Chinese Journal of Traumatology最新文献

{"title":"Disability in subjects who survive road traffic injuries in 2 regions of southwest Colombia: A causal mediation analysis","authors":"Lina Marcela Sandoval ,&nbsp;Andrés Fandiño-Losada ,&nbsp;Elvis Siprian Castro-Alzate ,&nbsp;Claudio Bustos ,&nbsp;Alberto Federico García ,&nbsp;Adrián David Fernández","doi":"10.1016/j.cjtee.2025.01.005","DOIUrl":"10.1016/j.cjtee.2025.01.005","url":null,"abstract":"<div><h3>Purpose</h3><div>The objective of the study was to determine the causal interrelationships between sociodemography, clinic, and injury characteristics, and to access to rehabilitation services that generate disability in road traffic injury survivors in 2 regions of Southwest Colombia during the 2018–2021 period.</div></div><div><h3>Methods</h3><div>An ambispective cohort study included 261 survivors from road traffic in 2 regions of Southwest Colombia (Cauca and Valle del Cauca) between April 19, 2021 and June 03, 2022. These survivors accepted treatment in 3 high-level comprehensive health institutions in Cali, Colombia, which are regional referral centers for trauma in the region. Patients (1) with hospitalization time ≥12 h, (2) aged ≥18 years, and (3) having the ability to understand the research questionnaires by themselves or their legal representatives, were included. Those with a history of deficiency before the road traffic injury were excluded. A structural equation model of causal pathways of disability was established to estimate exposure variables that are sociodemography, clinic, and access to rehabilitation services. The main outcome variable was disability, estimated by the World Health Organization Disability Assessment Schedule 2.0. Exposure variables related to clinical characteristics were measured through medical record review. The variables of access to rehabilitation services and disability were measured through a telephone-based survey. Structural equation analysis was performed, estimating the mediating effects of disability. The analyses were conducted in the software R Studio® y Mplus®.</div></div><div><h3>Results</h3><div>The study found a significant gender difference in disability, with women presenting a significantly higher disability than men (β: 6.21; <em>p</em> = 0.041). Disability was also associated with clinical conditions, such as injury severity score (β: 0.67; <em>p</em> &lt; 0.001) and length of hospitalization (β: 0.28; <em>p</em> &lt; 0.001). Regarding access to health services, the risk of disability was higher among those who were readmitted to the health institution (β: 4.96; <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Disability caused by road traffic injuries must be conceived as a complex phenomenon to be studied, involving the non-linear interaction between the individual's deficiencies and contextual factors.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"29 2","pages":"Pages 96-105"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805311","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,&nbsp;Xiao Liu,&nbsp;Yuanqiang Li,&nbsp;Zhenyu Wang,&nbsp;Yunjiao Wang,&nbsp;Wei Wang,&nbsp;Lin Guo","doi":"10.1016/j.cjtee.2024.10.010","DOIUrl":"10.1016/j.cjtee.2024.10.010","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to evaluate the treatment of scaphoid nonunion with dual screw fixation in preventing postoperative humpback deformity.</div></div><div><h3>Methods</h3><div>This retrospective study is from December 2010 to December 2021, and 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 (&gt;6 months) classified as Mack-Lichtman types I–III (mild arthritis), while excluding those with immature osteogenesis (&lt;16 years), osteoporosis (&gt;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.</div></div><div><h3>Results</h3><div>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 (<em>n</em>=5), II (<em>n</em>=11), and III (<em>n</em>=2) nonunions based on the Mack-Lichtman classification. Nonunion sites included proximal 1/3 (<em>n</em>=4), waist (<em>n</em>=8), and distal 1/3 (<em>n</em>=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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"29 2","pages":"Pages 118-122"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","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":"Chinese expert consensus on the prehospital management of major trauma","authors":"Yang Li ,&nbsp;Liangjun Lang ,&nbsp;Jiliang Zhang ,&nbsp;Quanwei Bao ,&nbsp;Rui Long ,&nbsp;Zeng Huang ,&nbsp;Zilong Li ,&nbsp;Lianyang Zhang","doi":"10.1016/j.cjtee.2026.01.002","DOIUrl":"10.1016/j.cjtee.2026.01.002","url":null,"abstract":"<div><div>To