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Margaret Murphy, Kate Curtis, Mary K Lam, Cameron S Palmer, Jeremy Hsu, Andrea McCloughen
BACKGROUND: Simulation has been promoted as a platform for training trauma teams. However, it is not clear if this training has an impact on health service delivery and patient outcomes. This study evaluates the association between implementation of a simulation based multidisciplinary trauma team training program at a metropolitan trauma centre and subsequent patient outcomes. METHOD: This was a retrospective review of trauma registry data collected at an 850-bed Level 1 Adult Trauma Centre in Sydney, Australia...
January 8, 2018: Injury
Rocío Menéndez-Colino, Teresa Alarcon, Pilar Gotor, Rocío Queipo, Raquel Ramírez-Martín, Angel Otero, Juan I González-Montalvo
INTRODUCTION: The aim of this study was to determine the patient characteristics that predict 1-year mortality after a hip fracture (HF). METHODS: All patients admitted consecutively with fragility HF during 1 year in a co-managed orthogeriatric unit of a university hospital (FONDA cohort) were assesed. Baseline and admission demographic, clinical, functional, analytical and body-composition variables were collected in the first 72 h after admission. A protocol designed to minimize the consequences of the HF was applied...
January 6, 2018: Injury
Jowan G Penn-Barwell, Philippa M Bennett, Andrew C Gray
No abstract text is available yet for this article.
December 26, 2017: Injury
Ruben A Mazzucchelli, Katharina Jenny, Vilijam Zdravkovic, Johannes B Erhardt, Bernhard Jost, Christian Spross
INTRODUCTION: Bone mineral density and fracture morphology are widely discussed and relevant factors when considering the different treatment options for proximal humerus fractures. It was the aim of this study to investigate the influence of local bone quality on fracture patterns of the Neer classification as well as on fracture impaction angle in these injuries. MATERIALS AND METHODS: All acute, isolated and non-pathological proximal humerus fractures admitted to our emergency department were included...
December 26, 2017: Injury
Lee M Reichel, Lauren M MacCormick, Anthony J Dugarte, Amir R Rizkala, Sara C Graves, Peter A Cole
OBJECTIVES: Anterior external fixation for pelvic ring fractures has shown to effectively improve stability and reduce mortality. However, these fixators can be associated with substantial morbidity such as pin tract infection, premature loss of fixation, and decreased quality of life in patients. Recently, two new methods of subcutaneous anterior pelvic internal fixation have been developed; the INFIX and the Pelvic Bridge. These methods have the purported advantages of lower wound complications, less surgical site pain, and improved quality of life...
December 19, 2017: Injury
Mohammad Al-Ashqar, Michalis Panteli, Gautam Chakrabarty, Peter V Giannoudis
Atypical Femoral Fractures (AFF) represent fractures located between the lesser trochanter and the supracondylar flare of a femur. An increasing pool of evidence supports their association with the prolonged use of bisphosphonates, even though a direct correlation is yet to be proved. The purpose of this review is to encapsulate the current evidence associating bisphosphonate use and the development of AFFs, the clinical features related to their presentation, as well as to report the armamentarium of strategies available in the prevention and treatment of AFFs...
December 16, 2017: Injury
Arun Aneja, T David Luo, Boshen Liu, Molina Domingo, Kerry Danelson, Jason J Halvorson, Eben A Carroll
BACKGROUND: Intra-articular Pilon fractures remain therapeutically challenging due to osteochondral fracturing and comminution, marginal impaction, and insult to the soft tissue envelope. The purpose of this study was to compare the efficacy of anterolateral distal tibial locking plates in capturing main fracture fragments in tibial plafond fractures. METHODS: From May 2011 to Dec 2015, 169 OTA C-type pilon fractures met inclusion and exclusion criteria with computed tomographic (CT) scans performed prior to definitive fixation...
December 16, 2017: Injury
Eun Seok Choi, Jin Heon Hong, Jae Ang Sim
INTRODUCTION: Concern has been growing about trampoline-related injuries among young children. Several published policy statements have repeatedly recommended that children younger than 6 years should not use trampolines. However, few studies have investigated the injuries caused by trampoline-related accidents among young children. This study aimed to identify the distinct features of trampoline-related orthopedic injuries in children younger than 6 years. METHODS: We retrospectively reviewed the medical records of pediatric patients aged between 0 and 16 years who visited our regional emergency center due to trampoline-related orthopedic injuries between 2012 and 2015...
