Chinese Journal of Traumatology最新文献

{"title":"Shrapnel in carotid sheath: A rare penetrating neck injury","authors":"Muhammad Rehan ,&nbsp;Savera Anwar ,&nbsp;Hadia Wali ,&nbsp;Aysha Noor ,&nbsp;Omer Ehsan ,&nbsp;Shayan Shahid Ansari","doi":"10.1016/j.cjtee.2023.07.001","DOIUrl":"10.1016/j.cjtee.2023.07.001","url":null,"abstract":"<div><div>Injuries deeper than the platysma are considered as penetrating neck injuries, constituting approximately 5% – 10% of all trauma. Many vital organs are at risk from a penetrating neck injury. These injuries in zone 1 have the highest mortality, because the injuries are close to the vital organs and difficult to access surgically. A 41-year-old male, a car mechanic by profession, presented to the emergency department with a penetrating neck injury on the right side. CT scan demonstrated a metallic foreign body in zone 1 between the right internal jugular vein and the common carotid artery. The patient was asymptomatic, and the foreign body was removed surgically. This case shows a rare presentation of a penetrating neck injury with a foreign body located in zone 1, where no vital internal structure was injured. As of now, no previous case report has been identified on such presentation. Thus, it will provide a valuable addition to the pre-existing literature.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 3","pages":"Pages 231-234"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9897044","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":"Effectiveness and safety of augmentative plating technique in managing nonunion following intramedullary nailing of long bones in the lower extremity: A systematic review and meta-analysis","authors":"Cong-Xiao Fu ,&nbsp;Hao Gao ,&nbsp;Jun Ren ,&nbsp;Hu Wang ,&nbsp;Shuai-Kun Lu ,&nbsp;Guo-Liang Wang ,&nbsp;Zhen-Feng Zhu ,&nbsp;Yun-Yan Liu ,&nbsp;Wen Luo ,&nbsp;Yong Zhang ,&nbsp;Yun-Fei Zhang","doi":"10.1016/j.cjtee.2024.04.004","DOIUrl":"10.1016/j.cjtee.2024.04.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To methodically assess the effectiveness of augmentative plating (AP) and exchange nailing (EN) in managing nonunion following intramedullary nailing for long bone fractures of the lower extremity.</div></div><div><h3>Methods</h3><div>PubMed, EMBASE, Web of Science, and the Cochrane Library were searched to gather clinical studies regarding the use of AP and EN techniques in the treatment of nonunion following intramedullary nailing of lower extremity long bones. The search was conducted up until May 2023. The original studies underwent an independent assessment of their quality, a process conducted utilizing the Newcastle-Ottawa scale. Data were retrieved from these studies, and meta-analysis was executed utilizing Review Manager 5.3.</div></div><div><h3>Results</h3><div>This meta-analysis included 8 studies involving 661 participants, with 305 in the AP group and 356 in the EN group. The results of the meta-analysis demonstrated that the AP group exhibited a higher rate of union (odds ratio: 8.61, 95% confidence intervals (<em>CI</em>): 4.12 − 17.99, <em>p</em> &lt; 0.001), shorter union time (standardized mean difference (SMD): -1.08, 95% <em>CI</em>: -1.79 − -0.37, <em>p</em> = 0.003), reduced duration of the surgical procedure (SMD: -0.56, 95% <em>CI</em>: -0.93 − -0.19, <em>p</em> = 0.003), less bleeding (SMD: -1.5, 95% <em>CI</em>: -2.81 − -0.18, <em>p</em> = 0.03), and a lower incidence of complications (relative risk: -0.17, 95% <em>CI</em>: -0.27 − -0.06, <em>p</em> = 0.001). In the subgroup analysis, the time for union in the AP group in nonisthmal and isthmal nonunion of lower extremity long bones was shorter compared to the EN group (nonisthmal SMD: -1.94, 95% <em>CI</em>: -3.28 − -0.61, <em>p</em> &lt; 0.001; isthmal SMD: -1.08, 95% <em>CI</em>: -1.64 − -0.52, <em>p</em> = 0.002).</div></div><div><h3>Conclusion</h3><div>In the treatment of nonunion in diaphyseal fractures of the long bones in the lower extremity, the AP approach is superior to EN, both intraoperatively (with reduced duration of the surgical procedure and diminished blood loss) and postoperatively (with an elevated union rate, shorter union time, and lower incidence of complications). Specifically, in the management of nonunion of lower extremity long bones with non-isthmal and isthmal intramedullary nails, AP demonstrated shorter union time in comparison to EN.