Journal of Trauma and Injury最新文献

{"title":"Clinical practice guideline recommendations for orthopedic surgical management of traumatic hip fractures: a systematic review.","authors":"Tia Kalise Shutes, Kaylan Nicole Johnson, Emily Wayent Blevins, Madeline Grace Shipley, Saurabh P Mehta","doi":"10.20408/jti.2025.0105","DOIUrl":"https://doi.org/10.20408/jti.2025.0105","url":null,"abstract":"<p><strong>Purpose: </strong>Hip fractures pose a critical orthopedic challenge, disproportionately affecting older adults and significantly compromising mobility and independence. The complexity of both the injury and the patient profile necessitates adopting best practices grounded in research evidence to optimize surgical management and recovery. This study comprehensively evaluated the quality and clinical applicability of existing clinical practice guidelines (CPGs) for the orthopedic surgical management of traumatic hip fractures and summarized key practice recommendations.</p><p><strong>Methods: </strong>A systematic literature search was performed across five databases (PubMed, CINAHL, Scopus, Embase, and PEDro) for CPGs published since January 2000. Two reviewers independently identified eligible CPGs using predefined criteria. The methodological quality of eligible CPGs was assessed using the AGREE II tool, which examines quality across the domains of scope, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence. The complementary AGREE-REX tool was used to assess the guidelines' clinical relevance and applicability.</p><p><strong>Results: </strong>Six CPGs were critically appraised, and two demonstrated high methodological quality scores (2009 SIGN and 2023 NICE CPGs). Across all CPGs, there was consensus emphasizing surgical timing within 24 to 48 hours after a hip fracture. In addition, most CPGs recommended against the use of preoperative traction. Recommendations for diagnostic imaging were supported by limited high-quality evidence. Domains addressing target users' values and resource feasibility scored lowest across CPGs, diminishing implementability.</p><p><strong>Conclusions: </strong>Fewer than half of the appraised CPGs were rated high quality, and important clinical practice domains were insufficiently addressed. Orthopedic surgeons should follow recommendations to perform operative intervention within 24 to 48 hours after injury and avoid preoperative traction. The findings also underscore the need to develop CPGs with higher methodological rigor and more actionable practice recommendations.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective urethral catheterization in trauma: balancing risk, need, and clinical judgment.","authors":"Christos Bartsokas, Mohammad Alsenani","doi":"10.20408/jti.2025.0268","DOIUrl":"https://doi.org/10.20408/jti.2025.0268","url":null,"abstract":"","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of diagnostic performance of PECARN clinical decision rule in children with minor head trauma presenting to the emergency department of a tertiary care center: an observational study.","authors":"Salooja Sulthana N, Nikhil Paul, Archu Mj, Keerthana Manoharan K K, Linu Sm, Visakh S Vinod","doi":"10.20408/jti.2025.0165","DOIUrl":"https://doi.org/10.20408/jti.2025.0165","url":null,"abstract":"<p><strong>Purpose: </strong>Minor head trauma is one of the most common reasons for pediatric emergency department visits. Accurate identification of children at risk for clinically important traumatic brain injury (ciTBI) is essential to reduce unnecessary computed tomography (CT) imaging. This study evaluated the diagnostic performance of the PECARN (Pediatric Emergency Care Applied Research Network) clinical decision rule in children with minor head trauma presenting to a tertiary care hospital in South India.</p><p><strong>Methods: </strong>In this observational study conducted between September 2022 and April 2024, 235 children aged <18 years presenting with head trauma and Glasgow Coma Scale scores of 14-15 were prospectively enrolled. Participants were stratified into age-specific PECARN risk categories. Diagnostic performance was assessed against ciTBI outcomes defined by clinical and radiological criteria.</p><p><strong>Results: </strong>The PECARN rule demonstrated strong diagnostic performance, with a sensitivity of 82.4%, specificity of 74.1%, and an area under the receiver operating characteristic curve of 0.90 (P=0.01). No cases requiring neurosurgical intervention were missed. Children aged ≥2 years had a higher incidence of ciTBI than those aged <2 years (13.4% vs. 1.8%, P=0.048). ciTBI was significantly associated with loss of consciousness, vomiting, severe headache, and signs of basilar skull fracture (all P<0.001).</p><p><strong>Conclusions: </strong>The PECARN rule appears to be a reliable and safe tool for evaluating pediatric minor head trauma in Indian emergency settings. Its high sensitivity and negative predictive value support its use in reducing unnecessary CT imaging while accurately identifying children at risk for ciTBI.