinical data collected were age, sex, comorbidities, medication, type of fracture and presence of delirium...
May 26, 2023: Injury
https://read.qxmd.com/read/37268533/socioeconomic-and-clinical-factors-associated-with-prolonged-hospital-length-of-stay-after-traumatic-brain-injury
#3
JOURNAL ARTICLE
John K Yue, Nishanth Krishnan, Lawrence Chyall, Paloma Vega, Sabah Hamidi, Leila L Etemad, Joye X Tracey, Phiroz E Tarapore, Michael C Huang, Geoffrey T Manley, Anthony M DiGiorgio
BACKGROUND: Hospital length of stay (HLOS) after traumatic brain injury (TBI) is a metric of injury severity, resource utilization, and access to services. This study aimed to evaluate socioeconomic and clinical factors associated with prolonged HLOS after TBI. METHODS: Retrospective data from adult hospitalized patients diagnosed with acute TBI at a US Level 1 trauma center between August 1, 2019 - April 1, 2022 were extracted from the electronic health record...
May 25, 2023: Injury
https://read.qxmd.com/read/37248113/adipose-delivered-stem-cells-protect-liver-after-ischemia-reperfusion-injury-by-controlling-autophagy
#4
JOURNAL ARTICLE
Bahar Kartal, Ebru Alimoğulları, Pınar Elçi, Hazal Demir
OBJECTIVE: Ischemia-reperfusion(I/R) injury is an unavoidable side effect of liver surgery and transplantation. A potentially useful tool for cellular therapy and tissue engineering is adipose-derived stem cells (ADSCs).The process of autophagy is used by the cell to break down inappropriate molecules.The study's goal was to examine the impact of ADSCs on the autophagic pathway after rat hepatic ischemia-reperfusion injury. MATERIAL AND METHODS: Thirty male rats used in our study were divided into control, ADSC, ischemia, I/R, and I/R+ ADSC groups (n = 6)...
May 25, 2023: Injury
https://read.qxmd.com/read/37258403/epidemiology-and-socioeconomic-consequences-of-work-related-pelvic-and-acetabular-fractures-recorded-in-the-german-social-accident-insurance
#5
JOURNAL ARTICLE
Nico Hinz, Julius Dehoust, Klaus Seide, Birgitt Kowald, Stefan Mangelsdorf, Karl-Heinz Frosch, Maximilian J Hartel
INTRODUCTION: Pelvic and acetabular fractures can result from work-related accidents and frequently require lengthy medical treatments. Consequently, high medical costs as well as delayed or absent return to work can be the consequence. Therefore, we aimed to study the socioeconomic consequences of work-related pelvic and acetabular fractures. MATERIALS AND METHODS: This retrospective study investigated work-related pelvic and acetabular fractures recorded in the German Social Accident Insurance in 2011 and 2017, in terms of age, sex, type of accident, duration of incapacity to work, reductions in earning capacity, costs for outpatient and inpatient treatment and costs for pension and severance pay...
May 24, 2023: Injury
https://read.qxmd.com/read/37246112/evaluation-of-the-new-south-wales-ambulance-t1-major-trauma-transport-protocol-a-state-wide-data-linkage-study
#6
JOURNAL ARTICLE
Michael Dinh, Hardeep Singh, Colin Deans, Grant Pople, Pooria Sarrami, Glenn Sisson, Jonathon Newman, Jason Bendall
INTRODUCTION: Prehospital triage and transport protocols are critical components of the trauma systems. Still, there have been limited studies evaluating the performance of trauma protocols in New South Wales, such as the NSW ambulance major Trauma transport protocol (T1). OBJECTIVES: Determine the performance of a major trauma transport protocol in a cohort of ambulance road transports METHODS: A data-linkage study using routine ambulance and hospital datasets across New South Wales Australia...
