Journal of Trauma and Injury最新文献

{"title":"The C-MAC video laryngoscope versus fiberoptic bronchoscope for awake intubation under ketofol sedation in cervical spine injury patients who are immobilized with a cervical collar: a prospective randomized controlled trial.","authors":"Yugala Thalishetti, Sapna Annaji Nikhar, Akhya Kumar Kar, Abinash Patro, Srilata Moningi","doi":"10.20408/jti.2025.0111","DOIUrl":"https://doi.org/10.20408/jti.2025.0111","url":null,"abstract":"<p><strong>Purpose: </strong>The recently introduced C-MAC video laryngoscope combines the advantages of conventional laryngoscopes and fiberoptic bronchoscopy. Therefore, we compared the C-MAC video laryngoscope with the fiberoptic bronchoscope (FOB) for awake intubation under ketofol sedation in patients with cervical spine injuries.</p><p><strong>Methods: </strong>Sixty patients with traumatic cervical spine injury undergoing elective surgery under general anesthesia were randomly allocated into two groups, FOB and C-MAC, with 30 patients each. After premedication and airway topicalization, an infusion of ketofol was initiated. Intubation was attempted according to group assignment once a sedation score ≥2 was achieved. Total intubation time was recorded along with the percentage of glottic opening score. Patient cooperativeness was assessed by their response to a request to open their mouth and by the degree of cough. The primary objective was intubation success, while secondary assessments included ease of intubation on a Likert scale, complications, and hemodynamic changes.</p><p><strong>Results: </strong>The odds of successful intubation were lower in the C-MAC group than in the FOB group (odds ratio, 0.32; 95% confidence interval, 0.01-8.15; P>0.999). The mean total intubation time was significantly shorter in the C-MAC group than in the FOB group (2.97±2.29 minutes vs. 6.48±2.33 minutes, P<0.001). No significant differences were observed between groups in ease of intubation, patient cooperativeness, or hemodynamic parameters.</p><p><strong>Conclusions: </strong>The C-MAC provided a faster glottic view with comparable ease of intubation and patient cooperation relative to fiberoptic intubation in cervical spine injury under ketofol sedation.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026683","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":"Bowel maneuvers for achieving colonic continuity after extensive colon resection due to abdominopelvic trauma: two case reports.","authors":"Barak Raguan, Fahim Awaad, Ephraim Katz, Dean Lutrin, Yoram Klein, Ilan Kent","doi":"10.20408/jti.2025.0052","DOIUrl":"10.20408/jti.2025.0052","url":null,"abstract":"<p><p>Restoring large bowel continuity after extensive resection due to abdominopelvic trauma may be challenging because of the limited length of the remaining bowel. Achieving a tension-free anastomosis can be particularly difficult when attempting this within the pelvis due to a short rectal stump. Two maneuvers that can aid in these situations are the retroileal pull-through approach and the Deloyers procedure. We describe two cases in which each maneuver was utilized to facilitate colostomy closure following extensive large bowel resection resulting from abdominopelvic trauma. Both maneuvers proved feasible, successfully allowing bowel continuity to be restored with tension-free anastomoses. Protective loop ileostomies were performed in both cases. Postoperative contrast enema studies did not show evidence of anastomotic leaks. After ileostomy closure, both patients regained bowel function with good bowel control. Bowel manipulation maneuvers following abdominal trauma are therefore feasible and facilitate tension-free anastomosis after extensive colonic and rectal resections. Trauma and colorectal surgeons managing abdominal trauma patients requiring ostomy closure should become familiar with these techniques.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"307-311"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between craniofacial trauma and traumatic brain injury in patients admitted to a tertiary care hospital: a prospective cross-sectional study.","authors":"Peer Asad Aziz, Abdul Wajid, Etizaz Ahmed, Arslan Mehmood, Babar Ali Qureshi, Hameedullah Khan, Zeeshan Nasir Bhatti","doi":"10.20408/jti.2025.0068","DOIUrl":"10.20408/jti.2025.0068","url":null,"abstract":"<p><strong>Purpose: </strong>Craniofacial trauma and traumatic brain injuries (TBIs) frequently coexist due to their close anatomical proximity, making it essential to understand their correlation for optimal patient management. This study examines the association between specific types of craniofacial fractures and corresponding brain injuries in patients admitted to a tertiary care hospital.</p><p><strong>Methods: </strong>A prospective cross-sectional study was carried out in the Department of Neurosurgery, Liaquat University of Medical and Health Sciences, from October 2024 to February 2025. Fifty-six patients with both craniofacial and brain injuries were included. Data collection involved systematic clinical evaluation, imaging studies, and statistical analyses using Pearson correlation coefficients, Spearman correlation coefficients, and ordinal logistic regression.</p><p><strong>Results: </strong>The most common mechanism of injury was road traffic accidents (87.5%), and the most frequent craniofacial injuries were midface fractures (82.1%), with zygomaticomaxillary complex and naso-orbito-ethmoid fractures showing a significant association with pneumocephalus (P<0.05). Le Fort type I fractures were associated with subarachnoid hemorrhage. Patients with more than two midface fractures were 4.16 times more likely to sustain brain injuries (B=1.069; 95% confidence interval [CI], 0.301-1.837; P=0.006). Frontal air sinus fractures, especially with bilateral and both-table involvement, were strongly correlated with contusions and pneumocephalus (B=1.627; 95% CI, 0.569-2.684; P=0.003). Palatal fractures demonstrated a significant association with diffuse axonal injury (P=0.032).