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penile artery traumatic occlusion causing arteriogenic erectile dysfunction: a case report.","authors":"Francesco Michele Ronza, Teresa Letizia Di Gennaro, Francesco Palmieri, Stefania Tamburrini","doi":"10.20408/jti.2025.0085","DOIUrl":"https://doi.org/10.20408/jti.2025.0085","url":null,"abstract":"<p><p>We present a case of traumatic penile artery occlusion resulting in arteriogenic erectile dysfunction. A 34-year-old man was referred to the emergency department following a motorbike collision that caused pelvic trauma. Contrast-enhanced multidetector computed tomography revealed a complex pelvic fracture pattern, including pubic diastasis, fracture of the left sacral ala, and avulsion of the left ischiatic spine, along with penile artery occlusion and absence of homolateral cavernosal corpora blushes. Contrast-enhanced multidetector computed tomography is a comprehensive and precise imaging modality for evaluating pelvic trauma. Assessment of the penile artery and internal pudendal artery network is crucial in pelvic trauma cases to promptly identify arterial occlusion and facilitate timely evaluation and management of erectile dysfunction.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic posterior dislocation of the sternoclavicular joint in a 12-year-old boy: a case report.","authors":"Amani Azizalrahman, Altaf Ahmad Bhat, Abdulaziz Khalid Alareefy, Abdulaziz Abdullah Oalsuhaiban","doi":"10.20408/jti.2025.0057","DOIUrl":"https://doi.org/10.20408/jti.2025.0057","url":null,"abstract":"<p><p>Sternoclavicular joint (SCJ) dislocation is a rare but serious orthopedic injury, representing fewer than 1% of all fractures or dislocations. Posterior dislocations are particularly concerning due to the SCJ's proximity to vital structures such as the trachea, esophagus, subclavian vessels, and brachial plexus. Clinical suspicion should be heightened when a patient presents with a compression-type injury to the shoulder girdle and pain around the SCJ. We report the case of a 12-year-old boy who presented to the emergency department after being punched in the right shoulder by another child, resulting in severe pain and an inability to move his right shoulder. Clinical assessment raised suspicion for a posterior SCJ dislocation, which was confirmed by computed tomography scan. The rarity of this condition in pediatric patients, coupled with the potential for severe complications, underscores the significance of this case for clinical recognition and management.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of a peritoneal injury during acetabular fracture surgery using the Stoppa approach: a case report.","authors":"Reza Zandi, Shahin Talebi, Mohammad Rahnama, Milad Saeidi, Shirin Sheibani","doi":"10.20408/jti.2025.0103","DOIUrl":"https://doi.org/10.20408/jti.2025.0103","url":null,"abstract":"<p><p>As the global population ages, acetabular fractures are increasingly diagnosed in older adults. These injuries, often caused by low-energy trauma, present treatment challenges due to reduced bone quality and the presence of comorbidities. Surgical fixation is frequently required to restore mobility and prevent long-term disability. In some cases, however, associated abdominopelvic injuries may remain occult until discovered intraoperatively. We report the case of a 67-year-old woman who sustained an acetabular fracture after a fall from height. During internal fixation using the modified Stoppa approach, an undetected peritoneal rupture was identified. This case underscores the importance of careful preoperative evaluation and preparedness for intraoperative collaboration with abdominal surgery teams, particularly when subtle abdominal signs are present.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of ketamine on posttraumatic stress disorder (PTSD) symptomatology in trauma-exposed populations: a narrative review.","authors":"Minaal Ahmed Malik, Michele Halasa, Jack Chia, Venera Derguti, Holly Hathway, Fahad Hussain, Abdel Saad","doi":"10.20408/jti.2025.0086","DOIUrl":"https://doi.org/10.20408/jti.2025.0086","url":null,"abstract":"<p><p>Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, is widely used in trauma and emergency medicine for its rapid analgesic and sedative properties. While its efficacy in acute pain management is well established, concerns persist regarding its long-term psychological effects, particularly its potential role in the development of posttraumatic stress disorder (PTSD). Some studies indicate that ketamine may provide rapid symptom relief in PTSD, whereas others raise concerns about its contribution to dissociative states and maladaptive memory consolidation. This narrative review examines existing literature on ketamine's influence on PTSD symptomatology in trauma-exposed populations. A comprehensive assessment of randomized controlled trials and observational studies was undertaken to explore ketamine's effects on dissociation, memory processing, and long-term psychiatric outcomes. Relevant studies were identified from major medical databases, and findings were synthesized to present an integrated overview of ketamine's psychological impact in trauma care settings. Clinical trials suggest that a single intravenous infusion of ketamine (0.5 mg/kg) may significantly reduce PTSD symptoms within 24 hours compared to midazolam, with improvements in overall clinical presentation and no lasting dissociative effects. Conversely, some observational studies have linked ketamine use in acute trauma care to heightened dissociation, hyperarousal, and stress symptoms during early follow-up. Research on burn patients receiving intraoperative ketamine suggests a possible reduction in PTSD incidence, although a later study reported no significant difference compared with non-ketamine controls. The relationship between ketamine and PTSD is complex, with effects appearing to depend on dose and timing of administration. While perioperative ketamine may confer protective benefits against long-term psychiatric sequelae, immediate post-trauma administration may worsen dissociative symptoms and acute stress responses. Further well-controlled clinical trials are needed to refine dosing protocols and identify patient-specific risk factors, including preexisting psychiatric conditions, to better guide its use.