Xiang-Ping Luo, Jian Peng, Ling Zhou, Hao Liao, Xiao-Chun Jiang, Xiong Tang, Dun Tang, Chao Liu, Jian-Hui Liu
{"title":"Intramedullary administration of tranexamic acid reduces bleeding in proximal femoral nail antirotation surgery for intertrochanteric fractures in elderly individuals: A randomized controlled trial.","authors":"Xiang-Ping Luo, Jian Peng, Ling Zhou, Hao Liao, Xiao-Chun Jiang, Xiong Tang, Dun Tang, Chao Liu, Jian-Hui Liu","doi":"10.1016/j.cjtee.2024.01.006","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.01.006","url":null,"abstract":"<p><strong>Purpose: </strong>Intertrochanteric fractures undergoing proximal femoral nail antirotation (PFNA) surgery are associated with significant hidden blood loss. This study aimed to explore whether intramedullary administration of tranexamic acid (TXA) can reduce bleeding in PFNA surgery for intertrochanteric fractures in elderly individuals.</p><p><strong>Methods: </strong>A randomized controlled trial was conducted from January 2019 to December 2022. Patients aged over 60 years with intertrochanteric fractures who underwent intramedullary fixation surgery with PFNA were eligible for inclusion and grouped according to random numbers. A total of 249 patients were initially enrolled, of which 83 were randomly allocated to the TXA group and 82 were allocated to the saline group. The TXA group received intramedullary perfusion of TXA after the bone marrow was reamed. The primary outcomes were total peri-operative blood loss and post-operative transfusion rate. The occurrence of adverse events was also recorded. Continuous data was analyzed by unpaired t-test or Mann-Whitney U test, and categorical data was analyzed by Pearson Chi-square test.</p><p><strong>Results: </strong>The total peri-operative blood loss (mL) in the TXA group was significantly lower than that in the saline group (577.23 ± 358.02 vs. 716.89 ± 420.30, p = 0.031). The post-operative transfusion rate was 30.67 % in the TXA group and 47.95 % in the saline group (p = 0.031). The extent of post-operative deep venous thrombosis and the 3-month mortality rate were similar between the 2 groups.</p><p><strong>Conclusion: </strong>We observed that intramedullary administration of TXA in PFNA surgery for intertrochanteric fractures in elderly individuals resulted in less peri-operative blood loss and decreased transfusion rate, without any adverse effects, and is, thus, recommended.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013740","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 pediatric pelvic fractures and associated injuries caused by different types of road traffic accidents","authors":"Bao-Jian Song, Qiang Wang, Wei Feng, Dan-Jiang Zhu, Xue-Jun Zhang","doi":"10.1016/j.cjtee.2024.01.005","DOIUrl":"10.1016/j.cjtee.2024.01.005","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the clinical characteristics of pediatric pelvic fracturs caused by traffic accidents and to analyze the accompanying injuries and complications.</div></div><div><h3>Methods</h3><div>A total of 222 cases involved traffic accidents was enrolled in this case-control study. The data of children with pelvic fractures caused by traffic accidents who were admitted to our hospital from January 2006 to December 2021 were analyzed retrospectively. Sex, age, Tile classification, abbreviated injury scale score, injury severity score, mortality, and accompanying injuries were studied. The ANOVA was used for measurement data, and the non-parametric rank sum test was used for non-normally distributed data. The Fisher's exact probability method was used for the count data.