journal of trauma

INTRODUCTION: The shock index (SI) is a known predictor of unfavorable outcomes in trauma. This study seeks to examine and compare the SI values between geriatric patients and younger adults. METHODS: We conducted a retrospective study of the Trauma Quality Improvement Program database from 2017 to 2019. All patients≥ 25 y with injury severity score ≥ 16 were included. Age groups were defined as 25-44 y (group A), 45-64 y (group B), and ≥65 y (group C)...

INTRODUCTION: Although non-accidental trauma continues to be a leading cause of morbidity and mortality among children in the United States, the underlying factors leading to NAT are not well characterized. We aim to review reporting practices, clinical outcomes, and associated disparities among pediatric trauma patients experiencing NAT. METHODS: A literature search utilizing PubMed, Google Scholar, EMBASE, ProQuest, and Cochrane was conducted from database inception until April 6, 2023...

Rohingya Muslims have been forcefully displaced from their mother land, Rakhaine State, Myanmar to Bangladesh, a country with about 170 million population with a treatment gap of more than 90% for standard mental health care. Due to the experienced trauma and displacement, high prevalence of depression, anxiety and post-traumatic tress disorders has been identified among Rohingya refugees in addition to the enduring mental health burden of Bangladesh. Very little has been known regarding the practical challenges of mental health services among Rohingya refugees in Bangladesh...

OBJECTIVE: The current pediatric neurosurgery capacity in lower-middle-income countries (LMICs) in South America is poorly understood. Correspondingly, the authors sought to interrogate the neurosurgical inpatient experience of the sole publicly funded pediatric hospital in one of the largest regional departments of Bolivia to better understand this capacity. METHODS: A retrospective review of all neurosurgical procedures performed at the Children's Hospital of La Paz, Bolivia (Hospital del Niño "Dr...

Needle decompression is a mainstay intervention for tension pneumothorax in trauma medicine. It is used in combat and prehospital medicine when definitive measures are often not available or ideal. It can temporarily relieve increased intrathoracic pressure and treat a collapsed lung or great vessel obstruction. However, when done incorrectly, it can result in underlying visceral organ and vessel trauma. This is a case of an adult male who presented to the emergency department after sustaining multiple stab wounds during an altercation...

Childhood abuse can have long-term adverse outcomes in adulthood. These outcomes may pose a particular threat to the health and well-being of perinatal women; however, to date, this body of knowledge has not been systematically collated and synthesized. This systematic review examined the child abuse literature and a broad range of perinatal outcomes using a comprehensive search strategy. The aim of this review was to provide a clearer understanding of the distinct effect of different abuse types and areas where there may be gaps in our knowledge...

This study aimed to understand young gay men's experiences of social support, relationships, community networks, talking about psychological distress, and their impact on distress and wellbeing. Eight verbatim transcriptions from semi-structured interviews with gay men aged 18-35 years were analyzed using Interpretative Phenomenological Analysis. Three super-ordinate themes were developed; 1) Growing up gay in a straight world: Developmental traumas, regarding men's experiences of homophobic abuse and exclusion and the internalized impact on their identities and identity concealment...

It is incumbent upon our profession to reevaluate our preference for routinely replacing a missing single maxillary incisor, especially a maxillary lateral incisor, with a dental implant in a young adult. The dental literature is replete with beautiful restorative results using implants in this area, but there is minimal discussion regarding the long-term consequences of this treatment. The maxillary lateral incisor is one of the most commonly missing teeth due to agenesis, and it is also one of the most common teeth to be lost due to trauma in the developing child...

Peripheral giant cell granulomas (PGCGs) are benign oral cavity tumors, reactive in nature, caused by local trauma or irritation. A 51-year-old woman presented with a soft tissue lesion related to an implant at site 36 (FDI numbering system). An excisional biopsy was completed, and the soft tissue mass was diagnosed as a PGCG. The biopsy led to a lack of keratinized tissue and vestibular depth around the implant site. After the initial healing phase, a free gingival graft was completed. Then, following soft tissue maturation, the cement-retained implant-supported prosthesis was converted into a screwretained implant-supported prosthesis that was easily accessible...

BACKGROUND: Small bowel obstruction (SBO) frequently necessitates emergency surgical intervention. The impact of frailty and age on operative outcomes is uncertain. This study evaluated postoperative outcomes of SBO surgery based on patient's age and frailty and explore the optimal timing to operation in elderly and/or frail patients. METHODS: Patients who underwent SBO surgery were identified in ACS-NSQIP database 2005-2021. Patients aged ≥65 years were defined as elderly...