May 24, 2023: Injury
https://read.qxmd.com/read/37246114/impact-of-oral-anticoagulation-on-inhospital-mortality-of-patients-with-hip-fracture-analysis-of-nationwide-hospitalization-data
#7
JOURNAL ARTICLE
Kathrin Feller, Nabil Abdel-Jalil, Christian Blockhaus, Knut Kröger, Bernd Kowall, Andreas Stang
OBJECTIVES: Oral anticoagulation (OAC) may have an impact on mortality in cases hospitalized for hip fracture (HF). We studied nationwide time trends of OAC prescriptions and compared time trends of inhospital mortality of HF cases with and without OAC in Germany DESIGN: Retrospective cohort study SETTING: Nationwide German hospitalization, Diagnosis-Related Groups Statistic PATIENTS/PARTICIPANTS: All hospital admissions for HF 60 years and older in the years 2006 through 2020. INTERVENTION: Additional diagnosis with a personal history of long-term use of anticoagulants (ICD code Z92...
May 23, 2023: Injury
https://read.qxmd.com/read/37230827/biomechanical-analysis-of-a-novel-y-plate-designed-for-the-treatment-of-extraarticular-distal-humerus-fractures
#8
JOURNAL ARTICLE
Petra Adamović, Lea Kalajžić, Danijela Hrman, Janoš Kodvanj, Srećko Sabalić
Adult distal humerus fractures are infrequent, yet they account for one-third of all humerus fractures. For the treatment of comminuted and osteoporotic fractures, locking plates are claimed to be biomechanically superior to alternative internal fixing techniques. Treatment remains difficult despite recent advancements and the use of locking plates due to frequent comminution, low bone quality, and limited healing ability in osteoporotic bone. An optimal design of the newly constructed plate and the control model were selected...
May 22, 2023: Injury
https://read.qxmd.com/read/37236854/outcomes-of-simultaneous-versus-staged-intramedullary-nailing-fixation-of-multiple-long-bone-lower-extremity-fractures
#9
JOURNAL ARTICLE
Blake Miller, Maxwell Phillips, Laura Krech, Bryce Biberstein, Jessica Parker, Steffen Pounders, Chelsea Fisk, Alistair J Chapman, Gable Moffitt
INTRODUCTION: Repair of multiple lower extremity long bone fractures with intramedullary nail (IMN) fixation is associated with significant cardiopulmonary burden and may result in mortality. These patients are at an increased risk for fat embolism syndrome, pulmonary embolism, Acute Respiratory Distress Syndrome (ARDS), and pneumonia. No standardized guidelines exist to guide treatment of these patients. Further, there is a paucity of data regarding the risk of simultaneous versus staged fixation of multiple long bone fractures that includes both tibial and femoral injuries, as patients with multiple concomitant fractures are often excluded from relevant analyses...
May 21, 2023: Injury
https://read.qxmd.com/read/37225543/the-use-of-whole-body-trauma-ct-should-be-based-on-mechanism-of-injury-a-risk-analysis-of-3920-patients-at-a-tertiary-trauma-centre
#10
JOURNAL ARTICLE
Salam Findakly, Adil Zia, Helen Kavnoudias, Joseph Mathew, Dinesh Varma, Bruno Di Muzio, Robin Lee, Heather K Moriarty, Tim Joseph, Warren Clements
BACKGROUND: Mechanism of injury (MOI) plays a significant role in a decision to perform whole-body computed tomography (CT) imaging for trauma patients. Various mechanisms have unique patterns of injury and therefore form an important variable in decision making. METHODS: Retrospective cohort study including all patients >18 years old who received a whole-body CT scan between 1 January 2019 and 19 February 2020. The outcomes were divided into CT 'positive' if any internal injuries were detected and CT 'negative' if no internal injuries were detected...