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 3","pages":"Pages 164-174"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960786","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":"Empirical and modified hemostatic resuscitation for liver blast injury combined with seawater immersion: A preliminary study","authors":"Haoyang Yang,&nbsp;Chenglin Dai,&nbsp;Dongzhaoyang Zhang,&nbsp;Can Chen,&nbsp;Zhao Ye,&nbsp;Xin Zhong,&nbsp;Yijun Jia,&nbsp;Renqing Jiang,&nbsp;Wenqiong Du,&nbsp;Zhaowen Zong","doi":"10.1016/j.cjtee.2024.07.008","DOIUrl":"10.1016/j.cjtee.2024.07.008","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the effects of empirical and modified hemostatic resuscitation for liver blast injury combined with seawater immersion.</div></div><div><h3>Methods</h3><div>Thirty rabbits were subjected to liver blast injury combined with seawater immersion, and were then divided into 3 groups randomly (<em>n</em> = 10 each): group A (no treatment after immersion), group B (empirical resuscitation with 20 mL hydroxyethyl starch, 50 mg tranexamic acid, 25 IU prothrombin complex concentrate and 50 mg/kg body weight fibrinogen concentrate), and group C (modified resuscitation with additional 10 IU prothrombin complex concentrate and 20 mg/kg body weight fibrinogen concentrate based on group B). Blood samples were gathered at specified moments for assessment of thromboelastography, routine coagulation test, and biochemistry. Mean arterial pressure, heart rate, and survival rate were also documented at each time point. The Kolmogorov-Smirnov test was used to examine the normality of data distribution. Multigroup comparisons were conducted with one-way ANOVA.</div></div><div><h3>Results</h3><div>Liver blast injury combined with seawater immersion resulted in severe coagulo-fibrinolytic derangement as indicated by prolonged prothrombin time (s) (11.53 ± 0.98 <em>vs</em>. 7.61 ± 0.28, <em>p</em>＜0.001), activated partial thromboplastin time (APTT) (s) (33.48 ± 6.66 <em>vs</em>. 18.23 ± 0.89, <em>p</em>＜0.001), reaction time (R) (min) (5.85 ± 0.96 <em>vs</em>. 2.47 ± 0.53, <em>p</em>＜0.001), decreased maximum amplitude (MA) (mm) (53.20 ± 5.99 <em>vs</em>. 74.92 ± 5.76, <em>p</em>＜0.001) and fibrinogen concentration (g/L) (1.19 ± 0.29 <em>vs</em>. 1.89 ± 0.32, <em>p</em> = 0.003), and increased D-dimer concentration (mg/L) (0.38 ± 0.32 <em>vs</em>. 0.05 ± 0.03, <em>p</em> = 0.005). Both empirical and modified hemostatic resuscitation could improve the coagulo-fibrinolytic states and organ function, as indicated by shortened APTT and R values, decreased D-dimer concentration, increased fibrinogen concentration and MA values, lower concentration of blood urea nitrogen and creatine kinase-MB in group B and group C rabbits in comparison to that observed in group A. Further analysis found that the R values (min) (4.67 ± 0.84 <em>vs</em>. 3.66 ± 0.98, <em>p</em> = 0.038), APTT (s) (23.16 ± 2.75 <em>vs</em>. 18.94 ± 1.05, <em>p</em> = 0.001), MA (mm) (60.10 ± 4.74 <em>vs</em>. 70.21 ± 3.01, <em>p</em> &lt; 0.001), and fibrinogen concentration (g/L) (1.68 ± 0.21 <em>vs</em>. 1.94 ± 0.16, <em>p</em> = 0.013) were remarkably improved in group C than in group B at 2 h and 4 h after injury. In addition, the concentration of blood urea nitrogen (mmol/L) (24.11 ± 1.96 <em>vs</em>. 21.00 ± 3.78, <em>p</em> = 0.047) and creatine kinase-MB (U/L) (85.50 ± 13.60 <em>vs</em>. 69.74 ± 8.56, <em>p</em> = 0.013) were lower in group C than in group B at 6 h after injury. The survival rates in group B and group C were significantly higher than those in group A","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 3","pages":"Pages 220-225"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141841492","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":"Posterior-only fixation in pelvic fractures: Is it sufficient in lateral compression injuries?","authors":"Sameer Aggarwal,&nbsp;Sandeep Patel,&nbsp;Lav Mehta,&nbsp;Mohak Kataria,&nbsp;Vishal Kumar,&nbsp;Prasoon Kumar","doi":"10.1016/j.cjtee.2024.07.002","DOIUrl":"10.1016/j.cjtee.2024.07.