Trauma-England最新文献

Penetrating firearm tracheal injury with cardiac arrest due to tension pneumopericardium 穿透性火器气管损伤并心包张力引起的心脏骤停

Trauma-England Pub Date : 2023-11-09 DOI: 10.1177/14604086231189340

Takshaka Patel, Deirdre Dulak, Lars Ola Sjoholm, Roman Petrov

引用次数: 0

Intact peritoneum in a child with ileal perforation from a firearm injury 儿童因火器伤致回肠穿孔腹膜完整

Trauma-England Pub Date : 2023-11-07 DOI: 10.1177/14604086231205720

Syed Waqas Ali, Yaqoot Jahan, Farah Anwar, Saad Khalid, Muhammad Arif Mateen Khan

{"title":"Intact peritoneum in a child with ileal perforation from a firearm injury","authors":"Syed Waqas Ali, Yaqoot Jahan, Farah Anwar, Saad Khalid, Muhammad Arif Mateen Khan","doi":"10.1177/14604086231205720","DOIUrl":"https://doi.org/10.1177/14604086231205720","url":null,"abstract":"Introduction Indirect intra-abdominal injury with an intact peritoneum following close passage of highly energized projectiles is an uncommon but clearly described phenomenon; likewise delayed gastrointestinal perforation hours or days after passage of a high-energy stress wave from primary blast injury is uncommon. Awareness of these two rare occurrences is required to ensure delayed perforations are diagnosed and managed in a timely manner. Case report An 8-year-old male child sustained a shotgun injury to the right elbow and the abdominal wall only of the right hypochondrium. Due to a non-salvageable joint injury, he underwent amputation of the right upper limb above the elbow, but on the third day of admission, he developed peritonitis and an X-ray revealed pneumoperitoneum. On abdominal exploration, two small ileal perforations were found without penetration of the peritoneum or diaphragm. The ileal injuries were primarily repaired and the postoperative course was uneventful. Conclusion Indirect injury to abdominal viscera from the primary blast effect of close passage of high-energy projectiles resulting is rare and can have significant consequences if not diagnosed and managed early.","PeriodicalId":45797,"journal":{"name":"Trauma-England","volume":"43 177","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135540152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A potential predictor of future firearm-related violence, driving while impaired conviction 这可能预示着未来的枪支暴力，在定罪受损的情况下开车

Trauma-England Pub Date : 2023-10-19 DOI: 10.1177/14604086231208492

Robert D Flint

引用次数: 0

Ballistic injuries of the humerus: A matched cohort analysis 肱骨弹道性损伤:匹配队列分析

Trauma-England Pub Date : 2023-10-09 DOI: 10.1177/14604086231197053

Walter Smith, Samuel Schick, Rodney Arthur, Kyle Paul, Joseph Elphingstone, Srihari Prahad, Kevin Luque-Sanchez, Amit Momaya, Clay Spitler, Eugene Brabston