</div></div><div><h3>Results</h3><div>Of all enrolled cases, 140 are boys and 82 are girls, including 144 cases aged < 6 years, 65 aged between 6 and 12 years, and 13 aged > 12 years. Depending on the injury mechanism, there are 15 cases involving pedestrians <em>vs</em>. motorcycles (PVM), 91 cases involving pedestrians <em>vs</em>. passenger cars (PVC), 78 cases involving pedestrians <em>vs</em>. commercial vehicles (PVV), and 38 cases involving motor vehicles <em>vs</em>. motor vehicles (MVM). Associated injuries are reported in 198 cases (89.2%), primarily involving the abdomen injury in 144 cases (64.9%), and lower limb injury in 99 cases (44.6%). PVV injury involves longer hospital stay (<em>p</em> = 0.004). Intensive care unit admission rate is significantly higher in the MVM group than in other groups (<em>p</em> = 0.004). Head injury (<em>p</em> = 0.001) and face injury (<em>p</em> = 0.037) are more common in the MVM group, whereas abdominal injury (<em>p</em> = 0.048) and lower limb injury (<em>p</em> = 0.037) are more common in the PVV group. In the MVM group, the brain injury (<em>p</em> = 0.004) and femoral neck injury (<em>p</em> = 0.044) are more common. In the PVM group, the mediastinum (<em>p</em> = 0.004), ear (<em>p</em> = 0.009), lumbar vertebrae (<em>p</em> = 0.008), and spinal cord (<em>p</em> = 0.011) are the most vulnerable regions, while in the PVV group, the perineum (<em>p</em> < 0.001), urethra (<em>p</em> = 0.001), rectum (<em>p</em> = 0.006), anus (<em>p</em> = 0.004), and lower limb soft tissues (<em>p</em> = 0.024) are the most vulnerable regions. Children aged > 12 years have higher pelvic abbreviated injury scale scores (<em>p</em> = 0.019). There are significant differences in the classification of pelvic fractures among children < 6, 6 – 12, and > 12 years of age, with Tile C being more likely to occur in children > 12 years of age (<em>p</em> = 0.033). Children aged > 12 years are more likely to sustain injuries to the spleen (<em>p</em> = 0.022), kidneys (<em>p</em> = 0.019), pancreas (<em>p</em> < 0.001), lumbar vertebrae (<em>p</em> = 0.013), and sacrum (<em>p</em> = 0.024). The MVM group ha","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 6","pages":"Pages 372-379"},"PeriodicalIF":1.8,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139631302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Blast injuries with contrasting outcomes treated by military surgery strategies: A case report","authors":"Di-You Chen , Xi-Yan Zhu , Wei Ma , Shi-Feng Shao , Liang Zhang , Jing-Ru Xie , Yao-Li Wang , Hui Zhao","doi":"10.1016/j.cjtee.2024.01.003","DOIUrl":"10.1016/j.cjtee.2024.01.003","url":null,"abstract":"<div><div>The treatment strategy for blast injuries is closely linked to the clinical outcome of blast injury casualties. However, the application of military surgery experience to blast injuries caused by production safety accidents is relatively uncommon. In this study, the authors present 2 cases of blast injuries caused by one gas explosion, both cases involved individuals of the same age and gender and experienced similar degree of injury. The authors highlight the importance of using a military surgery treatment strategy, specifically emphasizing the need to understand the concept of damage control and disposal. It is recommended that relevant training in this area should be strengthened to improve the clinical treatment of such injuries. This study provides a valuable reference for healthcare professionals dealing with blast injuries.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 6","pages":"Pages 414-419"},"PeriodicalIF":1.8,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139636306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Soliudeen Adebayo Arojuraye , Ibrahim Abolaji Alabi , Ibrahim Usman Mustapha
{"title":"Outcome of percutaneous reconstruction of chronic lateral collateral ligament rupture","authors":"Soliudeen Adebayo Arojuraye , Ibrahim Abolaji Alabi , Ibrahim Usman Mustapha","doi":"10.1016/j.cjtee.2023.09.004","DOIUrl":"10.1016/j.cjtee.2023.09.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Many techniques have been described for the reconstruction of chronic lateral collateral ligament (LCL) rupture with different autograft options. The advantages of percutaneous LCL reconstruction include small incisions, minimal soft tissue disruption, less postoperative pain, and speedy rehabilitation and recovery. The aim of this study was to report the functional outcome of percutaneous LCL reconstruction and overall patient satisfaction in Africans.