Chinese Journal of Traumatology最新文献

{"title":"Celebrating the life of Professor Wang Zhengguo","authors":"Dr. Leonard Evans","doi":"10.1016/j.cjtee.2025.02.001","DOIUrl":"10.1016/j.cjtee.2025.02.001","url":null,"abstract":"","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 2","pages":"Page 79"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517252","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":"Application of the distraction support in intramedullary nailing treatment for tibial shaft fracture","authors":"Liwei Yao ,&nbsp;Haijiao Mao ,&nbsp;Wenwei Dong ,&nbsp;Zeting Wu ,&nbsp;Qing Liu","doi":"10.1016/j.cjtee.2024.10.004","DOIUrl":"10.1016/j.cjtee.2024.10.004","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to investigate the efficacy of novel distraction support (DS) in intramedullary nailing treatment for tibial shaft fracture.</div></div><div><h3>Methods</h3><div>The random controlled trial included adult patients with tibial shaft fractures who were treated with intramedullary nailing at the trauma center between July 2013 and December 2018. Participants were randomly assigned to either control group (<em>n</em>=43) or DS group (<em>n</em>=42) based on whether DS was used during the operation. All surgical procedures were conducted by a single, experienced surgeon. Parameters such as hospital stay, blood loss, operative time, infection, delayed union, and malalignment were recorded for assessment. Shapiro-Wilk test was used to assess normality, and the <em>F</em> test was adopted to measure variance homogeneity. Continuous variables were presented as mean±standard deviation and compared via independent samples <em>t</em>-tests. Categorical variables are expressed as percentages. The Pearson's Chi-squared or Fisher's exact test was used for categorical variables <em>n</em> (%). Two-sided <em>p</em>&lt;0.05 indicated statistical significance.</div></div><div><h3>Results</h3><div>A total of 85 participants were enrolled in the study. All cases achieved acceptable reduction. The operative time was significantly shorter in the DS group than in control group ((75.3±10.5) min <em>vs</em><em>.</em> (90.4±15.5) min, <em>p</em>&lt;0.001). Additionally, the DS group showed lesser blood loss ((60.1±27.2) mL <em>vs</em><em>.</em> (85.4±25.4) mL, <em>p</em>&lt;0.001). No significant differences were observed between the 2 groups in terms of hospital stay ((9.4±2.7) days <em>vs</em><em>.</em> (10.2±3.1) days, <em>p</em>=0.370), infection (3 (7.1%) <em>vs</em><em>.</em> 2 (4.7%), <em>p</em>=0.978), delayed union (2 (4.8%) <em>vs</em>. 5 (11.6%), <em>p</em>=0.450), and malalignment (3 (7.1%) <em>vs</em>. 5 (11.6%), <em>p</em>=0.713).</div></div><div><h3>Conclusion</h3><div>The use of DS in intramedullary nailing surgery is effective. The application of this DS system may represent a valuable addition to future clinical practice.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 2","pages":"Pages 113-117"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411478","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":"The basal cisternostomy for management of severe traumatic brain injury: A retrospective study","authors":"Tangrui Han ,&nbsp;Zhiqiang Jia ,&nbsp;Xiaokai Zhang ,&nbsp;Hao Wu ,&nbsp;Qiang Li ,&nbsp;Shiqi Cheng ,&nbsp;Yan Zhang ,&nbsp;Yonghong Wang","doi":"10.1016/j.cjtee.2024.09.007","DOIUrl":"10.1016/j.cjtee.2024.09.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Traumatic brain injury (TBI) is a significant public health issue that impacts individuals all over the world and is one of the main causes of mortality and morbidity. Decompressive craniectomy is the usual course of treatment. Basal cisternostomy has been shown to be highly effective as an alternative procedure to decompressive craniectomy.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort of patients who received surgery for severe TBI between January 2019 and March 2023. Inclusion criterias were patients between the ages of 18 and 70 years who met the diagnostic criteria for severe TBI at first presentation and who underwent surgical intervention. The exclusion criteria were patients who have severe multiple injuries at the time of admission; preoperative intracranial pressure &gt; 60 mmHg; cognitive impairment before the onset of the disease; hematologic disorders; or impaired functioning of the heart, liver, kidneys, or other visceral organs. Depending on the surgical approach, the patients were categorized into decompressive craniectomy group as well as basal cisternostomy group. General data and postoperative indicators, including Glasgow coma scale, intracranial pressure, etc., were recorded for both groups of patients. Among them, the Glasgow outcome scale extended assessment at 6 months served as the primary outcome. After that, the data were statistically analyzed using SPSS software.