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Injury

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https://www.readbyqxmd.com/read/29789136/penetrating-trauma-in-children-on-the-united-states-mexico-border-hispanic-ethnicity-is-not-a-risk-factor
#1
Loc-Uyen T Vo, Clark Anderson, Samantha Thomas, Hannah Vernia, Jarett K Howe, Alan H Tyroch, Tamara N Fitzgerald
INTRODUCTION: The United States-Mexico border is perceived as dangerous by the media and current political leaders. Hispanic ethnicity, low socioeconomic status, male gender and adolescent age have previously been identified as risk factors for penetrating trauma (PT). METHODS: A retrospective review of PT was performed in a border region. Children 0-17 years old, admitted to the region's only level I trauma center between 2001 and 2016 were included. Standardized morbidity ratio was used to compare observed to expected morbidity...
May 17, 2018: Injury
https://www.readbyqxmd.com/read/29778274/outcomes-of-tibia-shaft-fractures-caused-by-low-energy-gunshot-wounds
#2
Charles A Su, Mai P Nguyen, Jeffrey A O'Donnell, Heather A Vallier
BACKGROUND: The purpose of this project was to compare the rates of infections, nonunions, malunions, and secondary operations in tibia fractures resultant from low energy GSWs versus those seen in open and closed tibia fractures resultant from blunt trauma. A secondary objective was to assess the utility of using the traditional Gustilo-Anderson classification system for open fractures to describe fractures secondary to low energy GSW. METHODS: A retrospective review of 327 patients with tibia shaft fractures was conducted at our level I trauma center...
May 16, 2018: Injury
https://www.readbyqxmd.com/read/29747942/avulsion-fracture-of-the-lesser-trochanter-in-adolescents
#3
Thomas Ruffing, Tilmann Rückauer, Frederic Bludau, Alexander Hofmann, Markus Muhm, Arnold J Suda
INTRODUCTION: Avulsion fractures of the lesser trochanter in adolescents are rare. They are a result of a sudden and forceful contraction of the iliopsoas muscle. Functional results in the medium term after non-operative treatment are unknown. Therefore we aimed to report these in the present study. MATERIALS AND METHODS: A retrospective two-center study was performed in a case series treated between 2011 and 2017. All adolescents with an acute avulsion fracture of the lesser trochanter were included...
May 4, 2018: Injury
https://www.readbyqxmd.com/read/29739654/car-seat-education-a-randomized-controlled-trial-of-teaching-methods
#4
Erin Kuroiwa, Rebecca L Ragar, Crystal S Langlais, Angelica Baker, Maria E Linnaus, David M Notrica
OBJECTIVE: To determine if a less labor-intensive video-based program for teaching car seat installation can be as effective as the traditional didactic lecture component. METHODS: This is a randomized controlled trial of caregivers seeking car seat education. Caregivers were assigned to didactic or video-based social learning classes. The didactic class involved live lecture; the social learning class included a brief lecture and the video, Simple Steps to Child Passenger Safety, utilizing social learning principles...
May 3, 2018: Injury
https://www.readbyqxmd.com/read/29731123/the-improved-oval-forceps-suture-guiding-method-for-minimally-invasive-achilles-tendon-repair
#5
Yang Liu, Lixiang Lin, Chuanlu Lin, Qihao Weng, Jianjun Hong
OBJECTIVE: To discuss the effect and advantage of the improved oval forceps suture-guiding method combined with anchor nail in the treatment of acute Achilles tendon rupture. METHODS: A retrospective research was performed on 35 cases of acute Achilles tendon rupture treated with the improved oval forceps suture-guiding method from January 2013 to October 2016. Instead of the Achillon device, we perform the Achillon technique with the use of simple oval forceps, combined with absorbable anchor nail, percutaneously to repair the acute Achilles tendon rupture...
