International Journal of Burns and Trauma最新文献

{"title":"Burns incident responses worldwide and the role of burn speciality teams: a review.","authors":"Laura Awad, Keith Allison","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Mass casualty incidents (MCIs) have a profound impact on health care systems worldwide. Following recent incidents within the United Kingdom (UK), notably terrorist attacks in Manchester and the Grenfell Tower fire in London, there has been a renewed interest in how the UK would cope with a burn MCI. A Burns Incidence Response Team (BIRT) is a new development incorporated into the Burn Annex of the NHS England National Concept of Operation for Managing Mass Casualties. It is a mobile advice team of healthcare professionals with burns expertise who can support the subsequent management of an MCI, and triage effectively. This review assesses the response to disasters worldwide, detailing national structure, and in particular the involvement of burn specialist teams. This review aims to highlight the roles of burns specialists, and their role within the UK.</p><p><strong>Method: </strong>A review of Web of Science, PubMed, Embase, UK government reports, annexes and textbooks was conducted.</p><p><strong>Results: </strong>A search resulted in 826 sources; 42 articles were included in this review, with 9 additional sources. BIRTs are described in the NHS Guideline Concept of Operations for the Management of Mass Casualties: Burns Annex, published September 2020.</p><p><strong>Conclusions: </strong>The implementation of a national burn response plan is a necessary step forward for effective management of these continuing MCIs. The available literature supports the need for preparation and organized response with a centralized control. Increased awareness and understanding of the role of BIRTs is important and highlights the need for specialist input in the long and short term. Factors which may affect the implementation of BIRT's need to be explored in further detail.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9677225/pdf/ijbt0012-0210.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40721792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pantalar dislocation: a rare presentation with review of treatment methods.","authors":"Mohammad Jesan Khan,&nbsp;Naiyer Asif,&nbsp;Mohd Hadi Aziz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pantalar dislocation means the simultaneous dislocation of the talocalcaneal, talonavicular, and tibiotalar joint. It is a rare injury comprising only 3.4% of major talar injuries. Treatment of closed Pantalar dislocation is controversial. However, the aim should be to attain a stable anatomic reduction of the Talus in the ankle joint. To prevent further damage to the skin and neurovascular structures, closed reduction of these dislocations should be performed as soon as possible. We report a case of Pantalar dislocation where we tried to reduce the talus both by closed and open methods but it was not possible to reduce the dislocation until the talonavicular joint was reduced first. Intending to improve the clinical knowledge of Pantalar dislocation, we want to convey our clinical experience and results from this rare dislocation.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9490156/pdf/ijbt0012-0180.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic brain injuries in children during COVID-19 pandemic: a national report from northern Iran.","authors":"Zoheir Reihanian, Nazanin Noori Roodsari, Siamak Rimaz, Payman Asadi, Naghmeh Khoshsima, Aryan Rafiee Zadeh, Seyyed Mahdi Zia Ziabari, Habib Eslami-Kenarsari, Elahe Abbaspour","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that referral cases of traumatic injuries have decreased during the COVID-19 pandemic both in childhood and in adulthood. Still we have very little evidence of referrals due to traumatic brain injury among children during the COVID-19 outbreak. The present study aimed to describe epidemiological and clinical features of pediatric traumatic brain injuries.</p><p><strong>Methods: </strong>This cross-sectional study was performed on all patients under 15 years with any evidence of head trauma, referring to Poursina teaching hospital, a referral center for trauma and road accidents in northern Iran. The patients' data were retrospectively collected by reviewing the hospital recorded files and the trauma-specific hospital information system.</p><p><strong>Results: </strong>Of all 543 pediatric traumatic injuries referred to our hospital during the two pointed periods, 166 had any evidence of head and neck injuries leading to an overall prevalence rate of 30.6%. In this regard, the prevalence rate of head/neck injuries was estimated to be 140 out of 436 within a pre-COVID-19 period (32.1%) and 26 out of 107 within the COVID-19 period (24.3%) indicating no significant difference between the two time periods (P = 0.243). However, assessing the rate of head/neck injuries pre-COVID-19 and COVID-19 periods according to patients' age showed a higher rate of such injuries in pre-COVID-19 as compared to COVID-19 periods in patients aged less than two years (55.6% versus 37.5%, P = 0.013) as well as aged 2 to six years (45.8% versus 30.0%, P = 0.036).</p><p><strong>Conclusion: </strong>The rate of admission of children due to traumatic brain injury during the COVID-19 period does not show a significant change compared to before, and only in children under 6 years of age a decrease in referrals due to brain trauma during the COVID-19 period was observed.