</div></div><div><h3>Results</h3><div>The trial enrolled 41 patients (32 men and 9 women) who met the inclusion criteria. Among them, 25 patients received decompressive decompressive craniectomy, and 16 patients received basal cisternostomy. Three days postoperative intracranial pressure levels were 10.07 ± 2.94 mmHg and 17.15 ± 14.65 mmHg (<em>p</em> = 0.013), respectively. The 6 months following discharge Glasgow outcome scale extended of patients was 4.73 ± 2.28 and 3.14 ± 2.15 (<em>p</em> = 0.027), respectively.</div></div><div><h3>Conclusion</h3><div>Our study reveals that basal cisternostomy in patients with surgically treated severe TBI has demonstrated significant efficacy in reducing intracranial pressure as well as patient prognosis follow-up and avoids removal of the bone flap. The efficacy of cisternostomy has to be studied in larger, multi-clinical center randomized trials.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 2","pages":"Pages 118-123"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781787","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":"Comparison of curettage vs. trephination technique for harvesting anterior iliac crest bone graft: A cadaveric study","authors":"Albert Cakar ,&nbsp;Omer Faruk Egerci ,&nbsp;Fırat Dogruoz ,&nbsp;Ersin Tasatan ,&nbsp;Serra Ozturk ,&nbsp;Muzaffer Sindel ,&nbsp;Ozkan Kose","doi":"10.1016/j.cjtee.2023.10.007","DOIUrl":"10.1016/j.cjtee.2023.10.007","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this cadaveric study was to compare the volume and weight of bone graft harvested using the curettage <em>vs</em>. the trephination technique from the anterior iliac crest.</div></div><div><h3>Methods</h3><div>Embalmed cadavers were studied in this experimental research. The right hemipelvis of each cadaver was used for the trephine bone harvesting technique, whereas the left hemipelvis was used for the conventional curettage technique. The weight and the volume of the harvested bone were measured and statistically compared between the 2 sides. The Wilcoxon Signed-Rank test was employed to compare the graft volume and weight obtained from the right and left sides of the hemipelvis.</div></div><div><h3>Results</h3><div>Ten embalmed adult cadavers were used in this study. All subjects were Caucasian males with a mean age of 59.8 years (range 44 – 73 years) at the time of death. A total of 81 cylindrical bone grafts were harvested from the right iliac crest. In 9 out of 81 (11.1%), the cortex of the ilium was penetrated by the chisel. The mean weight of the bone graft harvested with the trephine technique (26.97 ± 2.32) g was heavier than that harvested with the curettage technique (23.74 ± 2.09) g (<em>p</em> = 0.007). Similarly, the volume of the bone graft was higher in the trephine technique (8.40 ± 0.84) cm³ compared to the curettage technique (6.60 ± 1.26) cm³ (<em>p</em> = 0.011). The trephination technique lasted a mean of (12.76 ± 1.87) min (range 10.30–16.10 min), while the curettage technique lasted a mean of (14.53 ± 0.89) min (range 13.50–16.00 min) (<em>p</em> = 0.028).</div></div><div><h3>Conclusion</h3><div>Harvesting anterior iliac crest bone graft with the trephine technique provides a higher bone volume and weight than the conventional curettage technique. The trephine technique might be advocated over the curettage technique, especially when a large amount of autologous bone graft is required. However, a meticulous harvesting technique should be followed to prevent complications. In particular, the three-dimensional anatomy should be kept in mind, and the depth of trephination should be well-controlled.</div></div><div><h3>Clinical trial registration</h3><div>Institutional Review Board registration: 2022/499.