Chinese Journal of Traumatology最新文献

{"title":"Fatal intracranial bleedings in a viper bite.","authors":"Santosh Govind Rathod, Vinayagapandian Sakthivel, Ajay Vane, Saima Kabir, Vishvdeep Kishen Khushoo","doi":"10.1016/j.cjtee.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.02.007","url":null,"abstract":"","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of scaphoid nonunion with dual screw fixation in preventing postoperative humpback deformity.","authors":"Jingtong Lyu, Xiao Liu, Yuanqiang Li, Zhenyu Wang, Yunjiao Wang, Wei Wang, Lin Guo","doi":"10.1016/j.cjtee.2024.10.010","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.10.010","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the treatment of scaphoid nonunion with dual screw fixation in preventing postoperative humpback deformity.</p><p><strong>Methods: </strong>This retrospective study is from December 2010 to December 2021, 18 patients with scaphoid nonunion were treated with dual screw fixation through the dorsal approach. This study included patients aged 16-60 years with scaphoid nonunion (>6 months) classified as Mack-Lichtman types I-III (mild arthritis), while excluding those with immature osteogenesis (<16 years), osteoporosis (>60 years), prior wrist surgery or fractures, avascular necrosis, advanced degenerative changes (types IV-V), small fragment fixation difficulty, or loss to follow-up. Scaphoid length and angles were assessed on X-rays. Wrist function was assessed based on the Mayo wrist score.</p><p><strong>Results: </strong>The average age of the participants was 27 (range 17-49) years. The mean time from injury to surgery was 13 (range 6-48) months. There were types I (n=5), II (n=11), and III (n=2) nonunions based on the Mack-Lichtman classification. Nonunion sites included proximal 1/3 (n=4), waist (n=8), and distal 1/3 (n=6). All nonunions healed at a mean of 15 (range 10-28) weeks. The preoperative scaphoid length was 20 (range 17-23) mm, and the data at bone union was 23 (range 21-26) mm. The preoperative scapholunate angle was 46° (range 18°-72°), and the data at bone union was 39° (range 30°-48°). The preoperative radiolunate angle was 24° (range 5°-51°), and the data at bone union was 18° (range 8°-29°). Follow-up lasted for a mean of 52 (range 24-119) months. Mayo wrist score improved from 47 (range 13-64) to 95 (range 78-100). There were 15 excellent, 2 good, and 1 satisfactory results.</p><p><strong>Conclusion: </strong>In the treatment of scaphoid nonunion, dual screw fixation through the dorsal approach can successfully prevent postoperative humpback deformity. Reduction is maintained to bone union without complications. The technique can be an alternative for the treatment of scaphoid nonunion.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of risk factors, pathogenic bacteria characteristics, and drug resistance of postoperative surgical site infection in adults with limb fractures","authors":"Yan-Jun Wang ,&nbsp;Zi-Hou Zhao ,&nbsp;Shuai-Kun Lu ,&nbsp;Guo-Liang Wang ,&nbsp;Shan-Jin Ma ,&nbsp;Lin-Hu Wang ,&nbsp;Hao Gao ,&nbsp;Jun Ren ,&nbsp;Zhong-Wei An ,&nbsp;Cong-Xiao Fu ,&nbsp;Yong Zhang ,&nbsp;Wen Luo ,&nbsp;Yun-Fei Zhang","doi":"10.1016/j.cjtee.2024.04.007","DOIUrl":"10.1016/j.cjtee.2024.04.007","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;We carried out the study aiming to explore and analyze the risk factors, the distribution of pathogenic bacteria, and their antibiotic-resistance characteristics influencing the occurrence of surgical site infection (SSI), to provide valuable assistance for reducing the incidence of SSI after traumatic fracture surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A retrospective case-control study enrolling 3978 participants from January 2015 to December 2019 receiving surgical treatment for traumatic fractures was conducted at Tangdu Hospital of Air Force Medical University. Baseline data, demographic characteristics, lifestyles, variables related to surgical treatment, and pathogen culture were harvested and analyzed. Univariate analyses and multivariate logistic regression analyses were used to reveal the independent risk factors of SSI. A bacterial distribution histogram and drug-sensitive heat map were drawn to describe the pathogenic characteristics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Included 3978 patients 138 of them developed SSI with an incidence rate of 3.47% postoperatively. By logistic regression analysis, we found that variables such as gender (males) (odds ratio (&lt;em&gt;OR&lt;/em&gt;) = 2.012, 95% confidence interval (&lt;em&gt;CI&lt;/em&gt;&lt;em&gt;)&lt;/em&gt;: 1.235 − 3.278, &lt;em&gt;p&lt;/em&gt; = 0.005), diabetes