</p><p><strong>Conclusions: </strong>The study highlights a significant correlation between craniofacial fractures and TBI severity, highlighting the importance of early detection and multidisciplinary management. Further large-scale studies are warranted to refine predictive models and improve clinical outcomes.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"39 3","pages":"249-255"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heat-related illnesses in the Republic of Korea Armed Forces: epidemiology, comparative analysis, and preventive strategies.","authors":"Sunju Kim, Kun Hwang","doi":"10.20408/jti.2025.0212","DOIUrl":"10.20408/jti.2025.0212","url":null,"abstract":"<p><p>Heat-related illnesses (HRIs) represent an increasingly critical threat to the health and operational readiness of the Republic of Korea (ROK) Armed Forces. Rising global temperatures, combined with Korea's humid summers and intensive military training, have increased both the incidence and severity of HRIs among soldiers. This paper provides a comprehensive review of HRIs in the ROK military, beginning with an overview of their pathophysiology and classification, ranging from heat cramps to exertional heat stroke-the most severe and life-threatening form. We then examine recent epidemiological trends, which reveal over 1,200 documented cases between 2018 and 2023, with new recruits disproportionately affected. A comparative analysis across service branches indicates that Army personnel, who engage in high-intensity outdoor training, bear the greatest burden, while Navy and Air Force members face distinct occupational exposures in engine rooms and on airfields, respectively. The risk in the ROK military is striking in international comparison: odds ratios suggest that soldiers face more than 27 times the risk of HRIs compared with the civilian population, exceeding reported burdens in allied militaries such as the United States and Japan. Lessons from other nations, particularly the use of real-time surveillance, wearable technologies, and structured acclimatization programs, offer valuable models for ROK. Preventive strategies must therefore extend beyond medical management to include leadership accountability, environmental engineering, digital monitoring, and a cultural shift that promotes reporting. In an era of accelerating climate change, HRIs must be reframed not only as medical conditions but also as preventable threats to combat readiness, soldier welfare, and national security.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"205-210"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probable real injury to the abdomen in the Damoxenos-Creugas encounter: historical narratives interpreted through trauma mechanics.","authors":"Kun Hwang","doi":"10.20408/jti.2025.0218","DOIUrl":"10.20408/jti.2025.0218","url":null,"abstract":"","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"202-204"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic pitfalls of computed tomography angiography in high-energy knee trauma: two case reports on complete popliteal artery transection despite preserved distal flow.","authors":"Shinseok Kim, Joosuk Ahn","doi":"10.20408/jti.2025.0199","DOIUrl":"10.20408/jti.2025.0199","url":null,"abstract":"<p><p>This report describes two rare cases of complete popliteal artery transection in young, previously healthy men following high-energy trauma. In both cases, computed tomography (CT) angiography demonstrated a segmental arterial defect with preserved distal flow and no contrast extravasation, resulting in a delayed or uncertain diagnosis. These cases underscore the importance of incorporating the mechanism of injury into clinical decision-making. Both patients exhibited neurologic deficits in the affected limbs. Physical examination revealed signs of ischemia and sensorimotor dysfunction. Despite discordant CT findings, surgical exploration confirmed complete arterial transection in both cases, necessitating vascular reconstruction. In cases of high-energy knee trauma, surgical exploration should be considered when clinical findings suggest neurovascular compromise, even if CT angiography demonstrates preserved distal flow.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"291-296"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Damage control thoracotomy with chest packing for hemorrhage control in massive hemothorax and shock: a case report.","authors":"Shivinder Singh, Jitendra Kumar Singh, Shalendra Singh, Aishwainee Vg, Umesh Kumar, Venkat Narayanan","doi":"10.20408/jti.2025.0066","DOIUrl":"10.20408/jti.2025.0066","url":null,"abstract":"<p><p>Severe hemorrhagic shock is a leading cause of death among potentially salvageable casualties. We report the case of a 24-year-old man who sustained a gunshot wound to the right hemithorax and presented with class IV hemorrhagic shock. He underwent resuscitative damage control via a right posterolateral thoracotomy. Intraoperatively, the bleeding source was identified as a lacerated posterior intercostal artery at the level of the 11th dorsal vertebra. Because access to the bleeding site remained limited even after extending the incision, right thoracic packing was performed to control the hemorrhage. On reevaluation 48 hours later, no active bleeding was observed.