standardize the key techniques and protocols of prehospital emergency care for major trauma in China, and to improve the quality and efficiency of treatment, a multidisciplinary panel of experts in emergency medicine, trauma care, and prehospital rescue was organized to form an expert committee and a core working group. This initiative was co-sponsored by the Trauma Emergency and Multiple Trauma Group of the Trauma Society of the Chinese Medical Association, the Youth Group of the Disaster Medicine Society of the Chinese Medical Association, and the Combat and Trauma Care Specialty Alliance of Army Hospitals. The group systematically searched databases including PubMed, Embase, Cochrane Library, Web of Science, China Biology, Medicine, China National Knowledge Infrastructure, Wanfang Data, and VIP Information to collect relevant guidelines, systematic reviews, and clinical studies. Based on evidence-based findings and clinical practice scenarios, the consensus was drafted. Multiple rounds of consultation and voting were conducted, and a consensus meeting was held to resolve any disputed items. Ultimately, 16 recommendations were formulated addressing 14 core clinical questions in the prehospital management of severe trauma. The contents cover scene safety, rapid recognition and early warning of severe trauma, control of exsanguinating external hemorrhage (X), airway management (A), breathing management (B), circulation management (C), disability/neurologic assessment (D), exposure and temperature control (E), trauma in special populations (the elderly), immobilization and extrication, transport decision-making, prehospital-to-hospital handover, teamwork, and systematic training. This consensus strongly emphasizes the \"xABCDE\" assessment sequence and recommends key interventions such as the use of commercial tourniquets and wound packing for hemorrhage control, permissive hypotensive resuscitation, early administration of tranexamic acid, and the standardized application of pelvic binders. It also advocates the use of standardized communication models for prehospital-to-hospital handovers. This consensus provides prehospital emergency providers in China with a practical, evidence-based set of key techniques and protocols for severe trauma care, which will help promote the standardization of the prehospital trauma care system, support the development of a high-quality national prehospital trauma care system, and ultimately improve patient outcomes.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"29 2","pages":"Pages 79-89"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437144","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":"FM1-Editorial board","authors":"","doi":"10.1016/S1008-1275(26)00052-0","DOIUrl":"10.1016/S1008-1275(26)00052-0","url":null,"abstract":"","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"29 2","pages":"Page i"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147620581","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":"Dorsal metacarpal artery perforator flaps for traumatic soft tissue defect of finger: A prospective anatomical and clinical study","authors":"Apoorva Pratap Singh ,&nbsp;Pawan Kumar Dixit ,&nbsp;Dushyant Agrawal ,&nbsp;Deepti Katrolia ,&nbsp;Shilpi Karmakar ,&nbsp;Priyanka Singla ,&nbsp;Akhilesh Humnekar ,&nbsp;Prakash Chandra Kala","doi":"10.1016/j.cjtee.2024.11.002","DOIUrl":"10.1016/j.cjtee.2024.11.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Anatomical studies provide the foundation for surgical advancements, particularly in perforator-based procedures. Despite safety measures, hand injuries continue to occur, making reconstructive surgery essential for improving quality of life. Magnification techniques have transformed plastic surgery, aiding perforator-based surgeries and improving outcomes. This study aims to bridge the gap in anatomical knowledge and explore the potential benefits of dorsal metacarpal artery flap.</div></div><div><h3>Methods</h3><div>This prospective study, conducted from July 2021 to June 2023, focused on the dorsal metacarpal artery perforators in fresh frozen cadavers. Fresh un-embalmed cadavers without signs of trauma or deformity to the upper limb were included. The anatomical study comprised the process of injecting red latex into the arteries located at the wrist, followed by dissection and measurements of number of perforators, calibre, distance of perforators from metacarpal head, and radial styloid. In the clinical phase, hand held Doppler was used to locate the perforators of the metacarpal arteries between metacarpal heads. Based on these perforators, flaps were raised for the patients with defects over the proximal fingers. Details about defect and flap and patients characteristics were tabulated and presented.