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Sherif Galal
OBJECTIVES: The best fixation method for open tibial fractures has long been a matter of debate, many studies have recommended the use of intramedullary nails over external fixation for treating such fractures, recent studies also showed favorable results for the use of plates in managing open tibial fractures. However, there are very few (if any) reports in the literature comparing the use of minimally invasive plate osteosynthesis to reamed intramedullary nails in the fixation of open tibial fractures...
March 8, 2018: Injury
A I Mirulla, L Bragonzoni, S Zaffagnini, M Bontempi, V Nigrelli, T Ingrassia
INTRODUCTION: Traditional prosthetic solutions expose the amputee to numerous problems that limit his ability to safely perform the normal activities of daily life. In order to eliminate the problems related to the use of the traditional prosthesis with socket, a new technique was developed for fixing the prosthesis to the amputees based on the principle of osseointegration. The aim of this paper is to study and analyze the stress distribution on the interface between a trans-humeral osseointegrated prosthetic implant and the residual bone, identifying the most stressed areas and thus foreseeing possible failure phenomena of the entire prosthetic system and, after, to compare the stress distribution on three different prosthetic designs that differ from each other for some geometric characteristics...
March 7, 2018: Injury
Lukas Ernstbrunner, Eva Schulz, Matthaeus Ernstbrunner, Thomas Hoffelner, Thomas Freude, Herbert Resch, Maximilian Haas
INTRODUCTION: Little is known about injuries in canyoning. It was the purpose of this study to determine injury rates, patterns, causes and risk factors in canyoning; and to identify targets for future injury prevention strategies. METHODS: From May to October 2015, 109 participants from 17 different countries were prospectively followed via a monthly e-mail-based questionnaire. RESULTS: During 13,690 h of canyoning, 57 injury-events occurred...
March 6, 2018: Injury
Noora K Airaksinen, Ilona S Nurmi-Lüthje, J Matti Kataja, Heikki P J Kröger, Peter M J Lüthje
BACKGROUND: Most of the cycling accidents that occur in Finland do not end up in the official traffic accident statistics. Thus, there is minimal information on these accidents and their consequences, particularly in cases in which alcohol was involved. The focus of the present study is on cycling accidents and injuries involving alcohol in particular. METHODS: Data on patients visiting the emergency department at North Kymi Hospital because of a cycling accident was prospectively collected for two years, from June 1, 2004 to May 31, 2006...
March 3, 2018: Injury
Megan E Cain, Job N Doornberg, Robin Duit, Jock Clarnette, Ruurd Jaarsma, Bhavin Jadav
BACKGROUND: Intramedullary-nails (IMN) are the treatment of choice for most tibial shaft fractures due to their minimally-invasive nature and non-demanding surgical technique. However, a potential iatrogenic pitfall is intra-articular interlocking screw positioning within the proximal (PTFJ) and distal (DTFJ) tibiofibular joints that may go unrecognized. OBJECTIVE: To evaluate the incidence of intra-articular screw penetration of the PTFJ and DTFJs after interlocking of IMN for tibial fractures...
March 1, 2018: Injury
Bridget Kool, Sarah Buller, Ron Kuriyan, Charlotte M Jones-Todd, David Newcombe, Peter Jones
INTRODUCTION: We present a study that provides a contemporary view of alcohol-related injury prevalence amongst patients presenting to a New Zealand (NZ) emergency department (ED). METHODS: Adult injury patients presenting to Auckland City Hospital ED within 6 h of injury were invited to participate during three recruitment periods (2015-2016). An interviewer-administered questionnaire obtained information on demographic, injury, general health, and lifestyle factors...
February 27, 2018: Injury
M Galler, M Zellner, C Roll, C Bäuml, B Füchtmeier, F Müller
BACKGROUND: The proximal femoral fracture is one of the most common injuries in the elderly. Nevertheless, no results beyond the second year post surgery have been reported in the literature. Therefore, the purpose of this study was to evaluate any revision and mortality within 10 years follow-up as well as the walking ability of still alive patients. METHODS: A total of 200 consecutive patients were included. A prospective database was first used to collect the demographic data...
February 26, 2018: Injury
Matthew D Riedel, Jorge Briceno, Christopher P Miller, John Y Kwon
While broken or loose syndesmotic screws are typically of no clinical consequence, occasionally breakage can result in pain, metal fretting, or bony erosion. Despite quad-cortical syndesmotic screws being relatively easy to remove due to the prominent screw tip penetrating the medial tibial cortex, removal of a broken tri-cortical screw can be technically challenging. The purpose of this manuscript is to describe a safe technique for removing the buried, broken tri-cortical screw fragment via a minimally invasive medial tibial approach by verifying the screw location using intra-operative fluoroscopy...
February 26, 2018: Injury
Hyung-Joo Lee, Youn-Jung Kim, Dong-Woo Seo, Chang Hwan Sohn, Seung Mok Ryoo, Shin Ahn, Yoon-Seon Lee, Won Young Kim, Kyoung Soo Lim
OBJECTIVE: The detection of intracranial injury in patients with facial injury rather than traumatic brain injury (TBI) remains a challenge for emergency physicians. This study aimed to evaluate the incidence and risk factors of intracranial injury in patients with orbital wall fracture (OWF), who were classified with a chief complaint of facial injury rather than TBI. METHODS: This retrospective case-control study enrolled adult OWF patients (age ≥18 years) who presented at the hospital between January 2004 and March 2016...
February 24, 2018: Injury
Martijn H Hulsmans, Mark van Heijl, Roderick M Houwert, Bart J Burger, Egbert Jan M Verleisdonk, Dirk Jan Veeger, Olivier A van der Meijden
PURPOSE: Surgical treatment of displaced midshaft clavicle fractures requires a decision between plate fixation and intramedullary (IM) fixation. Numerous studies report on the biomechanical properties of various repair constructs. The goal of this systematic review was to provide an overview of studies describing the biomechanical properties of the most commonly used surgical fixations of midshaft clavicle fractures. Additionally, we aimed to translate these biomechanical results into clinically relevant conclusions...