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9490154/pdf/ijbt0012-0175.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of pedicle screw placement into the fractured vertebra in management of unstable thoracolumbar and lumbar fractures.","authors":"Aditya Vardhan Guduru,&nbsp;Ishwara Keerthi,&nbsp;Premjit Sujir,&nbsp;Manesh Kumar Jain,&nbsp;Praveen Sodavarapu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pedicle screw insertion at the level of the fractured vertebra has been shown to improve clinical and radiological outcomes in unstable thoracolumbar and lumbar fractures, albeit this requires further evidence. The study aims to evaluate the effect of pedicle screw placement on the fractured vertebra in such cases.</p><p><strong>Methods: </strong>A prospective study included adult patients with thoracolumbar and lumbar fractures treated with short-segment posterior instrumentation with a pedicle screw into the fractured vertebra. Anterior vertebral body height loss, kyphotic angle and degree of spinal canal compromise were measured preoperatively and postoperatively in radiographs and CT scans. The neurological status was followed up for one year of the postoperative period.</p><p><strong>Results: </strong>The study included a total of 30 patients. Five patients (16.7%) had grade C, three patients (10%) had grade D, and 22 patients (73.3%) had grade E neurological status. The mean (SD) preoperative kyphotic angle, vertebral body height and canal compromise were 5.54 (5.35), 39.67% (8.04), and 31.59% (10.62), respectively. Postoperatively there was a significant canal decompression, with a mean postoperative spinal canal compromise of 5.53% (SD=7.70; <i>p</i>-value <0.001). At the end of one year of follow-up, the radiological evaluation showed a correction of the kyphotic angle to 6.62 (SD=2.57; <i>p</i>-value <0.001), and the mean anterior vertebral body height was 70.38% (SD=11.25; <i>p</i>-value <0.001). At the end of one year, there was a significant overall neurological recovery with a final neurological status of grade D in 5 (16.7%) and grade E in 25 patients (83.3%). There was no significant association between canal decompression and neurology at the end of the one-year follow-up.</p><p><strong>Conclusion: </strong>Unstable thoracolumbar and lumbar fractures surgically treated with short-segment fixation with an additional intermediate screw can achieve significant restoration of vertebral body height and correction of kyphotic angle without any added complications.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9490151/pdf/ijbt0012-0139.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emphysematous osteomyelitis of the calcaneus: a case report and review.","authors":"Kaitlin M Gruenberg,&nbsp;Barret J Halgas,&nbsp;Jonathan Lundy","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Emphysematous osteomyelitis is a rare but potentially fatal condition, which classically features intraosseous air on imaging without a direct communication with the atmosphere. Prompt recognition and treatment of the disease cannot be overstated as there is a high mortality rate associated with this condition. Here we report a case of emphysematous osteomyelitis of the calcaneus in a sixty-one-year-old male with diabetes mellitus and end-stage renal disease. This case of osteomyelitis was associated with an overlying necrotizing soft tissue infection, mandating an urgent below-knee amputation for source control. This case report is the first of its kind in the literature involving the calcaneous as emphysematous osteomyelitis more commonly involves the vertebral column. The purpose of this case report is to discuss the presentation and treatment of emphysematous osteomyelitis involving the calcaneous as well as provide a review of the current literature on this diagnosis.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9490150/pdf/ijbt0012-0185.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of melatonin on prevention of postoperative delirium after lower limb fracture surgery in elderly patients: a randomized double blind clinical trial.","authors":"Mohammad Reza Fazel,&nbsp;Saba Mofidian,&nbsp;Mehrdad Mahdian,&nbsp;Hossein Akbari,&nbsp;Mohammad Reza Razavizadeh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium is a common complication with a high morbidity rate. This study was designed to consider the effectiveness of melatonin in prevention and treatment of postoperative delirium.</p><p><strong>Methods: </strong>Seventy-two patients aged >60 years old with Abbreviated Mental Test (AMT) >8 scheduled for orthopedic surgery under spinal anesthesia, were randomly distributed equally to melatonin or placebo groups. In the melatonin group, the patients were given 5 mg melatonin capsules orally the night before surgery, the night of the operation, and two nights after the surgical operation at 9 pm. Likewise, in the placebo group, the patients received placebo in the same times. For diagnosis of postoperative delirium, the AMT test was used before the operation and three days after that. The Generalized estimating equations model (GEE) with logit link to Multivariate analysis was used in the study and P<0.05 was considered statistically significant.