</div></div><div><h3>Results</h3><div>The study was carried out on 6 fresh frozen cadavers (12 hands). Anatomical findings revealed the anatomical location, calibre, and consistent number of metacarpal artery perforators and dorsal carpal artery perforators supplying the dorsum of the hand. There was one perforator from 1st, 2nd, and 3rd metacarpal arteries. More than 1 perforators was found originating from 4th and 5th metacarpal arteries. Perforator of 1st metacarpal artery was largest in size (1.23 ± 0.27) mm. The study included 25 patients with finger defects. Metacarpal artery perforator flaps were planned to cover these defects. Successful outcome were achieved in 92% of patients.</div></div><div><h3>Conclusion</h3><div>Perforator-based flaps are effective for small to medium-sized hand defects, reducing the need for distant pedicled flaps. These flaps provide functional and aesthetic benefits while minimizing donor site complications. The unique anatomical insights from our study include the consistent number and location of dorsal metacarpal artery perforators, as well as their relation to key landmarks such as the juncturae tendineae and 2 bony prominences (first metacarpal head and radial styloid process).</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"29 2","pages":"Pages 144-149"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607148","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":"LST-A novel junctional tourniquet: A study of feasibility and effectiveness","authors":"Giora Weiser","doi":"10.1016/j.cjtee.2025.04.004","DOIUrl":"10.1016/j.cjtee.2025.04.004","url":null,"abstract":"<div><div>Uncontrolled hemorrhage is a leading cause of mortality in trauma. It is considered the most significant preventable cause of death in trauma patients. Junctional hemorrhages are responsible for approximately 20% of this possibly preventable mortality. At this time, the options for controlling such hemorrhages are either by manual pressure points or the use of junctional tourniquets, which, although they have been proven to be effective, are cumbersome and not readily available to the medical team in the field. The objective of this study was to evaluate the effectiveness and feasibility of a new junctional tourniquet (Life Saving Tourniquet, T-W-Medical ltd.) that is simpler to use and can perform both as a regular tourniquet and a junctional one.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"29 2","pages":"Pages 150-152"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762270","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":"Scrotal reconstruction using anterolateral thigh flap in a pediatric patient: A case report","authors":"Shi Gao,&nbsp;Haiqiong Chen,&nbsp;Guoqiang Zhao","doi":"10.1016/j.cjtee.2025.05.002","DOIUrl":"10.1016/j.cjtee.2025.05.002","url":null,"abstract":"<div><div>Avulsion injury of genitalia is rare, particularly in pediatric patients. The reconstruction of necrotic scrotal tissue presents a significant challenge. This case report describes a pediatric patient who experienced complete avulsion of the left inguinal, scrotal, and penile regions, accompanied by multiple pelvic fractures, and the scrotal tissue subsequently became necrotic. We performed scrotal reconstruction using a pedicled anterolateral thigh flap and fixed both testes. Postoperatively, the scrotum had a satisfactory appearance, with no significant reduction in testicular size compared to age-matched peers, indicating a successful repair.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"29 2","pages":"Pages 153-156"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228647","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":"To compare the clinical outcomes of intra-capsular vs. extra-capsular lateral retinacular release in the treatment of excessive lateral pressure syndrome of patella using two novel surgical techniques: A retrospective comparative study","authors":"Minghao Li ,&nbsp;Weili Shi ,&nbsp;Jianli Gao ,&nbsp;Yueyang Hou ,&nbsp;Yuping Yang ,&nbsp;Guoqing Cui","doi":"10.1016/j.cjtee.2025.01.004","DOIUrl":"10.1016/j.cjtee.2025.01.004","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To retrospectively compare the clinical outcomes of intra-capsular &lt;em&gt;vs&lt;/em&gt;. extra-capsular release of the lateral patellar retinaculum using 2 novel surgical techniques: the capsule-uncut immaculate lateral retinacular release (CUI method), and the L-shaped lateral retinacular release (L-shaped release).