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Lateral compression (LC) injuries account for more than two-thirds of all pelvic fractures. The goal of surgical treatment is to provide adequate stability and early mobilization. The consensus on posterior fixation of such injuries is strong in the literature; however, the necessity of anterior ring fixation is not clear. Therefore, this study was formulated to determine the practicability of posterior-only fixation in LC injuries.</div></div><div><h3>Methods</h3><div>Between March 2015 and May 2020, all patients with LC type pelvic ring fractures who were admitted and operated upon in a single level 1 trauma center were included in this cross-sectional observational study. Demographic data, co-morbidities, treatment, types of surgical fixation, concomitant injuries and surgeries, surgical complications, length of hospital stay, injury to weight bearing duration, and follow-up period were documented. Functional outcome and quality of life were assessed using Majeed score and SF-36 questionnaire. Non-normally distributed data were presented as median (Q₁, Q₃) and normally distributed data were presented as mean ± standard deviation (SD). Spearman's rank correlation coefficient was used for correlation analysis.</div></div><div><h3>Results</h3><div>A total of 25 patients were included, with a mean age of 29.8 years. All patients were managed operatively with posterior-only fixation. The median Majeed score was 90 (76, 95). The median physical component summary score was 69.37 (38.75, 85.62). The median mental component summary score was 63.95 (39.25, 87.87). There was no significant difference compared to population norms of both physical component summary and mental component summary. Injury to weight bearing time correlated significantly (<em>p</em> = 0.002) with Majeed score as well as SF-36 score (<em>p</em> = 0.044). No other variable had a significant association with outcomes.</div></div><div><h3>Conclusion</h3><div>Posterior-only fixation is sufficient for fixing LC injuries with up to 80% of cases having good to excellent functional outcomes. However, comparative studies with larger sample sizes are needed for further validation.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 3","pages":"Pages 226-230"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565095","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":"Interposition of acellular amniotic membrane at the tendon to bone interface would be better for healing than overlaying above the tendon to bone junction in the repair of rotator cuff injury","authors":"Jiang-Tao Wang ,&nbsp;Chun-Bao Li ,&nbsp;Jia-Ting Zhang ,&nbsp;Ming-Yang An ,&nbsp;Gang Zhao ,&nbsp;Yu-Jie Liu","doi":"10.1016/j.cjtee.2024.04.001","DOIUrl":"10.1016/j.cjtee.2024.04.001","url":null,"abstract":"<div><h3>Purpose</h3><div>The retear rate of rotator cuff (RC) after surgery is high, and the rapid and functional enthesis regeneration remains a challenge. Whether acellular amniotic membrane (AAM) helps to promote the healing of tendon to bone and which treatment is better are both unclear. The study aims to investigate the effect of AAM on the healing of RC and the best treatment for RC repair.</div></div><div><h3>Methods</h3><div>Thirty-three Sprague Dawley rats underwent RC transection and repair using microsurgical techniques and were randomly divided into the suturing repair only (SRO) group (<em>n</em> = 11), the AAM overlaying (AOL) group (<em>n</em> = 11), and the AAM interposition (AIP) group (<em>n</em> = 11), respectively. Rats were sacrificed at 4 weeks, then examined by subsequent micro-CT, and evaluated by histologic and biomechanical tests. The statistical analyses of one-way ANOVA or Kruskal-Wallis test were performed using with SPSS 23.0. A <em>p</em> &lt; 0.05 was considered a significant difference.