{"title":"Ballistic injuries of the humerus: A matched cohort analysis","authors":"Walter Smith, Samuel Schick, Rodney Arthur, Kyle Paul, Joseph Elphingstone, Srihari Prahad, Kevin Luque-Sanchez, Amit Momaya, Clay Spitler, Eugene Brabston","doi":"10.1177/14604086231197053","DOIUrl":"https://doi.org/10.1177/14604086231197053","url":null,"abstract":"Introduction Ballistic fractures of the humerus secondary to gunshot wounds are increasingly common injuries that pose challenges for orthopedic surgeons. The primary purpose of this study was to examine the rates of neurovascular injury, compartment syndrome, and infection of ballistic humerus fractures relative to blunt, non-penetrating fractures. Methods A consecutive cohort of 135 patients with ballistic humerus fractures and 167 patients with blunt humerus fractures treated at a level 1 trauma center were identified. A review of patient medical records and radiographic studies was performed to obtain demographic information, injury mechanism, fracture location, choice of treatment, and complications. Statistical analysis was performed using independent sample t-tests, chi-square tests, and odds ratios ( p < 0.05 significance). Results Compared with blunt fractures, patients in the ballistic fracture cohort were younger, male, African American, test positive for illicit drug use, and sustain proximal fractures. Ballistic fractures had significantly lower Injury Severity Scores and New Injury Severity Scores. Ballistic fractures were three times as likely to present with neurovascular injury than blunt fractures (OR: 2.927, p < 0.001). The overall rate of spontaneous recovery of significant motor function for ballistic fractures with neurologic injury was 55%. There were no statistically significant differences in rates of vascular injury, compartment syndrome, infection, non-union, or the need for soft tissue reconstruction. Conclusion Compared with blunt humeral fractures, ballistic fractures appear to have a significantly higher rate of neurologic injury but no increased risk for compartment syndrome or infection. Surgical treatment of ballistic humeral injuries was not associated with increased neurological recovery compared to non-operatively managed fractures.","PeriodicalId":45797,"journal":{"name":"Trauma-England","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135095463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Iatrogenic ulnar nerve palsy associated with supracondylar humeral fracture in children: A systemic review on its management 儿童医源性尺神经麻痹伴肱骨髁上骨折:对其处理的系统回顾

Trauma-England Pub Date : 2023-09-27 DOI: 10.1177/14604086231197369

Mohammad Arshad Ikram, Huma Shahzad, Justin Vijay Gnanou

{"title":"Iatrogenic ulnar nerve palsy associated with supracondylar humeral fracture in children: A systemic review on its management","authors":"Mohammad Arshad Ikram, Huma Shahzad, Justin Vijay Gnanou","doi":"10.1177/14604086231197369","DOIUrl":"https://doi.org/10.1177/14604086231197369","url":null,"abstract":"Background Supracondylar humeral fractures (SCHFs) are among the most common pediatric fractures. Closed reduction and percutaneous pinning are considered the established gold standard. Biomechanically, cross-pinning is resilient for any axial rotation, but the medial pin increases the risk of iatrogenic injury to the ulnar nerve. Objective A systematic review was conducted to provide an evidence-based analysis of the literature on the management of iatrogenic ulnar nerve injury caused by the medial pin during closed reduction and percutaneous fixation of displaced SCHF in children. Methods MEDLINE, SCOPUS, and ScienceDirect databases were searched to identify all articles that reported ulnar nerve injury caused by the medial pin during closed reduction and percutaneous fixation of displaced SCHF in children and suggested the management. Reference lists from the articles retrieved were further scrutinized to identify any additional studies of interest. Results One thousand six hundred and six articles on SCHF treated by closed reduction and cross-pinning were identified initially with 25 studies included in the analysis after screening. Four thousand six hundred and seventy-five children sustained SCHF with a median age of 7 years. Of 3036 children treated by closed reduction and cross pinning, 205 (6.75%) were diagnosed with iatrogenic ulnar nerve injury. The management involves observation only, removal of the medial pin, or exploration. The average recovery time in the group treated by removal of wire was statistically shorter than the other two groups. Conclusion The evidence suggests surgical exploration of the ulnar nerve can be delayed for up to 7 months, with most studies favouring observation only. In selected cases, immediate removal of the medial pin should be considered.","PeriodicalId":45797,"journal":{"name":"Trauma-England","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135538831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prospective validation of Bowel Injury Prediction Score for early diagnosis of surgically significant blunt bowel and mesenteric injury 肠损伤预测评分用于外科意义的钝性肠和肠系膜损伤早期诊断的前瞻性验证