December 16, 2017: Injury
Jie Mi, Xiao-Jiang Sun, Kai Zhang, Chang-Qing Zhao, Jie Zhao
OBJECTIVE: To formulate radiological indexes based on CT for further MRI examination to detect posterior ligamentous complex injury (PLC) or disc injury in thoracolumbar burst fractures without neurological deficit in the emergent setting. MATERIALS AND METHODS: Patients with a single thoracolumbar burst fracture and no neurological deficit were included into this study. Radiological indexes on CT included canal compromise (CC), anterior and posterior vertebral height ratio (PVH and AVH ratio), local kyphosis (LK) and regional kyphosis (RK)...
December 15, 2017: Injury
Luke Harries, Ahmed Emam, Umraz Khan
INTRODUCTION: The incidence of pain after flap reconstruction of complex lower limb injury is poorly reported in the literature, and yet represents a significant source of morbidity in these patients. In our centre (Southmead Hospital, Bristol, England) patients who have had flap reconstruction for complex lower limb injury are followed up at a joint ortho-plastics lower limb clinic run weekly. The aim of this study was to report the incidence of pain in such patients at follow-up in the specialist clinic...
December 15, 2017: Injury
Tyler S Pidgeon, Joey P Johnson, Matthew E Deren, Andrew R Evans, Roman A Hayda
OBJECTIVES: While osteoporosis has been shown to be a contributing factor in low energy fractures in the elderly, limited data exists regarding the correlation of bone mineral density (BMD) and T-Scores to mortality and failure of fracture fixation. This study seeks to determine the relationship between femoral neck BMD in elderly patients with typical geriatric fractures and mortality and fracture fixation failure using Quantitative Computed Tomography (QCT). MATERIALS AND METHODS: Patients over the age of 65 who sustained fractures of the proximal humerus, distal radius, pelvic ring, acetabulum, hip, proximal tibia, and ankle who also underwent a CT scan that included an uninjured femoral neck were retrospectively reviewed...
December 15, 2017: Injury
Kate E Charters, Belinda J Gabbe, Biswadev Mitra
INTRODUCTION: Road traffic injuries are the fifth leading cause of years of life lost, with pedestrians comprising 39% of all road deaths (Global Burden of Disease Mortality and Causes of Death Collaborators [1]). Programs that use injury surveillance data to identify high-risk targets for intervention are known to be effective for reducing injury. This study aims to identify trends in the population incidence of pedestrian traffic injury (PTI) in Victoria, Australia. METHOD: A retrospective review of data from the Victorian Emergency Minimum Dataset, the Victorian Admitted Episodes Dataset, the Victorian State Trauma Registry and the National Coronial Information System was conducted of patients with a PTI who present to a public hospital emergency department, were admitted to hospital, sustained major trauma or who died of their injuries from January 1st 2009 to December 31st 2013...
December 15, 2017: Injury
Ida Leah Gitajn, Daniel Connelly, Daniel Mascarenhas, Stephen Breazeale, Peter Berger, Carrie Schoonover, Brook Martin, Robert V O'Toole, Raymond Pensy, Marcus Sciadini
OBJECTIVES: Evaluate whether mortality after discharge is elevated in geriatric fracture patients whose lower extremity weight-bearing is restricted. DESIGN: Retrospective cohort study SETTING: Urban Level 1 trauma center PATIENTS/PARTICIPANTS: 1746 patients >65 years of age INTERVENTION: Post-operative lower extremity weight-bearing status MAIN OUTCOME MEASURE: Mortality, as determined by the Social Security Death Index RESULTS: Univariate analysis demonstrated that patients who were weight-bearing as tolerated on bilateral lower extremities (BLE) had significantly higher 5-year mortality compared to patients with restricted weight-bearing on one lower extremity and restricted weight-bearing on BLE (30%, 21% and 22% respectively, p < 0...