May 20, 2023: Injury
https://read.qxmd.com/read/37263870/evaluation-of-a-30-day-mortality-risk-calculator-for-patients-undergoing-surgical-fixation-of-fragility-hip-fractures
#11
JOURNAL ARTICLE
Eliza R Pelrine, Patrick J Dunne, John Burke, Harrison S Mahon, Max Hoggard, Wendy Novicoff, Seth R Yarboro
INTRODUCTION: Hip fractures often occur in medically complex patients and can be associated with high perioperative mortality. Mortality risk assessment tools that are specific to hip fracture patients have not been extensively studied. The objective of this study is to evaluate a recently published 30-day mortality risk calculator (Hip Fracture Estimator of Mortality Amsterdam [HEMA]) in a group of patients treated at a university health system. MATERIALS & METHODS: 625 patients treated surgically for hip fractures between 2015 and 2020 at our institution were retrospectively reviewed...
May 19, 2023: Injury
https://read.qxmd.com/read/37258404/effect-of-surgical-delay-on-30-day-mortality-in-patients-receiving-direct-oral-anticoagulants-and-admitted-for-hip-fracture
#12
JOURNAL ARTICLE
Eric Noll, Ludovic Keller, Pierre Tran Ba Loc, Philippe Adam, Thomas Arat, Johanne Piotrowski, Elliott Bennett-Guerrero, Erik Sauleau, Julien Pottecher
BACKGROUND: Early hip fracture surgery is recommended to decrease mortality, however the impact of a delay in surgery due to previous treatment with direct oral anticoagulants (DOA) is unknown. Our objective was to determine if early surgery, defined as surgery within 48 h of hospital admission is associated with decreased postoperative mortality. We tested the hypothesis that early surgery was beneficial with regard for mortality in patients treated with direct oral anticoagulants...
May 19, 2023: Injury
https://read.qxmd.com/read/37217401/no-decay-in-outcomes-at-a-mean-8-years-following-surgical-treatment-for-aseptic-fracture-nonunion
#13
JOURNAL ARTICLE
Blake I Boadi, Sanjit R Konda, Adwin Denasty, Philipp Leucht, Kenneth A Egol
PURPOSE: The purpose of this study is to compare medium to long term patient reported outcomes to one-year data for patients treated surgically for an aseptic fracture nonunion. METHODS: 305 patients surgically treated for a fracture-nonunion were prospectively followed. Data collected included pain scores measured by the Visual Analog Scale (VAS), clinical outcomes assessed by the Short Musculoskeletal Functional Assessment (SMFA), and range of motion. 75% of patients in this study had lower extremity fracture nonunions and 25% had upper extremity fracture nonunions...
May 19, 2023: Injury
https://read.qxmd.com/read/37217400/perspective-recommendations-for-improved-patient-participation-in-decision-making-for-geriatric-patients-in-acute-surgical-settings
#14
EDITORIAL
H J Schuijt, D P J Smeeing, W R Verberne, R H H Groenwold, J J M van Delden, L P H Leenen, D van der Velde
Geriatric patients often present to the hospital in acute surgical settings. In these settings, shared decision-making as equal partners can be challenging. Surgeons should recognize that geriatric patients, and frail patients in particular, may sometimes benefit from de-escalation of care in a palliative setting rather than curative treatment. To provide more person-centred care, better strategies for improved shared decision-making need to be developed and implemented in clinical practice. A shift in thinking from a disease-oriented paradigm to a patient-goal-oriented paradigm is required to provide better person-centred care for older patients...
May 19, 2023: Injury
https://read.qxmd.com/read/37211472/injuries-related-to-sauna-bathing
#15
JOURNAL ARTICLE
Peter Kaiser, Ulrike Seeher, Arbnor Krasniqi, Alexander Keiler, Roman Crazzolara, Andreas Meryk
PURPOSE: Awareness of well-being and health issues have contributed to increased popularity of sauna bathing. However, little is known about potential risks and injuries. The aim of this study was to identify the causes for injuries, the affected body regions and to define recommendations for prevention. METHODS: A retrospective chart data analysis was conducted among patients treated for an injury related to sauna bathing at the local trauma centre of the Medical University of Innsbruck between January 1, 2005 and December 31, 2021...