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 2","pages":"Pages 151-156"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810388","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":"Multidetector computed tomography angiography for diagnosis of traumatic aneurysms associated with penetrating head injuries","authors":"Babichev Konstantin Nickolaevich ,&nbsp;Savello Aleksandr Viktorovich ,&nbsp;Isaeva Alla Vladimirovna ,&nbsp;Svistov Dmitrij Vladimirovich ,&nbsp;Men'kov Igor' Anatol'evich ,&nbsp;Isaev Dzhamaludin Magomedrasulovich","doi":"10.1016/j.cjtee.2024.12.002","DOIUrl":"10.1016/j.cjtee.2024.12.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze the diagnostic efficacy of computed tomography angiography compared to digital cerebral angiography for the diagnosis of traumatic aneurysms (TAs) associated with combat-related penetrating head injuries and propose the most suitable angiography protocol in this clinical context.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on patients admitted to the neurosurgical clinic for penetrating traumatic brain injuries between February, 2022 and July, 2024, for whom both cerebral multidetector computed tomography angiography (MCTA) and digital cerebral angiography (DCA) were available. The inclusion were patients (1) with penetrating head injuries, (2) with missile trajectory traverses through the Sylvian or great longitudinal fissure, (3) basal cisterns with/or major subarachnoid hemorrhage. The sensitivity, specificity, positive predictive value, and negative predictive value of MCTA were calculated. DCA was considered as the gold standard of diagnosis. The sensitivity, specificity, positive predictive value, and negative predictive value of MCTA were calculated. Descriptive statistics and nonparametric statistics were used to analyze the study results and their differences, respectively.</div></div><div><h3>Results</h3><div>A total of 40 patients with 45 TAs were included in the study. Of these, 26 patients (65.0%) were found to have aneurysms on MCTA. The median diameter of the aneurysms diagnosed by MCTA was 4.9 (3.6, 4.8) mm (range of 2.5 – 10.4 mm). However, the mean diameter of TAs not detected by MCTA but diagnosed by DCA was (3.0 ± 1.3) mm (range of 1.3 – 4.9 mm). MCTA demonstrated sensitivity and specificity of 35.5% and 99.5%, respectively, with positive and negative predictive values of 92.3% and 90.7%.</div></div><div><h3>Conclusions</h3><div>A low sensitivity of MCTA for the diagnosis of TAs associated with combat-related penetrating head injuries was reported. When MCTA is inconclusive in the setting of radiologic predictors of cerebral artery injury, DSA may be required.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 2","pages":"Pages 91-95"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076553","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":"Advances in rhabdomyolysis: A review of pathogenesis, diagnosis, and treatment.","authors":"Bo-Fan Yang, Duo Li, Chun-Li Liu, Yu Luo, Jie Shi, Xiao-Qin Guo, Hao-Jun Fan, Qi Lv","doi":"10.1016/j.cjtee.2024.10.005","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.10.005","url":null,"abstract":"<p><p>Rhabdomyolysis (RM) is a multifactorial clinical syndrome characterized by the disintegration and necrosis of muscle tissue, leading to the release of cellular contents into the circulation. One of the most severe complications of RM is acute kidney injury, with a mortality rate of 20%-50%. Early and timely diagnosis is the key to improving the prognosis of patients with RM. The etiology of RM is complex and associated with various traumas, drugs, medications, and hereditary diseases, and the clinical symptoms are nonspecific. Therefore, its diagnosis highly relies on the doctor's experience and the level of medical equipment. However, RM often occurs in situations with limited medical resources, such as natural disasters, battlefields, and large-scale traffic accidents. In these scenarios, the varying levels of expertise among rescue personnel can lead to delays in diagnosis and treatment, thereby increasing the risk of mortality. This article provides a comprehensive review of the etiology, pathogenesis, complications, diagnostic, and treatment methods of RM. It also aims to offer new perspectives on the diagnosis and prognosis of RM by integrating machine learning and artificial intelligence. It is believed that this article can help pre-hospital rescuers and in-hospital doctors have a comprehensive understanding of RM to improve the patients' outcomes and overcome the challenges.