</p></div><div><h3>Methods</h3><p>This prospective and interventional study involving 51 patients with chronic LCL rupture who had percutaneous LCL reconstruction using peroneus longus autograft was conducted between January 2021 and December 2022 in National Orthopaedic Hospital, Dala-Kano, Nigeria. The inclusion criteria were patients between the ages of 18 and 45 years with chronic isolated LCL and not more than 1 injury of knee ligament. Exclusion criteria were active infection, and multi-ligament knee injury requiring 2-staged surgery. The knee functions were assessed preoperatively, 3 months, 6 months, and 12 months postoperatively using the Lysholm scoring system. Patient satisfaction with the outcome of the treatment was assessed using a 5-point Likert scale. Relevant information was recorded into Microsoft Excel sheet and data was analyzed using SPSS version 23.0 for windows. The paired samples <em>t</em>-test was used to compare the clinical outcomes as continuous variables. Statistical significance was considered at <em>p</em> < 0.05.</p></div><div><h3>Results</h3><p>The mean age of the patients was (30.10 ± 5.90) years. The median time from injury to surgery was 7 months (ranging from 3 to 28 months). The mean follow-up period was (14.07 ± 3.13) months. The mean preoperative and 1-year postoperative Lysholm scores were 44.33 ± 12.97 and 97.96 ± 1.23, respectively.</p></div><div><h3>Conclusion</h3><p>Percutaneous LCL reconstruction using peroneus longus autograft significantly improves patient knee function and results in excellent patient satisfaction.</p></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 1","pages":"Pages 58-62"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127523000949/pdfft?md5=ab40746fad263be19999dc18424017a5&pid=1-s2.0-S1008127523000949-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hai-Zhen Duan , Xin Zhou , Quan Hu , Meng-Long Liu , Shu-Hong Wang , Ji Zhang , Xu-Heng Jiang , Tian-Xi Zhang , An-Yong Yu
{"title":"Mannitol inhibits the proliferation of neural stem cell by a p38 mitogen-activated protein kinase-dependent signaling pathway","authors":"Hai-Zhen Duan , Xin Zhou , Quan Hu , Meng-Long Liu , Shu-Hong Wang , Ji Zhang , Xu-Heng Jiang , Tian-Xi Zhang , An-Yong Yu","doi":"10.1016/j.cjtee.2023.10.004","DOIUrl":"10.1016/j.cjtee.2023.10.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Mannitol is one of the first-line drugs for reducing cerebral edema through increasing the extracellular osmotic pressure. However, long-term administration of mannitol in the treatment of cerebral edema triggers damage to neurons and astrocytes. Given that neural stem cell (NSC) is a subpopulation of main regenerative cells in the central nervous system after injury, the effect of mannitol on NSC is still elusive. The present study aims to elucidate the role of mannitol in NSC proliferation.</p></div><div><h3>Methods</h3><p>C57 mice were derived from the animal house of Zunyi Medical University. A total of 15 pregnant mice were employed for the purpose of isolating NSCs in this investigation. Initially, mouse primary NSCs were isolated from the embryonic cortex of mice and subsequently identified through immunofluorescence staining. In order to investigate the impact of mannitol on NSC proliferation, both cell counting kit-8 assays and neurospheres formation assays were conducted. The <em>in vitro</em> effects of mannitol were examined at various doses and time points. In order to elucidate the role of Aquaporin 4 (AQP4) in the suppressive effect of mannitol on NSC proliferation, various assays including reverse transcription polymerase chain reaction, western blotting, and immunocytochemistry were conducted on control and mannitol-treated groups. Additionally, the phosphorylated p38 (p-p38) was examined to explore the potential mechanism underlying the inhibitory effect of mannitol on NSC proliferation. Finally, to further confirm the involvement of the p38 mitogen-activated protein kinase-dependent (MAPK) signaling pathway in the observed inhibition of NSC proliferation by mannitol, SB203580 was employed. All data were analyzed using SPSS 20.0 software (SPSS, Inc., Chicago, IL). The statistical analysis among multiple comparisons was performed using one-way analysis of variance (ANOVA), followed by Turkey's post hoc test in case of the data following a normal distribution using a Shapiro-Wilk normality test. Comparisons between 2 groups were determined using Student's <em>t</em>-test, if the data exhibited a normal distribution using a Shapiro-Wilk normality test. Meanwhile, data were shown as median and interquartile range and analyzed using the Mann-Whitney <em>U</em> test, if the data failed the normality test. A <em>p</em> < 0.05 was considered as significant difference.