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Mengmeng Du, Jiuhui Han
BACKGROUND AND PURPOSE: The treatment of paediatric distal radius diaphyseal metaphyseal junction (DRDMJ) fractures is a challenge. The purpose of this study was to introduce a new operative approach at the proximal "safe zone" of the posterior interosseous nerve (PIN) to treat paediatric DRDMJ fractures and analyse the safety and efficacy of antegrade elastic stable intramedullary nail (ESIN) fixation. METHODS: Thirty paediatric patients with unstable and displaced DRDMJ fractures were treated by antegrade ESIN fixation from November 2015 to September 2017...
January 6, 2019: Injury
C A T van Leeuwen, R P C Hoffman, C C M A Donken, L W van der Plaat, T Schepers, J M Hoogendoorn
INTRODUCTION: In isolated Weber B fractures (type B fibular fractures), ruling out instability is critical for safe conservative treatment. In fractures without evident medial injury, additional diagnostics like MRI scan or gravity stress test should be done to differentiate between a stable and unstable fracture. The aim of the current study is to gain more insight in current practice and treatment of type B fractures by Dutch trauma- and orthopaedic surgeons. MATERIALS & METHODS: In December 2017 and January 2018, 559 trauma surgeons were invited by email to join an online survey...
January 3, 2019: Injury
Zoë Little, Jordan Bethel, Jennifer Clements, Alex J Trompeter
BACKGROUND: Differing mortality rates according to day of hospital admission is an area of debate, where a supposed increased rate of mortality with weekend admissions has been termed "the weekend effect". We sought to identify the 30-day mortality rates in major trauma patients attending our Major Trauma Centre (MTC) and the underlying reasons for these. METHODS: A retrospective review of data retrieved from the Trauma Audit and Research Network (TARN) database was undertaken for all patients attending between January 2013 and July 2015 with an Injury Severity Score of 9 or higher...
January 2, 2019: Injury
Buket Öztürk, Søren P Johnsen, Niels Dieter Röck, Lars Pedersen, Alma B Pedersen
PURPOSE: To examine the association between surgery delay and mortality in hip fracture patients with and without known comorbidity. METHODS: We identified all patients with a first time hip fracture diagnose operated between January 1, 2010 and December 31, 2015 (n = 36,552). As a measure of comorbidity we used Charlson Comorbidity Index stratified in categories: none (no registered comorbidities prior fracture), medium (1-2 points) and high (≥3 points). RESULTS: No association between surgery delay, regardless of the threshold, and 30-days mortality was observed among patients with high level of comorbidity...
December 29, 2018: Injury
Fathima T Kunhivalappil, Ashraf F Hefny, Fikri M Abu-Zidan
INTRODUCTION: Injury of the adrenal gland in blunt trauma is rare. The routine usage of the whole body computed tomography (CT) scan helps in early diagnosis. We aimed to study the incidence, mechanism of injury, management, and outcome of adrenal injury in blunt trauma patients treated in a community-based hospital. METHODS: CT scan of the abdomen of all blunt trauma patients who were admitted to our institution between October 2010 and March 2018 were retrospectively reviewed...
December 28, 2018: Injury
Siddhartha Sharma, Rakesh John, Mandeep S Dhillon, Kamal Kishore
No abstract text is available yet for this article.
December 28, 2018: Injury
Rui-Juan Guo, Fu-Shan Xue, Liu-Jia-Zi Shao, Zheng Li
No abstract text is available yet for this article.
December 28, 2018: Injury
Ernest Beng Kee Kwek
No abstract text is available yet for this article.
December 28, 2018: Injury
Philip J Wasicek, Yao Li, Shiming Yang, William A Teeter, Thomas M Scalea, Peter Hu, Megan L Brenner
BACKGROUND: The objective of this study was to investigate the hemodynamic effects of aortic occlusion (AO) during Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) using a sophisticated continuous vital sign (CVS) monitoring tool. METHODS: Patients admitted between February 2013 and May 2017 at a tertiary center that received REBOA were included. Patients in cardiac arrest before or at the time of REBOA were excluded. Time of AO was documented by time-stamped videography and correlated with CVS data...
December 21, 2018: Injury
W S Chen, J H Tan, Y Mohamad, R Imran
BACKGROUND: The establishment of an accurate prognostic model in major trauma patients is important mainly because this group of patients will benefit the most. Clinical prediction models must be validated internally and externally on a regular basis to ensure the prediction is accurate and current. This study aims to externally validate two prediction models, the Trauma and Injury Severity Score model developed using the Major Trauma Outcome Study in North America (MTOS-TRISS model), and the NTrD-TRISS model, which is a refined MTOS-TRISS model with coefficients derived from the Malaysian National Trauma Database (NTrD), by regarding mortality as the outcome measurement...
December 21, 2018: Injury
Thomas R E Anderson, Philip A Beak, Alex J Trompeter
AIMS: The anatomical safe zone for intra-medullary nail insertion through the tibial plateau is small, insertion outside of this area risks damage to intra-articular structures and poor fracture reduction. The purpose of this retrospective study was to determine if the new supra-patella (SP) approach confers improved nail insertion accuracy, when compared with the standard infra-patella (IP) technique. PATIENTS AND METHODS: Two hundred cases were included in the study (SP 95, IP 105)...