December 14, 2017: Injury
Heather K Vincent, Terrie Vasilopoulos, Laura Ann Zdziarski-Horodyski, Kalia K Sadasivan, Jennifer Hagen, Robert Guenther, JoAnna McClelland, MaryBeth Horodyski
PURPOSE: Pre-existing psychiatric illness, illicit drug use, and alcohol abuse adversely impact patients with orthopaedic trauma injuries. Obesity is an independent factor associated with poorer clinical outcomes and discharge disposition, and higher hospital resource use. It is not known whether interactions exist between pre-existing illness, illicit drug use and obesity on acute trauma care outcomes. PATIENTS AND METHODS: This cohort study is from orthopaedic trauma patients prospectively measured over 10 years (N = 6353)...
December 12, 2017: Injury
A Siebe De Boer, Esther M M Van Lieshout, Freek Van 't Land, Dominique Misselyn, Tim Schepers, Dennis Den Hartog, Michael H J Verhofstad
INTRODUCTION: Tongue-type displaced intra-articular calcaneal fractures (DIACF) are associated with a specific pattern of fracture displacement in contrast to joint depression fractures. This may result in tension of soft tissue in the posterior part of the heel. Tension-induced ischemia can result in skin necrosis. The objectives of this study were to investigate whether patients with tongue-type calcaneal fractures exert a higher risk of complications, especially of the posterior soft tissues, than joint depression type fractures...
December 11, 2017: Injury
Beatrice Sanna, Brandon Michael Henry, Jens Vikse, Bendik Skinningsrud, Jakub R Pękala, Jerzy A Walocha, Roberto Cirocchi, Krzysztof A Tomaszewski
PURPOSE: Corona mortis is a highly variable vascular connection between the obturator and external iliac or inferior epigastric arteries or veins located behind the superior pubic ramus in the retropubic space (space of Retzius). Due to the significant variation in this collateral circulation, detailed anatomical knowledge of the corona mortis is vital to enhance the prevention of possible iatrogenic errors in hernia repair and other pubic surgical procedures. The aim of our meta-analysis was to provide comprehensive data on the prevalence, anatomical characteristics, and ethnic variations of the corona mortis vessel...
December 9, 2017: Injury
Aliasghar A Kiadaliri, Björn E Rosengren, Martin Englund
PURPOSE: To assess fracture-related mortality among adults (aged ≥20years) in southern Sweden using multiple causes of death approach. METHODS: All death certificates (n=201 488) in adults recorded in the region of Skåne from 1998 to 2014 were examined. We identified fracture-related deaths and computed mortality rates by sex, age group, and fracture site. Temporal trends were evaluated using joinpoint regression and associated causes were identified by age- and sex-adjusted observed/expected ratios...
December 9, 2017: Injury
Ryan J Lilly, Denise M Koueiter, Kelly C Graner, Gregory P Nowinski, Jason Sadowski, Kevin D Grant
INTRODUCTION: Lag screw cutout is one of the most commonly reported complications following intramedullary nail fixation of intertrochanteric femur fractures. However, its occurrence can be minimized by a well-positioned implant, with a short Tip-to-Apex Distance (TAD). Computer-assisted navigation systems provide surgeons with the ability to track screw placement in real-time. This could allow for improved lag screw placement and potentially reduce radiation exposure to the patient and surgeon...
December 7, 2017: Injury
Daniel S Owers, Diana M Perriman, Paul N Smith, Teresa Neeman, Alexandra L Webb
INTRODUCTION: Morphometric changes to cervical musculature in whiplash associated disorder have been reported in several studies with varying results. However, the evidence is not clear because only a limited number of cohorts have been studied and one cohort has been reported in multiple publications. The aim of this study was to assess the evidence for cervical muscle morphometric changes on magnetic resonance (MR) images after whiplash using a systematic review with meta-analysis. MATERIALS AND METHODS: PubMed, MEDLINE and Cochrane Library were searched without language restriction using combinations of the MeSH terms "muscles", "whiplash injuries", and "magnetic resonance imaging"...
December 6, 2017: Injury
Tammy Jiang, Jessica L Webster, Andrew Robinson, Nancy Kassam-Adams, Therese S Richmond
PURPOSE: The burden of injuries is disproportionately concentrated among Black men in the United States. Previous studies suggest that the mental health effects of trauma may vary by the intentionality of the injury (intentional vs. unintentional), yet little is known about this experience among Black men. We explored the emotional responses to traumatic injuries in the context of injury intentionality among Black men in an urban area. METHODS: We conducted semi-structured, qualitative interviews with 74 Black men who were traumatically injured...
December 6, 2017: Injury
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