</div></div><div><h3>Results</h3><div>AAM being intervened between tendon and bone (AIP group) or overlaid over tendon to bone junction (AOL group) in a rat model, promoted enthesis regeneration, increased new bone and cartilage generation, and improved collagen arrangement and biomechanical properties in comparison with suturing repair only (SRO group) (AOL <em>vs</em>. SRO, <em>p</em> &lt; 0.001, <em>p</em> = 0.004, <em>p</em> = 0.003; AIP <em>vs</em>. SRO, <em>p</em> &lt; 0.001, <em>p</em> &lt; 0.001, <em>p</em> &lt; 0.001). Compared with the AOL group, the AIP group had better results in micro-CT evaluation, histological score, and biomechanical testing (<em>p</em> = 0 0.039, <em>p</em> = 0.011, <em>p</em> = 0.003, respectively).</div></div><div><h3>Conclusion</h3><div>In the RC repair model, AAM enhanced regeneration of the tendon to bone junction. This regeneration was more effective when the AAM was intervened at the tendon to bone interface than overlaid above the tendon to bone junction.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 3","pages":"Pages 187-192"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786509","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":"Factors affecting sexual health in individuals with spinal cord injury: A systematic scoping review","authors":"Azam Rahmani ,&nbsp;Ataollah Shahbandi ,&nbsp;Shahryar Ghashghaie ,&nbsp;Zahra Ghodsi ,&nbsp;Zahra Khazaeipour ,&nbsp;Mahkameh Abbaszadeh ,&nbsp;Mohammad Amin Dabbagh Ohadi ,&nbsp;Seyed Aria Nejadghaderi ,&nbsp;Rasha Atlasi ,&nbsp;Raziyeh Maasoumi ,&nbsp;Elaheh Khodadoust ,&nbsp;Alex R. Vaccaro ,&nbsp;Vafa Rahimi-Movaghar","doi":"10.1016/j.cjtee.2024.05.002","DOIUrl":"10.1016/j.cjtee.2024.05.002","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to review the literature to explore some factors affecting sexual and partnership adjustment in individuals with spinal cord injury (SCI).</div></div><div><h3>Methods</h3><div>This study was based on the methodological framework of scoping reviews, including 3 methodological steps: (1) identifying relevant studies (searching for related studies); (2) selecting related studies; (3) collecting key findings, summarizing, and reporting the results. The electronic databases were searched including Medline (PubMed), Scopus, Web of Science, Embase, and Cochrane Library. Studies were included if they reported data about the related factors of sexual and partnership adjustment in individuals with SCI. No limitations were considered in terms of time or methodology of the search.</div></div><div><h3>Results</h3><div>After the full-text screening, 52 studies were included from the year of 1978 – 2019 with various methodologies. The present review demonstrated that proper sexual health among individuals with SCI is related to several factors including the anatomical factor, level of the injury, completeness of the injury, psycho-social factor, socio-economic status, and type of relationship.</div></div><div><h3>Conclusion</h3><div>With consideration of factors affecting sexual and partnership adjustment in individuals with SCI, a better estimation of sexual health can be achieved in clinical to improve the relationship and quality of life.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 3","pages":"Pages 193-200"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141135639","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":"Injury of sonic weapons to human body: A narrative review.","authors":"Yue Li, Guangming Yang, Yongbo Zhao, Bingcang Li","doi":"10.1016/j.cjtee.2024.10.009","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.10.009","url":null,"abstract":"<p><p>Sonic weapons are non-lethal weapons that some countries around the world are actively developing and equipping in their troop. Its injury to the human body is increasingly valued. Given that previous research on the injury, prevention, and treatment of sonic weapons to the human body has not been systematic and comprehensive, after explaining certain acoustic concepts, these authors introduce infrasonic and intense sound weapons from aspects of weapon types and applications, injury mechanisms and characteristics, injury thresholds, biological effects, injury diagnosis, and injury prevention and treatment. Finally, ultrasonic weapons are briefly introduced, based on a small amount of public literature reports both domestically and internationally. The aim is to provide a reference for future prevention, and treatment of sonic weapons injury.