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"312-315"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic carotid artery dissection without head or neck trauma: a case report following thoracoabdominal crush injury.","authors":"Shin-Ah Son","doi":"10.20408/jti.2025.0207","DOIUrl":"10.20408/jti.2025.0207","url":null,"abstract":"<p><p>A previously healthy 41-year-old woman was admitted after being crushed beneath a forklift from the chest to the lower extremities, presenting with traumatic asphyxia. Initial evaluation revealed no apparent trauma to the head or neck, but multiple fractures from the chest to the lower extremities were diagnosed. The patient underwent emergent thoracoabdominal surgery with subsequent clinical improvement. However, 4 days after the accident, anisocoria developed, and neuroimaging confirmed ischemic stroke due to traumatic carotid artery dissection. Anticoagulation and lipid-lowering therapy were initiated, and the patient successfully underwent the remaining orthopedic procedures without hemorrhagic complications. This report emphasizes that traumatic carotid artery dissection may occur even in the absence of concomitant cervical or cranial injuries, highlighting the importance of considering vascular injury in patients with severe trauma regardless of the mechanism of injury.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"297-301"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight-based dosing for low-molecular-weight heparin administration to achieve optimal venous thromboembolism prophylaxis in trauma patients: a systematic review and meta-analysis.","authors":"Jeffrey Curran Henson, Brooke E Nunn, Anders B Nowell, Jeff D Thostenson, Dillon J Wade, Avi Bhavaraju, Hanna K Jensen","doi":"10.20408/jti.2025.0170","DOIUrl":"10.20408/jti.2025.0170","url":null,"abstract":"<p><strong>Purpose: </strong>Venous thromboembolism (VTE) remains a major cause of morbidity in trauma patients. Enoxaparin, a low-molecular-weight heparin (LMWH), is widely used for VTE prevention; however, the optimal dosing strategy has not been established. This meta-analysis provides the most comprehensive comparison to date of weight-based (WB) versus fixed-dose (FD) enoxaparin regimens for achieving effective prophylaxis in trauma patients.</p><p><strong>Methods: </strong>PubMed, Embase, and the Web of Science were searched, yielding 653 studies, of which 29 met the inclusion criteria. Systematic reviews, database studies, preclinical studies, and meta-analyses were excluded. The primary outcomes were the proportions of patients achieving prophylactic anti-factor Xa (anti-Xa) levels. Secondary outcomes included the incidence of deep vein thrombosis (DVT), pulmonary embolism (PE), and bleeding events.</p><p><strong>Results: </strong>A total of 4,183 patients in the FD group and 563 patients in the WB group were included. WB dosing achieved higher rates of initial prophylaxis (86.5% vs. 46.8%; odds ratio [OR], 7.27) and ever-prophylaxis (95.6% vs. 71.0%; OR, 8.87). WB dosing was associated with a lower incidence of DVT (1.8% vs. 5.0%; OR, 0.34) and a nonsignificant reduction in PE (0.4% vs. 1.2%; OR, 0.29). Bleeding events were more frequent with WB dosing (3.0% vs. 1.2%; OR, 2.26). Proportional meta-analysis similarly demonstrated higher pooled proportions of initial prophylaxis (89.5% vs. 42.7%, P<0.01) and ever-prophylaxis (95.7% vs. 77.6%, P<0.01) with WB dosing. WB strategies showed a lower pooled DVT incidence (1.7% vs. 3.4%, P=0.06) and significantly fewer PE events (0% vs. 0.6%, P<0.01). No significant difference in pooled bleeding rates was observed (1.9% vs. 0.6%, P=0.69).</p><p><strong>Conclusions: </strong>Weight-based enoxaparin dosing was more effective than fixed dosing for achieving prophylactic anti-Xa levels and reducing DVT in trauma patients. Although bleeding events were more frequent in some cohorts, pooled analyses showed no significant increase in bleeding risk. Individualized assessment of bleeding risk remains essential.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":"39 3","pages":"211-223"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transdiaphragmatic pericardial window approach for blunt suprahepatic inferior vena cava injury: a case report.","authors":"Hye Young Woo, Dongmin Seo, Jieun Kim, Jonghwan Moon","doi":"10.20408/jti.2025.0227","DOIUrl":"10.20408/jti.2025.0227","url":null,"abstract":"<p><p>Suprahepatic inferior vena cava (SHIVC) injuries from blunt trauma are exceptionally rare and nearly uniformly fatal, with reported mortality rates ranging from 70% to 90%. Traditional approaches require cardiopulmonary bypass or extensive thoracotomy, often unavailable in emergency trauma settings. We report successful management of SHIVC injury utilizing the transdiaphragmatic pericardial window (TDPW) technique. An 18-year-old man presented with hemorrhagic shock after a high-speed motorcycle collision. Emergency laparotomy revealed grade V splenic and renal injuries and an SHIVC laceration at the hepatic vein junction. Through an extended midline incision, a 10-cm diaphragmatic incision provided direct pericardial access, enabling SHIVC visualization and repair without sternotomy. Despite requiring staged operations and a 31-day course of continuous renal replacement therapy, the patient achieved complete recovery with preserved renal function. This case demonstrates that TDPW, although previously described for other indications, can be successfully adapted for life-threatening SHIVC injuries when conventional resources are unavailable.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":" ","pages":"286-290"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}