mellitus (&lt;em&gt;OR&lt;/em&gt; = 5.848, 95% &lt;em&gt;CI&lt;/em&gt;: 3.513 − 9.736, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), hypoproteinemia (&lt;em&gt;OR&lt;/em&gt; = 3.400, 95% &lt;em&gt;CI&lt;/em&gt;: 1.280 − 9.031, &lt;em&gt;p&lt;/em&gt; = 0.014), underlying disease (&lt;em&gt;OR&lt;/em&gt; = 5.398, 95% &lt;em&gt;CI&lt;/em&gt;: 2.343 − 12.438, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), hormonotherapy (&lt;em&gt;OR&lt;/em&gt; = 11.718, 95% &lt;em&gt;CI&lt;/em&gt;: 6.269 − 21.903, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), open fracture (&lt;em&gt;OR&lt;/em&gt; = 29.377, 95% &lt;em&gt;CI&lt;/em&gt;: 9.944 − 86.784, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), and intraoperative transfusion (&lt;em&gt;OR&lt;/em&gt; = 2.664, 95% &lt;em&gt;CI&lt;/em&gt;: 1.572 − 4.515, &lt;em&gt;p&lt;/em&gt; &lt; 0.001) were independent risk factors for SSI, while, aged over 59 years (&lt;em&gt;OR&lt;/em&gt; = 0.132, 95% &lt;em&gt;CI&lt;/em&gt;: 0.059 − 0.296, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), prophylactic antibiotics use (&lt;em&gt;OR&lt;/em&gt; = 0.082, 95% &lt;em&gt;CI&lt;/em&gt;: 0.042 − 0.164, &lt;em&gt;p&lt;/em&gt; &lt; 0.001) and vacuum sealing drainage use (&lt;em&gt;OR&lt;/em&gt; = 0.036, 95% &lt;em&gt;CI&lt;/em&gt;: 0.010 − 0.129, &lt;em&gt;p&lt;/em&gt; &lt; 0.001) were protective factors. Pathogens results showed that 301 strains of 38 species of bacteria were harvested, among which 178 (59.1%) strains were Gram-positive bacteria, and 123 (40.9%) strains were Gram-negative bacteria. &lt;em&gt;Staphylococcus aureus&lt;/em&gt; (108, 60.7%) and &lt;em&gt;Enterobacter cloacae&lt;/em&gt; (38, 30.9%) accounted for the largest proportion. The susceptibility of Gram-positive bacteria to Vancomycin and Linezolid was almost 100%. The susceptibility of Gram-negative bacteria to Imipenem, Amikacin, and Meropenem exceeded 73%.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Orthopedic surgeons need to develop appropriate surgical plans based on the risk factors and protective factors associated with postoperative SSI to reduce its","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 4","pages":"Pages 241-251"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141138544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guide for Author","authors":"","doi":"10.1016/S1008-1275(25)00072-0","DOIUrl":"10.1016/S1008-1275(25)00072-0","url":null,"abstract":"","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 4","pages":"Pages I-V"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The construction and application of a trauma limb salvage map in Shaanxi province","authors":"Meng Wang ,&nbsp;Jian-Min Liu ,&nbsp;Xing-Bo Dang ,&nbsp;Long-Yang Ma ,&nbsp;Gong-Liang Du ,&nbsp;Wei Hu","doi":"10.1016/j.cjtee.2024.08.004","DOIUrl":"10.1016/j.cjtee.2024.08.004","url":null,"abstract":"<div><div>Trauma is an important cause of death in young- and middle-aged people. Trauma is comprehensive and includes many surgical specialties, and the surgical techniques of these specialties have long been mature. To reduce the mortality and disability rate of trauma patients, it is necessary to improve trauma management. Trauma has attracted attention in China and trauma treatment and care developed rapidly in recent years. To decrease traumatic mortality and disability rates, our team is committed to building an efficient trauma system in Shaanxi province and has successfully developed a trauma limb salvage map to address the high rates of amputation and disability in patients with limb injuries. This article elaborates on the construction experience of a trauma limb salvage map and its application details in Shaanxi province of China.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 4","pages":"Pages 235-240"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphometric and anatomic characteristics of pronator quadratus muscle","authors":"Nurşen Zeybek ,&nbsp;Özcan Gayretli ,&nbsp;Yüsra Nur Şanlıtürk ,&nbsp;Ayşin Kale","doi":"10.1016/j.cjtee.2024.09.004","DOIUrl":"10.1016/j.cjtee.2024.09.004","url":null,"abstract":"<div><h3>Purpose</h3><div>In surgical procedures commonly employed for the management of scaphoid and distal radial fractures, the incision and dissection of the pronator quadratus muscle play a pivotal role. Nevertheless, comprehensive investigations into the anatomical intricacies of the pronator quadratus muscle have been relatively scarce within the clinical community. In light of this, our study endeavors to make a substantive contribution to the medical literature by conducting a meticulous examination of the morphology and morphometry of this muscle.