May 19, 2023: Injury
https://read.qxmd.com/read/37246115/incidence-of-alpine-skiing-and-snowboarding-injuries
#16
JOURNAL ARTICLE
Moritz Wagner, Michael Liebensteiner, Dietmar Dammerer, Johannes Neugebauer, Paul Nardelli, Alexander Brunner
BACKGROUND: The incidence of injuries on alpine ski slopes have been assessed using various methods. A decline in injury rate has been observed throughout the literature; however, the actual incidence remains unclear. The purpose of this study was therefore to evaluate the incidence of skiing and snowboarding injuries using large-sample data from an entire geographic state. METHODS: Data on alpine injuries over the course of five winter seasons between 2017 and 2022 were prospectively collected from the emergency service dispatch center of Tyrol (Austria)...
May 18, 2023: Injury
https://read.qxmd.com/read/37217398/femoral-fractures-in-the-immature-skeleton-characterization-risk-factors-and-treatment-options-in-a-developing-country
#17
JOURNAL ARTICLE
Daniel Navarro Vergara, Alberto Navarro Fretes
INTRODUCTION: Femur fracture is one of the most frequent reasons for admission to paediatric trauma units and has a bimodal incidence. The trauma mechanism varies according to the patient's age. Non-operative treatment continues to be performed, although surgical treatment has gained popularity in recent years. Paediatric orthopaedic traumatologists should always bear in mind the already known general principles of treatment. In this study, we aimed to provide a general characterization of femoral fractures, risk factors, and current definitive treatment methods in a developing Latin American country...
May 18, 2023: Injury
https://read.qxmd.com/read/37208254/femoral-shaft-fractures-in-eldery-patients-an-epidemiological-risk-analysis-of-incidence-mortality-and-complications
#18
JOURNAL ARTICLE
Nike Walter, Dominik Szymski, Steven M Kurtz, Volker Alt, David W Lowenberg, Edmund C Lau, Markus Rupp
OBJECTIVES: This work aimed at answering the following research questions: (1) What is the incidence of femoral shaft fractures in the geriatric population in the U.S.? (2) What is the rate of mortality, mechanical complications, nonunion and infection, and what are the associated risk factors? STUDY DESIGN AND SETTING: In this cross-sectional study, femoral shaft fractures occurred between January 1, 2009, and December 31, 2019, were identified from Medicare records...
May 16, 2023: Injury
https://read.qxmd.com/read/37217399/evidence-on-treatment-of-clavicle-fractures
#19
JOURNAL ARTICLE
Christian von Rüden, Julia Rehme-Röhrl, Peter Augat, Jan Friederichs, Simon Hackl, Fabian Stuby, Oliver Trapp
Depending on the severity of the injury and the involvement of the soft tissue envelope, clavicle fractures can be treated operatively or non-operatively. In the past, displaced fractures of the clavicle shaft in adults have been treated non-operatively. However, the rate of nonunion following non-operative treatment seems to be higher than previously reported. In addition, publications reporting better functional outcomes following operative treatment are increasing. In recent years this has led to a paradigm shift towards an increase of operative fracture treatment...
May 15, 2023: Injury
https://read.qxmd.com/read/37246113/predictive-factors-for-fracture-related-infection-in-open-tibial-fractures-in-a-sub-saharan-african-setting
#20
JOURNAL ARTICLE
Loïc Fonkoue, Elizabeth K Tissingh, Olivier Kennedy Muluem, Denis Kong, Olivier Ngongang, Urich Tambekou, Daniel Handy, Olivier Cornu, Martin McNally
INTRODUCTION: The management of open tibial fractures (OTF) is challenging in low and middle-income countries (LMICs) where appropriate human resources and infrastructure (including equipment, implants and surgical supplies) are not readily available and medical care is not readily accessible. OTF are not rarely associated with a subsequent fracture-related infection (FRI), which is one of the most devastating and difficult to cure complications in orthopaedic trauma care. The aim of this study was to determine the rate and the predictive factors of FRI in OTF in a limited-resource setting of sub-Saharan Africa...
May 14, 2023: Injury
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