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626791","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, Pawan Kumar Dixit, Dushyant Agrawal, Deepti Katrolia, Shilpi Karmakar, Priyanka Singla, Akhilesh Humnekar, Prakash Chandra Kala","doi":"10.1016/j.cjtee.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.11.002","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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, flap and patients characteristics were tabulated and presented.</p><p><strong>Results: </strong>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 on perforators were 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.</p><p><strong>Conclusion: </strong>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).</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-27","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":"Multiomics analysis elucidated the role of inflammatory response and bile acid metabolism disturbance in electric shock-induced liver injury in mice.","authors":"Wenjuan Zhang, Luncai Yin, Hui Wang, Ce Long, Jin Liu, Ping Deng, Yang Yue, Jingdian Li, Mindi He, Yonghui Lu, Yan Luo, Siyu Chen, Jiawen Tao, Li Tian, Jia Xie, Mengyan Chen, Zhengping Yu, Zhou Zhou, Peng Gao, Huifeng Pi","doi":"10.1016/j.cjtee.2024.08.011","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.08.011","url":null,"abstract":"<p><strong>Purpose: </strong>Organ damage caused by electric shock has attracted great attention. Some animal investigations and clinical cases have suggested that electric shock can induce liver injury. This study aimed to investigate the potential mechanism of liver injury induced by electric shock.</p><p><strong>Methods: </strong>Healthy male C57BL/6J mice aged 6-8 weeks were romandly divided into two groups: control group and electric shock group. Mice in the electric shock group were shocked on the top of the skull with an electric baton (20 kV) for 5 sec, while mice in the control group were exposed to only the acoustic and light stimulation produced by the electric baton. The effect of electric shock on liver function was evaluated by histological and biochemical analysis, and a metabolomics and transcriptomics study was performed to investigate how electric shock might induce liver damage. All data of this study were analyzed using a two-tailed unpaired Student's t-test in SPSS 22.0 Statistical Package.</p><p><strong>Results: </strong>The electric shock group had significantly higher serum aspartate aminotransferase and alanine aminotransferase levels than the control group (p < 0.001), and the shock notably caused cytoplasmic swelling and vacuolization, mild inflammatory cell (mainly macrophages and monocytes) infiltration and acute focal necrosis in hepatocytes (p < 0.001). A total of 47 differential metabolites and 249 differentially expressed genes (DEGs) were detected using metabolomic and transcriptomic analyses. These differential metabolites were significantly enriched in primary bile acid biosynthesis (p < 0.05). Gene ontology functional analysis of the DEGs revealed that electric shock disturbed a key biological process involved in the inflammatory response in the mouse liver, and a significant number of DEGs were enriched in Kyoto Encyclopedia of Genes and Genomes-identified pathways related to inflammation, such as the interleukin-17, tumor necrosis factor and mitogen-activated protein kinase signalling pathway. Transcriptomic and metabolomic analyses revealed that bile acid metabolism disturbance including up-regulation of the taurochenodesoxycholic acid, chenodeoxycholic acid and taurocholic acid, and down-regulation of chenodeoxycholic acid clycine conjugate may contribute to the electric shock-induced inflammatory response.</p><p><strong>Conclusion: </strong>Electric shock can induce liver inflammatory injury through the interleukin-17, tumor necrosis factor, and mitogen-activated protein kinase signaling pathway, and the bile acid metabolism disturbance including up-regulation of the taurochenodesoxycholic acid, chenodeoxycholic acid and taurocholic acid, and down-regulation of chenodeoxycholic acid clycine conjugate may contribute to inflammatory liver injury following electric shock.