Trauma-England Pub Date : 2023-09-26 DOI: 10.1177/14604086231187523

Shubham Kumar Gupta, Pramod Kumar Singh, Sumit Sharma, Sanjeev Kumar Gupta

{"title":"Prospective validation of Bowel Injury Prediction Score for early diagnosis of surgically significant blunt bowel and mesenteric injury","authors":"Shubham Kumar Gupta, Pramod Kumar Singh, Sumit Sharma, Sanjeev Kumar Gupta","doi":"10.1177/14604086231187523","DOIUrl":"https://doi.org/10.1177/14604086231187523","url":null,"abstract":"Background Blunt bowel and mesenteric injuries (BBMI) are frequently missed despite the widespread use of computed tomography (CT). Early diagnosis for timely management of surgically significant blunt bowel and mesenteric injuries (sBBMI) can be challenging. Several tools predictive for sBBMI have been proposed such as the “Bowel Injury Prediction Score” (BIPS) that is based on presence of abdominal tenderness, white blood cell count ≥17,000/mm 3 and CT grade. The utility of this scoring system for early diagnosis of sBBMI has neither been studied in an Indian population nor prospectively validated. Methods A single-centre prospective cohort study was conducted at a Trauma Centre in India. After screening of 1793 patients with blunt trauma abdomen who presented between 1st January 2022 and 31st August 2022 and underwent CT scan, eventually, 80 patients of age >18 years, hemodynamically stable and CT finding suspicious of BBMI were included. BIPS score was calculated. Patients were followed to evaluate the outcome. Results The incidence of sBBMI was 3.06%. Mean age of study patients was 36.2 ± 16.5 years with male predominance (92.5%) and road traffic accidents the commonest mode of injury. Patients with BBMI were more likely to require operative intervention in the presence of abdominal tenderness at presentation (p < 0.01) and CT grade ≥4 (p < 0.01). For patients with WBC counts of ≥17,000/mm 3 , no statistically significant difference was noted in the need for operative intervention. BIPS ≥2 had 94.5% sensitivity, 72% specificity, 88% PPV, and 86% NPV for identifying patients with sBBMI. Conclusion Calculation of BIPS at the time of presentation can avoid unnecessary delays in surgical management and thereby reduce overall morbidity and mortality even in an Indian setup. However, WBC counts > 17,000/mm 3 were not found to be predictive of sBBMI.","PeriodicalId":45797,"journal":{"name":"Trauma-England","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134958507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bilateral lower extremity injuries in pedestrian versus motor vehicle collisions 行人与机动车碰撞的双侧下肢损伤

Trauma-England Pub Date : 2023-09-21 DOI: 10.1177/14604086231201533

David T Marvin, Jesse Seilern und Aspang, Alexander Webb, Jason Shah, Nicholas Cantu, Roberto C Hernandez-Irizarry, Thomas J Moore

{"title":"Bilateral lower extremity injuries in pedestrian versus motor vehicle collisions","authors":"David T Marvin, Jesse Seilern und Aspang, Alexander Webb, Jason Shah, Nicholas Cantu, Roberto C Hernandez-Irizarry, Thomas J Moore","doi":"10.1177/14604086231201533","DOIUrl":"https://doi.org/10.1177/14604086231201533","url":null,"abstract":"Background Lower extremity (LE) injuries following pedestrian versus motor vehicle collision (PMVC) are a common cause of morbidity and mortality in orthopedic trauma. There is currently no evidence illustrating the presentation of orthopedic bilateral LE injuries (BLEI). This study aimed to evaluate the patterns of BLEI on postoperative outcomes and hospital utilization following PMVC. Methods This retrospective cohort analysis included 532 consecutive patients presenting to a single level I trauma center with LE injuries following PMVC from January 1, 2017 to May 31, 2021. Injury location was categorized by extremity region (hip/femur, knee, leg, ankle, midfoot). Outcome measures included 30-day postoperative complications (infection, compartment syndrome, myocardial infarction, pneumonia, pulmonary embolism, sepsis, stroke) and hospital utilization (length of stay, ICU admission, prolonged ventilation [≥48 h], readmission). Mann–Whitney U, chi-square, and logistic regressions were performed calculating odds ratio (OR) with 95% confidence intervals. Results A total of 142 (26.7%) patients sustained BLEI. The most common BLEI complexes (212 total) were bilateral leg (25.0%), hip/femur and leg (17.0%), leg and knee (12.3%), and hip/femur and knee (8.0%). Bilateral and unilateral injuries showed no difference for postoperative complications (11.3% vs. 6.2%; p = 0.062). However, BLEI had higher odds of ICU admission (OR:2.97, CI:1.68–5.26), prolonged ventilation (OR:2.38, CI:1.24–4.59), and patients remained hospitalized 10.87 days longer (p < 0.001). Conclusion Our findings indicate that more than a quarter of PMVCs with LE injuries present with BLEI and require significantly more hospital resources. This is the first study to characterize BLEI in PMVCs, highlighting associated patterns to encourage heightened awareness in trauma evaluation. Level of Evidence: III","PeriodicalId":45797,"journal":{"name":"Trauma-England","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136155668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pedal cyclist fatalities in the United States: 2011–2021 美国骑自行车死亡人数:2011-2021