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This is a retrospective comparative study. The clinical data of patients admitted to our department between October 2010 and October 2020 were retrospectively analyzed. Patients diagnosed with excessive lateral pressure syndrome and treated with arthroscopic retinacular release, with complete imaging data, and followed up for &gt;1 year were included in the study. Previous history of knee surgery, cruciate ligament or collateral ligament ruptures, neoplastic diseases of the knee, patellar instability, history of knee fracture, varus/valgus of the knee joint, or Q angle &gt;20° were exclusion criteria. All the included cases were divided into 2 groups based on the surgical method and subsequently stratified by age. The visual analogue pain scale was used to evaluate the degree of knee pain. Lysholm score and the International Knee Documentation Committee knee evaluation form score were used to evaluate knee function and activity. The preoperative and postoperative patellar tilt angles of the affected knee were measured. Comparison between groups was performed by the Wilcoxon test or the Mann-Whitney &lt;em&gt;U&lt;/em&gt; test. Count data was represented by frequency, and comparison between groups was performed by χ&lt;sup&gt;2&lt;/sup&gt; test. Mann-Whitney &lt;em&gt;U&lt;/em&gt; test and multiple linear regression model were used for univariate and multivariate analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The clinical data of 200 patients were retrospectively analyzed. After screening by inclusion and exclusion criteria, 90 cases met the inclusion and exclusion criteria and were included in this study. The postoperative visual analogue scale scores of both groups were significantly lower than those before operation (&lt;em&gt;p&lt;/em&gt;&lt;0.001), and the postoperative Lysholm score and the score of the postoperative International Knee Documentation Committee knee evaluation form of the 2 groups were significantly higher than those before operation (&lt;em&gt;p&lt;/em&gt;&lt;0.001). The L-shaped release group was significantly higher than the CUI method group in Lysholm score (&lt;em&gt;p&lt;/em&gt;=0.008). In the age ≥50 years group, the Lysholm score of the CUI method group was significantly lower than the L-shaped release group (&lt;em&gt;p&lt;/em&gt;&lt;0.001), and the changes in patellar tilt angle were significantly larger in the CUI method group than in the L-shaped release group (&lt;em&gt;p&lt;/em&gt;=0.016). In the age &lt;50 years group, there was no significant difference.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Both the surgical methods have good clinical effects. L-shaped release is superior to the CUI method in improving knee function in the elderly pati","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"29 2","pages":"Pages 136-143"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250845","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":"Prevalence and factors associated with muscle atrophy and frailty in Vietnamese elderly with knee osteoarthritis and chronic spinal pain.","authors":"Nguyen The Diep, Nguyen Trong Duynh, Tien Van Nguyen","doi":"10.1016/j.cjtee.2025.11.002","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.11.002","url":null,"abstract":"<p><strong>Purpose: </strong>Sarcopenia is a prevalent geriatric syndrome, particularly among the elderly with chronic musculoskeletal diseases, where it exacerbates the risk of functional decline and reduced quality of life. This study aimed to describe the prevalence of muscle weakness and wasting and to investigate some factors related to these 2 syndromes in the elderly with coexisting knee osteoarthritis and chronic spinal pain.</p><p><strong>Methods: </strong>A cross-sectional descriptive study enrolled 88 elderly patients (aged ≥60 years) at the musculoskeletal department of Thai Binh General Hospital between May 2024 and October 2024. Muscle weakness was defined according to the Fried criteria, and muscle wasting was diagnosed based on the criteria of the Asian Working Group for Sarcopenia. Data were collected via direct interviews and clinical examinations with measurements, including muscle strength measurement (handgrip strength using the InGrip device), walking speed (by the 15-foot walk test), and body composition analysis using the Inbody 770 machine (using the bioelectrical impedance analysis method). Statistical analysis was performed using SPSS 27.0 software, and multivariate regression was used to investigate a number of related factors, with p < 0.05 being considered statistically significant.