</div></div><div><h3>Methods</h3><div>This study is a cross-sectional observational study conducted on 22 cadaveric upper extremities (44 sides) preserved between January 2005 and December 2018 at Istanbul University. The study included specimens with intact dissection areas and no prior surgical intervention. Observations focused on the morphometry of the pronator quadratus muscle and related anatomical structures. Statistical analysis was performed using SPSS v23.0, employing Student's <em>t</em>-test and paired <em>t</em>-test, with significance set at <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Significant differences were found in the morphometric measurements of the pronator quadratus muscle between the right and left upper extremities, particularly in the vertical distance between the proximal and distal attachment points of the pronator quadratus to the radius (<em>p</em> = 0.008). Additionally, significant differences were observed between male and female samples for radius length (<em>p &lt;</em> 0.001), ulna length (<em>p &lt;</em> 0.001), pronator quadratus width (<em>p &lt;</em> 0.001), and the vertical distance between pronator quadratus attachment points on both the radius (<em>p</em> = 0.001) and ulna (<em>p</em> = 0.001). Furthermore, significant correlations were identified between radius length and parameters such as the vertical distance between pronator quadratus attachment points on both the radius (<em>p</em> = 0.002) and pronator quadratus width (<em>p</em> = 0.030), and between ulna length and parameters including the vertical distances on the radius (<em>p</em> = 0.001) and ulna (<em>p</em> = 0.024).</div></div><div><h3>Conclusion</h3><div>In light of our comprehensive analysis, which encompasses not only the anatomical features of the pronator quadratus muscle but also its vascular supply and the organization of its neurovascular structures, we posit that our study holds significant implications for the field of orthopedic surgery. We anticipate that this research will furnish valuable insights that can inform and enhance orthopedic procedures.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 4","pages":"Pages 252-256"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular mechanism underlying the protective effects of ischemic preconditioning in total knee arthroplasty","authors":"Yongli Wang ,&nbsp;Bencai Du ,&nbsp;Xueliang Han ,&nbsp;Lianjun Qu","doi":"10.1016/j.cjtee.2024.02.007","DOIUrl":"10.1016/j.cjtee.2024.02.007","url":null,"abstract":"<div><h3>Propose</h3><div>To investigate the molecular mechanisms underlying the protective effects of ischemic preconditioning (IPC) in patients undergoing total knee arthroplasty.</div></div><div><h3>Methods</h3><div>GSE21164 was extracted from an online database, followed by an investigation of differentially expressed genes (DEGs) between IPC treatment samples at 2 time points (T0T and T1T). Function and pathway enrichment analyses were performed on the DEGs. A protein-protein interaction network was constructed to identify hub genes according to 5 different algorithms, followed by enrichment analysis. In addition, long noncoding RNAs (lncRNAs) were identified between the T0T and T1T samples. Furthermore, a competing endogenous RNA network was predicted based on the identified lncRNA-messenger RNA (mRNA), lncRNA-microRNA (miRNA), and mRNA-miRNA relationships revealed in this study. Finally, a drug-gene network was investigated. Statistical analyses were performed using GraphPad Prism 8.0. Differences between groups were determined using an unpaired <em>t</em>-test. <em>p</em> &lt; 0.05 was considered significant.</div></div><div><h3>Results</h3><div>A total of 343 DEGs at T0 and 10 DEGs at T1 were identified and compared with their respective control groups, followed by 100 DEGs between T0T and T1T. Based on these 100 DEGs, protein-protein interaction network analysis revealed 9 hub genes, mainly with mitochondria-related functions and the carbon metabolism pathway. Six differentially expressed lncRNAs were investigated between T0T and T1T. A competing endogenous RNA network was constructed using 259 lncRNA–miRNA–mRNA interactions, including alpha-2-macroglobulin antisense RNA 1-miR-7161-5p-iron-sulfur cluster scaffold. Finally, 13 chemical drugs associated with the hub genes were explored.</div></div><div><h3>Conclusion</h3><div>Iron-sulfur cluster scaffold may promote IPC-induced ischemic tolerance mediated by alpha-2-macroglobulin antisense RNA 1-miR-7161-5p axis. Moreover, IPC may induce a protective response after total knee arthroplasty via mitochondria-related functions and the carbon metabolism pathway, which should be further validated in the near future.