</p></div><div><h3>Results</h3><p>Primary NSC were isolated from the mice, and the characteristics were identified using immunostaining analysis. Thereafter, the results indicated that mannitol held the capability of inhibiting NSC proliferation in a dose-dependent and time-dependent manner using cell counting kit-8, neurospheres formation, and immunostaining of Nestin and Ki67 assays. During the process of mannitol suppressing NSC proliferation, the expression of AQP4 mRNA and protein was downregulated, while the gene expression of p-p38 was elev","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 1","pages":"Pages 42-52"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127523001025/pdfft?md5=231c4a072c3c931c9dcc26d80cf983e2&pid=1-s2.0-S1008127523001025-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xu-Feng Mao, Xi-Qian Zhang, Zhe-Yu Yao, Hai-Jiao Mao
{"title":"Advances in mesenchymal stem cells therapy for tendinopathies","authors":"Xu-Feng Mao, Xi-Qian Zhang, Zhe-Yu Yao, Hai-Jiao Mao","doi":"10.1016/j.cjtee.2023.11.002","DOIUrl":"10.1016/j.cjtee.2023.11.002","url":null,"abstract":"<div><p>Tendinopathies are chronic diseases of an unknown etiology and associated with inflammation. Mesenchymal stem cells (MSCs) have emerged as a viable therapeutic option to combat the pathological progression of tendinopathies, not only because of their potential for multidirectional differentiation and self-renewal, but also their excellent immunomodulatory properties. The immunomodulatory effects of MSCs are increasingly being recognized as playing a crucial role in the treatment of tendinopathies, with MSCs being pivotal in regulating the inflammatory microenvironment by modulating the immune response, ultimately contributing to improved tissue repair. This review will discuss the current knowledge regarding the application of MSCs in tendinopathy treatments through the modulation of the immune response.</p></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 1","pages":"Pages 11-17"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127523001165/pdfft?md5=761790d72f00a614dc7dc988f07e3116&pid=1-s2.0-S1008127523001165-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135664800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jie Zhu , Ya-Hong Chen , Jing-Jing Ji , Cheng-Xiang Lu , Zhi-Feng Liu
{"title":"Calcitonin gene-related peptide inhibits neuronal apoptosis in heatstroke rats via PKA/p-CREB pathway","authors":"Jie Zhu , Ya-Hong Chen , Jing-Jing Ji , Cheng-Xiang Lu , Zhi-Feng Liu","doi":"10.1016/j.cjtee.2023.06.002","DOIUrl":"10.1016/j.cjtee.2023.06.002","url":null,"abstract":"<div><h3>Purpose</h3><p>The incidence of heatstroke (HS) is not particularly high; however, once it occurs, the consequences are serious. It is reported that calcitonin gene-related peptide (CGRP) is protective against brain injury in HS rats, but detailed molecular mechanisms need to be further investigated. In this study, we further explored whether CGRP inhibited neuronal apoptosis in HS rats via protein kinase A (PKA)/p-cAMP response element-binding protein (p-CREB) pathway.