</p><p><strong>Results: </strong>Among the 88 elderly patients, the overall prevalence of sarcopenia was 40.9% (including 23.9% sarcopenia and 17.0% severe sarcopenia), while the prevalence of frailty was 9.1%. Notably, the co-occurrence of both syndromes was significantly higher in men than in women (21.1% vs. 4.3%, p = 0.037), a novel and clinically important finding. After multivariate regression analysis, age was the only significant independent risk factor and those over 70 years old had a 9.0-fold higher risk of developing the condition compared to those aged 60 - 65 years (adjusted odds ratio = 9.0; 95% confidence interval: 2.4 - 33.6).</p><p><strong>Conclusion: </strong>The high prevalence of sarcopenia, with advanced age identified as the most critical independent risk factor, underscores its significant burden in this patient population. These findings highlight the urgent need for early screening and the development of targeted intervention strategies, particularly for high-risk groups such as those aged over 70 years.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464150","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":"Dual receptor therapy with pituitrin for spinal cord injury-induced diabetes insipidus: A propensity-matched retrospective cohort study.","authors":"Lianhua Li, Jie Gao, Hao Wang, Zhonghe Wang, Hua Chen, Zhi Liu","doi":"10.1016/j.cjtee.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.07.003","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Spinal cord injury (SCI)-induced diabetes insipidus (DI) presents a unique therapeutic challenge due to concurrent autonomic hypotension unresponsive to conventional desmopressin. This study evaluates the clinical efficacy of Pituitrin, a synthetic vasopressin analog with dual V1a/V2 receptor agonism, designed to simultaneously address antidiuretic hormone deficiency and hemodynamic instability in acute SCI-related DI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective propensity-matched cohort study, 317 consecutive acute SCI patients (2010 -2021) were screened, with 60 (18.9%) developing DI. Patients were stratified into a Pituitrin-treated group (2014 - 2021, n = 30) and historical controls (2010 - 2013, n = 30). Propensity score matching (1:1 nearest-neighbor, caliper = 0.2 standard deviation) adjusted for age, American Spinal Injury Association (ASIA) grade, injury level (cervical/thoracic), concurrent mild brain injury (Glasgow coma scale 13 - 15), and treatment era covariates, yielding 23 matched pairs. Post-matching groups demonstrated balanced baseline characteristics with cervical injury prevalence 95.7% and ASIA grade A/B injuries 100%. The intervention group received protocolized Pituitrin infusion (initial 1 U/h, titrated 0.5 - 5 U/h based on urine output) with fluid restriction (&lt;2000 mL/day), while controls received standard care including desmopressin and vasopressors as needed. Primary outcomes included DI duration (days to urine output &lt;3000 mL/day concurrent with serum sodium ≥135 mmol/L), in-hospital mortality, and hospitalization length.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This study of 317 acute SCI patients (84% male) revealed DI developed in 18.9% (60/317), with striking cervical predominance (57 (31.0%) cervical vs. 3 (4.9%) thoracic SCI; χ&lt;sup&gt;2&lt;/sup&gt; = 21.4, p &lt; 0.001). In propensity score-matched cohorts (23 pairs balanced for age, ASIA grade, injury level, and era). Early Pituitrin therapy demonstrated transformative efficacy: DI duration reduced by 7.6 days (4.4 ± 1.5 vs. 12.0 ± 2.6 days; 95% confidence interval (CI): 6.4 - 8.8, p &lt; 0.001), 26% absolute mortality reduction (number needed to treat (NNT) = 3.85; p = 0.014), and shortened median hospitalization by 5 days (14 vs. 19 days, p = 0.008). Cervical ASIA A/B patients exhibited maximal benefit with 24% mortality reduction (NNT = 4.17, p = 0.014) and universal hemodynamic stabilization-Pituitrin eliminated vasopressor need in 87% of cases (vs. 23/30 controls requiring norepinephrine; risk difference = 0.63, NNT = 1.59). Notably, 100% of DI cases demonstrated autonomic hypotension preceding hyponatremia, with treatment initiation within 24 h of diagnosis accelerating recovery (r = -0.818, p &lt; 0.001). The intervention proved exceptionally safe, with only 1 (3.3%) experiencing transient headaches.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study establishes the first evidence-based protocol for dual V1a/V2 receptor targeting in SCI-induced D","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460903","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}