May 2, 2018: Injury
https://www.readbyqxmd.com/read/29729820/tachycardic-and-non-tachycardic-responses-in-trauma-patients-with-haemorrhagic-injuries
#6
Andrew T Reisner, Shwetha Edla, Jianbo Liu, Jiankun Liu, Maxim Y Khitrov, Jaques Reifman
BACKGROUND: Analyses of large databases have demonstrated that the association between heart rate (HR) and blood loss is weaker than what is taught by Advanced Trauma Life Support training. However, those studies had limited ability to generate a more descriptive paradigm, because they only examined a single HR value per patient. METHODS: In a comparative, retrospective analysis, we studied the temporal characteristics of HR through time in adult trauma patients with haemorrhage, based on documented injuries and transfusion of ≥3 units of red blood cells (RBCs)...
April 30, 2018: Injury
https://www.readbyqxmd.com/read/29753451/single-stage-reconstruction-of-post-traumatic-and-post-excisional-composite-perigenual-defects-using-chimeric-pedicled-propelled-osteomyocutaneous-fibula-flap
#7
T M Balakrishnan, Sruthi Sridhar, J Jaganmohan, Hemantha Kumar Govinda Rajan, Singaravadivelu Vaidyanathan
INTRODUCTION: Composite perigenual defects (CPGDs) are exacting the expertise of the reconstructive surgeons. Segmental skeletal defects continue to be a challenge for both orthopedic and plastic surgeons. There are many techniques available for the reconstruction of segmental skeletal defects in the perigenual region. This study explores the outcomes of pedicled chimeric propelled osteomyocutaneous fibula flap reconstruction of post traumatic and post excisional composite perigenual defects (CPGDs) MATERIALS AND METHODS: It was a retrospective study conducted from 2011 to 2016 including 16 patients (5 post excisional defects and 11 post traumatic defects)...
April 27, 2018: Injury
https://www.readbyqxmd.com/read/29739656/hip-dislocations-and-concurrent-injuries-in-motor-vehicle-collisions
#8
Joseph Cooper, Justin Tilan, Alexis D Rounds, Santano Rosario, Kenji Inaba, Geoffrey S Marecek
INTRODUCTION: Motor Vehicle Collisions (MVC) can cause high energy hip dislocations associated with serious injury profiles impacting triage. Changes in safety and regulation of restraint devices have likely lowered serious injuries from what was previously reported in the 1990s. This study aims to describe modern-day injury profile of patients with traumatic hip dislocations, with special attention to aortic injury. METHODS: Retrospective review of a prospectively maintained trauma database at an urban level 1 trauma center was conducted...
April 27, 2018: Injury
https://www.readbyqxmd.com/read/29729818/long-term-patient-reported-outcomes-following-acetabular-fracture-fixation
#9
Diederik O Verbeek, Jelle P van der List, Camden M Tissue, David L Helfet
INTRODUCTION: Patient reported outcome scores may be the preferred method to assess clinical results following acetabular fracture fixation. However, in current acetabular fracture research, there is a scarcity of studies using these scores and long-term follow-up is lacking. The aim of this study is to describe long-term patient reported outcomes following acetabular fracture surgery and to evaluate the association between reduction quality and these outcome measures. METHODS: Patients who received operative fixation for acetabular fractures (1992-2012) were sent questionnaires (short musculoskeletal functional assessment (SMFA) function index and short form (SF)-12), which was returned by 106 patients (22%) (mean age 51 years, 74% male)...
April 27, 2018: Injury
https://www.readbyqxmd.com/read/29729819/one-year-after-proximal-or-distal-periprosthetic-fracture-of-the-femur-two-conditions-with-divergent-outcomes
#10
D Eschbach, B Buecking, H Kivioja, M Fischer, T Wiesmann, R Zettl, L Oberkircher, J Barthel, R Aigner, S Ruchholtz, C Bliemel
INTRODUCTION: Arthroplasty of the hip and knee is 1 of the 20 most frequent operations in Germany. Periprosthetic fracture is one of the most feared complications following primary or revision arthroplasty. Present publication aims to analyse differences between patients with periprosthetic fracture around total knee arthroplasty (PFTKA) and patients with periprosthetic fracture around total hip arthroplasty (PFTHA) concerning demographics, clinical course, complications and return to pre-fracture mobility...