Trauma-England Pub Date : 2023-09-16 DOI: 10.1177/14604086231198761

Robert D Flint, Ryan M Flint

引用次数: 0

The diurnal and seasonal relationships of pedestrian injuries secondary to motor vehicles in young people 青少年机动车继发性行人伤害的昼夜和季节关系

Trauma-England Pub Date : 2023-02-01 DOI: 10.1177/14604086221148954

Amina Akhtar, Adam Brooks, Samuel Kitchen, Rory C. O'Connor

{"title":"The diurnal and seasonal relationships of pedestrian injuries secondary to motor vehicles in young people","authors":"Amina Akhtar, Adam Brooks, Samuel Kitchen, Rory C. O'Connor","doi":"10.1177/14604086221148954","DOIUrl":"https://doi.org/10.1177/14604086221148954","url":null,"abstract":"Introduction There remains a significant morbidity and mortality in young pedestrians hit by motor vehicles, even in the era of pedestrian crossings and speed limits. The aim of this study was to compare the incidence and injury severity of motor vehicle-related pedestrian trauma according to time of day and season in a young population, based on the supposition that injuries would be more prevalent during dusk and dawn and during autumn and winter. Methods Data were retrieved from the National Trauma Audit and Research Network (TARN) database for patients between 10 and 25 years old who had been involved as pedestrians in road traffic collisions between 2013 and 2020. The incidence of injuries, their severity (using the injury severity score (ISS)) and mortality were analysed according to the hours of daylight, darkness and season. Results The study identified a seasonal pattern, highlighting that injuries were most prevalent during autumn (34.9% of injuries). Prevalence decreased throughout the year from winter (25.4%) to spring (21.4%), to summer (18.3%). The greatest incident rate (number of incidents/hour) occurred between 1500–1630 h, correlating to school pick up times, but overall there was no significant difference in injury prevalence between hours of darkness (47.3%) and daylight (52.7%). However, a significant relationship between ISS and daylight hours was demonstrated ( p-value = 0.0124), whereby moderate injuries (ISS score: 9–15) were more likely during the day (72.7%), while severe injuries (ISS score > 15) were more likely at night (55.8%). Conclusion We identified a relationship between the time of day and the frequency and severity of pedestrian trauma in young people. In addition, particular time groupings correspond to the greatest incidents rate, suggesting that reduced visibility coupled with school pick up times play a significant role. We recommend targeted public health measures to improve road safety that focus on these high-risk times of the day.","PeriodicalId":45797,"journal":{"name":"Trauma-England","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136172699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Regional strategy development in the East Midlands 东米德兰的区域战略发展

IF 0.6

Trauma-England Pub Date : 2002-07-24 DOI: 10.46692/9781847425539.011

P. Foley

引用次数: 2