</p></div><div><h3>Methods</h3><p>We established a HS rat model in a pre-warmed artificial climate chamber with a temperature of (35.5 ± 0.5) °C and a relative humidity of 60% ± 5%. Heatstress was stopped once core body temperature reaches above 41 °C. A total of 25 rats were randomly divided into 5 groups with 5 animals each: control group, HS group, HS+CGRP group, HS+CGRP antagonist (CGRP8-37) group, and HS+CGRP+PKA/p-CREB pathway blocker (H89) group. A bolus injection of CGRP was administered to each rat in HS+CGRP group, CGRP8-37 (antagonist of CGRP) in HS+CGRP8-37 group, and CGRP with H89 in HS+CGRP+H89 group. Electroencephalograms were recorded and the serum concentration of S100B, neuron-specific enolase (NSE), neuron apoptosis, activated caspase-3 and CGRP expression, as well as pathological morphology of brain tissue were detected at 2 h, 6 h, and 24 h after HS <em>in vivo</em>. The expression of PKA, p-CREB, and Bcl-2 in rat neurons were also detected at 2 h after HS <em>in vitro</em>. Exogenous CGRP, CGRP8-37, or H89 were used to determine whether CGRP plays a protective role in brain injury via PKA/p-CREB pathway. The unpaired <em>t</em>-test was used between the 2 samples, and the mean ± SD was used for multiple samples. Double-tailed <em>p</em> < 0.05 was considered statistically significant.</p></div><div><h3>Results</h3><p>Electroencephalogram showed significant alteration of θ (54.50 ± 11.51 <em>vs.</em> 31.30 ± 8.71, <em>F</em> = 6.790, <em>p</em> = 0.005) and α wave (16.60 ± 3.21 <em>vs.</em> 35.40 ± 11.28, <em>F</em> = 4.549, <em>p</em> = 0.020) in HS group compared to the control group 2 h after HS. The results of triphosphate gap terminal labeling (TUNEL) showed that the neuronal apoptosis of HS rats was increased in the cortex (9.67 ± 3.16 <em>vs.</em> 1.80 ± 1.10, <em>F</em> = 11.002, <em>p</em> = 0.001) and hippocampus (15.73 ± 8.92 <em>vs.</em> 2.00 ± 1.00, <em>F</em> = 4.089, <em>p</em> = 0.028), the expression of activated caspase-3 was increased in the cortex (61.76 ± 25.13 <em>vs.</em> 19.57 ± 17.88, <em>F</em> = 5.695, <em>p</em> = 0.009) and hippocampus (58.60 ± 23.30 <em>vs.</em> 17.80 ± 17.62, <em>F</em> = 4.628, <em>p</em> = 0.019); meanwhile the expression of serum NSE (5.77 ± 1.78 <em>vs.</em> 2.35 ± 0.56, <em>F</em> = 5.174, <em>p</em> = 0.013) and S100B (2.86 ± 0.69 <em>vs.</em> 1.35 ± 0.34, <em>F</em> = 10.982, <em>p</em> = 0.001) were increased significantly under HS. Exogenous CGRP decreased the concentrations of NSE and S100B, ","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 1","pages":"Pages 18-26"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127523000500/pdfft?md5=182ab4d1fd2aa99930f931f262651db9&pid=1-s2.0-S1008127523000500-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9820168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association of ABCB1 gene polymorphisms rs1128503, rs2032582, rs4148738 with anemia in patients receiving dabigatran after total knee arthroplasty","authors":"Alina Kasimova , Dmitry Labutin , Anton Gvozdetsky , Svetlana Bozhkova","doi":"10.1016/j.cjtee.2023.06.003","DOIUrl":"10.1016/j.cjtee.2023.06.003","url":null,"abstract":"<div><h3>Purpose</h3><p>Dabigatran is usually prescribed in recommended doses without monitoring of the blood coagulation for the prevention of venous thromboembolism after joint arthroplasty. ABCB1 is a key gene in the metabolism of dabigatran etexilate. Its allele variants are likely to play a pivotal role in the occurrence of hemorrhagic complications.</p></div><div><h3>Methods</h3><p>The prospective study included 127 patients with primary knee osteoarthritis undergoing total knee arthroplasty. Patients with anemia and coagulation disorders, elevated transaminase and creatinine levels as well as already receiving anticoagulant and antiplatelet therapy were excluded from the study. The association of ABCB1 gene polymorphisms rs1128503, rs2032582, rs4148738 with anemia as the outcome of dabigatran therapy was evaluated by single-nucleotide polymorphism analysis with a real-time polymerase chain reaction assay and laboratory blood tests. The beta regression model was used to predict the effect of polymorphisms on the studied laboratory markers. The probability of the type 1 error (<em>p</em>) was less than 0.05 was considered statistically significant. BenjaminiHochberg was used to correct for significance levels in multiple hypothesis tests. All calculations were performed using Rprogramming language v3.6.3.