December 20, 2018: Injury
Zahra Hassannejad, Shayan Abdollah Zadegan, Alexander R Vaccaro, Vafa Rahimi-Movaghar, Omid Sabzevari
BACKGROUND: The complex pathophysiological events occurring after traumatic spinal cord injuries (TSCI) make this devastating trauma still incurable. Peptide amphiphile (PA) hydrogels are nanobiomaterials displaying desirable properties for application in regenerative medicine because they are absorbable, injectable, allowing biofunctionalization, controlling release of trophic factors and mimic extracellular matrix (ECM). In this study, we explored the potentiality of the IKVAV-functionalized PA hydrogel to provide a permissive environment for cell migration and growth as well as sustained release of BDNF at the lesion after severe compression injury model...
December 19, 2018: Injury
B L S Borger van der Burg, J Van Schaik, J J W M Brouwers, C Y Wong, T E Rasmussen, J F Hamming, R Hoencamp
BACKGROUND: Aortic Occlusion Balloons (AOB) are used for hemorrhage control in hemodynamically unstable patients. Stability of an AOB is essential for reliable aortic occlusion. The primary aim of this study is to determine whether different types of AOB migrate after total, intermittent or partial occlusion in a porcine aorta positioned in an in vitro model. MATERIALS AND METHODS: A porcine thoracic aortic section was positioned in a model of the human circulation...
December 19, 2018: Injury
Z Jawad, S Nemes, E Bülow, C Rogmark, P Cnudde
INTRODUCTION: Hip fractures are a common problem of the elderly population with significant mortality and morbidity. The choice between total hip arthroplasty (THA) and hemiarthroplasty depends on multiple factors including comorbidity. The Swedish Hip Arthroplasty Register (SHAR) provides a unique opportunity to study mortality and revision rates in this population. Linkage with government databases allow for in-depth research into the factors that influence risk of revision surgery and death in the hip fracture patient...
December 19, 2018: Injury
S F Baumbach, V Herterich, A Damblemont, F Hieber, W Böcker, H Polzer
AIM: Comparison of unfixed, CRIF, and ORIF of the posterior malleolus fragment (PMF) regarding the frequency of trans-syndesmotic fixation and quality of reduction in trimalleolar (equivalent) fractures. MATERIAL AND METHODS: Retrospective registry study. Patients with a trimalleolar (equivalent) ankle fractures were identified within the departments' fracture database. General demographics, treatment details, and fracture specific details (CT-scans) were assessed...
December 18, 2018: Injury
Meng-Qiang Fan, Xu-Song Li, Xian-Jun Jiang, Jian-Jian Shen, Pei-Jian Tong, Jie-Feng Huang
BACKGROUND: This study assessed the surgical outcomes of Lisfranc injuries accompanied by multiple metatarsal fractures. Metatarsal fractures here refers to metatarsal head, neck, and shaft (including shaft fractures accompanied by fractures of the base) fractures, as well as mixed (i.e., segmental fracture) fractures, as seen on imaging studies. METHODS: Between 2002 and 2015, one hundred and seventy-six patients were followed-up for a mean of 92 months, including eight patients who underwent secondary arthrodesis due to severe arthritis after ORIF...
December 18, 2018: Injury
W C Prall, T Kusmenkov, J Fürmetz, F Haasters, H O Mayr, W Böcker, S Grote
INTRODUCTION: Patients with widened or misplaced tunnels may require bone grafting prior to revision anterior cruciate ligament (ACL) reconstruction. Utilising reamer-irrigator-aspirator (RIA) harvested bone from the femur showed promising filling rates. Nevertheless, the procedure has neither been validated in a larger population nor been assessed with regards to radiological and clinical outcome of the subsequently conducted revision ACL reconstruction. Therefore, the aim of this study was to evaluate tunnel filling rates, positioning of the revision tunnels and outcome parameters of such two-staged revision ACL reconstructions...
December 17, 2018: Injury
Wei Nie, Fei Gu, Zhaojun Wang, Rui Wu, Yang Yue, Anze Shao
OBJECTIVE: Surgical management of bicondylar tibial plateau fractures, which is frequently associate with high wound complication rates and functional impairment, remains a challenge for orthopedic surgeons. Recently, the emergence of three-dimension(3D) printing provided orthopedic surgeons with a new technology which has revolutionary impacts on surgical planning, operative guidance and custom-made implants manufacture. The aim of this study is to explore the clinical feasibility and application value of 3D printing in the surgical management of bicondylar tibial plateau fractures...
December 17, 2018: Injury
Thomas Ruffing, Tilmann Rückauer, Frederic Bludau, Alexander Hofmann, Markus Muhm, Arnold J Suda
INTRODUCTION: Compression fractures of the cuboid bone in children and adolescents are rare. Fracture morphology, associated lesions, treatment options and long-term outcomes of this very rare injury are published in a few case reports. This study with review of the literature aims to support the understanding of fracture pattern and optimize pathways of decision making. MATERIAL AND METHODS: A retrospective two-center study was performed in a patient cohort treated between 2001 and 2016...
December 17, 2018: Injury
M Weinlich, P Martus, M B Blau, H Wyen, F Walcher, S Piatek, J P Schüttrumpf
OBJECTIVES: The aim of the study was to analyze helicopter emergency medical service (HEMS) in comparison to EMS, in respect to patient's mortality and morbidity. DESIGN: From a cohort of traumatized patients (n = 1724) prospectively enrolled in the German trauma registry (DGU-R) at Frankfurt University Hospital from 2009 to 2013, 1646 could be analyzed for in-hospital mortality and short-term outcome (GOS) at discharge and compared between HEMS and EMS. MEASUREMENTS AND MAIN RESULTS: 129 patients (7...
December 16, 2018: Injury
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