</p><p><strong>Results: </strong>In total, 72 patients completed the study. Thirty-three patients (45.8%) were male with a mean (SD) age 71.4 (3.6) years. On the first day after the surgery, the incidence of delirium was significantly lower in the melatonin group compared to the placebo group (22.2% vs. 44.4%, P=0.046). On the second and third days after the surgery, the level of delirium in the melatonin group was also significantly lower than that in the placebo one. The GEE model showed a significant interaction between time and treatment groups.</p><p><strong>Conclusion: </strong>The findings of the study showed that melatonin prevented delirium after the orthopedic surgeries in the elderly patients and could be useful for the patients as such.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9490153/pdf/ijbt0012-0161.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of postoperative bracing on unstable traumatic lumbar fractures after pedicle screw fixation.","authors":"Sayed Mohammad Amin Nourian,&nbsp;Safura Mozafari,&nbsp;Saeed Farzinnia,&nbsp;Milad Saeidi,&nbsp;Mahshid Bahrami","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Fractures of the thoracolumbar and lumbar regions are very important. There is still debate on the use of braces after surgical operations. The current study aims to evaluate and report the outcomes of postoperative bracing following pedicle screw fixation in patients with thoracolumbar and lumbar fractures in Iran.</p><p><strong>Methods: </strong>This is a clinical trial performed from 2012 to 2022 on 144 patients diagnosed with lumbar and thoracolumbar fractures. Demographic data of patients including age and gender were obtained. Patients' fractures were classified as Frankel (A to E) in terms of clinical and neurological manifestations. Patient's quality of life (QOL) was measured using the 36-Item Short Form Survey (SF-36). All patients underwent surgical fixation of the fracture. Patients were then randomized into two groups using Random Allocation Software. The first group received post-operation bracing and the second group did not receive braces. Thus, radiographic and clinical evaluation data of 1, 3, and 12 months after surgery were used to determine bone fusion.</p><p><strong>Results: </strong>The most common mechanisms of trauma included falling from a height in 99 patients (68.7%), vehicle accidents in 39 patients (27.1%), and the most common fracture sites were the L1 vertebrae in 73 patients (50.7%), 111 patients (77.1%) had burst fractures, and 105 patients (72.3%) had no neurological defects (Frankel E). At the beginning of the study, there were no significant differences between the two groups regarding the mentioned data, patients' QOL, and pain severity. All patients (100%) had early mobilization. Most patients (85.4%) did not report persistent back pain 12 months after surgeries. 90.2% returned to their daily activities and all patients (100%) had full fusion based on radiologic data. The QOL and pain severity of patients improved significantly compared to baseline (P < 0.001 for both).</p><p><strong>Conclusion: </strong>The use or non-use of braces did not affect the treatment results. As a result, patients who have received pedicle screw fixation for unstable thoracolumbar fractures do not require braces in the postoperative period.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9490152/pdf/ijbt0012-0168.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma center risk conditions for blood alcohol-positive and alcohol misuse patients: a retrospective study.","authors":"Carl M Dunham,&nbsp;Gregory S Huang,&nbsp;Elisha A Chance,&nbsp;Barbara M Hileman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Because few studies have assessed blood alcohol concentration (BAC)-positive risk conditions in trauma activation patients, this retrospective investigation pursued such an analysis. The parent database included consecutive trauma center admissions from January 21 to July 21 for 2018-2020. The supplementary electronic medical record audit of trauma activation patients aged 18-60 years (TA18-60) assessed alcohol misuse, smoking history, and serum bicarbonate levels. An alcohol misuse risk score was created by assigning a value of 0 (no) or 1 (yes) for each risk condition: 1) smoking history, 2) BAC-positive status, 3) BAC ≥ 100 mg/dL with Glasgow Coma Scale score (GCS) ≥ 13, 4) age ≥ 40 years, and 5) bicarbonate level ≥ 20 mmol/L in BAC-positive patients and summing the total score (range, 0-5). Of 2,076 patients, BAC testing occurred in 60.9% (n = 1,265). BAC positivity was greater in TA18-60 (36.9%) than in other patients (20.8%; <i>P</i> < 0.0001; odds ratio [OR] = 2.2). In the TA18-60 audit (n = 742), categorizations were available for BAC status, 98.5%; smoking history, 99.3%; alcohol misuse history, 99.5%; and bicarbonate level, 99.5%. BAC positivity was greater in smokers (41.3%) than in non-smokers (31.5%; <i>P</i> = 0.0061; OR = 1.5). BAC positivity was greater with alcohol misuse (87.0%) than without (17.7%; <i>P</i> < 0.0001; OR = 31.2). BAC-positive was associated with a greater proportion of bicarbonate levels < 20 mmol/L (52.0%) than BAC-negative (31.8%; <i>P</i> < 0.0001; OR = 2.3). The alcohol misuse proportion was greater with an alcohol misuse risk score of 3-5 (74.4% [142/191]) than with a risk score of 0-2 (10.4% [57/546]; <i>P</i> < 0.0001; OR = 24.9; area under the receiver operating characteristic curve = 0.89). This retrospective study demonstrates that BAC positivity is associated with TA18-60, smoking and alcohol misuse histories, and metabolic acidosis. An alcohol misuse history is associated with multiple risk conditions. Trauma center leadership should provide procedures to identify patients who are BAC-positive or have a positive smoking or alcohol misuse history. Then, such patients should be referred to care providers who can offer assistance and guidance for enhancing overall patient wellbeing.