</p></div><div><h3>Results</h3><p>For all polymorphisms there was no association with the level of platelets, protein, creatinine, alanine transaminase, prothrombin, international normalized ratio, activated partial thromboplastin time and fibrinogen. Carriers of rs1128503 (TT) had a significant decrease of hematocrit (<em>p</em> = 0.001), red blood count and hemoglobin (<em>p</em> = 0.015) while receiving dabigatran therapy during the postoperative period compared to the CC, CT. Carriers of rs2032582 (TT) had a significant decrease of hematocrit (<em>p</em> = 0.001), red blood count and hemoglobin (<em>p</em> = 0.006) while receiving dabigatran therapy during the postoperative period compared to the GG, GT phenotypes. These differences were not observed in carriers of rs4148738.</p></div><div><h3>Conclusion</h3><p>It might be necessary to reconsider thromboprophylaxis with dabigatran in carriers of rs1128503 (TT) or rs2032582 (TT) polymorphisms in favor of other new oral anticoagulants. The long-term implication of these findings would be the reduction of bleeding complications after total joint arthroplasty.</p></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 1","pages":"Pages 27-33"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127523000640/pdfft?md5=ebb1ffd04b83c70f3a1642d7007f9741&pid=1-s2.0-S1008127523000640-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9820167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ioannis Tsouknidas , Nikolaos Tasis , Maria Ioanna Antonopoulou , Vasileios Acheimastos , Dimitrios K. Manatakis
{"title":"Traumatic lumbar hernia: A systematic review of the literature","authors":"Ioannis Tsouknidas , Nikolaos Tasis , Maria Ioanna Antonopoulou , Vasileios Acheimastos , Dimitrios K. Manatakis","doi":"10.1016/j.cjtee.2023.05.006","DOIUrl":"10.1016/j.cjtee.2023.05.006","url":null,"abstract":"<div><h3>Purpose</h3><p>Traumatic lumbar hernia (TLH) constitutes a protrusion of content through a defect in the posterior abdominal wall, as a result of injury. This rare entity has been described in limited number of cases.</p></div><div><h3>Methods</h3><p>A systematic review of the literature was performed according to the meta-analysis of observational studies in epidemiology guidelines. The English literature from 1990 until 2021 was reviewed, using PubMed, EMBASE and Google Scholar bibliographic databases, to identify case reports and case series with patients that were diagnosed with TLH. For each eligible study, demographics, clinical presentation, hernia characteristics, preoperative imaging investigations, operation details, and postoperative data were extracted for assessment. Statistical analysis was performed on SPSS, version 20.0.</p></div><div><h3>Results</h3><p>A total of 62 studies were included for review, with 164 patients with TLH. Mean age was (42.6 ± 14.3) years (47.6% males, 31.1% females, gender not specified in 35 cases). Mean diameter of hernia neck was (6.3 ± 3.1) cm, while the triangles of Petit and Grynfeltt were affected in 74.5% and 14.6%, respectively. Patients diagnosed in the emergency setting account for 54.2%, with CT scan establishing diagnosis in all but one case (97.7%). A delayed diagnosis was made in 45.8%, at a mean 1 year following trauma. Flank bulging (82.8%) and chronic back pain (34.3%) were the most frequent symptoms. In both delayed and acute group, open surgery (63.6% and 92.3%, respectively) was the preferred surgical approach. Postoperative complications were reported in 11.4% of acute and 15.0% of delayed patients. Hernia recurrence was 7%.</p></div><div><h3>Conclusions</h3><p>TLH is uncommon with 164 cases described since 1990. CT scan is the gold standard in diagnosis. Open surgery is generally the preferred approach, particularly in the emergency setting. Acute TLH can be treated either by primary suture repair or mesh, depending on the local conditions, whereas delayed cases usually require a mesh.</p></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 1","pages":"Pages 53-57"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127523000482/pdfft?md5=45727d8ab0e438a8a90cb9900ddfa21e&pid=1-s2.0-S1008127523000482-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9890922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}