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043690","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":"Research on the correlation between rib fracture characteristics and the risk of intrathoracic and intra-abdominal injuries.","authors":"Hang Cao, Qiang Chen, Yan Ding, Llion Roberts","doi":"10.1016/j.cjtee.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.04.002","url":null,"abstract":"<p><strong>Purpose: </strong>Intrathoracic and intra-abdominal injuries in patients with rib fractures are often overlooked, leading to delayed and ineffective treatment. However, the relationship between rib fractures and organ damage has been rarely studied. The purpose of this study was to analyze the risk factors associated with intrathoracic and intra-abdominal injuries in patients with rib fractures.</p><p><strong>Methods: </strong>This retrospective observational study included 1269 patients diagnosed with rib fractures from September 2020 to April 2023. Patient data were collected, including gender, age, body mass index, systolic blood pressure, heart rate, type of rib fracture, number of fractured ribs, location of the rib fracture, and the presence of thoracic and abdominal organ injuries. Patients without imaging examinations, the patient with rib fractures from iatrogenic causes or mental illnesses or rheumatic immune diseases was excluded. The primary outcomes were intra-thoracic and intra-abdominal injuries. Multivariate logistic regression analysis was conducted to identify the risk factors for these injuries in patients with rib fractures.</p><p><strong>Results: </strong>The rib fracture characteristics in the occurrence group included bilateral fractures, higher number of fractures (≥3), and fractures located anteriorly, posteriorly, and laterally, as well as greater fracture displacement, compared to the non-occurrence group. The results of the multivariate logistic regression analysis indicated that age (p=0.016, odds ratio (OR)=0.95, 95% CI =0.92-0.98), the number of rib fractures (≥3, p=0.001, OR=1.46, 95% CI=1.13-1.89), rib type (bilateral rib fractures, p=0.043, OR=2.63, 95% CI=2.16-3.12), and rib fracture location (lateral rib fractures, p=0.041, OR=2.85, 95% CI=1.31-4.97; posterior rib fractures, p=0.022, OR=3.25, 95% CI=1.46-6.92) were independent risk factors for thoracic and abdominal organ injuries in patients with traumatic rib fractures.</p><p><strong>Conclusions: </strong>Patients with rib fractures resulting from blunt trauma, particularly those with lateral or posterior rib fractures, fractures involving more than 3 ribs, and bilateral rib fractures, are at an increased risk for significant intrathoracic and intra-abdominal injuries. These findings warrant attention and the implementation of appropriate preventive measures during treatment.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991771","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":"Pyogenic flexor tenosynovitis: A current problem of hand surgery.","authors":"Konstantin Lipatov, Arthur Asatryan, George Melkonyan, Aleksandr D Kazantcev, Ekaterina Solov'eva, Irina Gorbacheva, Alexander S Vorotyntsev, Andrey Y Emelyanov","doi":"10.1016/j.cjtee.2024.10.008","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.10.008","url":null,"abstract":"<p><strong>Purpose: </strong>Pyogenic flexor tenosynovitis is one of the most severe purulent diseases of the hand and is characterized by a high level of development of stiffness and contractures.</p><p><strong>Methods: </strong>This is a retrospective study conducted on patients hospitalized in our center in 2022. Patients diagnosed with pyogenic flexor tenosynovitis, aged from 18 to 90 years were included. Exclusion criteria are pregnancy or breastfeeding, concomitant oncological diseases, and collagen diseases. All patients were operated on urgently. Debridement, drainage and irrigation were performed. On the 4th-5th day after the operation, when the inflammation subsided, rehabilitation began. The long-term outcome was assessed throughout 3-12 months after discharge and was based on the restoration of the volume of active movements. The results are assessed according to the total active motion scale. Continuous variables were presented as median (Q₁, Q₃), and were compared using the Mann-Whitney U test. Categorical variables were expressed as n (%), and comparisons were made between the 3 groups using the Spearman's rank correlation coefficient. Statistical significance was defined as a 2-sided p < 0.05.