April 24, 2018: Injury
https://www.readbyqxmd.com/read/29709377/high-energy-injury-is-a-risk-factor-for-preoperative-venous-thromboembolism-in-the-patients-with-hip-fractures-a-prospective-observational-study
#11
Jin Sup Park, Jae Hoon Jang, Ki Young Park, Nam Hoon Moon
BACKGROUND: The purpose of this study was to identify the incidence of preoperative venous thromboembolism (VTE), and determine if high energy hip fracture affects preoperative VTE occurrence. METHODS: Three-hundred nine patients (244 low and 61 high energy injuries) treated between March 2015 and March 2017 were included in this study. Indirect multidetector computed tomographic venography for the detection of preoperative VTE was performed at admission. The incidence of preoperative VTE was compared between high and low energy injury hip fractures...
April 24, 2018: Injury
https://www.readbyqxmd.com/read/29704953/risk-factors-associated-with-amputation-in-civilian-popliteal-artery-trauma
#12
Michael J Ramdass, Alyssa Muddeen, Patrick Harnarayan, Richard Spence, David Milne
Popliteal artery trauma is uncommon but is associated with a high risk of limb loss depending on the scenario involving blunt or penetrating trauma as well as the severity and extent of injury that has occurred. In our setting there is a significant amount of gang and civilian warfare resulting in Vascular Trauma. There were 32 patients over a decade who sustained traumatic injury to the popliteal artery consisting of 30 males (94%) and 2 females with an age range 16-59 years with a mean of 32. There were 20 cases of penetrating trauma (63%) and 12 cases of blunt trauma (37%)...
April 24, 2018: Injury
https://www.readbyqxmd.com/read/29706250/incidence-and-severity-of-malreduction-of-the-tibiofibular-syndesmosis-following-surgical-treatement-of-displaced-ankle-fractures-and-impact-on-the-function-clinical-study-and-mri-evaluation
#13
D Ntalos, M Rupprecht, L G Grossterlinden, A Hamurcu, M Regier, T O Klatte, J M Rueger, A S Spiro
PURPOSE: To compare tibiofibular reduction quality in different types of operatively treated ankle fractures and the impact on clinical and functional outcome at mid-term follow-up. PATIENTS AND METHODS: One hundred patients with an acute ankle fracture who had undergone open reduction and internal fixation were included. Eighty-eight patients who suffered from ligamentous ankle injury with neither fracture nor syndesmotic lesions served as a control group. Tibiofibular alignment was measured on MR images in all 188 patients...
April 23, 2018: Injury
https://www.readbyqxmd.com/read/29724590/cement-augmentation-of-the-proximal-femoral-nail-antirotation-pfna-a-multicentre-randomized-controlled-trial
#14
Christian Kammerlander, Einar S Hem, Tim Klopfer, Florian Gebhard, An Sermon, Michael Dietrich, Olaf Bach, Yoram Weil, Reto Babst, Michael Blauth
INTRODUCTION: New implant designs like the Proximal Femoral Nail Antirotation (PFNA) were developed to reduce failure rates in unstable pertrochanteric fractures in the elderly. Standardized implant augmentation with up to 6 mL of polymethylmethacrylate (PMMA) cement has been introduced to enhance implant anchorage by increasing the implant-bone interface in osteoporotic bone conditions. Biomechanically, loads to failure were significantly higher with augmentation. The primary objective of this study was to compare the mobility of patients with closed unstable trochanteric fractures treated by PFNA either with or without cement augmentation...
April 22, 2018: Injury
https://www.readbyqxmd.com/read/29699732/vertebral-fragility-fractures-vff-who-when-and-how-to-operate
#15
Opinder Sahota, Terence Ong, Khalid Salem
Vertebral Fragility Fractures (VFF) are common and lead to pain, long term disability and increased mortality. Most patients will have mild to moderate pain symptoms and can be managed conservatively. However, patients with severe pain who have minimal or no pain relief with potent analgesia, or who only achieve adequate pain relief with high doses of morphine based analgesia which results in significant adverse events, should be considered for vertebral augmentation. Ideally, for vertebral augmentation, patients should present within four months of the fracture (onset of acute pain) and have at least 3 weeks of failure of conservative treatment although early intervention may be more appropriate for hospitalised patients, who tend to be older, more frail and likely to be less tolerant to the adverse effects of conservative treatment...