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete avulsion of the proximal hamstring tendon in a young gymnast: a case report.","authors":"Shreya Jaiwant Gudigar, Pavan Kumar A, P K Karthik Yelamarthy, S T Ramanuja Chari, Raghava Dutt Mulukutla, Preeti Shah","doi":"10.20408/jti.2025.0121","DOIUrl":"https://doi.org/10.20408/jti.2025.0121","url":null,"abstract":"<p><p>Proximal hamstring complex tears are uncommon injuries in gymnastics. This case report describes a rare instance of a 17-year-old female gymnast who sustained a complete avulsion of the proximal hamstring complex during exercise. The injury was diagnosed clinically and later confirmed by magnetic resonance imaging as a proximal hamstring tear, prompting surgical repair with suture anchors. The patient underwent a structured rehabilitation program with progressive milestones in weight-bearing, mobility, and strength training. By postoperative 26 weeks, she had regained functional strength and returned to competitive activity. This case highlights the importance of early diagnosis, timely surgical intervention, and a carefully managed rehabilitation protocol in achieving successful outcomes for young gymnasts. It also underscores the need for greater awareness and documentation of proximal hamstring complex tears in gymnastics, where such cases remain underreported. This report demonstrates the potential for full recovery and return to sport with appropriate treatment and rehabilitation, providing valuable insight into the management of this rare injury.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blunt traumatic right-sided pericardial rupture without cardiac injury: a case report.","authors":"Muhyung Heo, Hyung Won Kim, Sanghyun Sung","doi":"10.20408/jti.2025.0112","DOIUrl":"https://doi.org/10.20408/jti.2025.0112","url":null,"abstract":"<p><p>Blunt traumatic pericardial rupture is an exceptionally rare condition, often associated with high morbidity and mortality. Isolated pericardial rupture without vascular or cardiac involvement accounts for only 17% of reported cases. We describe a rare case of right-sided pericardial rupture following blunt chest trauma, an unusual presentation since most pericardial tears occur on the left side. A 23-year-old woman involved in a motor vehicle accident sustained multiple injuries, including right hemothorax, bilateral pulmonary contusions, left-sided rib fractures, and a humerus fracture. Although preoperative computed tomography showed no diagnostic findings, persistent bleeding from the right chest tube prompted exploratory thoracotomy. Intraoperative evaluation revealed a 10-cm right pericardial tear extending from the superior vena cava to the inferior vena cava, with no associated cardiac injury. Surgical management included primary closure of the pericardial tear and repair of adjacent pleural injuries. Postoperatively, the patient developed right diaphragmatic palsy due to phrenic nerve involvement. Pericardial rupture is challenging to diagnose, but in this case, persistent hemothorax facilitated early recognition and intervention. Prompt identification allowed timely surgical repair, likely preventing life-threatening complications such as cardiac herniation. This case highlights the importance of considering pericardial rupture in patients with blunt chest trauma presenting with unexplained clinical findings and underscores the value of early surgical management.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An unusual open pneumothorax due to high-voltage electrical burn injury: a case report.","authors":"Norberto Navarrete, Sandra J Bernal, Laura S Nasiff, Federico Fernandez","doi":"10.20408/jti.2025.0122","DOIUrl":"https://doi.org/10.20408/jti.2025.0122","url":null,"abstract":"<p><p>Open intrathoracic visceral injuries are rare in electrical burns. We report the case of a 65-year-old man who sustained a high-voltage electrical burn through direct cable exposure. He arrived at the burn intensive care unit with respiratory distress secondary to an open wound on the right side of the chest wall measuring approximately 4×2 cm, with a calculated total body surface area of 2%. An immediate thoracostomy tube was placed to treat the open pneumothorax. Pneumopericardium, pneumomediastinum, and pleural infection developed later as delayed complications despite initial stabilization. After 42 days of hospitalization, the patient was discharged. This case highlights the rare occurrence of thoracic complications following electrical injury and underscores the importance of multidisciplinary, phased therapy in the management of severe electrical damage.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}