</p><p><strong>Results: </strong>The results of the examination and treatment of 60 patients were analyzed. The frequency of pyogenic flexor tenosynovitis was 5.3% among all patients with purulent diseases of the hand during this period. Tendon necrosis was noted in 8 (13.3%) cases. Surgical treatment in 37 (61.7%) patients was completed with drainage and primary suture. The rest of the patients (23, 38.3%) underwent repeated debridement, which ended in 10 (16.7%) cases with the imposition of secondary sutures. The best recovery of function was noted in cases of maintaining the viability of the tendon.</p><p><strong>Conclusions: </strong>Timely diagnosis and provision of comprehensive surgical care for patients with pyogenic flexor tenosynovitis in combination with early rehabilitation should be considered the key to successful treatment of this complex category of patients.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049268","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":"Explainable machine learning model for predicting septic shock in critically sepsis patients based on coagulation indexes: A multicenter cohort study.","authors":"Qing-Bo Zeng, En-Lan Peng, Ye Zhou, Qing-Wei Lin, Lin-Cui Zhong, Long-Ping He, Nian-Qing Zhang, Jing-Chun Song","doi":"10.1016/j.cjtee.2024.08.012","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.08.012","url":null,"abstract":"<p><strong>Purpose: </strong>Septic shock is associated with high mortality and poor outcomes among sepsis patients with coagulopathy. Although traditional statistical methods or machine learning (ML) algorithms have been proposed to predict septic shock, these potential approaches have never been systematically compared. The present work aimed to develop and compare models to predict septic shock among patients with sepsis.</p><p><strong>Methods: </strong>It is a retrospective cohort study based on 484 patients with sepsis who were admitted to our intensive care units between May 2018 and November 2022. Patients from the 908th Hospital of Chinese PLA Logistical Support Force and Nanchang Hongdu Hospital of Traditional Chinese Medicine were respectively allocated to training (n=311) and validation (n=173) sets. All clinical and laboratory data of sepsis patients characterized by comprehensive coagulation indexes were collected. We developed 5 models based on ML algorithms and 1 model based on a traditional statistical method to predict septic shock in the training cohort. The performance of all models was assessed using the area under the receiver operating characteristic curve and calibration plots. Decision curve analysis was used to evaluate the net benefit of the models. The validation set was applied to verify the predictive accuracy of the models. This study also used SHapley Additive exPlanations method to assess variable importance and explain the prediction made by a ML algorithm.</p><p><strong>Results: </strong>Among all patients, 37.2% experienced septic shock. The characteristic curves of the 6 models ranged from 0.833 to 0.962 and 0.630 to 0.744 in the training and validation sets, respectively. The model with the best prediction performance was based on the support vector machine (SVM) algorithm, which was constructed by age, tissue plasminogen activator-inhibitor complex, prothrombin time, international normalized ratio, white blood cells, and platelet counts. The SVM model showed good calibration and discrimination and a greater net benefit in decision curve analysis.</p><p><strong>Conclusion: </strong>The SVM algorithm may be superior to other ML and traditional statistical algorithms for predicting septic shock. Physicians can better understand the reliability of the predictive model by SHapley Additive exPlanations value analysis.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057768","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}