February 21, 2018: Injury
Shani Samuel, Raja Elina Ahmad, Thamil Selvee Ramasamy, Faizal Manan, Tunku Kamarul
BACKGROUND: It has been previously suggested that the use of regenerative promoters, which include bone marrow-derived mesenchymal stem cells (MSCs) or natural growth factors supplement such as platelet-rich concentrate (PRC) could promote cartilage regeneration. However, the notion that the concurrent use of both promoters may provide a synergistic effect that improves the repair outcome of focal cartilage injury has not been previously demonstrated. This study was thus conducted to determine whether the concomitant use of PRC could further enhance the reparative potential of MSCs encapsulated in alginate transplanted into focal cartilage injury in rabbits...
February 21, 2018: Injury
A Siebe De Boer, Esther M M Van Lieshout, Gerson Van Moolenbroek, Dennis Den Hartog, Michael H J Verhofstad
BACKGROUND: Post-operative weightbearing guidelines for displaced intra-articular calcaneal fractures (DIACF) have been pragmatically developed in the past, however hardly adapted to current health care insights. A period of six to nine weeks of non-weightbearing is usually recommended. It is unknown whether an earlier start of weightbearing is advisable. OBJECTIVES: The primary aim was to evaluate the effect of time to post-operative weightbearing on Böhler's angle...
February 21, 2018: Injury
Nora Renz, Sabrina Cabric, Christian Morgenstern, Michael A Schuetz, Andrej Trampuz
INTRODUCTION: Bone healing disturbance following fracture fixation represents a continuing challenge. We evaluated a novel fully automated polymerase chain reaction (PCR) assay using sonication fluid from retrieved orthopedic hardware to diagnose infection. PATIENTS AND METHODS: In this prospective diagnostic cohort study, explanted orthopedic hardware materials from consecutive patients were investigated by sonication and the resulting sonication fluid was analyzed by culture (standard procedure) and multiplex PCR (investigational procedure)...
February 21, 2018: Injury
Arvind Kumar, Vivek Trikha, Samarth Mittal
No abstract text is available yet for this article.
February 19, 2018: Injury
Melissa K James, R Jonathan Robitsek, Syed M Saghir, Patricia A Gentile, Marylin Ramos, Frances Perez
BACKGROUND: Falls can result in injuries that require rehabilitation and long-term care after hospital discharge. Identifying factors that contribute to prediction of discharge disposition is crucial for efficient resource utilization and reducing cost. Several factors may influence discharge location after hospitalization for a fall. The aim of this study was to examine clinical and non-clinical factors that may predict discharge disposition after a fall. We hypothesized that age, injury type, insurance type, and functional status would affect discharge location...
February 14, 2018: Injury
Rayan El Sibai, Rana Bachir, Mazen El Sayed
INTRODUCTION: Drowning leads to 372,000 deaths annually worldwide and to severe morbidity secondary to asphyxiation or aspiration. Previous studies described submersion injuries mainly in the pediatric population. This study describes characteristics of patients presenting with submersion injuries to United States emergency departments (EDs) and identifies predictors of poor outcomes (death or long term neurologic deficits) after drowning. METHODS: This retrospective cross-sectional study included ED visits for submersion injuries from the United States 2013 Nationwide Emergency Department Sample (NEDS) dataset using discharge data (CCS diagnosis codes)...
February 13, 2018: Injury
Gareth S Turnbull, Mounir Hakimi, George J McLauchlan
INTRODUCTION: With rising NHS clinical and financial demands, improving theatre efficiency is essential to maintain quality of patient care. Consistent teams and consultant presence have been shown to improve outcomes and productivity in elective orthopaedic surgery. The aim of this study was to investigate the impact on trauma theatre productivity of different surgeons and anaesthetists working together in a Major Trauma Centre. The influence of consultant presence and weekend operating on productivity was also considered...
February 12, 2018: Injury
Stefan Heschl, Ben Meadley, Emily Andrew, Warwick Butt, Stephen Bernard, Karen Smith
INTRODUCTION: Prehospital airway management of the paediatric patient with traumatic brain injury (TBI) is controversial. Endotracheal intubation of children in the field requires specific skills and has potential benefits but also carries potentially serious complications. We aimed to compare mortality and functional outcomes after six months between children with TBI who either underwent prehospital rapid sequence intubation (RSI) by trained Intensive Care paramedics (ICP) or received no intubation...
February 12, 2018: Injury
Samir Mehta, Matthew Chin, Jennifer Sanville, Surena Namdari, Michael W Hast
INTRODUCTION: In locked plate fixation of proximal humerus fractures, the calcar is an important anchor point for screws providing much-needed medial column support. Most locking plate implants utilize a fixed-trajectory locking screw to achieve this goal. Consequently, adjustments of plate location to account for patient-specific anatomy may result in a screw position outside of the calcar. To date, little is known about the consequences of "missing" the calcar during plate positioning...
February 11, 2018: Injury
Neil Chotai, Sulaiman Alazzawi, Syeda Saman Zehra, Matthew Barry
AIMS: The aim of this retrospective review was to identify all children that presented to our institution with a pelvic or acetabular fracture and to compare these children to a previous cohort of paediatric pelvic fractures that we have reported. PATIENTS: 53 children under the age of 16 were identified over a ten year period. METHODS: We reviewed our trauma database, hospital records and radiological imaging to determine the age, gender, fracture pattern, associated injuries and management of the pelvic fracture...
February 11, 2018: Injury
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