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 4","pages":"Pages 257-268"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival predictor in emergency resuscitative thoracotomy for blunt trauma patients: Insights from a Chinese trauma center","authors":"Shan Liu ,&nbsp;Lin Ling ,&nbsp;Yong Fu ,&nbsp;Wen-Chao Zhang ,&nbsp;Yong-Hu Zhang ,&nbsp;Qing Li ,&nbsp;Liang Zeng ,&nbsp;Jun Hu ,&nbsp;Yong Luo ,&nbsp;Wen-Jie Liu","doi":"10.1016/j.cjtee.2024.07.009","DOIUrl":"10.1016/j.cjtee.2024.07.009","url":null,"abstract":"<div><h3>Purpose</h3><div>Emergency resuscitative thoracotomy (ERT) is a final salvage procedure for critically injured trauma patients. Given its low success rate and ambiguous indications, its use in blunt trauma scenarios remains highly debated. Consequently, our study seeks to ascertain the overall survival rate of ERT in blunt trauma patients and determine which patients would benefit most from this procedure.</div></div><div><h3>Methods</h3><div>A retrospective case-control study was conducted for this research. Blunt trauma patients who underwent ERT between January 2020 and December 2023 in our trauma center were selected for analysis, with the endpoint outcome being in-hospital survival, divided into survival and non-survival groups. Inter-group comparisons were conducted using Chi-square and Fisher's exact tests, the Kruskal-Wallis test, Student's <em>t</em>-test, or the Mann-Whitney <em>U</em> test. Univariate and multivariate logistic regression analyses were conducted to assess potential predictors of survival. Then, the efficacy of the predictors was assessed through sensitivity and specificity analysis.</div></div><div><h3>Results</h3><div>A total of 33 patients were included in the study, with 4 survivors (12.12%). Multivariate logistic regression analysis indicated a significant association between cardiac tamponade and survival, with an adjusted odds ratio of 33.4 (95% <em>CI</em>: 1.31 – 850.00, <em>p</em> = 0.034). Additionally, an analysis of sensitivity and specificity, targeting cardiac tamponade as an indicator for survivor identification, showed a sensitivity rate of 75.0% and a specificity rate of 96.6%.</div></div><div><h3>Conclusion</h3><div>The survival rate among blunt trauma patients undergoing ERT exceeds traditional expectations, suggesting that select individuals with blunt trauma can significantly benefit from the procedure. Notably, those presenting with cardiac tamponade are identified as the subgroup most likely to derive substantial benefits from ERT.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 4","pages":"Pages 288-293"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relevance of intra-abdominal pressure monitoring in non-operative management of patients with blunt liver and splenic injuries","authors":"Vivek Kumar ,&nbsp;Ramesh Vaidyanathan ,&nbsp;Dinesh Bagaria ,&nbsp;Pratyusha Priyadarshini ,&nbsp;Abhinav Kumar ,&nbsp;Narendra Choudhary ,&nbsp;Sushma Sagar ,&nbsp;Amit Gupta ,&nbsp;Biplab Mishra ,&nbsp;Mohit Joshi ,&nbsp;Kapil Dev Soni ,&nbsp;Richa Aggarwal ,&nbsp;Subodh Kumar","doi":"10.1016/j.cjtee.2024.02.006","DOIUrl":"10.1016/j.cjtee.2024.02.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Non-operative management (NOM) has been validated for blunt liver and splenic injuries. Literature on continuous intra-abdominal pressure (IAP) monitoring as a part of NOM remains to be equivocal. The study aimed to find any correlation between clinical parameters and IAP, and their effect on the NOM of patients with blunt liver and splenic injury.</div></div><div><h3>Method</h3><div>A prospective cross-sectional study conducted at a level I trauma center from October 2018 to January 2020 including 174 patients who underwent NOM following blunt liver and splenic injuries. Hemodynamically unstable patients or those on ventilators were excluded, as well as patients who suffered significant head, spinal cord, and/or bladder injuries. The study predominantly included males (83.9%) with a mean age of 32.5 years. IAP was monitored continuously and the relation of IAP with various parameters, interventions, and outcomes were measured. Data were summarized as frequency (percentage) or mean ± SD or median (Q₁, Q₃) as indicated. χ² or Fisher's exact test was used for categorical variables, while for continuous variables parametric (independent <em>t</em>-test) or nonparametric tests (Wilcoxon rank sum test) were used as appropriate. Clinical and laboratory correlates of IAP &lt; 12 with <em>p</em> &lt; 0.200 in the univariable logistic regression analysis were included in the multivariable analysis. A <em>p</em> &lt; 0.05 was used to indicate statistical significance.