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9490155/pdf/ijbt0012-0149.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex distal tibia fractures treated with multi-planar external fixation - a single center experience.","authors":"Yiu Hin Kwan,&nbsp;Joshua Decruz,&nbsp;Antony Xr Premchand,&nbsp;Suheal A Khan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Multi-planar external fixation is used for the management of complex distal tibia fractures. This study aims to describe our experience of treating distal tibia fractures using the Ilizarov, Taylor Spatial Frame and True-Lok Hex external fixation methods.</p><p><strong>Methodology: </strong>We conducted a retrospective analysis of clinical and radiological records of all distal tibia fractures that were managed with multi-planar external fixation over a period of 3 years. A total of 13 cases were included, of which most were high-energy injuries.</p><p><strong>Results: </strong>The average age of the patients was 44 years old. 11 (85%) cases were high-energy trauma due to road traffic accidents. 8 (62%) cases involved the revision of a previous fixation method. Most (77%) cases were AO classification Type 3, and the majority (62%) of cases were open fractures. The average duration in the external fixator frame and time to radiological union was 5 months and 6 months respectively. The average malalignment at union was 1.3 degrees and 0.5 degrees in the coronal plane and sagittal plane respectively. All fractures involving the joint line were adequately restored. There were 2 (16%) case of non-union and 2 (15%) cases of pin site infections. 1 case required a corticotomy and subsequent lengthening.</p><p><strong>Conclusion: </strong>Multi-planar circular external fixation is a reliable method to treat complex distal tibia fractures, both in the acute setting and as revision surgery. The rates of fracture union is high, with minimal malalignment. Although pin site infections are relatively common, they are uncomplicated and easily treated.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301155/pdf/ijbt0012-0098.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40548957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of Proximal Femoral Nail (PFN) versus Dynamic Condylar Screw (DCS) in management of unstable trochanteric fractures.","authors":"Md Faraz Jamil,&nbsp;Julfiqar Mohd,&nbsp;Mazhar Abbas,&nbsp;Yasir Salam Siddiqui,&nbsp;Mohammad Jesan Khan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Trochanteric hip fractures have become very common with 35-40% of these fractures being unstable. Trochanteric fractures, especially unstable ones are associated with high rates of mortality and morbidity and thus remain an inordinate challenge for surgeon to treat these fractures with proper choice of implant. Aim of the study was to compare the proximal femoral nail and dynamic condylar screw in the management of unstable trochanteric fractures. Our study was a prospective comparative study which included 26 patients with fresh (≤3 weeks old) unstable trochanteric fractures AO 31A2 and AO 31A3, with age ≥18 years of both sexes. Eleven patients in DCS and fifteen patients in PFN were included. Harris hip score was used to compare functional outcomes. Average age of patients in DCS group was 59.82±11.59 years and PFN was 54.2±16.22 years. AO 31A2 fracture pattern (63.64%) was more common than AO 31A3 in DCS group and AO 31A3 fracture pattern (60.00%) was more common than AO 31A2 in PFN group. Mean operative time for DCS was 96.36±15.51 minutes and for PFN it was 79.67±12.02 minutes with <i>P</i>-value of 0.003. Two patients in DCS group and 1 patient in PFN group were lost to follow up. Two patients in DCS group and 1 patient in PFN group died. Seven out of 11 (63.64%) patients in DCS group and 13 out of 15 (86.60%) patients in PFN group were available for final follow up. Union seen in 2 (28.57%) patients with DCS and 12 (92.31%) patients fixed with PFN with <i>P</i>-value of 0.007. Mean HHS of 62.29±24.26 in DCS and 86.92±11.65 in PFN with <i>P</i>-value of 0.037. Patients with combined excellent and good HHS in DCS group and PFN group were 2 (28.57%) and 11 (84.62%) respectively. Non-union was seen in 5 (71.43%) patients fixed with DCS and 1 (7.69%) patient fixed with PFN. Implant failure was seen in 3 (42.86%) patients in DCS group in which barrel plate was broken in 2 (28.57%) patients and lag screw cut out through femoral head in 1 (14.29%) patient and 1 (7.69%) patient in PFN group due to varus collapse and complete backout of screw. Varus collapse was seen in 3 (42.86%) patients in DCS group and 4 (30.76%) patients in PFN group. Proximal femoral nail is better implant as compared to dynamic condylar screw which was statistically significant in terms of lesser operative time, higher union rate and better functional outcome. So PFN is a better implant choice for unstable trochanteric fractures when compared with DCS.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9301162/pdf/ijbt0012-0083.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40546872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}