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016105","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 progress of tourniquets and their application in the Russia-Ukraine Conflict","authors":"Shaojie Nie ,&nbsp;Kangkang Zhi ,&nbsp;Lefeng Qu","doi":"10.1016/j.cjtee.2024.07.010","DOIUrl":"10.1016/j.cjtee.2024.07.010","url":null,"abstract":"<div><div>Against the backdrop of the Russia-Ukraine Conflict in 2022, this article reviews the characteristics of traumatic hemorrhage in modern warfare spanning the past century. It investigates several types of tourniquets used by the Russian and Ukrainian armed forces, including limb tourniquets and junctional tourniquets recommended by the Committee on Tactical Combat Casualty Care, tourniquets employed by the Armed Forces of the Russian Federation, and those used by the Armed Forces of Ukraine in the Russia-Ukraine Conflict. The analysis is conducted from perspectives, including the structure, usage methods, and limitations of different tourniquets. Additionally, the article synthesizes the research progress on tourniquets from 3 angles: battlefield adaptability, the impact of tourniquet application methods on patient outcomes, and training in tourniquet usage, offering insights from our team's perspective.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 1","pages":"Pages 1-6"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632467","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":"Protocolized approach saves the limb in peripheral arterial injury: A decade experience","authors":"Pratyusha Priyadarshini,&nbsp;Supreet Kaur,&nbsp;Komal Gupta,&nbsp;Abhinav Kumar,&nbsp;Junaid Alam,&nbsp;Dinesh Bagaria,&nbsp;Narender Choudhary,&nbsp;Amit Gupta,&nbsp;Sushma Sagar,&nbsp;Biplab Mishra,&nbsp;Subodh Kumar","doi":"10.1016/j.cjtee.2022.12.010","DOIUrl":"10.1016/j.cjtee.2022.12.010","url":null,"abstract":"<div><h3>Purpose</h3><div>Outcomes of peripheral arterial injury (PAI) depend on various factors, such as warm ischemia time and concomitant injuries. Suboptimal prehospital care may lead to delayed presentation, and a lack of dedicated trauma system may lead to poorer outcome. Also, there are few reports of these outcomes. The study aims to review our experience of PAI management for more than a decade, and identify the predictors of limb loss in these patients.</div></div><div><h3>Methods</h3><div>This is a retrospective analysis of prospectively maintained database of trauma admissions at a level I trauma center from January 2008 to December 2019. Patients with acute upper limb arterial injuries or lower limb arterial injuries at or above the level of popliteal artery were included. Association of limb loss with ischemia time, mechanism of injury, and concomitant injuries was studied using multiple logistic regressions. Statistical analysis was performed using STATA version 15.0 (Stata Corp LLC, Texas).</div></div><div><h3>Results</h3><div>Out of 716 patients with PAI, the majority (91.9%) were young males. Blunt trauma was the most common mechanism of injury. Median ischemia time was 4 h (interquartile range 2–7 h). Brachial artery (28.5%) was the most common injured vessel followed by popliteal artery (17.5%) and femoral artery (17.3%). Limb salvage rate was 78%. Out of them, 158 (22.1%) patients needed amputation, and 53 (7.4%) had undergone primary amputation. The majority (88.6%) of patients who required primary or secondary amputations had blunt trauma. On multivariate analysis, blunt trauma, ischemia time more than 6 h and concomitant venous, skeletal, and soft tissue injuries were associated with higher odds of amputation.</div></div><div><h3>Conclusion</h3><div>Over all limb salvage rates was 77.9% in our series. Blunt mechanism of injury and associated skeletal and soft tissue injury, ischemia time more than 6 h portend a poor prognosis. Injury prevention, robust prehospital care, and rapid referral to specialized trauma center are few efficient measures, which can decrease the morbidity associated with vascular injury.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"28 1","pages":"Pages 62-68"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10581922","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}