</div></div><div><h3>Results</h3><div>Intra-abdominal hypertension (IAH) was seen in 19.0% of the study population. IAH was strongly associated with a high injury severity score (<em>p</em> &lt; 0.001), and other physiological parameters like respiratory rate (<em>p</em> &lt; 0.001), change in abdominal girth (AG) (<em>p</em> &lt; 0.001), and serum creatinine (<em>p</em> &lt; 0.001). IAH along with the number of solid organs involved, respiratory rate, change in AG, and serum creatinine was associated with the intervention, either operative or non-operative (<em>p</em> = 0.001, <em>p</em> = 0.002, <em>p</em> &lt; 0.001, <em>p</em> &lt; 0.001, <em>p</em> = 0.013, respectively). On multivariable analysis, IAP (<em>p</em> = 0.006) and the mean change of AG (<em>p</em> = 0.004) were significantly associated with the need for intervention.</div></div><div><h3>Conclusion</h3><div>As a part of NOM, IAP should be monitored as a continuous vital. However, the decision for any intervention, either operative or non-operative cannot be guided by IAP values alone.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 4","pages":"Pages 307-312"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of hook plates vs. locking plates for Neer type IIB fractures of lateral end clavicle: A systematic review","authors":"Ravi Patel ,&nbsp;Muhammad Murtaza Khan ,&nbsp;William Gibson ,&nbsp;Robin Banerjee ,&nbsp;Asif Pardiwala","doi":"10.1016/j.cjtee.2024.03.012","DOIUrl":"10.1016/j.cjtee.2024.03.012","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Surgical management of the lateral end of clavicle fractures has been a challenge for orthopedic surgeons considering the high rate of non-union. There has been no right and wrong answer to these types of fractures and many methods discussed in the literature, but the 2 most used bony procedures are hook plate and locking plate with or without the use of supplementary soft tissue procedures. The available evidence, in this case, is scarce with questionable reliability. The idea of this systemic review is to promote evidence-based practice when choosing between the 2 implants for this fracture. This study aims to review the results by performing a systemic review of the literature comparing the results of locking plate &lt;em&gt;vs&lt;/em&gt;. hook plate for the lateral end of clavicle fracture fixation with an emphasis on outcome and associated complications.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A search of the literature was made with the keyword “clavicle” in PubMed/Ovid Medline/Embase and University of Edinburgh online library “discover Ed”. A total of 4063 articles were identified including case series (with at least 3 cases) and review articles focusing on locking plate alone, comparisons of locking plate and hook plate, or hook plate alone. Articles were excluded if they were not published in English, focused on pediatric studies, or consisted only of book chapters. Studies examining tension band wiring, soft tissue procedures for fracture fixation, arthroscopic-assisted procedures, additional soft tissue procedures along with plate fixation, and fracture dislocation of the lateral end of the clavicle were also excluded. The search was then narrowed down to 21 articles after consideration of inclusion and exclusion criteria. A detailed review of the surgical methodology further excluded additional soft tissue procedures, resulting in a final selection of 15 studies. The quality of the studies was assessed using the Modified Coleman Score by the authors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 15 studies related to Neer type II fracture met the inclusion criteria. However, 2 other studies also included type V fracture as well. The mean age of patients in these studies was 32 years. The mean follow-up period was 24.3 months (ranging from 6 to 65 months). The time of radiological union was documented from 2 to 4.5 months. Constant and disabilities of arm, shoulder, and hand scores were most used as the criteria for patient outcomes. The size of the lateral fragment that can accommodate/provide bicortical fracture was documented in only 3 studies. The mean incidence of removal of hook plate was 86.9%. In contrast, the mean incidence of removal of locking plate was 27.0%. Superficial wound infection was documented in 5 studies and deep wound infection was seen in 1 study. The mean union rate for hook plate was 97.0% compared to 100% for locking plate. Complications associated with hook plate have been documented in 11 studi","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 4","pages":"Pages 269-275"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}