BACKGROUND: Combat casualties receiving damage control laparotomy at forward deployed, resource-constrained US Military Role 2 surgical units (R2) require multiple evacuations, but the added risk of venous thromboembolism (VTE) in this population has not been defined. To fill this gap, we retrospectively analyzed 20 years of Department of Defense Trauma Registry (DoDTR) data to define the VTE rate in this population. METHODS: DoDTR from 2002 to 2023 was queried for US Military combat casualties requiring damage control laparotomy at R2...

PURPOSE: The purpose of this study was to analyze the prevalence of and complications resulting from temporal bone fractures in adult and pediatric patients evaluated for cranio-facial trauma in an emergency setting. METHODS: A retrospective blinded analysis of CT scans of a series of 294 consecutive adult and pediatric patients with cranio-facial trauma investigated in the emergency setting was conducted. Findings were compared between the two populations. Preliminary reports made by on-call residents were compared with the retrospective analysis, which was performed in consensus by two experienced readers and served as reference standard...

Skin and soft tissue reconstruction has long been based on the reconstructive ladder. However, a skin substitute has become popular due to its predictable outcomes, without donor-site morbidity. The biodegradable temporizing matrix (BTM; NovoSorb, PolyNovo Ltd., Port Melbourne, Australia) is a synthetic skin substitute that has recently gained its clinical application. Compared with those of other dermal templates, the clinical efficacy and performance of the BTM are not well established, especially among the Asian population...

OBJECTIVES: In 2021, opioid-related deaths have increased by 96% and continue to be higher than prepandemic levels. In particular, women and gender-diverse individuals face numerous challenges when assessing harm reduction supports, including physical supervised consumption sites, compared with male counterparts. Mobile overdose response services (MORSs) including overdose response hotlines and phone-based overdose response applications are novel virtual overdose response technologies that may help mitigate this issue...

INTRODUCTION: Traumatic glenohumeral dislocation is very rare in skeletally immature patients, and there are no reports in the literature describing the risk of associated nerve injuries. In the general population, the most commonly affected nerve is the axillary, but anatomical variations with a common origin between the musculocutaneous and median nerves exist that alter the respective positions and courses of these nerves and can make them more prone to injury during a glenohumeral dislocation...

INTRODUCTION: Ankylosing spinal disorders present significant challenges in cases of trauma, and the treatment of ankylosed spine infections may also be challenging. However, to the best of our knowledge, only one study to date has addressed this topic, reporting a mortality rate of 62%. CASE REPORT: Our patients were four men and one woman with a mean age of 72 years. Treatments consisted of intravenous antibiotics, a hard brace, and surgical interventions including percutaneous pedicle screw fixation in two patients, laminectomy and evacuation of the epidural abscess in one, and percutaneous lavage of the affected disc in two...

INTRODUCTION: The relationship between physical trauma and subsequent symptoms of rheumatoid arthritis (RA) has been described in the past though onset of newer disease of RA in apparently normal patient is doubtful. Trauma can cause precipitation of RA symptoms. Such trauma includes fractures, joint injuries, road traffic accidents, and also surgeries and deliveries. Although post-traumatic osteoarthritis following anterior cruciate ligament (ACL) injury is more common pathology, association of RA following ACL injury has not been reported in the literature...

INTRODUCTION: Hoffa fractures are uncommon fractures in adults and less common in children. They are defined as fractures of the femoral condyles that occur in the coronal planes. To this day, Hoffa fractures in children comprise only of case reports. CASE REPORT: Our case report is focused on a 12-year-old patient victim of a high-impact trauma causing a bicondylar Hoffa fracture. The diagnosis was based on an X-ray in front and lateral views and confirmed by a computed tomography scan and 3D reconstructions...

INTRODUCTION: The extensor mechanism and patellar tendon (PT) are considered essential components. Adult PT avulsion from the tibial tubercle is uncommon, with little information in the literature. Technical challenges arise during injury management. Knotless anchors have several applications in treating tendon injuries, such as the rotator cuff, distal biceps, and quadriceps tendons but were not used to repair distal PT avulsions. CASE REPORT: A 50-year-old male patient, an active adult, presented to emergency department with significant right knee pain, giving away and limitation of range of motion (ROM) that had started after he sustained direct trauma with a ground-level fall on his knee that morning...

INTRODUCTION: The masquelet technique is a two-stage procedure used by orthopedic surgeons to treat large segmental bone defects secondary to infection, trauma, and tumor resection. This technique characteristically requires the placement of a temporary cement spacer and subsequent bone grafting for complete reconstruction. We describe a unique case of segmental bone loss reconstruction in which a patient successfully achieved fracture union after the first step of the masquelet technique without bone grafting...