April 22, 2018: Injury
https://www.readbyqxmd.com/read/29739655/identifying-research-priorities-around-psycho-cognitive-and-social-factors-for-recovery-from-hip-fractures-an-international-decision-making-process
#16
Mohammad Auais, Simon D French, Lauren Beaupre, Lora Giangregorio, Jay Magaziner
Hip fractures rank in the top ten disabling conditions worldwide. With an ageing population, this public health problem is expected to increase. Despite the success of surgery for hip fractures and the extensive health services utilisation, health outcomes are often poor. Considering the recovery process as multifactorial and intervening to address all relevant factors may improve recovery rates. However, we need first to fully understand the factors contributing to recovery after hip fractures, including psycho-cognitive and social factors...
April 20, 2018: Injury
https://www.readbyqxmd.com/read/29709376/the-biology-of-fracture-healing-in-osteoporosis-and-in-the-presence-of-anti-osteoporotic-drugs
#17
David J Hak
Compromised bone strength in osteoporosis predisposes patients to an increased fracture risk. The management of these fractures is complicated due to the poor bone quality, which may lead to inadequate fixation strength and stability. While a number of studies using osteoporotic animal models have shown a detrimental impact on fracture healing, clinical evidence regarding whether fracture healing is impaired in the presence of osteoporosis is complicated by numerous associated conditions including advancing age...
April 20, 2018: Injury
https://www.readbyqxmd.com/read/29706249/isolated-traumatic-brain-injury-results-in-significant-pre-hospital-derangement-of-cardiovascular-physiology
#18
M Gavrilovski, M El-Zanfaly, R M Lyon
INTRODUCTION: Major trauma can result in both life-threatening haemorrhage and traumatic brain injury (TBI). The pre-hospital management of these conditions, particularly in relation to the cardiovascular system, is very different. TBI can result in cardiovascular instability but the exact incidence remains poorly described. This study explores the incidence of cardiovascular instability in patients undergoing pre-hospital anaesthesia for suspected TBI. METHODS: Retrospective case series of all pre-hospital trauma patients attended by Kent, Surrey & Sussex Air Ambulance Trust (United Kingdom) trauma team during the period 1 January 2015-31 December 2016...
April 20, 2018: Injury
https://www.readbyqxmd.com/read/29699733/acute-compartment-syndrome-do-guidelines-for-diagnosis-and-management-make-a-difference
#19
D Bodansky, A Doorgakant, J Alsousou, H J Iqbal, B Fischer, G Scicluna, M Bowers, B Narayan
BACKGROUND: The best outcomes following Acute Compartment Syndrome (ACS) are attributed to early diagnosis and treatment. National guidelines were issued in the United Kingdom in 2014 (BOAST 10) to standardise and improve management. We analysed standards of diagnosis and management before and after the introduction of the guidelines. METHODS: We retrospectively reviewed the data of all patients with ACS requiring fasciotomy between March 2010 and May 2015 across four Major Trauma Centres (MTCs) in the Northwest of England...
April 20, 2018: Injury
https://www.readbyqxmd.com/read/29699731/epidemiology-and-social-costs-of-hip-fracture
#20
Nicola Veronese, Stefania Maggi
Hip fracture is an important and debilitating condition in older people, particularly in women. The epidemiological data varies between countries, but it is globally estimated that hip fractures will affect around 18% of women and 6% of men. Although the age-standardised incidence is gradually falling in many countries, this is far outweighed by the ageing of the population. Thus, the global number of hip fractures is expected to increase from 1.26 million in 1990 to 4.5 million by the year 2050. The direct costs associated with this condition are enormous since it requires a long period of hospitalisation and subsequent rehabilitation...
April 20, 2018: Injury
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